tag:blogger.com,1999:blog-49017022749371240682024-03-12T19:30:18.344-07:00One Heartdewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.comBlogger32125tag:blogger.com,1999:blog-4901702274937124068.post-68413476492730289892012-02-12T19:48:00.000-08:002012-02-17T19:55:31.034-08:00Venous Thromboembolism<div style="text-align: justify;"><div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-UOdrx0amBsg/Tz8hKrjF1vI/AAAAAAAAAGs/IE8xxJjYx84/s1600/AA.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-UOdrx0amBsg/Tz8hKrjF1vI/AAAAAAAAAGs/IE8xxJjYx84/s1600/AA.jpg" /></a></div>Venous thromboembolism causes substantial disability and death. The incidence of deep venous thrombosis (DVT) is about 1 per 1000 person years. The most serious and potentially preventable complication, pulmonary embolus, kills an estimated 50,000 Americans each year. Venous stasis secondary to chronic valvular incompetence, of- ten a consequence of venous thrombosis, causes varying degrees of pain, edema, and ulceration. The changing demographic patterns, particularly the aging of society, are increasing the risk of venous thromboembolism and the importance of prevention. Recent identificationof inherited defects causing thrombosis (inherited thrombophilias) allows improved prevention through identification of individuals at high risk. The knowledge and tools for effective prevention and treatment are available but currently underused.</div><div>Early identification, office-based diagnostic tests, safer treatments, and targeted education programs for physicians may offer the chance to reduce the incidence of venous thrombosis and associated morbidity.</div><div><br />
</div></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0United States37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-41116399238211731182012-02-06T19:17:00.000-08:002012-02-06T11:27:28.552-08:00What Are Stents?<div style="text-align: justify;">Excerpted from “ Stent,” by the National Heart, Lung, and</div><div style="text-align: justify;">Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National</div><div style="text-align: justify;">Institutes of Health, July 2009.</div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-tPSWZJy20PQ/TxOWpwOw2xI/AAAAAAAAAFA/0AbR8idTk3o/s1600/22.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-tPSWZJy20PQ/TxOWpwOw2xI/AAAAAAAAAFA/0AbR8idTk3o/s1600/22.jpg" /></a></div><div style="text-align: justify;"><br />
A stent could be a tiny mesh tube that’s used to treat narrowed or weakened arteries within the body. Arteries are blood vessels that carry blood off from your heart to different components of your body. you will have a stent placed in an artery as a part of a procedure referred to as angioplasty. Angioplasty restores blood flow through narrowed or blocked arteries. S tents facilitate forestall the arteries from turning into narrowed or blocked once more within the months or years when angioplasty.<br />
You also might have a stent placed during a weakened artery to boost blood flow and to assist forestall the artery from bursting. S tents typically are manufactured from metal mesh, however generally they’re manufactured from material. material stent, additionally referred to as stent grafts, are employed in larger arteries.<br />
Some stents are coated with medicines that are slowly and continuously released into the artery. These stents are referred to as drugging stent. The medicines facilitate forestall the artery from turning into blocked once more.<br />
How Stents Are Used<br />
For the Coronary Arteries<br />
In a condition referred to as coronary heart disease (CHD), or coronary artery disease, a fatty substance referred to as plaque will build up within the coronary (heart) arteries. Plaque narrows the coronary arteries, reducing the flow of oxygen-rich blood to the center muscle. High blood cholesterol, high blood pressure, diabetes, and smoking might cause CHD. When your coronary arteries are narrowed or blocked, oxygen-rich blood can’t reach your heart muscle. this may cause angina (chest pain) or a heart attack. throughout angioplasty, doctors use an expanding balloon within the artery to compress plaque and widen the passage. Angioplasty improves blood flow to the center, that reduces angina and different CHD symptoms. Unless an artery is simply too tiny, doctors typically place a stent within the treated portion of the artery throughout angioplasty. The stent supports the inner artery wall and reduces the prospect of the artery turning into narrowed or blocked once more. A stent can also support an artery that was torn or injured throughout angioplasty. When stent are employed in coronary arteries, there’s a few ten to twenty p.c likelihood that the arteries can re-narrow or shut within the 1st year when angioplasty. When stent aren’t used, the danger of the arteries closing will be twice as high.<br />
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For the Carotid Arteries<br />
Both the proper and left sides of your neck have blood vessels referred to as carotid arteries. These arteries carry blood from the center to the brain. Plaque can also slender the carotid arteries. When this happens, the condition is named carotid artery disease. Plaque deposits within the carotid arteries limit blood flow to the brain and place you in danger for stroke. a similar factors that raise your risk for CHD additionally increase your risk for carotid artery disease. Stent are used to assist keep the carotid arteries absolutely open when they’re widened with angioplasty. How well this treatment works future still is not known. analysis is ongoing to explore the risks and edges of carotid artery stinting.<br />
For different Arteries<br />
The arteries within the kidneys might become narrowed. This reduces blood flow to the kidneys, which might have an effect on their perform and skill to regulate blood pressure. this may cause severe high blood pressure.<br />
Plaque will slender the arteries within the arms and legs over time. When this happens, the condition is named peripheral arterial disease, or P.A.D. This narrowing will cause pain and cramping within the affected limbs. If the narrowing is severe, it will fully interrupt blood flow to a limb, that might need surgery. to alleviate these issues, doctors might do angioplasty on a narrowed kidney, arm, or leg artery. This procedure typically is followed by inserting a stent within the treated artery. The stent helps keep the artery absolutely open. For the Aorta within the Abdomen or Chest the main artery starting of the center that provides blood to the body is named the aorta. The aorta travels through the chest and down into the abdomen. Over time, some areas of the aorta’s walls will become weak. These weakened areas will cause a bulge within the artery referred to as an aneurysm. An aorta with an aneurysm will burst, resulting in probably deadly internal bleeding. When aneurysms occur, they’re typically within the a part of the aorta within the abdomen. to assist avoid a burst, doctors might place a material stent within the weakened space of the abdominal aorta. The stent creates a stronger inner lining for the artery. Aneurysms can also develop within the a part of the aorta within the chest. These aneurysms can also be treated with stent. How well these stent work over the future still is not known.<br />
To Close off Aortic Tears<br />
Another downside which will develop within the aorta could be a tear in its inner wall. Blood will be forced into this tear, inflicting it to widen. The tear will scale back blood flow to the tissues that the aorta serves. Over time, the tear will block blood flow through the artery or burst. When this happens, it’s typically within the a part of the aorta that’s within the chest.<br />
Fabric stents are being developed and used experimentally to forestall aortic tears by stopping blood from flowing into the tear. a material stent placed at intervals the torn space of the aorta will facilitate restore traditional blood flow and scale back the danger of a burst aorta. Researchers are still learning stent to treat aortic tears.<br />
Placing Stent<br />
To place a stent, your doctor can build alittle gap during a blood vessel in your groin (upper thigh), arm, or neck. Through this gap, your doctor can thread a skinny, versatile tube referred to as a catheter with a deflated balloon on its finish.<br />
A stent could also be placed round the deflated balloon. The tip of the catheter is threaded up to the narrowed section of the artery or to the aneurysm or aortic tear website. Special x-ray movies are taken of the tube as it’s threaded up into your blood vessel. These movies facilitate your doctor position the catheter.<br />
For Arteries Narrowed by Plaque<br />
Once the tube is within the space of the artery that wants treatment, the doctor can take the subsequent steps:<br />
• Your doctor uses a special dye to assist see narrowed areas of the blood vessel.<br />
• Your doctor inflates the balloon. It pushes against the plaque and compresses it against the artery wall. The absolutely extended balloon additionally expands the encircling stent, pushing it into place within the artery.<br />
• The balloon is deflated and brought out in conjunction with the catheter.<br />
The stent remains in your artery. Cells in your artery eventually grow to hide the mesh of the stent and build an inner layer that appears just like the inside a standard blood vessel. a really slender artery, or one that’s arduous to succeed in with a catheter, might need a lot of steps to put a stent. this sort of artery typically is 1st expanded by inflating alittle balloon. The balloon is then re-moved and replaced by another larger balloon with the collapsed stent around it. At now, your doctor will follow the quality apply of compressing the plaque and inserting the stent. When angioplasty and stent placement are done on carotid arteries, a special filter device is employed. The filter helps keep blood clots and loose items of plaque from passing into the bloodstream and traveling up to the brain throughout the procedure.<br />
For Aortic Aneurysms<br />
The procedure to put a stent in an artery with an aneurysm is extremely kind of like the one used for an artery narrowed by plaque. The stent used to treat an aneurysm is completely different, though. It’s created out of pleated material, typically with one or a lot of little hooks. Once the stent has been placed and expanded to suit tight against the artery wall, the hooks on the stent latch on to the artery wall. This anchors the stent.<br />
The stent creates a brand new inner lining for that portion of the artery. Cells within the artery eventually grow to hide the material and build an inner layer that appears just like the inside a standard blood vessel.<br />
What to Expect before a Stent Procedure<br />
Most stent procedures need an overnight keep within the hospital and somebody to require you home. confer with your doctor the subsequent is sues:<br />
• When to prevent eating and drinking before coming back to the hospital<br />
• What medicines you must or shouldn’t war the day of the procedure<br />
• When to return to the hospital and where to travel<br />
If you have got diabetes, kidney disease, or different conditions, speak along with your doctor concerning whether or not you wish to require any further steps throughout or when the procedure to avoid complications. Before the procedure, your doctor might speak with you concerning medicines you’ll most likely have to be compelled to take when the stent is placed. These medicines facilitate forestall blood clots from forming. It’s necessary that you just savvy long you must take these medicines and why they’re necessary.<br />
What to Expect throughout a Stent Procedure<br />
For Arteries Narrowed by Plaque<br />
This procedure typically takes concerning an hour. It might take longer if stent are inserted into quite one artery throughout the procedure. Before the procedure starts, you’ll get medication to assist you relax. You’ll be on your back and awake throughout the procedure thus you'll be able to follow the doctor’s directions. the world where the catheter is inserted are numbed, and you won’t feel the doctor threading the catheter, balloon, or stent within the artery. you will feel some pain when the balloon is expanded to push the stent into place.<br />
For Aortic Aneurysms<br />
This procedure takes some hours. it always needs a 2- to 3-day keep within the hospital. Before the procedure, you’ll be given medication to assist you relax. If a stent is placed within the abdominal aorta, your doctor might provide medication to numb the world, however you’ll be awake throughout the procedure. If a stent is placed within the chest portion of the aorta, your doctor can possible provide you with medication to create you sleep through the procedure. Once you’re numbed or asleep, your doctor can build alittle cut in your groin (upper thigh). He or she's going to insert a catheter into the blood vessel through this cut.<br />
Sometimes, 2 cuts (one within the groin space of every leg) are required to put material stent that are available 2 components. you'll not feel the doctor threading the catheter, balloon, or stent into the artery.<br />
What to Expect when a Stent Procedure<br />
Recovery<br />
After either style of stent procedure (for arteries narrowed by plaque or aortic aneurysms), the catheter are removed and also the tube insertion website are bandaged.<br />
A small sandbag or different style of weight could also be placed on high of the bandage to use pressure and facilitate forestall bleeding. You’ll recover during a special care space where your movement are restricted. whereas you’re in recovery, a nurse can check your heart rate and blood pressure frequently. The nurse additionally can see whether or not there’s any bleeding from the insertion website. Eventually, alittle bruise and a few times alittle, arduous “knot” can seem at the insertion website. This space might feel sore or tender for a few week.<br />
You should let your doctor understand if any of the subsequent occur:<br />
• you have got a continuing or great amount of bleeding at the positioning that can’t be stopped with alittle bandage.<br />
• you have got any uncommon pain, swelling, redness, or different signs of infection at or close to the insertion website.<br />
Common Precautions when a Stent Procedure<br />
Blood Clotting Precautions<br />
After a stent procedure, your doctor can possible suggest that you just take aspirin and another anti-clotting medication. These medicines facilitate forestall blood clots from forming within the stent. A blood clot will cause heart attack, stroke, or different serious issues. If you have got a metal stent, your doctor can possible suggest aspirin and another anti-clotting medication for a minimum of one month. If your stent is coated with medication, your doctor might suggest aspirin and another anti-clotting medication for twelve months or a lot of. Your doctor can work with you to work out the simplest course of treatment.<br />
The risk of developing a blood clot considerably will increase if you stop taking the anti-clotting medication too early. It’s necessary to require these medicines for as long as your doctor recommends. He or she might suggest lifelong treatment with aspirin.<br />
If you’re considering surgery for a few different reason whereas you’re on these medicines, visit your doctor concerning whether or not it will wait till when you've got stopped the medication. Anti-clotting medicines might increase the danger of bleeding. additionally to an increased risk of bleeding, anti-clotting medicines will cause different aspect effects, like an allergic rash. visit your doctor concerning a way to scale back the danger of those aspect effects.<br />
Other Precautions<br />
You should avoid vigorous exercise and significant lifting for a brief time when the stent procedure. Your doctor can allow you to understand after you will return to your traditional activities. If you have got a metal stent, you should not have a magnetic resonance imaging (MRI) take a look at at intervals the primary number of months when the procedure. Metal detectors employed in airports and different screening areas don’t have an effect on stent. Your stent should not cause metal detectors to travel off. If you have got an aortic material stent, your doctor can most likely suggest that you just have followup imaging tests (for example, chest x-ray) at intervals the primary year of getting the procedure. when the primary year, he or she might suggest yearly imaging tests.<br />
Risks of getting a Stent<br />
Risks associated with Angioplasty<br />
Angioplasty, the procedure used to put stents, could be a common medical procedure. Angioplasty carries alittle risk of the subsequent serious complications:<br />
• Bleeding from the positioning where the catheter was inserted into the skin<br />
• injury to the blood vessel from the catheter<br />
• Arrhythmia's (irregular heartbeats)<br />
• injury to the kidneys caused by the dye used throughout the procedure<br />
• An hypersensitivity to the dye used throughout the procedure<br />
• Infection<br />
Another downside when angioplasty is simply too a lot of tissue growth<br />
within the treated portion of the artery. this may cause the artery to slender or shut once more, that is named restiveness. This downside typically is avoided with the utilization of drugging stent. These stents are coated with medicines that facilitate forestall an excessive amount of tissue growth. Treating the tissue round the stent with radiation can also forestall tissue growth. For this procedure, the doctor puts a wire through a catheter to where the stent is placed. The wire releases radiation and stops cells round the stent from growing and blocking the artery.<br />
Risks associated with Stent<br />
About one to a pair of p.c of individuals who have a stented artery develop a blood clot at the stent website. Blood clots will cause heart attack, stroke, or different serious issues. the danger of blood clots is greatest throughout the primary few months when the stent is placed within the artery. Your doctor can possible suggest that you just take aspirin and another anti clotting medication, like clopped, for a minimum of one month or up to a year or a lot of when having a stent procedure.<br />
These medicines facilitate forestall blood clots.<br />
The length of your time you wish to require anticlotting medicines depends on the kind of stent you get. Your doctor might suggest lifelong treatment with aspirin. Stent coated with medication, which regularly are used to stay clogged heart arteries open, might increase your risk for probably dangerous blood clots. However, no conclusive proof shows that these stent increase the possibilities of getting a heart attack or dying, if used as suggested.<br />
Risks associated with Aortic Stents within the Abdomen<br />
Although rare, some serious complications will occur when surgery or a material stent is employed to repair an aneurysm within the abdominal region of the aorta. These complications embody the following:<br />
• A burst artery (aneurysm rupture)<br />
• Blocked blood flow to the abdomen or lower body<br />
• Paralysis within the legs owing to interruption of blood flow to the spinal wire (this complication is extremely rare)<br />
Another potential complication is that the material stent moving any down the aorta. This generally happens years when the stent is 1st placed. Such stent movement might need a doctor to put another material stent within the space of the aneurysm.<br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-25313367959138315422012-02-02T11:46:00.000-08:002012-02-07T04:08:50.450-08:00Overview of Heart Surgery<div class="Section1"><div><div style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;">Excerpted from “Heart Surgery,” by the National Heart,Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, September 2007. Heart surgery is done to correct problems with the heart. More than half a million heart surgeries are done each year in the United States for a variety of heart problems. Heart surgery is used to correct heart problems in children and adults. This text discusses heart surgeries for adults.</div></div><div style="text-align: justify;">Overview</div><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-ewgAvJpjvQ0/TxCJ-xb7h6I/AAAAAAAAAEs/NvMAoJmBsUU/s1600/2A.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-ewgAvJpjvQ0/TxCJ-xb7h6I/AAAAAAAAAEs/NvMAoJmBsUU/s1600/2A.jpg" /></a></div><div style="text-align: justify;"><br />
The most common form of heart surgery for adults is coronary artery bypass grafting (CABG). throughout CABG, surgeons use healthy arteries or veins taken from another a part of the body to bypass (that is, go around) blocked arteries. CABG relieves chest pain and reduces the chance of heart attack.<br />
Heart surgery is also done to perform the following:<br />
• Repair or replace valves that management blood flow through the center<br />
• Repair abnormal or broken structures within the heart<br />
• Implant medical devices that regulate heart rhythms or blood flow<br />
• Replace a broken heart with a healthy heart from a donor<br />
(heart transplant) ancient heart surgery, typically referred to as “open heart surgery,” is finished by gap the chest wall to control on the center. nearly always, the chest is opened by cutting through a patient’s breastbone. Once the center is exposed, the patient is connected to a heart-lung bypass machine. The machine takes over the pumping action of the center. this permits surgeons to control on a still heart.<br />
In recent years, new ways that of doing heart surgery are developed. One new manner is termed off-pump, or beating heart, surgery. It’s like ancient open-heart surgery, however it does not use a heart-lung by pass machine. Minimally invasive heart surgery uses smaller incisions (cuts) than ancient open-heart surgery. Some styles of minimally invasive heart surgery use a heart-lung bypass machine and others don’t.<br />
These new ways could cut back risks and speed up recovery time. Studies are underneath thanks to compare these new styles of heart surgery to ancient open-heart surgery. The results of those studies can facilitate doctors decide the most effective procedure to use for every patient.<br />
Outlook<br />
The results of heart surgery in adults are typically wonderful. For terribly unwell folks with severe heart issues, heart surgery will cut back symptoms, improve quality of life, and increase lifespan.<br />
Types of Heart Surgery<br />
Different types of heart surgery are used to repair totally different heart issues.<br />
Coronary Artery Bypass Grafting<br />
Coronary artery bypass grafting (CABG) is that the most typical form of heart surgery. over five hundred,000 of those surgeries are done every year within the u. s.. CABG improves blood flow to the center. It’s used for folks with severe coronary artery disease (CAD). In CAD, a fatty material referred to as plaque builds up within your coronary (heart) arteries. It narrows the arteries and limits blood flow to your heart muscle. CAD will cause angina (chest pain or discomfort), shortness of breath, and might even result in a heart attack. throughout CABG, a surgeon takes a vein or an artery from your chest, your leg, or another a part of your body and connects, or grafts, it to the blocked artery. The grafted artery bypasses (that is, goes around) the blockage. this permits oxygen-rich blood to achieve the center muscle. Surgeons will bypass as several as four blocked coronary arteries throughout one surgery. generally you'll be able to choose from CABG and angioplasty to treat CAD. check with your doctor regarding these totally different treatments. Transmyocardial Laser Revascularization Transmyocardial laser revascularization, or TLR, could be a surgery used to treat angina when no alternative treatments work. as an example, if you've got already had one CABG procedure and can’t have another one, TLR could also be an choice. this kind of heart surgery isn’t common. During TLR, the surgeon uses lasers to create channels within the heart muscle. These channels permit oxygen-rich blood to flow from a heart chamber directly into the center muscle.<br />
Valve Repair or Replacement<br />
For the center to figure right, blood should flow in just one direction. The heart’s valves create this potential. Healthy valves open and shut in an exceedingly precise manner because the heart pumps blood. every valve contains a set of flaps referred to as leaflets. The leaflets open to permit blood to pass from the center chambers into the arteries. Then the leaflets shut tightly to prevent blood from flowing into the chambers.<br />
Heart surgery is finished to repair leaflets that don’t open as wide as they ought to. this could happen once they become thick or stiff or fuse along. As a result, not enough blood flows through the valve into the artery. Heart surgery is also done to repair leaflets that don’t shut tightly. this implies blood will leak backward into the chambers, instead of solely moving forward into the artery because it ought to. to repair these issues, surgeons either repair the valve or replace it. Replacement valves are taken from animals, made up of human tissue, or made up of man-made substances.<br />
Arrhythmia Treatment<br />
An arrhythmia could be a downside with the speed or rhythm of the heart-beat. throughout an arrhythmia, the center will beat too quick, too slow, or with an irregular rhythm. Most arrhythmia's are harmless, however some may be serious or perhaps life threatening. When the center rate is abnormal, the center might not be able to pump enough blood to the body. Lack of blood flow will dam- age the brain, heart, and alternative organs. Arrhythmia's are sometimes treated with medication initial. If medicines don’t work well enough, you will want surgery. as an example, your doctor could use surgery to grant you a pacemaker or an implantable cardiovascular defibrillator (ICD).<br />
A pacemaker could be a little device that’s placed underneath the skin of your chest or abdomen. Wires lead from the pacemaker to the heart’s chambers. The pacemaker sends electrical signals through the wires to regulate the speed of the heartbeat. Most pacemakers have a sensor that activates the device solely when the heartbeat is abnormal. An ICD is another little device that’s placed in your chest or abdomen. This device is also connected to the center with wires. It checks your heartbeat for dangerous arrhythmia's. If it senses one, it sends an electrical shock to the center to revive a traditional heartbeat. Another form of surgery for arrhythmia is termed Maze surgery. during this operation, the surgeon makes new methods (a maze) for the heart’s electrical signals to travel through. this kind of surgery is employed to treat atrial fibrillation, the foremost common form of serious arrhythmia.<br />
Aneurysm Repair<br />
An aneurysm is an abnormal bulge or “ballooning” within the wall of an artery or the center muscle. This bulge happens when the wall weakens. Pressure from blood moving through the artery or heart causes the weak space to bulge out. Over time an aneurysm will grow and might burst, inflicting dangerous, typically fatal bleeding within the body. Aneurysms within the heart most frequently occur within the heart’s lower left chamber. they'll develop when a heart attack. Repairing an aneurysm involves surgery to switch the weak section of the artery or heart wall with a patch or graft.<br />
Ventricular Assist Devices<br />
Ventricular assist devices (VADs) are mechanical pumps that support your heart or take over your heart’s pumping action. VADs are used when your heart can’t pump enough blood to support your body. you will want a VAD if you have got heart failure or if you’re watching for a heart transplant. you'll be able to use a VAD for a brief time or for months or years, betting on your scenario.<br />
Heart Transplant<br />
A heart transplant is surgery within which a diseased heart is replaced with a healthy heart from a deceased donor. Heart transplants are done on patients whose hearts are therefore broken or weak that they can’t pump enough blood to satisfy the body’s desires. this kind of surgery could be a life-saving live that’s used when medical treatment and fewer drastic surgery have failed. as a result of donor hearts are briefly provide, patients who want a heart transplant undergo a careful choice method. they have to be sick enough to wish a brand new heart, nevertheless healthy enough to receive it.<br />
Patients on the waiting list for a donor heart receive ongoing treatment for heart failure and alternative medical conditions. VADs could also be used to treat these patients.<br />
Surgical Approaches<br />
In recent years, new ways that of doing heart surgery are developed. betting on a patient’s heart downside, general health, and alternative factors, he or she will currently have open-heart surgery or minimally invasive heart surgery.<br />
Open-heart surgery:<br />
Open-heart surgery is any quite surgery where the chest wall is opened and surgeons operate on the center. “Open” refers to the chest, not the center. betting on the kind of surgery, the center could also be opened, too. Open-heart surgery is employed to bypass blocked arteries within the heart, repair or replace heart valves, fix atrial fibrillation, and transplant hearts.<br />
In recent years, additional surgeons have began to use off-pump, or beating heart, surgery to try and do CABG. This approach is like ancient open-heart surgery, however surgeons don’t use a heart-lung bypass machine. Off-pump heart surgery could cut back complications that may occur when a heart-lung bypass machine is employed. It additionally could speed up recovery time. Off-pump heart surgery is not right for all patients. Your doctor can decide whether or not you must have this kind of surgery. He or she's going to rigorously think about your heart downside, age, overall health, and alternative factors that will have an effect on the surgery.<br />
Minimally invasive heart surgery:<br />
For minimally invasive heart surgery, a surgeon does not create an oversized incision (cut) down the middle of the chest to open the rib cage. Instead, he or she makes little incisions within the aspect of the chest between the ribs. A heart-lung bypass machine is employed in some styles of minimally invasive heart surgery, however not others. This newer heart surgery is employed for a few CABG and Maze procedures. It’s additionally used to repair or replace heart valves and insert pace-makers. One form of minimally invasive heart surgery that’s still being developed is robotic-assisted surgery. For this surgery, a surgeon uses a laptop to regulate surgical tools on skinny robotic arms. The tools are inserted through little incisions within the chest. this permits surgeons to perform complicated and highly precise surgery. The surgeon is usually in total management of the robotic arms; they don’t move on their own. advantages of minimally invasive heart surgery compared to open heart surgery embrace smaller incisions and scars, lower risk of infection, less pain, a shorter hospital keep, and a faster recovery.<br />
What to Expect before Heart Surgery<br />
There are many sorts of heart surgery. the kind you would like depends on your scenario. One person’s expertise before an operation may be terribly totally different from another’s. Some folks rigorously arrange their surgeries with their doctors. They apprehend precisely when and the way it'll happen. people want emergency heart surgery. Others are diagnosed with blocked coronary arteries and are admitted to the hospital promptly for surgery as soon as potential. If you’re having a planned surgery, you will be admitted to the hospital the afternoon or morning before your surgery. Your doctors and others on your health care team can meet with you to clarify what's going to happen. they'll offer you directions on the way to prepare for the surgery.<br />
You also may have to own some tests, like an EKG (electrocardiogram), chest x-ray, or blood tests. An intravenous (IV) line are placed in your arm to grant you fluids and medicines. Hair close to the incision website could also be shaved. Your skin could also be washed with special soap to scale back the chance of infection. simply before the surgery, you'll be moved to the operating area. you'll be given medication so you go to sleep and feel no pain throughout the surgery.<br />
What to Expect throughout Heart Surgery<br />
Heart surgery is finished in an exceedingly hospital. A team of specialists is concerned. Cardiothoracic surgeons perform the surgery with a team of alternative doctors and nurses who assist. The length of your time for the surgery depends on the kind of surgery. CABG, the foremost common form of heart surgery, sometimes takes three to five hours.<br />
Traditional Open-Heart Surgery<br />
For this kind of surgery, you’re given medication to create you go to sleep. A doctor checks your heartbeat, blood pressure, oxygen levels, and respiratory throughout the surgery. A respiratory tube is placed in your lungs through your throat and connected to a ventilator (breathing machine).<br />
A surgeon makes a 6- to 8-inch incision (cut) down the middle of your chest wall. Your chest bone is cut and your rib cage is opened so the surgeon will get to your heart. You’re given medication to skinny your blood and keep it from clotting. A heart-lung bypass machine is connected to your heart. This machine takes over for your heart by replacing the heart’s pumping action. A specialist oversees the machine. The bypass machine permits the surgeon to control on a heart that won't moving and filled with blood. You’re given medicines to prevent your heartbeat once you’re connected to the heart-lung bypass machine. A pipe is placed in your heart to empty blood to the machine. The machine removes carbon dioxide (a waste product) from your blood, adds oxygen, and then pumps the blood into your body. Tubes are inserted into your chest to empty fluid. Once the bypass machine begins to figure, the surgeon performs the surgery to repair your heart downside. At the top of the surgery, your heart is restarted using gentle electrical shocks. The pipes and tubes are faraway from your heart, and also the heart-lung bypass machine is stopped. You’re given medication to permit your blood to clot once more.<br />
Your chest bone is closed with wires. Stitches or staples are used to shut the incision. The respiratory tube is removed. a plus of ancient open-heart surgery is that it’s easier for the surgeon to control. this can be important for long and sophisticated surgeries.<br />
Off-Pump Heart Surgery<br />
This type of surgery is that the same as ancient open-heart surgery, except you are not connected to a heart-lung bypass machine. Instead, your heart is steadied with a machine whereas the surgeon works on it. Your heart continues to pump blood to your body. the benefits of off-pump heart surgery are that there aren't any complications associated with employing a heart-lung bypass machine and there's faster recovery from the surgery.<br />
Minimally Invasive Heart Surgery<br />
For this kind of heart surgery, the surgeon makes little incisions within the aspect of your chest between the ribs. These incisions may be as little as two to three inches. Then the surgeon inserts surgical tools through these little incisions. A tool with alittle video camera at the tip is also inserted through an incision. this permits the surgeon to check within the body.<br />
Some styles of minimally invasive heart surgery use a heart-lung bypass machine; alternative sorts don’t.<br />
The advantages of minimally invasive heart surgery are the following:<br />
• Less bleeding throughout surgery and a lower likelihood of needing a blood transfusion<br />
• Lower risk of infection<br />
• Less pain<br />
• Smaller incisions and scars<br />
• A shorter hospital keep and faster recovery<br />
Patients who don’t want the heart-lung bypass machine aren’t in danger for the complications that the machine could cause.<br />
What to Expect when Heart Surgery<br />
Recovery within the Hospital<br />
Depending on the kind of heart surgery, you will pay one day or additional within the hospital’s intensive care unit. Then you'll be moved to a different a part of hospital for many days before you go home. whereas you’re within the hospital, doctors and nurses can closely watch your heart rate, blood pressure, breathing, important signs, and incision site(s). you will have an intravenous (IV) needle inserted in your arm to grant you fluids till you’re able to drink on your own. you furthermore mght could also be given further oxygen through a face mask or nasal prongs that match simply within your nose. These items of apparatus are removed after you don’t want them to any extent further.<br />
Recovery at Home<br />
Each person responds differently to heart surgery. Your recovery at home additionally can depend upon what quite heart downside and surgery you had. Your doctor can offer you specific directions regarding the way to look after your healing incisions, acknowledge signs of infection or alternative complications, and address after-effects of surgery. you furthermore mght can get info regarding followup appointments, medicines, and things after you ought to decision the doctor promptly. After-effects of heart surgery are traditional. they will embrace the following:<br />
• Muscle pain<br />
• Chest pain<br />
• Swelling (especially if you have got an incision in your leg from coronary artery bypass grafting, or CABG) alternative after-effects could embrace loss of appetite, issue sleeping, constipation, and mood swings and depression. After-effects gradually depart. Recovery time varies with form of heart surgery. Full recovery from ancient open-heart CABG could take half dozen to twelve weeks or additional. Less recovery time is required for off-pump heart surgery and minimally invasive heart surgery. Your doctor can allow you to apprehend after you will return to your daily activities, like operating, driving, and physical activity.<br />
</div><div style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-2HPCSV7wTVE/Txft1P-jKnI/AAAAAAAAAGc/kqzBDLTkkcQ/s1600/SEEP4.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="http://4.bp.blogspot.com/-2HPCSV7wTVE/Txft1P-jKnI/AAAAAAAAAGc/kqzBDLTkkcQ/s320/SEEP4.JPG" width="320" /></a></div><br />
</div></div></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-51750999905532631172012-01-23T07:31:00.000-08:002012-02-06T10:42:03.615-08:00Cardiac Rehabilitation<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-0KUuytQEhQ4/TwgUisglrjI/AAAAAAAAACM/2_lKoRAdsdg/s1600/6.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-0KUuytQEhQ4/TwgUisglrjI/AAAAAAAAACM/2_lKoRAdsdg/s1600/6.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> Cardiac rehabilitation (rehab) is a medically supervised program that helps improve the health and well-being of people who have heart problems.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rehab programs include exercise training, education on heart- healthy living, and counseling to reduce stress and help you return to an active life.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cardiac rehab helps people who have heart problems do the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Recover after a heart attack or heart surgery</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Prevent future hospital stays, heart problems, and death related to heart problems</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Address risk factors that lead to coronary heart disease (also called coronary artery disease) and other heart problems</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Adopt healthy lifestyle changes</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve their health and quality of life</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Each patient will have a program that’s designed to meet his or her needs.</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Excerpted from “Cardiac Rehabilitation,” by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, August 2009.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span></b><br />
<b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The Cardiac Rehabilitation Team</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cardiac rehab involves a long-term commitment from the patient and a team of health care providers.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The cardiac rehab team may include doctors (such as a family doc-tor, a heart specialist, and a surgeon), nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and psychologists or other mental health specialists. In some cases, a case manager will help track the patient’s care.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Working with the team is an important part of cardiac rehab. The patient should share questions and concerns with the team. This will help the patient reach his or her goals.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Outlook</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">People of all ages can benefit from cardiac rehab. The lifestyle changes made during rehab have few risks. These changes can improve your overall health and prevent future heart problems and even death.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercise training as part of cardiac rehab may not be safe for all patients. For example, people who have very high blood pressure or severe heart disease may not be ready to exercise. These patients can still benefit from other parts of the cardiac rehab program.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Ask your doctor whether cardiac rehab can help you prevent a future heart problem and improve your health.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When Cardiac Rehabilitation Is Needed</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">People of all ages and ethnic backgrounds can benefit from cardiac rehabilitation (rehab). Rehab may help people who have had the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A heart attack</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Angioplasty or coronary artery bypass grafting for coronary heart disease</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Heart valve repair or replacement</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A heart transplant or a lung transplant</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Stable angina</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Heart failure</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cardiac rehab is equally helpful to both men and women. It can improve your overall health and prevent future heart problems and even death.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect When Starting Cardiac Rehabilitation</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may refer you to cardiac rehabilitation (rehab) during an office visit or while you’re in the hospital recovering from a heart attack or heart surgery. If your doctor doesn’t mention it, ask him or her whether cardiac rehab might benefit you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rehab activities vary depending on your condition. If you’re recovering from major heart surgery, rehab will start with a member of the rehab team helping you sit up in a chair or take a few steps. You’ll work on range-of-motion exercises. These include moving your fingers, hands, arms, legs, and feet. Over time, you’ll increase your activity level.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Once you leave the hospital, rehab will continue in a rehab center. The rehab center may be part of the hospital or in another place. Try to find a center close to home that offers services at a convenient time. If no centers are near your home, or if it’s too hard to get to them, ask your doctor about home-based rehab.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For the first 2 to 3 months, you’ll need to go to rehab regularly to learn how to reduce risk factors and to begin an exercise program. After that, your rehab team may recommend less frequent visits. Overall, you may work with the rehab team for 12 months or more. The length of time you continue cardiac rehab depends on your situation.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Health Assessment</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Before you start your cardiac rehab program, your rehab team will assess your health. This includes taking your medical history and doing a physical exam and tests.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Medical history:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A doctor or nurse will ask you about previous heart problems, heart surgery, and any heart-related symptoms you have. He or she also will ask whether you’ve had medical procedures or other health problems (such as diabetes or kidney disease).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The doctor or nurse may ask questions about the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Whether your family has a history of heart disease</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• What medicines you’re taking, including over-the-counter medicines and dietary supplements (such as vitamins and herbal remedies)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Whether you smoke and how much</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• How you check your blood sugar level, and how often you do it (if you have diabetes)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Whether you’ve ever had hypoglycemia, a condition can occur in people who take medicines to control their blood sugar levels</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your rehab team will ask questions to help them assess your quality of life and well-being.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical exam:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A doctor or nurse will do a physical exam to check your overall health, including your heart rate, blood pressure, reflexes, and breathing.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Tests:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may recommend tests to check your heart. A resting EKG (electrocardiogram) is a simple test that detects and records your heart’s electrical activity. The test shows how fast your heart is beating and your heart’s rhythm (steady or irregular). An EKG also shows the strength and timing of electrical signals as they pass through each part of your heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You also may need tests to measure your cholesterol and blood sugar levels. If you have diabetes, staff also will do an HbA1C test to check your blood sugar control. This test shows how well your diabetes has been managed over time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during Cardiac Rehabilitation</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During cardiac rehabilitation (rehab), you’ll learn how to do the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Increase your physical activity and exercise safely</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Follow a heart-healthy diet</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reduce risk factors for future heart problems</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve your emotional health</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The rehab team will work with you to create a plan that meets your needs. Each part of cardiac rehab will help lower your risk for future heart problems.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Over time, the lifestyle changes you make during rehab will be-come more routine. They will help you maintain a reduced risk for heart disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Support from your family can help make cardiac rehab easier. For example, family members can help you plan healthy meals and do physical activities. The healthy lifestyle changes you learn during cardiac rehab can benefit your entire family.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Increase Physical Activity and Exercise Safely</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical activity is an important part of a healthy lifestyle. It can strengthen your heart muscle, reduce your risk for heart disease, and improve your muscle strength, flexibility, and endurance.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your rehab team will assess your physical activity level to learn how active you are at home, at work, and during recreation. If your job includes heavy labor, the team may recreate your workplace conditions to help you practice in a safe setting.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You’ll work with the team to find ways to safely add physical activity to your daily routine. For example, you may decide to park farther from building entrances, walk up two or more flights of stairs, or walk for 15 minutes during your lunch break.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your rehab team also will work with you to create an easy-to-follow exercise plan. It will include time for a warm-up, flexibility exercises, and cooling down. It also may include aerobic exercise and muscle-strengthening activities. You’ll get a written plan that lists each exercise and explains how often and for how long you should do it.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You’re more likely to make exercise a habit if you enjoy the activity. Work with the rehab team to find the types of activity that you enjoy and that are safe for you. If you prefer to exercise with other people, join a group or ask a friend to join you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercise training as part of cardiac rehab may not be safe for all patients. For example, if you have very high blood pressure or severe heart disease, you may not be ready for exercise training. Or, you may only be able to tolerate very light conditioning exercises. The rehab team will help decide what level of exercise is safe for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Aerobic exercise:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Typically, your rehab team will ask you to do aerobic exercise 3 to 5 days per week for 30 to 60 minutes. The exercise specialist on your team will make sure that your exercise plan is safe and right for you. Examples of aerobic exercise are walking (out- side or on a treadmill), cycling, rowing, or climbing stairs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Muscle-strengthening activities:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Typically, your rehab team will ask you to do muscle-strengthening activities 2 or 3 days per week. Your exercise plan will show how many times to repeat each exercise. Muscle-strengthening activities may include lifting weights (hand weights, free weights, or weight machines), using a wall pulley, or using elastic bands to stretch and condition your muscles.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercise at the rehab center and at home:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When you start cardiac rehab, you’ll exercise at the rehab center. Members of your rehab team will carefully watch you to make sure you’re exercising safely.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A team member will check your blood pressure several times during exercise training. You also may need an EKG (electrocardiogram) to check your heart’s electrical activity during exercise. This test shows how fast your heart is beating and whether its rhythm is steady or irregular.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your exercise program will change as your health improves. After a while, you’ll add at-home exercises to your plan.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Follow a Heart-Healthy Diet</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your rehab team will help you create and follow a heart-healthy diet. The diet will help you reach your rehab goals, which may include managing your weight, cholesterol levels, blood pressure, diabetes, kidney disease, heart failure, and/or other health problems that your diet can affect.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You’ll learn how to plan meals that meet your calorie needs and are low in saturated and trans fats, cholesterol, and sodium (salt). Your rehab team also may advise you to limit alcohol and other substances. Alcohol can raise your blood pressure and harm your liver,</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">brain, and heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Reduce Risk Factors for Future Heart Problems</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your cardiac rehab team will work with you to control your risk factors for heart problems. Risk factors include high blood pressure, high blood cholesterol, overweight or obesity, diabetes, and smoking.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood pressure:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood pressure raises your risk for future heart problems. The rehab team will work with you to reach the blood pressure goal your doctor sets. This goal will depend on factors such as your age and whether you have heart failure, diabetes, or kidney disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercising, losing weight, limiting how much salt and alcohol you consume, and quitting smoking can help you lower your blood pressure. You may need medicine to lower your blood pressure if lifestyle changes aren’t enough.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood cholesterol:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Too much cholesterol in the blood can cause heart disease. Your rehab team will work with you to lower high blood cholesterol. You can do this by following a heart-healthy diet, losing weight, exercising, quitting smoking, and limiting how much alcohol you drink.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical activity also can increase HDL [high-density lipoprotein] cholesterol, which is sometimes called good cholesterol. This is because it helps remove cholesterol from your arteries. You may need medicine to lower your cholesterol if lifestyle changes aren’t enough.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overweight and obesity:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you’re overweight or obese, your rehab team will help you set short- and long-term weight-loss goals. You can reach these goals by following the diet and exercise plans that the team creates for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Diabetes:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you have diabetes, your rehab team will work with you to control your blood sugar level. Following a heart-healthy diet, losing weight, and exercising can lower your blood sugar level.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may suggest that you test your blood sugar before and after exercising to watch for numbers that are too high or too low. Your doctors will tell you what numbers to look for.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may need medicine to lower your blood sugar level if lifestyle changes aren’t enough.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Smoking:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Smoking is a risk factor for heart disease. If you smoke, quitting can help you avoid future heart problems. Quitting can help lower your blood pressure and keep your cholesterol levels healthy. Talk to your rehab team about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">It may help to set a quit date. Some people find it helpful to enroll in smoking cessation programs or to seek counseling. Other people find acupuncture or hypnosis helpful.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Improve Emotional Health</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Psychological factors increase the risk of getting heart disease or making it worse. Depression, anxiety, and anger are common among people who have heart disease or have had a heart attack or heart surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Get treatment if you feel sad, anxious, angry, or isolated. These feelings can affect your physical recovery. Depression is linked to complications such as irregular heartbeats, chest pain, a longer recovery time, the need to return to the hospital, and even an increased risk of death.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Seeking help is important. Group or individual counseling helps lower your risk for future heart attacks and death. It also may motivate you to exercise and help you relax and learn how to reduce stress. People with heart disease who get mental health treatment often show improvements in blood pressure, cholesterol, and other measures of physical health.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The rehab team may include a mental health specialist, or some-one from the team may be able to refer you to one. Without help from a professional, these problems may not go away.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Some communities have support groups for people who have had heart attacks or heart surgery. They also may have walking groups or exercise classes. Help with basic needs and transportation also may be available.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Counseling for Sexual Dysfunction</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">People who have heart problems sometimes have sexual problems. The most common problem is less interest or no interest in sex. Impotence or premature or delayed ejaculation may occur in men. Depression, medicines, fear of causing a heart attack, or diabetes can contribute to sexual problems.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Sexual activity often is safe for low-risk patients. The maximum heart rate during usual sexual activity is similar to other daily activities, such as walking up one or two flights of stairs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Talk to your doctor if you’re having sexual problems or to find out whether sexual activity is safe for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-15580542594998048532012-01-13T11:17:00.000-08:002012-02-06T10:41:22.294-08:00Heart Valve Surgery<div style="text-align: justify;">“Heart valve surgery,” © 2009 A.D.A.M., Inc.</div><div style="text-align: justify;">Reprinted with permission.</div><div style="text-align: justify;">Heart valve surgery is used to repair or replace diseased heart valves.</div><div class="separator" style="clear: both; text-align: center;"></div><div style="text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-w8GOTIIHl34/TxCDlS8OF7I/AAAAAAAAAEk/PobVrLWiKmM/s1600/1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-w8GOTIIHl34/TxCDlS8OF7I/AAAAAAAAAEk/PobVrLWiKmM/s1600/1.jpg" /></a></div>Description</div><div style="text-align: justify;">There are four valves in your heart:</div><div style="text-align: justify;">1. Aortic valve</div><div style="text-align: justify;">2. Mitral valve</div><div style="text-align: justify;">3. Tricuspid valve</div><div style="text-align: justify;">4. Pulmonary valve</div><div style="text-align: justify;">The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat. Heart valve surgery is open-heart surgery that is done while you are under general anesthesia. A cut is made through the breast bone (sternum). Your blood is routed away from your heart to a heart-lung bypass machine. This machine keeps the blood circulating while your heart is being operated on.</div><div style="text-align: justify;">Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical):</div><div style="text-align: justify;">• Natural valves are from human donors (cadavers).</div><div style="text-align: justify;">• Modified natural valves come from animal donors. (Porcine valves are from pigs, bovine are from cows.) </div><a name='more'></a>These are placed in synthetic rings.<br />
<div style="text-align: justify;">• Artificial valves are made of metal.</div><div style="text-align: justify;">If you receive an artificial valve, you may need to take lifelong medication to prevent blood clots. Natural valves rarely require life long medication.</div><div style="text-align: justify;">Why the Procedure Is Performed</div><div style="text-align: justify;">Heart valve surgery may be recommended for the following conditions:</div><div style="text-align: justify;">• Narrowing of the heart valve (stenosis)</div><div style="text-align: justify;">• Leaking of the heart valve (regurgitation)</div><div style="text-align: justify;">Valve problems may be caused by:</div><div style="text-align: justify;">• birth defects;</div><div style="text-align: justify;">• calcium deposits (calcification);</div><div style="text-align: justify;">• infections such as rheumatic fever;</div><div style="text-align: justify;">• medications.<br />
Defective valves may cause congestive heart failure and infections ( invective endocarditis).<br />
Risks</div><div style="text-align: justify;">The risks for any anesthesia include:<br />
• problems breathing;</div><div style="text-align: justify;">• reactions to medications.</div><div style="text-align: justify;">The risks for any surgery include:</div><div style="text-align: justify;">• bleeding;</div><div style="text-align: justify;">• infection.</div><div style="text-align: justify;">The risks for cardiac surgery include:</div><div style="text-align: justify;">• death;</div><div style="text-align: justify;">• heart attack;</div><div style="text-align: justify;">• irregular heartbeat (arrhythmia);</div><div style="text-align: justify;">• kidney failure;</div><div style="text-align: justify;">• stroke;</div><div style="text-align: justify;">• temporary confusion after surgery due to the heart-lung machine.</div><div style="text-align: justify;">It is very important to take steps to prevent valve infections. You may need to take antibiotics indefinitely, or before dental work and other invasive procedures.</div><div style="text-align: justify;">After the Procedure</div><div style="text-align: justify;">The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life. The death rate averages 2% to 5%, depending on the heart valve. About two of every three patients who received an artificial mistral valve are still alive 9 years after the surgery.</div><div style="text-align: justify;">The clicking of the mechanical heart valve may be heard in the chest. This is normal.</div><div style="text-align: justify;">Outlook (Prognosis)</div><div style="text-align: justify;">You will stay in an intensive care unit for the first 2 or 3 days following the operation. Your heart functions will be monitored constantly. The average hospital stay is 1 to 2 weeks. Complete recovery will take a few weeks to several months, depending on your health before surgery.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-11325039250454564832012-01-12T04:59:00.000-08:002012-02-06T10:40:26.681-08:00Coronary Angioplasty<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-mStBUBB706k/TwgLIPqV7WI/AAAAAAAAABk/RN0nXHnAZH8/s1600/one+heart.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="304" src="http://1.bp.blogspot.com/-mStBUBB706k/TwgLIPqV7WI/AAAAAAAAABk/RN0nXHnAZH8/s320/one+heart.jpeg" width="320" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Coronary angioplasty is a medical procedure in which a balloon is used to open a blockage in a coronary (heart) artery narrowed by atherosclerosis. This procedure improves blood flow to the heart. Atherosclerosis is a condition in which a material called plaque builds up on the inner walls of the arteries. This can happen in any artery, including the coronary arteries. The coronary arteries carry </span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> oxygen-rich blood to your heart. When atherosclerosis affects the coronary arteries, the condition is called coronary artery disease (CAD).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Angioplasty is a common medical procedure. It may be used to do the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve symptoms of CAD, such as angina and shortness of breath</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reduce damage to the heart muscle from a heart attack</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reduce the risk of death in some patients</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A heart attack occurs when blood flow through a coronary artery is completely blocked. Angioplasty is used during a heart attack to open the blockage and restore blood flow through the artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Angioplasty is done on more than 1 million people a year in the United States. Serious complications don’t occur often, but can happen no matter how careful your doctor is or how well he or she does the procedure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 200%;">Excerpted from “Angioplasty,” by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, January 2009.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Research on angioplasty is ongoing to make it safer and more effective, to prevent treated arteries from closing again, and to make the procedure an option for more people.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other Names for Coronary Angioplasty</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Percutaneous coronary intervention (PCI)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Percutaneous intervention</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Percutaneous transluminal angioplasty</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Percutaneous transluminal coronary angioplasty (PTCA)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Balloon angioplasty</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Coronary artery angioplasty</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Who Needs Coronary Angioplasty?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Coronary angioplasty is used to restore blood flow to the heart when the coronary arteries have become narrowed or blocked due to coronary artery disease (CAD).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When medicines and lifestyle changes, such as following a healthy diet, quitting smoking, and getting more physical activity, don’t improve your CAD symptoms, your doctor will talk to you about other treatment options. These options include angioplasty and coronary artery bypass grafting (CABG), a type of open-heart surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will take into account a number of factors when recommending the best procedure for you. These factors include how severe your blockages are, where they’re located, and other diseases you may have.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Angioplasty is often used when there is less severe narrowing or blockage in your arteries, and when the blockage can be reached during the procedure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG might be chosen if you have severe heart disease, multiple arteries that are blocked, or if you have diabetes or heart failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Compared with CABG, some advantages of angioplasty are:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It has fewer risks than CABG.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It isn’t surgery, so it won’t require a large cut.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It is done with medicines that numb you and help you relax.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Unlike CABG, you won’t be put to sleep for a short time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It has a shorter recovery time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Angioplasty also is used as an emergency procedure during a heart attack. As plaque builds up in the coronary arteries, it can burst, causing a blood clot to form on its surface. If the clot becomes large enough, it can mostly or completely block blood flow to part of the heart muscle.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Quickly opening a blockage lessens the damage to the heart during a heart attack and restores blood flow to the heart muscle. Angioplasty can quickly open the artery and is the best approach during a heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A disadvantage of angioplasty as compared with CABG is that the artery may narrow again over time. The chance of this happening is lower when stents are used, especially medicine-coated stents. How-ever, these stents aren’t without risk. In some cases, blood clots can form in the medicine-coated stents and cause a heart attack. Your doctor will discuss with you the treatment options and which procedure is best for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">How Coronary Angioplasty Is Done</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Before coronary angioplasty is done, your doctor will need to know whether your coronary arteries are blocked. If one or more of your arteries are blocked, your doctor will need to know where and how severe the blockages are.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">To find out, your doctor will do an angiogram and take an x-ray picture of your arteries. During an angiogram, a small tube called a catheter with a balloon at the end is put into a large blood vessel in the groin (upper thigh) or arm. The catheter is then threaded to the coronary arteries. A small amount of dye is injected into the coronary arteries and an x-ray picture is taken.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This picture will show any blockages, how many, and where they’re located. Once your doctor has this information, the angioplasty can proceed. Your doctor will blow up (inflate) the balloon in the blockage and push the plaque outward against the artery wall. This opens the artery more and improves blood flow.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A small mesh tube called a stent is usually placed in the newly widened part of the artery. The stent holds up the artery and lowers the risk of the artery renarrowing. Stents are made of metal mesh and look like small springs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Some stents, called drug-eluting stents, are coated with medicines that are slowly and continuously released into the artery. These medicines help prevent the artery from becoming blocked again from scar tissue that grows around the stent.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In some cases, plaque is removed during angioplasty. In a procedure called atherectomy, a catheter with a rotating shaver on its tip is inserted into the artery to cut away plaque. Lasers also are used to dissolve or break up the plaque. These procedures are now rarely done because angioplasty gives better results for most patients.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect before Coronary Angioplasty</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Meeting with Your Doctor</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A cardiologist (a doctor who treats people with heart conditions) performs coronary angioplasty at a hospital. If your angioplasty isn’t done as emergency treatment, you’ll meet with your cardiologist before the procedure. Your doctor will go over your medical history (including the medicines you take), do a physical exam, and talk about the procedure with you. Your doctor also will order some routine tests, including the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Blood tests</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• An EKG (electrocardiogram)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A chest x-ray</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When the procedure is scheduled, you will be advised on the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• When to begin fasting (not eating or drinking) before the procedure (often you have to stop eating or drinking by midnight the night before the procedure)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• What medicines you should and shouldn’t take on the day of the angioplasty</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• When to arrive at the hospital and where to go</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Even though angioplasty takes 1 to 2 hours, you will likely need to stay in the hospital overnight. In some cases, you will need to stay in the hospital longer. Your doctor may advise you not to drive for a certain amount of time after the procedure, so you may have to arrange for a ride home.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during Coronary Angioplasty</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Coronary angioplasty is performed in a special part of the hospital called the cardiac catheterization laboratory. The “cath lab” has special video screens and x-ray machines. Your doctor uses this equipment to see enlarged pictures of the blocked areas in your coronary arteries.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Preparation</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In the cath lab, you will lie on a table. An intravenous (IV) line will be placed in your arm to give you fluids and medicines. The medicines will relax you and prevent blood clots from forming. These medicines may make you feel sleepy or as though you’re floating or numb.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Here is what usually happens to prepare for the procedure:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• The area where the catheter will be inserted, usually the arm or groin (upper thigh), will be shaved.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• The shaved area will be cleaned to make it germ free and then numbed. The numbing medicine may sting as it’s going in.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Steps in Angioplasty</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When you’re comfortable, the doctor will begin the procedure. You will be awake but sleepy.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A small cut is made in your arm or groin into which a tube called a sheath is put. The doctor then threads a very thin guide wire through the artery in your arm or groin toward the area of the coronary artery that’s blocked.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor puts a long, thin, flexible tube called a catheter through the sheath and slides it over the guide wire and up to the heart. Your doctor moves the catheter into the coronary artery to the blockage. He or she takes out the guide wire once the catheter is in the right spot.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A small amount of dye may be injected through the catheter into the bloodstream to help show the blockage on x-ray. This x-ray picture of the heart is called an angiogram.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Next, your doctor slides a tube with a small deflated balloon in-side it through the catheter and into the coronary artery where the blockage is.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When the tube reaches the blockage, the balloon is inflated. The balloon pushes the plaque against the wall of the artery and widens it. This helps to increase the flow of blood to the heart. The balloon is then deflated. Sometimes the balloon is inflated and deflated more than once to widen the artery. Afterward, the balloon and tube are removed.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In some cases, plaque is removed during angioplasty. A catheter with a rotating shaver on its tip is inserted into the artery to cut away hard plaque. Lasers also may be used to dissolve or break up the plaque.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If your doctor needs to put a stent (small mesh tube) in your artery, another tube with a balloon will be threaded through your artery. A stent is wrapped around the balloon. Your doctor will inflate the balloon, which will cause the stent to expand against the wall of the artery. The balloon is then deflated and pulled out of the artery with the tube. The stent stays in the artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After the angioplasty is done, your doctor pulls back the catheter and removes it and the sheath. The hole in the artery is either sealed with a special device, or pressure is put on it until the blood vessel seals.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During angioplasty, strong antiplatelet medicines are given through the IV to prevent blood clots from forming in the artery or on the stent. These medicines help thin your blood. They’re usually started just before the angioplasty and may continue for 12–24 hours afterward.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect after Coronary Angioplasty</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After coronary angioplasty, you will be moved to a special care unit, where you will stay for a few hours or overnight. While you recover in this area, you must lie still for a few hours to allow the blood vessels in your arm or groin (upper thigh) to seal completely. While you recover, nurses will check your heart rate and blood pressure. They also will check your arm or groin for bleeding. After a few hours, you will be able to walk with help. The place where the tube was inserted may feel sore or tender for about a week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-80780029833558526252012-01-02T02:29:00.000-08:002012-02-06T10:39:23.868-08:00Coronary Artery Bypass Grafting<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-EKCt5opx5mo/TwgNTB1PNUI/AAAAAAAAABs/g_lNbzCmxjc/s1600/2.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="227" src="http://1.bp.blogspot.com/-EKCt5opx5mo/TwgNTB1PNUI/AAAAAAAAABs/g_lNbzCmxjc/s320/2.jpeg" width="320" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> Coronary artery bypass grafting (CABG) is a type of surgery called revascularization, used to improve blood flow to the heart in people with severe coronary artery disease (CAD).</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CAD occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become blocked due to the buildup of a material called plaque on the inside of the blood vessels. If the blockage is severe, chest pain (also called angina), shortness of breath, and, in some cases, heart attack can occur.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG is one treatment for CAD. During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, it goes around) the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle. As many as four major blocked coronary arteries can be by-passed during one surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overview</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG is the most common type of open-heart surgery in the United States, with more than 500,000 surgeries performed each year. Doc-tors called cardiothoracic surgeons perform this surgery. </span></div><div class="MsoNormal" style="line-height: normal; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from text by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, March 2007.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG isn’t used for everyone with CAD. Many people with CAD can be treated by other means, such as lifestyle changes, medicines, and another revascularization procedure called angioplasty.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG may be an option if you have severe blockages in the large coronary arteries that supply a major part of the heart muscle with blood—especially if the heart’s pumping action has already been weakened.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CABG may also be an option if you have blockages in the heart that can’t be treated with angioplasty. In these situations, CABG is considered more effective than other types of treatment.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you’re a candidate for CABG, the goals of having the surgery are the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve your quality of life and decrease angina and other symptoms of CAD</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Resume a more active lifestyle</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve the pumping action of the heart if it has been damaged by a heart attack</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Lower the chances of a heart attack (in some patients, such as those with diabetes)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Improve your chance of survival</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Repeat surgery may be needed if grafted arteries or veins become blocked, or if new blockages develop in arteries that weren’t blocked before. Taking medicines as prescribed and making lifestyle changes that your doctor recommends can lower the chance of a graft becoming blocked.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In people who are candidates for the surgery, the results are usually excellent, with 85 percent of people having significantly reduced symptoms, less risk for future heart attacks, and a decreased chance of dying within 10 years following the surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Types of Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Traditional Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This is the most common type of coronary artery bypass grafting (CABG). It’s used when at least one major artery needs to be bypassed. During the surgery, the chest bone is opened to access the heart. Medicines are given to stop the heart, and a heart-lung machine is used to keep blood and oxygen moving throughout the body during surgery. This allows the surgeon to operate on a still heart. After surgery, the heart is restarted using mild electric shocks.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Off-Pump Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This type of CABG is similar to traditional CABG in that the chest bone is opened to access the heart. However, the heart isn’t stopped, and a heart-lung machine isn’t used. Off-pump CABG is sometimes called beating heart bypass grafting. This type of surgery may reduce complications that can occur when a heart-lung machine is used, and it may speed up recovery time after surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Minimally Invasive Direct Coronary Artery Bypass Grafting This surgery is similar to off-pump, but instead of a large incision to open the chest bone, several small incisions are made on the left side of the chest between the ribs. This type of surgery is used mainly for bypassing the vessels in front of the heart. It’s a fairly new procedure, which is performed less often than the other types. This type of surgery is not for everybody, especially if more than one or two coronary arteries need to be bypassed.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other Names for Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Bypass surgery</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Coronary artery bypass surgery</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Heart bypass surgery</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When Coronary Artery Bypass Grafting Is Needed</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Coronary artery bypass grafting (CABG) is only used to treat people who have severe coronary artery disease (CAD) that could lead to a heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may recommend CABG if other treatments, such as lifestyle changes or medicines, haven’t worked. He or she also may recommend CABG if you have severe blockages in the large coronary arteries that supply a major part of the heart muscle with blood— especially if your heart’s pumping action has already been weakened. CABG also may be a treatment option if you have blockages in the heart that can’t be treated with angioplasty.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will determine if you’re a candidate for CABG based on a number of factors. These include the presence and severity of CAD symptoms, the severity and location of blockages in your coronary arteries, your response to other treatments, your quality of life, and any other medical problems you may have.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In some cases, CABG may be performed on an emergency basis, such as pending or during a heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect before Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Tests may be done to prepare you for coronary artery bypass grafting, including blood tests, EKG, echocardiogram, chest x-ray, cardiac</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">catheterization, and angiography.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will give you specific instructions about how to pre-pare for surgery. There will be instructions about what to eat or drink, what medicines to take, and what activities to stop (such as smoking). You will likely be admitted to the hospital on the same day as the surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Coronary artery bypass grafting (CABG) requires a team of experts. A cardiothoracic surgeon performs the surgery with support from an anesthesiologist, per fusionist (heart-lung machine specialist), other surgeons, and nurses.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">There are several different types of CABG. They range from traditional surgery in which the chest is opened to reach the heart, to a nontraditional surgery in which small incisions are made to bypass the narrowed artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Traditional Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This type of surgery usually lasts 3 to 5 hours, depending on the number of arteries being bypassed. Numerous steps take place during traditional CABG.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Anesthesia is given to put you to sleep. During the surgery, the anesthesiologist monitors your heartbeat, blood pressure, oxygen levels, and breathing. A breathing tube is placed in your lungs through your throat, and connected to a ventilator (breathing machine). An incision is made down the center of your chest. The chest bone is then cut and your ribcage is opened so that the surgeon can get to your heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Medicines are used to stop your heart, which allows the surgeon to operate on it while it’s not beating. A heart-lung machine keeps oxygen-rich blood moving throughout your body. An artery or vein is taken from a different part of your body, such as your chest or leg, and prepared to be used as a graft for the bypass. In surgery with several bypasses, a combination of both artery and vein grafts is commonly used.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Artery grafts:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">These grafts are much less likely than vein grafts to become blocked over time. The left internal mammary artery is most commonly used for an artery graft. It’s located in-side the chest close to the heart. Arteries from the arm or other places in the body are sometimes used as well.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">•Vein grafts:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Although veins are commonly used as grafts, they’re more likely than artery grafts to develop plaque and become blocked over time. The saphenous vein—a long vein running along the inner side of the leg—is typically used. After the grafting is complete, your heart is restarted using mild electric shocks. You’re disconnected from the heart-lung machine.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Tubes are inserted into your chest to drain fluid. The surgeon uses wires that stay in your body permanently to close your chest bone and stitches or staples to close the skin incision. The breathing tube is removed when you’re able to breathe without it.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Nontraditional Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Nontraditional CABG includes off-pump CABG and minimally invasive CABG. Off-pump coronary artery bypass grafting: This type of surgery can be used to bypass any of the coronary arteries. Off-pump CABG also is called beating heart bypass grafting because the heart isn’t stopped and a heart-lung machine isn’t used. Instead, the part of the heart where grafting is being done is steadied with a mechanical device.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Off-pump CABG may reduce complications that can occur when a heart-lung machine is used, especially in people who have had a stroke or mini-strokes in the past, who are over age 70, and who have diabetes, lung disease, or kidney disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other advantages of this type of bypass surgery include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reduced bleeding during surgery and a lower chance of needing a blood transfusion</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A lower chance of infection, stroke, and kidney complications</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A lower chance of complications such as memory loss, difficulty concentrating, or difficulty thinking clearly</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Faster recovery from the surgery Minimally invasive direct coronary artery bypass grafting:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">There are several types of minimally invasive direct coronary artery bypass (MIDCAB) grafting. These types of surgery differ from traditional bypass surgery because they only require small incisions rather than opening the chest bone to get to the heart. These procedures sometimes use a heart-lung machine.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• MIDCAB procedure:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This procedure is used when only one or two coronary arteries need to be bypassed. A series of small incisions is made between your ribs on the left side of your chest, directly over the artery to be bypassed. The incisions are usually about 3 inches long. (The incisions made in traditional CABG are at least 6 to 8 inches long.) The left internal mammary artery is most often used for the graft. A heart-lung machine isn’t used during this procedure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Port-access coronary artery bypass procedure: </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This procedure is performed through small incisions (ports) made in your chest. Artery or vein grafts are used. The heart-lung machine is used during this procedure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Robot-assisted technique:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This type of procedure allows for even smaller, keyhole-sized incisions. A small video camera is inserted in one incision to show the heart, while the surgeon uses remotely controlled surgical instruments to perform the surgery. The heart-lung machine is sometimes used during this procedure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Advantages of minimally invasive CABG include smaller incisions, smaller scars, shorter recovery and hospital stay, less bleeding, less chance for infection, and less pain.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect after Coronary Artery Bypass Grafting</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Recovery in the Hospital</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After surgery, you will typically spend 1 or 2 days in an intensive care unit. Your heart rate and blood pressure will be continuously monitored during this time. Intravenous medicines (medicines injected through a vein) are often given to regulate blood circulation and blood pressure. You will then be moved to a less intensive care area of the hospital for 3 to 5 days before going home.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Recovery at Home</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will give you specific instructions for recovering at home, especially concerning the following issues:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• How to care for your healing incisions</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• How to recognize signs of infection or other complications</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• When to call the doctor immediately</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• When to make follow-up appointments</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may also receive instructions on how to deal with common after-effects from surgery. After-effects often go away within 4 to 6 weeks after surgery, but may include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Discomfort or itching from healing incisions</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Swelling of the area where an artery or vein was taken for grafting</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Muscle pain or tightness in the shoulders and upper back</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fatigue (tiredness), mood swings, or depression</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Difficulty sleeping or loss of appetite</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Constipation</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Chest pain around the site of the chest bone incision (more frequent with the traditional surgery)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for nontraditional CABG.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will provide instructions on resuming physical activity. This varies from person to person, but there are some typical timeframes. Most people can resume sexual activity within about 4 weeks and driving after 3 to 8 weeks.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Returning to work after 6 weeks is common unless the job involves specific and demanding physical activity. Some people may need to find less physically demanding types of work or work a reduced schedule at first.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-49714015739395712652011-12-28T04:22:00.000-08:002012-02-06T10:37:28.753-08:00Total Artificial Heart Surgery<div class="MsoNormal" style="line-height: 200%; text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-AEplMeUcZ9E/TwgVgseT42I/AAAAAAAAACU/vzmIYh6Uy1k/s1600/7.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-AEplMeUcZ9E/TwgVgseT42I/AAAAAAAAACU/vzmIYh6Uy1k/s1600/7.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A total artificial heart (TAH) is a device that replaces the two lower chambers of the heart. These chambers are called ventricles. You may benefit from a TAH if both of your ventricles don’t work due to end- stage heart failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Heart failure is a condition in which the heart is damaged or weakened and can’t pump enough blood to meet the body’s needs. “End stage” means the condition has become so severe that all treatments, except heart transplant, have failed.</span><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></b><br />
<div style="text-align: left;"><b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overview</span></b></div></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may need a TAH for one of two reasons:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• To keep you alive while you wait for a heart transplant </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you’re not eligible for a heart transplant, but you have end stage heart failure in both ventricles</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> The TAH is attached to your heart’s upper chambers—the atria. Between the TAH and the atria are mechanical valves that work like the heart’s own valves. Valves control the flow of blood in the heart. Currently, there are two types of TAH. They’re known by their brand names: the Cardio West and the AbioCor. The main difference</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from “Total Artificial Heart,” by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, September 2008.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">between these TAHs is that the Cardio West is connected to an out- side power source and the AbioCor isn’t.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> The Cardio West has tubes that, through holes in the abdomen, connect from inside the chest to an outside power source. The AbioCor TAH is completely contained inside the chest. A battery powers this TAH. The battery is charged through the skin with a special magnetic charger.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Energy from the external charger reaches the internal battery through an energy transfer device called transcutaneous energy trans-mission, or TET.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">An implanted TET device is connected to the implanted battery. An external TET coil is connected to the external charger. Also, an implanted controller monitors and controls the pumping speed of the heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Outlook</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A TAH usually extends life for months beyond what is expected with end-stage heart failure. If you’re waiting for a heart transplant, a TAH can keep you alive while you wait for a donor heart. It also can improve your quality of life. However, a TAH is a very complex device.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">It’s challenging for surgeons to implant, and it can cause complications. Currently, TAHs are used only in a small number of people. Researchers are working to make even better TAHs that will allow people to live longer and have fewer complications.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other Names for a Total Artificial Heart</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Artificial heart</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• AbioCor</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• CardioWest</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When a Total Artificial Heart Is Needed</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may benefit from a total artificial heart (TAH) if both of your ventricles don’t work due to end-stage heart failure. If you’re waiting for a heart transplant, a TAH can help you survive longer. It also can improve your quality of life. If your life expectancy is less than 30 days and you’re not eligible for a heart transplant, a TAH may extend your life beyond the expected 30 days.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A TAH is a “last resort” device. This means only people who have tried every other type of treatment, except heart transplant, can get it. The TAH isn’t used for people who may benefit from medicines or other procedures.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">TAHs also have a size limit. These devices are fairly large and can only fit into large chest areas. Currently, no TAHs are available that can fit into children’s chests. However, researchers are trying to make smaller models.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The United States Food and Drug Administration (FDA) has approved the TAH for certain types of patients. Your doctor will discuss with you whether you meet the conditions for getting a TAH.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you and your doctor decide that a TAH is a good option for you, you also will discuss which of the two types of TAH will work best for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect before Total Artificial Heart Surgery</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Before you get a total artificial heart (TAH), you will likely spend at least a week in the hospital to prepare for the surgery. You might already be in the hospital getting treatment for heart failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During this time, you will learn about the TAH and how to live with it. You and your loved ones will spend time with your surgeons, cardiologist (heart specialist), and nurses to make sure you have all the information you need before surgery. You can ask to see what the de-vice looks like and how it will be attached inside your body.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctors will make sure that your body is strong enough for the surgery. If your doctors think your body is too weak, you may need to get extra nutrition through a feeding tube before surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You also will have tests to make sure you’re ready for surgery. These tests include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A chest CT scan: This test is used to make sure the TAH will fit in your chest. Current TAHs are fairly large. Before you have surgery, your doctor will make sure there’s enough room in your chest for the device.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Blood tests: These tests are used to check how well your liver and kidneys are working. Blood tests also are used to check the levels of blood cells and important chemicals in your blood.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• <b style="mso-bidi-font-weight: normal;">Chest x-ray</b>: This test is used to create pictures of the inside of your chest to help your doctors prepare for surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• <b style="mso-bidi-font-weight: normal;">EKG (electrocardiogram):</b> This test is used to check how well your heart is working before the ventricles are replaced by the TAH.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during Total Artificial Heart Surgery</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Total artificial heart (TAH) surgery is complex and can take be-tween 5 and 9 hours. It requires many experts and assistants. As many as 15 people may be in the operating room during surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The team for TAH surgery includes the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Surgeons who do the operation</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Surgical nurses who assist the surgeons</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Anesthesiologists who are in charge of the medicine that makes you sleep during surgery</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Perfusionists who are in charge of the heart-lung machine that keeps blood flowing through your body while the TAH is put in your chest</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Engineers who are trained to assemble the TAH and make sure it’s working properly</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Before the surgery, you’re given anesthesia to make you sleep. During the surgery, the anesthesiologist checks your heartbeat, blood pressure, oxygen levels, and breathing. A breathing tube is placed in your windpipe through your throat. This tube is connected to a ventilator (a machine that helps you breathe).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A cut is made down the center of your chest. The chest bone is then cut and your ribcage is opened so that the surgeon can get to your heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Medicines are used to stop your heart. This allows the surgeon to operate on your heart while it’s not beating. A heart-lung machine keeps oxygen-rich blood moving through your body.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The surgeons remove your heart’s ventricles and attach the TAH to the upper chambers of your heart. When everything is attached properly, the heart-lung machine is switched off and the TAH starts pumping.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect after Total Artificial Heart Surgery</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Recovery in the Hospital</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Recovery time after total artificial heart (TAH) surgery depends a lot on your condition before the surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you had severe heart failure for a while before getting the TAH, your body may be weak and your lungs may not work very well. Thus, you may still need a ventilator (a machine that helps you breathe) after surgery. You also may need to continue getting nutrition through a feeding tube.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your hospital stay could last a month or longer after TAH surgery. Right after surgery, you’ll be in the hospital’s intensive care unit. An intravenous (IV) line will be inserted into a vein in your arm to give you fluids and nutrition. You’ll also have a tube in your bladder to drain urine.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After a few days or more, depending on how quickly your body re-covers, you’ll move to a regular hospital room. Nurses who have experience with TAHs and similar devices will take care of you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The nurses will help you get out of bed, sit, and walk around. As you get stronger, you’ll be able to go to the bathroom and have a regular diet. The feeding and urine tubes will be removed. You’ll also be able to take a shower. You’ll learn how to do this while taking care of your TAH device.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Nurses and physical therapists will help you gain your strength through a slow increase in activity. You’ll also learn how to care for your TAH device at home.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Having family or friends visit you at the hospital can be very helpful. They can help you with various activities. They also can learn about caring for the TAH device so they can help when you go home.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Going Home</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Activity level</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">: When you go home after TAH surgery, you’ll likely be able to do more activities than you could before. You’ll probably be able to get out of bed, get dressed, and move around the house. You may even be able to drive. Your health care team will advise you on the level of activity that’s right for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Bathing</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">: If you have an AbioCor TAH, you can shower or swim, as long as the device is charged.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you have a Cardio West TAH, you will have tubes connected to a power source outside of your body. The tubes go through an opening in your skin. This opening can let in bacteria and increase your risk for infections.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You will need to take special steps before you bathe to make sure the tubes going through your abdomen don’t get wet. Your health care team will explain how to do this.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-70769545324821988222011-12-23T04:03:00.000-08:002012-02-06T10:35:58.938-08:00Heart Transplants<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-hOIkEnpYleQ/TwgTHrfL_CI/AAAAAAAAACE/DlM5VQm5LGo/s1600/5.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-hOIkEnpYleQ/TwgTHrfL_CI/AAAAAAAAACE/DlM5VQm5LGo/s1600/5.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> A heart transplant is surgery to remove a person’s diseased heart and replace it with a healthy heart from a deceased donor. Ninety percent of heart transplants are done on patients who have end-stage heart failure.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Heart failure is a condition in which the heart is damaged or weakened and can’t pump enough blood to meet the body’s needs. End-stage means the condition has become so severe that all treatments, other than heart transplant, have failed.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overview</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Heart transplants are done as a life-saving measure for end-stage heart failure when medical treatment and less drastic surgery have failed.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> Because donor hearts are in short supply, patients who need a heart transplant go through a careful selection process. They need to be sick enough to need a new heart, yet healthy enough to receive it. Survival rates for people receiving heart transplants have improved over the past 5 to 10 years, especially in the first year after the transplant.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">About 88 percent of patients survive the first year after transplant surgery, and 72 percent survive for 5 years. The 10-year survival rate</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from “Heart Transplant,” by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, October 2009.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">is close to 50 percent, and 16 percent of heart transplant patients survive 20 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After the surgery, most heart transplant recipients (about 90 percent) can come close to resuming their normal lifestyles. However, fewer than 40 percent return to work for many different reasons.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The Heart Transplant Process</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The heart transplant process starts when doctors refer patients who have end-stage heart failure to a heart transplant center for evaluation. Patients found to be eligible for a heart transplant are placed on a waiting list for a donor heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Heart transplant surgery is done in a hospital when a suitable donor heart is found. After the transplant, patients are started on a lifelong health care plan. The plan involves multiple medicines and frequent medical checkups.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When a Heart Transplant Is Needed</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Referral to a Heart Transplant Center</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Most patients referred to a heart transplant center have end-stage heart failure. Of these patients, close to half have heart failure as a result of coronary heart disease (also called coronary artery disease).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Others have heart failure caused by hereditary conditions, viral infections of the heart, or damaged heart valves and muscles. (Some medicines, alcohol, and pregnancy can damage the heart valves and muscles.)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Most patients considered for a heart transplant have tried other, less drastic treatments and have been hospitalized a number of times for heart failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Eligibility for a Heart Transplant</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The heart transplant specialists at the heart transplant center will determine whether a patient is eligible for a transplant. Specialists often include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Cardiologist (a doctor who specializes in diagnosing and treating heart problems)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Cardiovascular surgeon (a doctor who does the transplant surgery)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Transplant coordinator (a person who makes arrangements for the surgery, such as transportation of the donor heart)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Social worker</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Dietitian</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Psychiatrist</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In general, patients selected for heart transplants have severe end-stage heart failure, but are healthy enough to have the transplant. Heart failure is considered end stage when all possible treatments—such as medicine, implanted devices and surgery—have failed. Patients who have the following conditions might not be candidates for heart transplant surgery because the procedure is less likely to be successful.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Advanced age</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Poor blood circulation throughout the body, including the brain</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Kidney, lung, or liver diseases that can’t be reversed</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• History of cancer or malignant tumors</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Inability or unwillingness to follow lifelong medical instructions after a transplant</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Pulmonary hypertension (high blood pressure in the lungs) that can’t be reversed</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Active infection throughout the body</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Although there’s no widely accepted upper age limit for a heart transplant, most transplant surgery is done on patients younger than 70 years old.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect before a Heart Transplant</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The Heart Transplant Waiting List</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Patients who are eligible for a heart transplant are placed on a waiting list for a donor heart. This waiting list is part of a national allocation system for donor organs run by the Organ Procurement and Transplantation Network (OPTN).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">OPTN has policies in place to make sure donor hearts are given out fairly. These policies are based on urgency of need, the organs that are available for transplant, and the location of the patient who is receiving the heart (the recipient). Organs are matched for blood type and size of donor and recipient.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The Donor Heart</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines on how a donor heart is selected require that the donor meet the legal requirement for brain death and that the appropriate consent forms are signed.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines suggest that the donor be younger than 65 years old, have little or no history of heart disease or trauma to the chest, and not be exposed to hepatitis or HIV. The guidelines also recommend that the donor heart not be without blood circulation for more than 4 hours.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Waiting Times</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Approximately 3,000 people in the United States are on the waiting list for a heart transplant on any given day. About 2,000 donor hearts are available each year. Wait times vary from days to several months and will depend on a recipient’s blood type and condition.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A person may be taken off the list for some time if he or she has a serious medical event such as a stroke, infection, or kidney failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Time spent on the waiting list plays a part in who receives a donor heart. For example, if a donor heart becomes available and two recipients have equal need, the recipient who has been waiting longer usually will get the heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Ongoing Medical Treatment</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Patients on the waiting list for a donor heart receive ongoing treatment for heart failure and other medical conditions. Treating arrhythmias (irregular heartbeats), for example, is very important because they can cause sudden cardiac arrest in people who have heart failure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">As a result, many transplant centers will place implantable cardio verter defibrillators (ICDs) in patients before surgery. An ICD is a small device that’s placed in the chest or abdomen to help control life-threatening arrhythmias.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Another treatment that may be recommended to waiting list patients is an implanted mechanical pump called a ventricular assist device (VAD). This device helps the heart pump blood. Regular outpatient care for waiting list patients may include frequent exercise testing, assessing the strength of the heartbeat, and right cardiac catheterization (a test to measure blood pressure in the right side of the heart).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Contact with the Transplant Center during the Wait</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">People on the waiting list often are in close contact with their trans-plant centers. Most donor hearts must be transplanted within 4 hours after removal from the donor.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">At some heart transplant centers, recipients get a pager so the center can contact them at any time. They’re asked to tell the trans-plant center staff if they’re going out of town. Recipients often need to be prepared to arrive at the hospital within 2 hours of being notified about a donor heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Not all patients who are called to the hospital will get a heart trans-plant. Sometimes, at the last minute, doctors find that a donor heart isn’t suitable for a patient. Other times, patients from the waiting list are called to come in as possible substitutes, in case something hap-pens with the selected recipient.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during a Heart Transplant</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Just before the heart transplant surgery, patients will get general anesthesia. The term “anesthesia” refers to a loss of feeling and aware-ness. General anesthesia temporarily puts you to sleep.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A bypass machine is hooked up to the arteries and veins of the heart. The machine pumps blood through the patient’s lungs and body while the diseased heart is removed and the donor heart is sewn into place.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect after a Heart Transplant In the Hospital</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The amount of time a heart transplant recipient spends in the hospital will vary with each person. It often involves 1 to 2 weeks in the hospital and 3 months of monitoring by the transplant team at the heart transplant center.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Monitoring may include frequent blood tests, lung function tests, EKGs (electrocardiograms), echocardiograms, and biopsies of the heart tissue.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A heart biopsy is a standard test used to see whether your body is rejecting the new heart. It might be done often in the weeks after a transplant.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During a heart biopsy, a tiny grabbing device is inserted into a vein in the neck or groin (upper thigh). The device is threaded through the vein to the right atrium of the new heart to take a small tissue sample. The tissue sample is checked for signs of rejection.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">While in the hospital, your health care team may recommend that you start a cardiac rehabilitation (rehab) program. Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems. </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cardiac rehab includes counseling, education, and exercise training to help you recover. Rehab may start with a member of the rehab team helping you sit up in a chair or take a few steps. Over time, you’ll increase your activity level.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Watching for Signs of Rejection</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The new heart is a foreign body that your immune system may attack if you’re not getting enough medicine to suppress your immune system after the surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You and the transplant team will work together to protect the new heart by watching for signs of rejection. These signs include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Shortness of breath</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fever</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fatigue (tiredness)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Weight gain (retaining fluid in the body)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reduced amounts of urine (problems in the kidneys can cause this)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You and the team also will work together to manage the transplant medicines and their side effects, prevent infections, and continue treatment of ongoing medical conditions.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may be asked to check your temperature, blood pressure, and pulse when you go home.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Preventing Rejection</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You’ll need to take medicine to suppress your immune system so that it doesn’t reject the new heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">These transplant medicines are called immunosuppressants. They’re a combination of medicines that are tailored to your situation. Often, they include cyclosporine, tacrolimus, MMF (mycophenolate mofetil), and steroids such as prednisone.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctors may need to change or adjust your transplant medicines if they aren’t working well or if you have too many side effects.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Managing Transplant Medicines and Their Side Effects</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You’ll have to manage multiple medicines. It’s helpful to set up a routine for taking medicines at the same time each day and for refilling prescriptions. It’s crucial to never run out of medicine. Always using the same pharmacy may help.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Keep a list of all your medicines with you at all times in case of an accident. When traveling, keep extra doses of medicine with you, not packed in your luggage. Bring your medicines with you to all doctor visits.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Side effects from medicines can be serious. Side effects include risk of infection, diabetes, osteoporosis (thinning of the bones), high blood pressure, kidney disease, and cancer—especially lymphoma and skin cancer.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Discuss any side effects of the medicines with your transplant team. Your doctors may change or adjust your medicines if you’re having problems. Make sure your doctors know all of the medicines you’re taking.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Preventing Infection</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Some transplant medicines can increase your risk of infection. You may be asked to watch for signs of infection, including fever, sore throat, cold sores, and flu-like symptoms.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Signs of possible chest or lung infections could include shortness of breath, cough, and a change in the color of sputum (spit). The incision (cut) from your surgery must be checked for redness, swelling, or drainage. It’s especially important to look for signs of infection because transplant medicines often can mask these signs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Talk to your doctor about what steps you should take to reduce your risk of infection. For example, your doctor may recommend that you avoid contact with animals or crowds of people in the first few months after your transplant.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Regular dental care also is important. Your doctor may prescribe antibiotics before any dental work to prevent infections.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Pregnancy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Many successful pregnancies have occurred after heart transplant surgeries; however, special care is important. If you’ve had a heart transplant, talk with your doctor before planning a pregnancy.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Emotional Issues and Support</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Having a heart transplant may cause fear, anxiety, and stress. While you’re waiting for a heart transplant, you may worry that you won’t live long enough to get a new heart. After surgery, you may feel overwhelmed, depressed, or worried about complications.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">All of these feelings are normal for someone going through major heart surgery. It’s important to talk about how you feel with your health care team. Talking to a professional counselor also can help. If you’re feeling very depressed, your health care team or counselor may prescribe medicines to make you feel better.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Support from family and friends also can help relieve stress and anxiety. Let your loved ones know how you feel and what they can do to help you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Risks of a Heart Transplant</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Although heart transplant surgery is a life-saving measure, it has many risks. Careful monitoring, treatment, and regular medical care can prevent or help manage some of these risks.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Risks of heart transplant include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Failure of the donor heart</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Complications from medicines</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Infection</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Cancer</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Problems that arise from not following a lifelong health care plan</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Failure of the Donor Heart</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Over time, the new heart may fail due to the same reasons that caused the original heart to fail. Failure of the donor heart also can occur if your body rejects the donor heart or if cardiac allograft vasculopathy (CAV) develops. CAV is a blood vessel disease. Patients who have a heart transplant that fails can be considered for another transplant (called a retrains plant).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Primary Graft Dysfunction</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The most frequent cause of death in the first 30 days after transplant is primary graft dysfunction. This occurs if the new donor heart fails and isn’t able to function.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Factors such as shock or trauma to the donor heart or narrowed blood vessels in the recipient’s lungs can cause primary graft dysfunction. Medicines (for example, inhaled nitric oxide and intravenous nitrates) may be used to treat this condition.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rejection of the Donor Heart</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rejection is one of the leading causes of death in the first year after transplant. The recipient’s immune system sees the new heart as a foreign body and attacks it.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During the first year, 25 percent of heart transplant patients have signs of a possible rejection at least once. Half of all possible rejections happen in the first 6 weeks after surgery, and most happen with-in 6 months of surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cardiac Allograft Vasculopathy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CAV is a chronic (ongoing) disease in which the walls of the coronary arteries in the new heart become thick, hard, and lose their elasticity. CAV can destroy blood circulation in the new heart and cause serious damage.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CAV is a leading cause of donor heart failure and death in the years following transplant surgery. CAV can cause heart attack, heart failure, dangerous arrhythmias, and sudden cardiac arrest. To detect CAV, your doctor may recommend coronary angiography yearly and other tests, such as stress echocardiography or intravascular ultrasound.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Complications from Medicines</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Taking daily medicines that stop the immune system from attacking the new heart is absolutely critical, even though the medicine combinations have serious side effects.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cyclosporine and other medicines can cause kidney damage. Kidney damage affects more than 25 percent of patients in the first year after transplant. Five percent of transplant patients will develop end stage kidney disease within 7 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Infection</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When the immune system—the body’s defense system—is suppressed, the risk of infection increases. Infection is a major cause of hospital admission for heart transplant patients and a leading cause of death in the first year after transplant.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cancer</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Suppressing the immune system leaves patients at risk of cancers and malignancies. Malignancies are a major cause of late death in heart transplant patients, accounting for nearly 25 percent of heart transplant deaths 3 years after transplant.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The most common malignancies are tumors of the skin and lips (patients at highest risk are older, male, and fair-skinned) and malignancies in the lymph system, such as non-Hodgkin lymphoma.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other Complications</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood pressure develops in more than 70 percent of heart transplant patients in the first year after transplant and in nearly 95 percent of patients within 5 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High levels of cholesterol and triglycerides in the blood develop in more than 50 percent of heart transplant patients in the first year after transplant and in 84 percent of patients within 5 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Osteoporosis can develop or worsen in heart transplant patients. This condition thins and weakens the bones.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Complications from Not Following a Lifelong Health Care Plan</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Not following a lifelong health care plan increases the risk of all heart transplant complications. Heart transplant patients are asked to closely follow their doctors’ instructions and check their own health status throughout their lives.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Lifelong health care includes taking multiple medicines on a strict schedule, watching for signs and symptoms of complications, keeping all medical appointments, and stopping unhealthy behaviors (such as smoking).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-79836585405768535722011-12-18T18:20:00.000-08:002012-02-06T10:38:19.677-08:00Carotid Endarterectomy<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-K6_vUQ4EClw/TwgP9jSUtWI/AAAAAAAAAB0/PBRmmqxiKm0/s1600/3.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-K6_vUQ4EClw/TwgP9jSUtWI/AAAAAAAAAB0/PBRmmqxiKm0/s1600/3.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Carotid endarterectomy, or CEA, is surgery to remove plaque from the carotid arteries. These are the two large arteries on each side of your neck. They supply oxygen-rich blood to your brain.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CEA is used to prevent stroke, or “brain attack,” in people who have carotid artery disease. Carotid artery disease occurs when plaque builds up in the carotid arteries.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows the arteries. This limits or blocks the flow of oxygen-rich blood to your brain, which can lead to a stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> A stroke also can occur if the plaque in an artery cracks or ruptures. Blood cells called platelets stick to the site of the injury and may clump together to form blood clots. Blood clots can partly or fully block a carotid artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span></b></div><b style="mso-bidi-font-weight: normal;">Overview</b><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CEA and carotid angioplasty are the two treatments used to reduce blockages in the carotid arteries. CEA can lower the risk of stroke in people who have narrowed or blocked carotid arteries and symptoms suggesting stroke or transient ischemic attack (TIA). During a TIA, or “mini-stroke,” you may have some or all of the symptoms of</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from text by the National Heart, Lung, and Blood Institute (NHLBI,www.nhlbi.nih.gov), part of the National Institutes of Health, February 2009.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">stroke. However, the symptoms usually go away on their own within 24 hours.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CEA also can lower the risk of stroke in people who have severely blocked carotid arteries, even if they don’t have stroke symptoms. Carotid angioplasty is another common treatment for carotid artery disease. For this procedure, a thin tube with a balloon on the end is threaded to the narrowed or blocked artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Once in place, the balloon is inflated to push the plaque outward against the wall of the artery. Usually, the doctor then places a small metal stent in the artery to reduce the risk that it will become blocked again.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Anti platelet medicines also may be used to treat people who have carotid artery disease. These medicines help reduce blood clotting and lower the risk of stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Outlook</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CEA can greatly reduce the risk of stroke in people who have carotid artery disease. The surgery is fairly safe when done by a surgeon who has experience with it. However, serious complications, such as stroke and death, can occur. If you have carotid artery disease, talk to your doctor about whether CEA is an option for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you’ve already had a CEA, you can take steps to lower your risk of future strokes. For example, get ongoing care, treat other conditions (such as high blood pressure and high blood cholesterol), and don’t smoke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other Names for Carotid Endarterectomy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Carotid endarterectomy also is called carotid artery surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When Carotid Endarterectomy Is Needed</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may recommend carotid endarterectomy (CEA) if you have carotid artery disease. CEA can help prevent strokes in people who have this condition.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">CEA is most helpful for people who have carotid artery disease and one or more of the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A prior stroke</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• A prior transient ischemic attack (TIA), or “mini-stroke” • Severely blocked carotid arteries (even if you don’t have stroke symptoms)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect before Carotid Endarterectomy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will talk to you about how to prepare for carotid en darterectomy (CEA). Before CEA, you may have one or more tests to examine your carotid arteries.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">These tests can show whether your arteries are narrowed or blocked, and how severe your condition is.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect during Carotid Endarterectomy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Carotid endarterectomy (CEA) is done in a hospital. The surgery usually takes about 2 hours. You will have anesthesia during the surgery so you don’t feel pain. General anesthesia temporarily puts you to sleep. Local anesthesia numbs only certain areas of your body.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your surgeon may choose to give you local anesthesia so he or she can talk to you during the surgery. This allows the surgeon to check your brain’s reaction to the decrease in blood flow that occurs during the surgery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During CEA, your surgeon will make an incision (cut) in your neck to expose the blocked section of the carotid artery. He or she will put a clamp on your artery to stop blood flow through it.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During the procedure, your brain gets blood from the carotid artery on the other side of your neck. However, your surgeon also may use a tube called a shunt to move blood around the narrowed or blocked carotid artery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Next, your surgeon will make a cut in the blocked part of the artery. To remove the plaque, he or she will remove the inner lining of the artery where the blockage is.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Finally, your surgeon will close the artery with stitches and stop any bleeding. He or she will then close the incision in your neck.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What to Expect after Carotid Endarterectomy</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">After carotid endarterectomy (CEA) surgery, you may stay in the hospital for 1 to 2 days. This allows your doctor to watch for any signs of complications.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If your surgery takes place early in the day and you’re doing well, you may be able to go home the same day.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-40558575098038417552011-12-15T09:30:00.001-08:002012-02-06T10:33:35.993-08:00Getting Back into Your Life after a Heart Attack<b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">How soon can I return to my regular activities?</span></b><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-Et_fUJN7mP0/TwgXj9a0w1I/AAAAAAAAACc/WjPauQbK3vo/s1600/8.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-Et_fUJN7mP0/TwgXj9a0w1I/AAAAAAAAACc/WjPauQbK3vo/s1600/8.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The amount of activity you can do after a heart attack will be based on the condition of your heart. Your doctor will work with you to develop a recovery plan. Most people can return to work and the activities they enjoy within a few months of having a heart attack. Others may have to limit their activity if the heart muscle is very weak.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You will need to start slowly. For the first few days after your heart attack, you may need to rest and let your heart heal. As your heart heals, you’ll be ready to start moving around again. A few days after your heart attack, your doctor may want you to move around more. You may do stretching exercises and get up and walk. You’ll then slowly become more active based on advice from your doctor.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Once you’ve gotten through the early period after a heart attack, your doctor may talk to you about how to be active within your limits. Your doctor will probably want you to do an exercise test, also called a stress test. During this test, your doctor will ask you to exercise (usually walking on a treadmill) while he or she monitors your heart. Based on the results, your doctor will develop an exercise plan for you.</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Reprinted with permission from “Heart Attack: Getting Back Into Your Life</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">After a Heart Attack,” September 2000, Updated April 2008, http://familydoctor</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">.org/online/famdocen/home/common/heartdisease/recovery/002.html. Copyright</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">© 2000 American Academy of Family Physicians. All Rights Reserved.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">How can I improve my recovery plan?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor may recommend that you get involved in a cardiac rehabilitation program. Cardiac rehabilitation programs are super-vised by exercise specialists. Many hospitals sponsor these programs to get people started with a safe level of exercise after a heart attack. After a while, you’ll probably be able to exercise on your own. But if you have any of the symptoms listed below, call your doctor. You may be working too hard.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercise alert! </span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Call your doctor right away if you have any of the<b style="mso-bidi-font-weight: normal;"> </b>following symptoms during exercise:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Shortness of breath for more than about 10 minutes</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Chest pain or pain in your arms, neck, jaw, or stomach</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Dizzy spells</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Pale or splotchy skin</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Very fast heartbeat or an irregular heartbeat</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Cold sweats</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Nausea and vomiting</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Weakness or fainting</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Swelling or pain in your legs</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Why is exercise so important?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Exercise strengthens your heart muscle. It can also boost your energy, help you feel more in control of your health, and help you lose weight and keep it off. Exercise may also lower your blood pressure and reduce your cholesterol level.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What kind of exercise is good?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The best types of exercise are those that involve your whole body, such as walking, cycling, jogging, cross-country skiing, or swimming. Your doctor or rehabilitation therapists may also prescribe activities to increase your strength and flexibility.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Risk factors for another heart attack: Taking charge of the things that put you at risk for another heart attack can help you feel better and reduce your risk of future problems. The following factors can put you at risk for another heart attack:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Not exercising</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Alcohol in excessive amounts</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Being overweight or obese</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• High cholesterol level</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• High blood sugar level if you have diabetes</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• High blood pressure</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Smoking</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Too much stress in your life</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">How often should I exercise?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This depends on your exercise plan. You’ll probably start slowly and gradually add to your routine. Your doctor may want you to exercise three or four times a week for about 10 to 30 minutes at a time. Be sure to warm up before exercising by stretching for 5 minutes or more.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What is a MET?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may hear your doctor talk about METs when he or she discusses your activity level. METs stands for metabolic equivalents. Different activities are given different MET levels depending on how much energy they take to do (see Table 64.1).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The higher the MET level, the more energy the activity takes. Your doctor may ask you not to do things that take more than 3 or 3.5 METs right after your heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What can I do to speed my recovery and stay healthy?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your doctor will probably recommend that you make some changes in your diet, such as cutting back on fat and cholesterol and watching how much salt you eat.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you smoke, you will have to quit. Your doctor may also suggest that you learn better ways to deal with stress, such as time management, relaxation training, and deep breathing.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When can I go back to work?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Most people go back to work within 1 to 3 months after having a heart attack. The amount of time you are off from work depends on the condition of your heart and how strenuous or stressful your work is. You may have to make some changes in how you do your job or you may have to change jobs, at least for a short time, if your job is too hard on your heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What about sex?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You can probably start having sex again in 3 to 4 weeks after your heart attack. As with other types of activity, you may need to start out slowly and work your way back into your normal patterns. Don’t be afraid of sex because of your heart attack. Try different positions if one position seems to make you uncomfortable. Let your partner be on top to reduce the amount of energy you use during sex. Talk with your doctor if you or your partner has any concerns.</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Table 64.1.</span></b></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">MET Activities</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Sitting in a chair 1.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Sweeping the floor 1.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Driving a car 2.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Ironing 3.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Showering 3.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Bowling 3.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Sex 3.7–5.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Golfing 4.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Gardening 4.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Playing tennis 6.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Lawn mowing 6.5</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Shoveling 7.0</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Skiing 8.0</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-3295702171541613302011-12-07T11:29:00.000-08:002012-02-06T10:32:46.164-08:00Post stroke Rehabilitation<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-1h-WsOtwDz8/TwgYfTeXwvI/AAAAAAAAACk/p9CObfV6eTg/s1600/9.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-1h-WsOtwDz8/TwgYfTeXwvI/AAAAAAAAACk/p9CObfV6eTg/s1600/9.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> In the United States more than 700,000 people suffer a stroke each year, and approximately two thirds of these individuals survive and require rehabilitation. The goals of rehabilitation are to help survivors become as independent as possible and to attain the best possible quality of life. Even though rehabilitation does not “cure” stroke in that it does not reverse brain damage, rehabilitation can substantially help people achieve the best possible long-term outcome.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What is post stroke rehabilitation?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rehabilitation helps stroke survivors relearn skills that are lost when part of the brain is damaged. For example, these skills can include coordinating leg movements in order to walk or carrying out the steps involved in any complex activity. Rehabilitation also teaches survivors new ways of performing tasks to circumvent or compensate for any residual disabilities. Patients may need to learn how to bathe and dress using only one hand, or how to communicate effectively when their ability to use language has been compromised. There is a strong consensus among rehabilitation experts that the most important element in any rehabilitation program is carefully directed, well-focused, repetitive practice—the same kind of practice used by all people when</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from “Post-Stroke Rehabilitation Fact Sheet,” by the National Institute of Neurological Disorders and Stroke (NINDS, www.ninds.nih.gov), part of the National Institutes of Health, October 30, 2009. </span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">they learn a new skill, such as playing the piano or pitching a baseball.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rehabilitative therapy begins in the acute-care hospital after the patient’s medical condition has been stabilized, often within 24 to 48 hours after the stroke. The first steps involve promoting independent movement because many patients are paralyzed or seriously weakened. Patients are prompted to change positions frequently while lying in bed and to engage in passive or active range-of-motion exercises to strengthen their stroke-impaired limbs. (Passive range-of-motion exercises are those in which the therapist actively helps the patient move a limb repeatedly, whereas “active” exercises are performed by the patient with no physical assistance from the therapist.) Patients progress from sitting up and transferring between the bed and a chair to standing, bearing their own weight, and walking, with or without assistance. Rehabilitation nurses and therapists help patients perform progressively more complex and demanding tasks, such as bathing, dressing, and using a toilet, and they encourage patients to begin using their stroke-impaired limbs while engaging in those tasks. Beginning to reacquire the ability to carry out these basic activities of daily living represents the first stage in a stroke survivor’s return to functional independence.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For some stroke survivors, rehabilitation will be an ongoing process to maintain and refine skills and could involve working with specialists for months or years after the stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What disabilities can result from a stroke?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The types and degrees of disability that follow a stroke depend upon which area of the brain is damaged. Generally, stroke can cause five types of disabilities: paralysis or problems controlling movement; sensory disturbances including pain; problems using or understanding language; problems with thinking and memory; and emotional disturbances.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Paralysis or problems controlling movement (motor control):</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Paralysis is one of the most common disabilities resulting from stroke. The paralysis is usually on the side of the body opposite the side of the brain damaged by stroke, and may affect the face, an arm, a leg, or the entire side of the body. This one-sided paralysis is called hemiplegia (one-sided weakness is called hemiparesis). Stroke patients with hemiparesis or hemiplegia may have difficulty with everyday activities such as walking or grasping objects. Some stroke patients have problems with swallowing, called dysphagia, due to damage to the part of the brain that controls the muscles for swallowing. Damage to a lower part of the brain, the cerebellum, can affect the body’s ability to coordinate movement, a disability called ataxia, leading to problems with body posture, walking, and balance.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Sensory disturbances including pain:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stroke patients may lose the ability to feel touch, pain, temperature, or position. Sensory deficits may also hinder the ability to recognize objects that patients are holding and can even be severe enough to cause loss of recognition of one’s own limb. Some stroke patients experience pain, numbness, or odd sensations of tingling or prickling in paralyzed or weakened limbs, a condition known as paresthesia.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stroke survivors frequently have a variety of chronic pain syndromes resulting from stroke-induced damage to the nervous system (neuropathic pain). Patients who have a seriously weakened or paralyzed arm commonly experience moderate to severe pain that radiates outward from the shoulder. Most often, the pain results from a joint becoming immobilized due to lack of movement and the tendons and ligaments around the joint become fixed in one position. This is commonly called a frozen joint; passive movement at the joint in a paralyzed limb is essential to prevent painful freezing and to allow easy movement if and when voluntary motor strength returns. In some stroke patients, pathways for sensation in the brain are damaged, causing the transmission of false signals that result in the sensation of pain in a limb or side of the body that has the sensory deficit. The most common of these pain syndromes is called thalamic pain syndrome, which can be difficult to treat even with medications.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The loss of urinary continence is fairly common immediately after a stroke and often results from a combination of sensory and motor deficits. Stroke survivors may lose the ability to sense the need to urinate or the ability to control muscles of the bladder. Some may lack enough mobility to reach a toilet in time. Loss of bowel control or constipation may also occur. Permanent incontinence after a stroke is uncommon. But even a temporary loss of bowel or bladder control can be emotionally difficult for stroke survivors.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Problems using or understanding language (aphasia):</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">At least one-fourth of all stroke survivors experience language impairments, involving the ability to speak, write, and understand spoken and written language. A stroke-induced injury to any of the brain’s language-control centers can severely impair verbal communication.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Damage to a language center located on the dominant side of the brain, known as the Broca area, causes expressive aphasia. People with this type of aphasia have difficulty conveying their thoughts through words or writing. They lose the ability to speak the words they are thinking and to put words together in coherent, grammatically correct sentences. In contrast, damage to a language center located in a rear portion of the brain, called the Wernicke area, results in receptive aphasia. People with this condition have difficulty understanding spoken or written language and often have incoherent speech. Although they can form grammatically correct sentences, their utterances are often devoid of meaning. The most severe form of aphasia, global aphasia, is caused by extensive damage to several areas involved in language function. People with global aphasia lose nearly all their linguistic abilities; they can neither understand language nor use it to convey thought. A less severe form of aphasia, called anomic or amnesic aphasia, occurs when there is only a minimal amount of brain damage; its effects are often quite subtle. People with anomic aphasia may simply selectively forget interrelated groups of words, such as the names of people or particular kinds of objects.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Problems with thinking and memory:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stroke can cause dam-age to parts of the brain responsible for memory, learning, and aware-ness. Stroke survivors may have dramatically shortened attention spans or may experience deficits in short-term memory. Individuals also may lose their ability to make plans, comprehend meaning, learn new tasks, or engage in other complex mental activities. Two fairly common deficits resulting from stroke are anosognosia, an inability to acknowledge the reality of the physical impairments resulting from stroke, and neglect, the loss of the ability to respond to objects or sensory stimuli located on one side of the body, usually the stroke-impaired side. Stroke survivors who develop apraxia lose their ability to plan the steps involved in a complex task and to carry the steps out in the proper sequence. Stroke survivors with apraxia may also have problems following a set of instructions. Apraxia appears to be caused by a disruption of the subtle connections that exist between thought and action.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Emotional disturbances:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Many people who survive a stroke feel fear, anxiety, frustration, anger, sadness, and a sense of grief for their physical and mental losses. These feelings are a natural response to the psychological trauma of stroke. Some emotional disturbances and personality changes are caused by the physical effects of brain damage.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 40.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Clinical depression, which is a sense of hopelessness that disrupts an individual’s ability to function, appears to be the emotional disorder most commonly experienced by stroke survivors. Signs of clinical depression include sleep disturbances, a radical change in eating patterns that may lead to sudden weight loss or gain, lethargy, social withdrawal, irritability, fatigue, self-loathing, and suicidal thoughts. Post-stroke depression can be treated with antidepressant medications and psychological counseling.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com2Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-45777837801070290852011-11-23T07:28:00.000-08:002012-02-06T10:31:28.616-08:00The Future of Cardiovascular Disorder Treatment: Stem Cell Research<div class="separator" style="clear: both; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">American Heart Association (AHA) Policy</span></b><a href="http://1.bp.blogspot.com/-QK3G52xKXlY/TwgZhXU_uxI/AAAAAAAAACs/wBEJfvxkUts/s1600/10.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="http://1.bp.blogspot.com/-QK3G52xKXlY/TwgZhXU_uxI/AAAAAAAAACs/wBEJfvxkUts/s320/10.jpg" width="320" /></a></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The American Heart Association funds meritorious research involving human adult stem cells as part of our scientific research grant program. We do not fund any research involving stem cells derived from human embryos or fetal tissue.</span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The American Heart Association recognizes the value of all types of stem cell research and supports federal funding of this research. We are committed to supporting medical and scientific research to help us pursue our mission of reducing death and disability from cardiovascular diseases and stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">To stay abreast of the benefits and challenges in the area of human stem cell research the American Heart Association Research Committee annually monitors scientific activity in the area and periodically assesses current scientific opinion on the potential impact of embryonic and adult stem cell research on CVD [cardiovascular disease] and stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">What are stem cells, and how can they be used?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stem cells are specialized cells within the body that have the potential to develop into one or many kinds of cells. Stem cells potentially </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 200%;">“Stem Cell Research,” reprinted with permission. © 2009 American Heart Association, Inc. (<a href="http://www.americanheart.org/">www.americanheart.org</a>). </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">could treat or cure many diseases and conditions, including Parkinson’s disease, Alzheimer’s disease, diabetes, certain heart diseases, stroke, arthritis, certain birth defects, osteoporosis, spinal cord injury, and burns.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">There are essentially two types of human stem cells—embryonic and adult. In order for a stem cell to differentiate into a specialized cell type, such as a cardiac or brain cell, the stem cell must achieve a “pluripotent” state. Pluripotent stem cells can potentially develop into any kind of cell in the body and come from three sources:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• fetal tissue from miscarriages and abortions;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• embryos created for in vitriol fertility treatments but not selected for implantation;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• adult cells that have been reprogrammed to embryonic stem cell-like state.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The American Heart Association funds meritorious research involving human adult stem cells.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Adult stem cells are found in a many organs and tissues. An adult stem cell is an undifferentiated cell found among differentiated cells in a tissue or organ, can renew itself, and can differentiate to yield the major specialized cell types of the tissue or organ. The primary roles of adult stem cells in a living organism are to maintain and repair the tissue in which they are found. In their original state they have less ability than embryonic stem cells to differentiate into other types of cells.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Until recently, it was thought that only embryonic stem cells were pluripotent. However, recent research has developed a way to successfully induce adult stem cells into a pluripotent state, which has the potential to create patient-specific cell therapies that could reduce many of the underlying complications seen in therapies with embryonic stem cells.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Even though this new method of inducing adult stem cells could provide an alternative to use of embryonic stem cells, it is still important for research to continue in both cell types. In order to know how induced adult stem cells need to perform, we must know more about the innate function of embryonic stem cells. Therefore, to bring effective and safe stem cell based therapies into reality, research on both cell types continues to be important.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">What is the importance of stem cell research to cardiovascular disease and stroke?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stem cell research offers great promise to treat or cure many diseases and conditions. It could be used to develop dramatic new procedures and techniques to reverse degenerative heart disease. For example, it may help generate new, healthy heart tissue, valves and other vital tissues and structures. About 128 million people suffer from diseases that might be cured or treated through stem cell research. About 58 million of these people suffer from cardiovascular disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">New discoveries in the field also show potential for being able to study the origins of disease, which could lead to new knowledge related to CVD and stroke prevention. Also, the development of cardiac cells from stem cells provides the unique opportunity for researchers to test new drugs on actual human tissue rather than in animals.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-1429067045238893252011-11-18T09:24:00.000-08:002012-02-06T10:29:40.431-08:00(7) Preventing Disease and Regaining Cardiovascular Health<div class="MsoNormal" style="color: black; text-align: justify;"><b style="line-height: 200%;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">The Importance of a Healthy Weight</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-OlGQ39lgZj8/Tw0Dekw4kzI/AAAAAAAAAC0/kY3mXdvmIO4/s1600/1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="132" src="http://2.bp.blogspot.com/-OlGQ39lgZj8/Tw0Dekw4kzI/AAAAAAAAAC0/kY3mXdvmIO4/s200/1.jpg" width="200" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Being overweight or obese increases your risk for many diseases and conditions. The more you weigh, the more likely you are to suffer from heart disease, high blood pressure, diabetes, gallbladder disease, sleep apnea, and certain cancers. On the other hand, a healthy weight has many benefits: It helps you to lower your risk for developing these problems, helps you to feel good about yourself, and gives you more energy to enjoy life.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Risk for Weight-Related Diseases</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Body Mass Index (BMI)</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your BMI accurately estimates your total body fat. And, the amount of fat that you carry is a good indicator of your risk for a variety of diseases.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">There are two ways to check your BMI:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Use a BMI chart. First, find your height in the left-hand column. Then, follow it over until you find your weight. The number on the top of that column is your BMI.</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt;">Excerpted from “Facts About Healthy Weight,” from the Aim for a Healthy Weight Provider Kit, by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, 2006.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Use the BMI calculator on the National Heart, Lung, and Blood Institute’s (NHLBI’s) Web site: <a href="http://www.nhlbisupport.com/bmi">http://www.nhlbisupport.com/bmi</a>. Although BMI can be used for most men and women, it does have some limitations:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It may overestimate body fat in athletes and others who have a muscular build.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• It may underestimate body fat in older persons and others who have lost muscle.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Waist Circumference Measurement</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your waist circumference is also an important measurement to help you figure out your overall health risks. If most of your fat is around your waist, then you are more at risk for heart disease and diabetes. This risk increases with a waist measurement that is greater than 35 inches for women and greater than 40 inches for men.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Other Risk Factors for Heart Disease</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you have other risk factors for heart disease and are overweight or obese, then you will be at greater risk for health problems. Your doctor will check your BMI, waist circumference, and other risk factors for heart disease:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you are overweight (BMI 25–29.9), do not have a high waist circumference, and have less than two risk factors, then it’s important that you not gain any more weight.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you are overweight (BMI 25–29.9) or have a high waist circumference and have two or more risk factors, then it is important for you to lose weight.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you are obese (BMI 30), then it is important for you to lose weight.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Even a small weight loss (just 5–10 percent of your current weight) will help to lower your risk of developing weight-related diseases.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">How to Lose Weight and Maintain It</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Changing the way you approach weight loss can help you be more successful at losing it. Most people who try to lose weight focus on one thing: weight loss. However, if you set goals, begin to eat healthy foods, become more physically active, and learn how to change behaviors, then you may be more successful at losing weight. Over time, these changes will become routine and part of your everyday life.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Weight Loss Goals</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Setting the right goals is an important first step to losing and maintaining weight.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Losing just 5–10 percent of your current weight over 6 months will lower your risk for heart disease and other conditions.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Losing 1–2 pounds per week is a reasonable and safe weight loss. Losing weight at this rate will help you to keep off the weight. And it will give you the time to make new healthy lifestyle changes.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Maintaining a modest weight loss over a longer period of time is better than losing a lot of weight and regaining it. You can think about additional weight loss after you’ve lost 10 percent of your current body weight and have kept it off for 6 months.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Keeping a Balance</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Maintaining a healthy weight calls for keeping a balance . . . a balance of energy. You must balance the calories or energy that you get from food and beverages with the calories that you use to keep your body going and to be physically active.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• The same amount of energy IN and OUT over time = weight stays the same</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• More energy IN than OUT over time = weight gain</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• More energy OUT than IN over time = weight loss</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Your energy IN and OUT doesn’t have to balance exactly every day: Balancing energy over time will help you to maintain a healthy weight in the long run.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Calories</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Cutting back on calories is part of a healthy eating plan to lose weight. Choose foods that are lower in fats, especially saturated and trans fats, cholesterol, and added sugars. Also, pay attention to portion sizes. To lose 1–2 pounds a week, daily intake should be reduced by 500 to 1,000 calories. In general:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Eating plans that contain 1,000–1,200 calories each day will help most women to lose weight safely.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Eating plans that contain 1,200–1,600 calories each day are suitable for men and may also be appropriate for women who weigh 165 pounds or more or who exercise regularly.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you eat 1,600 calories a day but do not lose weight, then you may want to cut back to 1,200 calories. If you are hungry on either diet, then you may want to boost your calories by 100 to 200 per day. Very low calorie diets of less than 800 calories per day should not be used unless you are being monitored by your doctor.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Staying physically active and eating fewer calories will help you lose weight and keep the weight off over time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">How much physical activity should you aim for?</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• For overall health and to reduce the risk of disease, aim for at least 30 minutes of moderate physical activity most days of the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• To help manage body weight and prevent gradual weight gain, aim for 60 minutes of moderate-to-vigorous physical activity most days of the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• To maintain weight loss, aim for at least 60–90 minutes of daily moderate physical activity. </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You can break up the amount of time that you do physical activity, such as 15 minutes at a time. If you haven’t been physically active for some time, then don’t let that stop you. Start slowly and gradually increase your activity. For example, start walking for 10–15 minutes three times a week, then gradually build up to the recommended amount with brisk walking.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Other Weight Loss Options</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Weight loss drugs and weight loss surgery may be options for some people who are at high risk from overweight or obesity or who have been unsuccessful at making lifestyle changes. If you think that you may benefit from weight loss drugs or surgery, then talk to your doctor.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Tips to Weight Loss Success</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Maintaining long-term weight loss can be difficult. Three keys to success are setting realistic goals, following a healthy diet, and aiming for 60–90 minutes of physical activity most days of the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Other tips for weight loss success include the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Set specific, realistic goals that are forgiving (less than perfect). To start, try walking 30 minutes, 3 days a week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Ask for encouragement from your health care provider(s) via telephone or e-mail; friends and family can help. You can also join a support group.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Keep a record of your food intake and the amount of physical activity that you do. This is an easy way to track how you are doing. A record can also inspire you. For example, when it shows that you’ve been more active, you’ll be encouraged to keep it up.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Change your surroundings to avoid overeating. For example, don’t eat while watching television. Plan to meet a friend in a nonfood setting.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Reward your success but not with food. Instead, choose rewards that you’ll enjoy, such as a movie, music CD, an after-noon off from work, a massage, or personal time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-24028116597866082682011-11-15T00:40:00.000-08:002012-02-06T10:26:55.696-08:00Physical Activity and Heart Health<div class="MsoNormal" style="color: lime; text-align: justify;"><b style="line-height: 200%;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-Cue6YhdSPCw/Tw0EN-E9tyI/AAAAAAAAAC8/sfxDOL_5jnY/s1600/1A.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="143" src="http://1.bp.blogspot.com/-Cue6YhdSPCw/Tw0EN-E9tyI/AAAAAAAAAC8/sfxDOL_5jnY/s200/1A.jpg" width="200" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical activity is any body movement that works your muscles and uses more energy than you use when you’re resting. Walking, running, dancing, swimming, yoga, and gardening are examples of physical activity.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 27pt;">According to the Department of Health and Human Services’ “2008 Physical Activity Guidelines for Americans,” physical activity generally refers to bodily movement that enhances health. </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 27pt;">Exercise is a type of physical activity that’s planned and structured. Lifting weights, taking an aerobics class, and playing on a sports team are examples of exercise. </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 27pt;">Physical activity is good for many parts of your body. This text focuses on the benefits of physical activity for your heart and lungs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Types of Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The four main types of physical activity are aerobic, muscle-strengthening, bone-strengthening, and stretching. Aerobic activity is the type that benefits your heart and lungs the most.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 10pt; line-height: 200%;">This chapter contains text excerpted from “Physical Activity,” by the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), part of the National Institutes of Health, May 2009, and from “Physical Activity and Weight Affect Coronary Heart Disease Risk,” by the National Institutes of Health (NIH,www.nih.gov), May 12, 2008.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Aerobic Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Aerobic activity moves your large muscles, such as those in your arms and legs. Running, swimming, walking, bicycling, dancing, and doing jumping jacks are examples of aerobic activity. Aerobic activity also is called endurance activity.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Aerobic activity makes your heart beat faster than usual. You also breathe harder during this type of activity. Over time, regular aerobic activity makes your heart and lungs stronger and able to work better.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Other Types of Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The other types of physical activity—muscle-strengthening, bone-strengthening, and stretching—benefit your body in other ways. Muscle-strengthening activities improve the strength, power, and endurance of your muscles. Doing pushups and sit-ups, lifting weights, climbing stairs, and digging in the garden are examples of muscle-strengthening activities.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">With bone-strengthening activities, your feet, legs, or arms support your body’s weight, and your muscles push against your bones. This helps make your bones strong. Running, walking, jumping rope, and lifting weights are examples of bone-strengthening activities. Muscle-strengthening and bone-strengthening activities also can be aerobic, depending on whether they make your heart and lungs work harder than usual. For example, running is both an aerobic activity and a bone-strengthening activity.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Stretching helps improve your flexibility and your ability to fully move your joints. Touching your toes, doing side stretches, and doing yoga exercises are examples of stretching.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Levels of Intensity in Aerobic Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You can do aerobic activity with light, moderate, or vigorous intensity. Moderate- and vigorous-intensity aerobic activities are better for your heart than light-intensity activities. However, even light-intensity activities are better than no activity at all.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The level of intensity depends on how hard you have to work to do the activity. To do the same activity, people who are less fit usually have to work harder than people who are more fit. So, for example, what is light-intensity activity for one person may be moderate-intensity for another.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Light- and moderate-intensity activities:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Light-intensity activities are common daily activities that don’t require much effort. Moderate-intensity activities make your heart, lungs, and muscles work harder than light-intensity activities do.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">On a scale of 0 to 10, moderate-intensity activity is a 5 or 6 and produces noticeable increases in breathing and heart rate. A person doing moderate-intensity activity can talk but not sing.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Vigorous-intensity activities:</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Vigorous-intensity activities make your heart, lungs, and muscles work hard. On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8. A person doing vigorous-intensity activity can’t say more than a few words without stopping for a breath.</span><br />
<div class="MsoNormal" style="color: black; line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Examples of Aerobic Activities</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Below are examples of aerobic activities. Depending on your level of fitness, they can be light, moderate, or vigorous in intensity:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Pushing a grocery cart around a store</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Gardening, such as digging or hoeing that causes your heart rate to go up</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Walking, hiking, jogging, running</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Water aerobics or swimming laps</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Bicycling, skateboarding, inline skating, and jumping rope</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Ballroom dancing and aerobic dancing</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Tennis, soccer, hockey, and basketball</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Benefits of Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical activity, especially aerobic activity, is good for your heart and lungs in many ways. The benefits of physical activity apply to people of all ages and races and both sexes.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical Activity Strengthens Your Heart and Improves Lung Function</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Moderate- and vigorous-intensity physical activity done regularly strengthens your heart muscle. This improves your heart muscle’s ability to pump blood to your lungs and throughout your body. As a result, more blood flows to your muscles, and oxygen levels in your blood rise. Capillaries, your body’s tiny blood vessels, also widen. This allows them to deliver more oxygen to your body and carry away waste products, such as carbon dioxide and lactic acid.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical Activity Reduces Coronary Heart Disease Risk Factors</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Moderate- and vigorous-intensity aerobic activity done regularly can lower your risk for coronary heart disease (CHD), also called coronary artery disease. CHD is a condition in which a fatty material called plaque builds up inside your coronary arteries. These arteries supply oxygen-rich blood to your heart.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Plaque narrows the coronary arteries and reduces blood flow to the heart. It also makes it more likely that blood clots will form in your arteries. Blood clots can partly or completely block blood flow. This can lead to a heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Certain traits, conditions, or habits may raise your risk for CHD. Physical activity can help control some of these risk factors:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity can lower blood pressure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity helps improve and manage levels of cholesterol and other fats in the blood. Physical activity can lower triglyceride levels. Triglycerides are a type of fat. Physical activity also can raise high-density lipoprotein (HDL), or “good,” cholesterol levels.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity improves your body’s ability to manage blood sugar and insulin levels. This lowers your risk for type 2 diabetes.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity reduces levels of C-reactive protein (CRP) in your body. This protein is a sign of inflammation. High levels of CRP may raise your risk for CHD.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity helps reduce overweight and obesity when combined with reduced calorie intake. Physical activity also helps you maintain a healthy weight over time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Physical activity may help people quit smoking. Smoking is a major risk factor for CHD. Inactive people are nearly twice as likely to develop CHD as people who are physically active. Studies suggest that like high blood cholesterol, high blood pressure, and smoking, inactivity is a major risk factor for CHD.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical Activity Reduces the Risk of Heart Attack</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In people who have CHD, aerobic activity done regularly helps the heart work better. It also may reduce the risk of a second heart at- tack in people who already have had a heart attack. Vigorous aerobic activity may not be safe for people who have CHD. Talk to your doctor about what type of activity is safe for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Risks of Physical Activity</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In general, the benefits of regular physical activity far outweigh risks to the heart and lungs.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Rarely, heart problems, such as arrhythmia, sudden cardiac arrest, or heart attack, occur during physical activity. These events generally happen to people who already have heart conditions. In youth and young adults, the risk for heart problems due to physical activity is higher in people who have underlying congenital heart problems. These are heart problems that have been present since birth. Congenital heart problems include hypertrophic cardiomyopathy, congenital heart defects, and myocarditis (inflammation of the heart muscle). People who have these conditions should talk to their doc-tors about which physical activities are safe for them. In middle-aged and older adults, the risk for heart problems due to physical activity is related to coronary heart disease (CHD). People who already have CHD are more likely to have a heart attack when they’re exercising vigorously than when they’re not.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The risk for heart problems due to physical activity is related to your fitness level and the intensity of the activity you’re doing. For example, someone who doesn’t do physical activity regularly is at higher risk for heart attack during vigorous activity than a person who is physically fit and regularly active.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">If you have a heart problem or chronic (ongoing) disease, such as heart disease, diabetes, or high blood pressure, talk to your doctor about what types of physical activity are safe for you. You also should talk to your doctor about safe physical activities if you have symptoms such as chest pain or dizziness. Discuss ways that you can slowly and safely build physical activity into your daily routine. </span><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></b><br />
<b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Recommendations for Physical Activity</span></b><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The U.S. Department of Health and Human Services (DHHS) has released new physical activity guidelines for all Americans aged 6 and older. The “2008 Physical Activity Guidelines for Americans” explains that regular physical activity improves health. They encourage people to be as active as possible.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The guidelines provide specific recommendations about the types and amounts of physical activity that children, adults, older adults, and other groups should do. The guidelines also provide suggestions for how to fit physical activity into your daily life. The information in this portion of text is based on the new guide-lines from DHHS.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines for Children and Youth For children and youth, the guidelines advise the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• They do 60 minutes or more of physical activity every day. These activities should vary and be a good fit for their age and physical development. Children are naturally active, especially when they’re involved in unstructured play (like recess). Any type of activity counts toward the advised 60 minutes or more.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Most physical activity should be moderate-intensity aerobic activity. Examples include walking, running, skipping, playing on the playground, playing basketball, and biking.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Vigorous-intensity aerobic activity should be included at least 3 days a week. Examples include running, doing jumping jacks, and fast swimming.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Muscle-strengthening activities should be included at least 3 days a week. Examples include climbing trees, playing tug-of war, and doing pushups and pull-ups.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Bone-strengthening activities should be included at least 3 days a week. Examples include hopping, skipping, doing jumping jacks, playing volleyball, and working with resistance bands. Children and youth who have disabilities should work with their doctors to find out what types and amounts of physical activity are safe for them. When possible, these children should meet the recommendations in the guidelines.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Some experts also advise that children and youth reduce screen time because it limits time for physical activity. They recommend that children aged 2 and older should spend no more than 2 hours a day watching television or using a computer (except for school work).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines for Adults</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For adults, the guidelines advise:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Some physical activity is better than none. Inactive adults should gradually increase their level of activity. People gain some health benefits from as little as 60 minutes of moderate intensity aerobic activity per week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• For major health benefits, do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity or 75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity each week. Another option is to do a combination of both. A general rule is that 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• When doing aerobic activity, do it for at least 10 minutes at a time. Spread the activity throughout the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• For more health benefits, do 300 minutes (5 hours) of moderate- intensity aerobic activity or 150 minutes (2 hours and 30 minutes) of vigorous-intensity activity each week (or a combination of both). More physical activity will increase your health benefits.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Muscle-strengthening activities that are moderate or high intensity should be included 2 or more days a week. These activities should work all of the major muscle groups (legs, hips, back, chest, abdomen, shoulders, and arms). Examples include lifting weights, working with resistance bands, doing sit-ups and push- ups, doing yoga, and doing heavy gardening.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines for Older Adults </span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For older adults, the guidelines advise:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• All older adults should avoid inactivity. Older adults who do any amount of physical activity gain some health benefits. If inactive, older adults should gradually increase their activity levels and avoid vigorous activity at first. You should follow the guidelines for adults, if possible.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Older adults should do a variety of activities, including walking. Walking has been shown to provide health benefits and a low risk of injury.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you can’t do 150 minutes (2 hours and 30 minutes) of activity each week, be as physically active as your abilities and condition allow.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• You should do balance exercises if you’re at risk for falls. Examples include walking backward or sideways, standing on one leg, and standing from a sitting position several times in a row. </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you have a chronic (ongoing) condition, such as heart disease, lung disease, or diabetes, talk to your doctor about whether you can do physical activity. Ask your doctor which activities are safe for you.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines for Women during Pregnancy and Soon after Delivery</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For pregnant women and women who have recently given birth, the guidelines advise:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• You should talk to your doctor about safe physical activities to do during pregnancy and after delivery.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you’re healthy but not already very active, do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity each week. If possible, spread this activity across the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you’re already very active, you can continue being active as long as you stay healthy and talk to your doctor about your activity level throughout your pregnancy.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• After the first 3 months of pregnancy, you shouldn’t do exercises that involve lying on your back.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• You shouldn’t do activities in which you might fall or hurt yourself, such as horseback riding, downhill skiing, soccer, and basketball.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Guidelines for Other Groups</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The guidelines also have recommendations for other groups, including people who have disabilities and people who have certain chronic conditions, such as osteoarthritis, diabetes, and cancer.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Physical Activity and Weight Affect Coronary Heart Disease Risk</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Researchers have long known that both physical activity and excess weight affect the risk of coronary heart disease. However, it’s been hard to tease apart how much each contributes. A study found that being physically active can considerably, but not completely, lower the risk of cardiovascular disease associated with being overweight or obese. The research stems from the Women’s Health Study, begun in 1992 by NIH’s National Cancer Institute (NCI) and National Heart, Lung, and Blood Institute (NHLBI). Its original goals were to evaluate the effects of vitamin E and low-dose aspirin on cardiovascular disease and cancer in healthy women. Recognizing the value of the data they were collecting, the researchers extended the study to do more follow- up and evaluate other cardiovascular risk factors.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Dr. Amy Weinstein at the Beth Israel Deaconess Medical Center in Boston and colleagues at Brigham and Women’s Hospital analyzed data collected in the Women’s Health Study on almost 39,000 women who were 45 and older. They compared the participants’ body mass index (BMI—a ratio of weight to height) and physical activity levels at the start of the study with cardiovascular outcomes (such as heart attacks) over an average of 11 years of follow-up. In the April 28, 2008, issue of Archives of Internal Medicine , the researchers reported that the group had 948 cases of coronary heart disease during the follow-up period. The risk of coronary heart dis-ease, they found, increased as BMI increased. Obese women were over twice as likely to have a coronary event as women in the normal weight category.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overall, the women who were physically active were 31% less likely to have coronary heart disease than those who weren’t active. After the researchers adjusted the data to account for other known influences—such as alcohol use, smoking, and diet—the physically active women still had an 18% lower risk of coronary heart disease. In particular, the researchers found that physical activity significantly reduced the risk of coronary heart disease in the overweight and obese women.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .75in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The researchers also looked at the time the women spent walking and found that the more the women walked, the lower their risk for coronary heart disease. The greatest drop, for each weight category, was between those who didn’t walk for exercise or recreation and those who walked 1–1.5 hours per week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 58.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">This study adds to a growing body of evidence showing that physical activity can help you live longer, regardless of whether you have excess weight. A half hour of moderate physical activity every day significantly reduces your risk of chronic disease, and more than 30 minutes further reduces the risk. Although walking and physical activity significantly reduced the risk of coronary heart disease among the overweight and obese women in this study, their risk didn’t drop as low as normal-weight women. Both weight control and physical activity are important for preventing coronary heart disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div></div></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-53749074048135254682011-11-03T00:15:00.000-07:002012-02-06T10:25:59.665-08:00Nutrition and Cardiovascular Health<div class="MsoNormal" style="color: yellow; line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 22pt; line-height: 200%;">What Is Heart-Healthy Eating? </span><br />
<br />
</div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Excerpted from “Heart Healthy Eating,” by the Office of Women’s Health (www.womenshealth.gov), January 1, 2008.</span></div><div class="MsoNormal" style="text-align: justify;"><div style="line-height: 200%;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Why do I need to be concerned about heart healthy eating?</span></b></div><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-zBBXnndpQCo/Tw0EwQV1DXI/AAAAAAAAADE/rVJ_honHk0s/s1600/1B.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-zBBXnndpQCo/Tw0EwQV1DXI/AAAAAAAAADE/rVJ_honHk0s/s1600/1B.jpg" /></a></div><div style="text-indent: 0px;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 27pt;"> What you eat affects your risk for having heart disease and poor blood circulation, which can lead to a heart attack or stroke. Heart disease is the number one killer and stroke is the number three killer of American women and men.</span></div></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In the main type of heart disease, a fatty substance called plaque builds up in the arteries that bring oxygen-rich blood to the heart. Over time, this buildup causes the arteries to narrow and harden. When this happens, the heart does not get all the blood it needs to work properly. The result can be chest pain or a heart attack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Most cases of stroke occur when a blood vessel bringing blood to the brain becomes blocked. The underlying condition for this type of blockage is having fatty deposits lining the vessel walls.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">What foods should I eat to help prevent heart disease and</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">stroke?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You should eat mainly the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fruits and vegetables</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Grains (at least half of your grains should be whole grains, such as whole wheat, whole oats, oatmeal, whole-grain corn, brown rice, wild rice, whole rye, whole-grain barley, buckwheat, bulgur, millet, quinoa, and sorghum)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fat-free or low-fat versions of milk, cheese, yogurt, and other milk products</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Fish, skinless poultry, lean meats, dry beans, eggs, and nuts</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Polyunsaturated and monounsaturated fats (found in fish, nuts, and vegetable oils)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Also, you should limit the amount of foods you eat that contain the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Saturated fat (found in foods such as fatty cuts of meat, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt, butter, lard, cakes, cookies, doughnuts, sausage, regular mayonnaise, coconut, palm oil)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Trans fat (found mainly in processed foods such as cakes, cookies, crackers, pies, stick or hard margarine, potato chips, corn chips)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Cholesterol (found in foods such as liver, chicken and turkey giblets, pork, sausage, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Sodium (found in salt and baking soda) </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Added sugars (such as corn syrup, corn sweetener, fructose, glucose, sucrose, dextrose, lactose, maltose, honey, molasses, raw sugar, invert sugar, malt syrup, syrup, caramel, and fruit juice concentrates)</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Eating lots of saturated fat, trans fat, and cholesterol may cause plaque buildup in your arteries. Eating lots of sodium may cause you to develop high blood pressure, also called hypertension. Eating lots of added sugars may cause you to develop type 2 diabetes. Both hypertension and diabetes increase your risk of heart disease and stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">How can I tell how much saturated fat, trans fat, and</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">other substances are in the foods I eat?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Prepared foods that come in packages—such as breads, cereals, canned and frozen foods, snacks, desserts, and drinks—have a Nutrition Facts label on the package. The label states how many calories and how much saturated fat, trans fat, and other substances are in each serving. For information on how to read a Nutrition Facts label, see the Fitness and Nutrition section of womenshealth.gov.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 22.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For food that does not have a Nutrition Facts label, such as fresh salmon or a raw apple, you can use the U.S. Department of Agriculure (USDA) National Nutrient Database. This is a bit harder than using the Nutrition Facts label. But by comparing different foods you can get an idea if a food is high or low in saturated fat, sodium, and other substances. To compare lots of different foods at one time, check out the Nutrient Lists.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-719813653169733312011-10-29T11:13:00.000-07:002012-02-06T10:25:03.194-08:00Lower Blood Pressure with the DASH Eating Plan<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-IVevWqOfkKE/Tw0HAOy5qHI/AAAAAAAAADc/6tqiAD9VXl4/s1600/1D.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-IVevWqOfkKE/Tw0HAOy5qHI/AAAAAAAAADc/6tqiAD9VXl4/s1600/1D.jpg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 31.5pt;">What you eat affects your chances of developing high blood pressure (hypertension). Research shows that high blood pressure can be prevented—and lowered—by following the Dietary Approaches to Stop Hypertension (DASH) eating plan, which includes eating less salt and sodium.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood pressure, which is blood pressure higher than 140/90 mmHg [millimeters of mercury], affects more than 65 million—or one out of every three—American adults. Another 59 million Americans have prehypertension, which is blood pressure between 120/80 and 140/89 mmHg. This increases their chances of developing high blood pressure and its complications.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"></span><br />
<a name='more'></a><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">High blood pressure is dangerous because it makes your heart work too hard, hardens the walls of your arteries, and can cause the brain to hemorrhage or the kidneys to function poorly or not at all. If not controlled, high blood pressure can lead to heart and kidney disease, stroke, and blindness.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">But high blood pressure can be prevented—and lowered—if you take these steps:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Follow a healthy eating plan, such as DASH, that includes foods lower in salt and sodium.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Maintain a healthy weight.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Be moderately physically active for at least 30 minutes on most days of the week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you drink alcoholic beverages, do so in moderation. If you already have high blood pressure and your doctor has prescribed medicine, take your medicine, as directed, and also follow these steps.</span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 16px; line-height: normal;">Excerpted from “In Brief: Your Guide to Lowering Your Blood Pressure With DASH,” from the National Heart, Lung, and Blood Institute (NHLBI, www.nhlbi.nih.gov), U.S. Department of Health and Human Services, and the National Institutes of Health, June 2007.</span> </div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">The DASH Eating Plan</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The DASH eating plan is rich in fruits, vegetables, fat-free or low- fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. It also contains less salt and sodium; sweets, added sugars, and sugar-containing beverages; fats; and red meats than the typical American diet. This heart healthy way of eating is also lower in saturated fat, trans fat, and cholesterol and rich in nutrients that are as-sociated with lowering blood pressure—mainly potassium, magnesium, and calcium, protein, and fiber.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">How Do I Make the DASH?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The DASH eating plan requires no special foods and has no hard- to-follow recipes. It simply calls for a certain number of daily servings from various food groups.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The number of servings depends on the number of calories you’re allowed each day. Your calorie level depends on your age and, especially, how active you are. Think of this as an energy balance system—if you want to maintain your current weight, you should take in only as many calories as you burn by being physically active. If you need to lose weight, eat fewer calories than you burn or increase your activity level to burn more calories than you eat.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Choose and prepare foods with less salt, and don’t bring the salt shaker to the table. Be creative—try herbs, spices, lemon, lime, vinegar, wine, and salt-free seasoning blends in cooking and at the table. And, because most of the salt, or sodium, that we eat comes from processed foods, be sure to read food labels to check the amount of sodium in different food products. Aim for foods that contain 5 percent or less of the Daily Value of sodium. Foods with 20 percent or more Daily Value of sodium are considered high. These include baked goods, certain cereals, soy sauce, some antacids—the range is wide.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">DASH Tips for Gradual Change</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Make these changes over a couple of days or weeks to give your-self a chance to adjust and make them part of your daily routine:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Add a serving of vegetables at lunch one day and dinner the next, and add fruit at one meal or as a snack.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Increase your use of fat-free and low-fat milk products to three servings a day.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Limit lean meats to 6 ounces a day—3 ounces a meal, which is about the size of a deck of cards. If you usually eat large portions of meats, cut them back over a couple of days—by half or a third at each meal.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Include two or more vegetarian-style, or meatless, meals each week.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Increase servings of vegetables, brown rice, whole wheat pasta, and cooked dry beans. Try casseroles and stir-fry dishes, which have less meat and more vegetables, grains, and dry beans.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• For snacks and desserts, use fruits or other foods low in saturated fat, trans fat, cholesterol, sodium, sugar, and calories—for example, unsalted rice cakes; unsalted nuts or seeds, raisins; graham crackers; fat-free, low-fat, or frozen yogurt; popcorn with no salt or butter added; or raw vegetables.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Use fresh, frozen, or low-sodium canned vegetables and fruits.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">DASH Hints</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Be aware that DASH has more servings of fruits, vegetables, and whole-grain foods than you may be used to eating. These foods are high in fiber and may cause some bloating and diarrhea. To avoid these problems, gradually increase the amount of fruit, vegetables, and whole-grain foods that you eat over several weeks.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you have trouble digesting milk products, try taking lactase-enzyme pills (available at drug stores and groceries) with milk products. Or buy lactose-free milk, which includes the lactase enzyme.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you don’t like or are allergic to nuts, use seeds or legumes (cooked dried beans or peas).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• If you take medicines to control your high blood pressure, keep taking them. But tell your doctor that you are now eating the DASH way.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-22297461383610932042011-10-21T00:14:00.000-07:002012-02-06T10:23:34.909-08:00What is a calorie?<div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">What is a calorie?</span></b><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-Ih5GCpxoLWc/Tw0Fg-haU4I/AAAAAAAAADM/LAmEeeAt-5w/s1600/1CC.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="color: black;"><img border="0" src="http://4.bp.blogspot.com/-Ih5GCpxoLWc/Tw0Fg-haU4I/AAAAAAAAADM/LAmEeeAt-5w/s1600/1CC.jpg" /></span></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 31.5pt;">When talking about a calorie in food, it is a measure of the energy that the food supplies to your body. When talking about burning calories during physical activity, a calorie is a measure of the energy used by your body. To maintain the same body weight, the number of food calories you eat during the day should be about the same as the number of calories your body uses.</span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 31.5pt;">The number of calories you should eat each day depends on your age, sex, body size, how physically active you are, and other conditions. For instance, a woman between the ages of 31 and 50 who is of normal weight and moderately active should eat about 2,000 calories each day.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">I’ve heard that eating fish is good for my heart. Why is</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">that?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Fish and shellfish contain a type of fat called omega-3 fatty acids. Research suggests that eating omega-3 fatty acids lowers your chances of dying from heart disease. Fish that naturally contain more oil (such as salmon, trout, herring, mackerel, anchovies, and sardines) have more omega-3 fatty acids than lean fish (such as cod, haddock, and catfish). Be careful, though, about eating too much shellfish. Shrimp is a type of shellfish that has a lot of cholesterol.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You can also get omega-3 fatty acids from plant sources, such as</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Canola oil</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Soybean oil</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Walnuts</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Ground flaxseed (linseed) and flaxseed oil</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Is drinking alcohol bad for my heart?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Drinking too much alcohol can, over time, damage your heart and raise your blood pressure. If you drink alcohol, you should do so moderately. For women, moderate drinking means one drink per day. For men, it means two drinks per day. One drink counts as:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 5 ounces of wine;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 12 ounces of beer; or</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 1.5 ounces of 80-proof hard liquor.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Research suggests that moderate drinkers are less likely to develop heart disease than people who don’t drink any alcohol or who drink too much. Red wine drinkers in particular seem to be protected to some degree against heart disease. Red wine contains flavonoids, which are thought to prevent plaque buildup. Flavonoids also are found in the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Red grapes</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Berries</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Apples</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Broccoli</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">On the other hand, drinking more than one drink per day increases the risks of certain cancers, including breast cancer. And if you are pregnant, could become pregnant, or have another health condition that could make alcohol use harmful, you should not drink.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 31.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">With the help of your doctor, decide whether moderate drinking to lower heart attack risk outweighs the possible increased risk of breast cancer or other medical problems.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">I need help working out an eating plan that’s right for me.</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Who can I ask for help?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">You may want to talk with a registered dietitian. A dietitian is a nutrition expert who can give you advice about what foods to eat and how much of each type. Ask your doctor to recommend a dietitian. You also can contact the American Dietetic Association.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 14pt; line-height: 200%;">Besides eating healthy foods, what else can I do to keep my heart healthy?</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">To reduce your risk of heart disease, try the following:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Quit smoking—talk with your doctor or nurse if you need help quitting.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Get at least 2 hours and 30 minutes of moderate aerobic physical activity each week. For more information on physical activity, see the Fitness and Nutrition section of womenshealth.gov.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Lose weight if you are overweight, and keep a healthy weight.</span></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;">• Get your blood pressure, cholesterol, and blood sugar levels checked regularly.</span>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-78466058073355209342011-10-15T00:12:00.000-07:002012-02-06T10:22:10.897-08:00Other Lifestyle Changes<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 27pt;">Making other lifestyle changes while following the DASH eating plan is the best way to prevent and control high blood pressure.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Lose Weight, If Necessary, while Following DASH</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-qKBvYkvTXPs/Tw0Hsg0QvvI/AAAAAAAAADk/3aC_2__WbDk/s1600/1E.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-qKBvYkvTXPs/Tw0Hsg0QvvI/AAAAAAAAADk/3aC_2__WbDk/s1600/1E.jpg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">DASH is rich in lower calorie foods, such as fruits and vegetables, so it can easily be changed to support weight loss. You can reduce calories even more by replacing higher calorie foods, such as sweets, with more fruits and vegetables.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The best way to take off pounds is to do it slowly, over time, by getting more physical activity and eating fewer calories. To develop a weight-loss or weight-maintenance program that’s tailored for you, talk to your doctor or registered dietitian.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Be Physically Active while Following the DASH Eating Plan</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 27.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Combining DASH with a regular physical activity program, such as walking or swimming, will help you shed pounds and stay trim for the long term. Start with a simple 15-minute walk during your favorite time of day and gradually increase the amount of time you are active. You can do an activity for 30 minutes at one time, or choose shorter periods of at least 10 minutes each. The important thing is to total about 30 minutes of moderate activity on most days. To avoid weight gain or sustain weight loss, try for 60 minutes of moderate-to-vigorous activity each day.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Make the DASH for Life</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">DASH can help you prevent and control high blood pressure. It can also help you lose weight, if you need to. It meets your nutritional needs and has other health benefits for your heart. So get started to-day and make the DASH for a healthy life.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-21537416313906835572011-10-05T21:41:00.000-07:002012-02-06T10:21:12.759-08:00Dietary Supplements and Cardiovascular Health<div class="MsoNormal" style="color: orange; line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 26pt; line-height: 200%;">Omega-3 Fatty Acids</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt; line-height: 200%;">“Fish and Omega-3 Fatty Acids,” reprinted with permission.© 2009 American Heart Association, Inc. (www.americanheart.org).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 18pt; line-height: 200%;">American Heart Association (AHA) Recommendation</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-DU3SolDWJmM/Tw0IVId-JpI/AAAAAAAAADs/-W1SFp7_jDg/s1600/1F.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-DU3SolDWJmM/Tw0IVId-JpI/AAAAAAAAADs/-W1SFp7_jDg/s1600/1F.jpg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of—or who have—cardiovascular disease. We recommend eating fish (particularly fatty fish) at least two times a week. Fish is a good source of protein and doesn’t have the high saturated fat that fatty meat products do. Fatty fish like mackerel, lake trout, herring, sardines, albacore tuna, and salmon are high in two kinds of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). To learn about omega-3 levels for different types of fish—as well as mercury levels, which can be a concern—see our Encyclopedia en- try on Fish, Levels of MercuryandOmega3FattyAcids[http://www.americanheart.org/presenter.jhtml?identifier=3013797]. We also recommend eating tofu and other forms of soybeans, canola, walnut and flaxseed, and their oils. These contain alpha-linolenic acid (LNA), which can become omega-3 fatty acid in the body. The extent of this modification is modest and controversial, however. More studies are needed to show a cause-and-effect relationship between alpha linolenic acid and heart disease. Table 70.1 is a good guide to use for consuming omega-3 fatty acids. Patients taking more than 3 g of omega-3 fatty acids from capsules should do so only under a physician’s care. High intakes could cause excessive bleeding in some people.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">Background</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In 2002, the American Heart Association released a scientific statement, “Fish Consumption, Fish Oil, Omega-3 Fatty Acids and Cardio-vascular Disease,” on the effects of omega-3 fatty acids on heart function (including antiarrhythmic effects), hemodynamics (cardiac mechanics),</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">Dietary Supplements and Cardiovascular Health</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">and arterial endothelial function. The link between omega-3 fatty ac ids and CVD risk reduction are still being studied, but research has shown that omega-3 fatty acids:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• decrease risk of arrhythmias, which can lead to sudden cardiac death;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• decrease triglyceride levels;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• decrease growth rate of atherosclerotic plaque;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• lower blood pressure (slightly).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">What do epidemiological and observational studies show? Epidemiologic and clinical trials have shown that omega-3 fatty acids re-duce CVD incidence. Large-scale epidemiologic studies suggest that people at risk for coronary heart disease benefit from consuming omega-3 fatty acids from plants and marine sources. The ideal amount to take isn’t clear. Evidence from prospective secondary prevention studies suggests that taking EPA+DHA ranging from 0.5 to 1.8 g per day (either as fatty fish or supplements) significantly reduces deaths from heart disease and all causes. For alpha-linolenic acid, a total intake of 1.5–3 g per day seems beneficial. Randomized clinical trials have shown that omega-3 fatty acid supplements can reduce cardiovascular events (death, nonfatal heart attacks, nonfatal strokes). They can also slow the progression of atherosclerosis in coronary patients. However, more studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for preventing a first or subsequent cardiovascular event.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Table 70.1.</span></b><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> Summary of Recommendations for Omega-3 Fatty Acid Intake</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Population Recommendation</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Patients without documented Eat a variety of (preferably fatty) fish at</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">coronary heart disease (CHD) least twice a week. Include oils and foods rich</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: 184.5pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> in alpha-linolenic acid (flaxseed, canola and</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: 184.5pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> soybean oils, flaxseed, and walnuts).</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Patients with documented CHD Consume about 1 g of EPA+DHA per day,</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: 184.5pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> preferably from fatty fish. EPA+DHA in capsule</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: 184.5pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> form could be considered in consultation with</span></div><div class="MsoNormal" style="line-height: normal; tab-stops: 184.5pt; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;"> the physician.</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">Patients who need to lower 2 to 4 g of EPA+DHA per day provided as</span></div><div class="MsoNormal" style="line-height: normal; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 9pt;">triglycerides capsules under a physician’s care.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">Cardiovascular Disorders Sourcebook, Fourth Edition</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">For example, placebo-controlled, double-blind, randomized clinical trials are needed to document the safety and efficacy of omega-3 fatty acid supplements in high-risk patients (those with type 2 diabetes, dyslipidemia, hypertension, and smokers) and coronary patients on drug therapy. Mechanistic studies on their apparent effects on sudden death also are needed. Increasing omega-3 fatty acid intake through foods is preferable. However, coronary artery disease patients may not be able to get enough omega-3 by diet alone. These people may want to talk to their doctor about taking a supplement. Supplements also could help people with high triglycerides, who need even larger doses. The availability of high quality omega-3 fatty acid supplements, free of contaminants, is an important prerequisite to their use.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-27739732043727841962011-09-28T22:40:00.000-07:002012-02-06T10:20:07.364-08:00Cardiovascular Benefits of Fish Oil Canceled by High-Fat Diet<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-FNu5at8NNn0/Tw7DN1yPgII/AAAAAAAAAD0/66wP6jO7CLM/s1600/1.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-FNu5at8NNn0/Tw7DN1yPgII/AAAAAAAAAD0/66wP6jO7CLM/s1600/1.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 9pt; line-height: 200%;"></span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Study highlights:</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• In an animal study of heart failure, fish oil supplementation was helpful to animals on a low-fat diet, but not to those on a high-fat diet.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• Researchers think that a high-fat diet may block the heart cells’ ability to absorb the omega-3 fatty acids in fish oil. </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Fish oil (EPA & DHA [eicosapentaenoic acid and docosahexaenoic acid]) supplementation helped the heart when paired with a low-fat diet, but not when added to a high saturated-fat diet fed to rats with heart failure, according to a [July 2009] study in Hypertension: Journal of the American Heart Association</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Dietary Supplements and Cardiovascular Health</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">A group of six researchers from different institutions, led by William C. Stanley, PhD, from the University of Maryland-Baltimore, hypothesized that when the heart is stressed, such as in heart failure, a high-fat diet may block the heart cells’ ability to absorb the heart- healthy omega-3 polyunsaturated fatty acids (PUFAs) found in fish oil.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The investigators found that heart size—measured by left ventricular mass (LV mass)—increased in rats fed low- and high saturated-fat diets without fish oil by 40 percent and 42 percent respectively. On a low-fat plus fish oil diet, LV mass increased just 4 percent, while the group fed high saturated-fat diet with fish oil saw a 36 percent LV mass increase.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The scientists also found that certain genes associated with heart failure did not get “switched on” in the group fed a low-fat diet supplemented with fish oil.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The researchers conclude, “This suggests that in order to maximize the benefit from fish oil supplementation, patients at risk for heart failure should not consume a high saturated fat diet.”</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">As part of an overall healthy diet, the American Heart Association recommends limiting saturated fat in the diet to 7 percent or less of calories and consuming fish, especially oily fish, two times per week. Author disclosures are on the manuscript. The National Institutes of Health funded the study.</span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 9pt; line-height: 200%;">“Benefits of fish oil cancelled by high-fat diet in lab study of heart failure,” reprinted with permission. © 2009 American Heart Association, Inc. (www.americanheart.org).</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-13050640493194190042011-09-22T23:40:00.000-07:002012-02-06T10:18:30.834-08:00Garlic and Cholesterol<span style="font-family: 'Times New Roman', serif; font-size: 9pt; line-height: 200%;">From “Garlic for LDL Cholesterol,” National Center for Complementary and Alternative Medicine (NCCAM, www.nccam.nih.gov), part of the National Institutes of Health, 2007.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-BYueSEF_XKA/Tw7D3PljonI/AAAAAAAAAD8/Of-G3n1d3Bw/s1600/2.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-BYueSEF_XKA/Tw7D3PljonI/AAAAAAAAAD8/Of-G3n1d3Bw/s1600/2.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">LDL (low-density lipoprotein) cholesterol is widely known as “bad cholesterol” and is believed to be a leading contributor to heart dis-ease. This 2007 study’s results cast doubt on garlic’s effectiveness in lowering LDL cholesterol levels in adults with moderately high cholesterol.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Dr. Gardner and his team conducted a randomized, placebo-controlled trial studying whether three different formulations of garlic could lower LDL cholesterol. The study participants were randomly divided into four groups to receive either raw garlic, a powdered garlic supplement, an aged extract supplement, or a placebo.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The 169 participants who completed the study had their cholesterol levels checked monthly during the 6-month trial. None of the formulations of garlic had a statistically significant effect on the LDL cholesterol levels. The authors caution that their results should not be generalized for all populations or all health effects. An accompanying editorial in the Archives of Internal Medicine points out that LDL cholesterol levels are only one factor contributing to heart dis-ease and that this trial did not investigate garlic’s effects on other risk factors, such as high blood pressure. Gardner CD, Lawson LD, Block E, et al. Effect of raw garlic vs. commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Archives of Internal Medicine.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">2007;167(4):346–353.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-16188894563795021152011-09-13T23:38:00.000-07:002012-02-06T10:17:25.798-08:00Vitamin D and Heart Disease<span style="font-family: 'Times New Roman', serif; font-size: 9pt;">“Lack of vitamin D may increase heart disease risk,” reprinted with permission. © 2009 American Heart Association, Inc. (www.americanheart.org).</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span><br />
<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-wKZBTZFGzVU/Tw7EpOyjQKI/AAAAAAAAAEE/PfBGlxoW8EE/s1600/3.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-wKZBTZFGzVU/Tw7EpOyjQKI/AAAAAAAAAEE/PfBGlxoW8EE/s1600/3.jpeg" /></a></div><div style="text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The same vitamin D deficiency that can result in weak bones now has been associated with an increased risk of cardiovascular disease, Framing ham Heart Study researchers report in Circulation: Journal of the American Heart Association [2008].</span></div><div style="text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">“Vitamin D deficiency is associated with increased cardiovascular risk, above and beyond established cardiovascular risk factors,” said Thomas J. Wang, MD, assistant professor of medicine at Harvard Medical School in Boston, Massachusetts. “The higher risk associated with vitamin D deficiency was particularly evident among individuals with high blood pressure.”</span></div></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In a study of 1,739 offspring from Framingham Heart Study participants (average age 59, all Caucasian), researchers found that those with blood levels of vitamin D below 15 nanograms per milliliter (ng/mL) had twice the risk of a cardiovascular event such as a heart attack, heart failure, or stroke in the next 5 years compared to those with higher levels of vitamin D.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">When researchers adjusted for traditional cardiovascular risk factors such as high cholesterol, diabetes, and high blood pressure, the risk remained significant with a 62 percent higher risk of a cardiovascular event in participants with low levels of vitamin D compared to those with higher levels.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Researchers observed the highest rate of cardiovascular disease events in subset analyses dividing 688 participants according to high blood pressure status. After researchers adjusted for conventional cardiovascular risk factors, participants with hypertension and a vitamin D deficiency had about two times the risk of having a cardio-vascular disease event in 5 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Researchers also found an increase in cardiovascular risk with each level of vitamin D deficiency. “We found that people with low vitamin D levels had a higher rate of cardiovascular events over the 5-year follow-up period,” Wang said.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> “These results are intriguing and suggestive but need to be followed up with further study.”</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Study participants had no prior cardiovascular disease and were tested for vitamin D status and then followed for an average of 5.4 years.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The participants attended the offspring examinations between 1996 and 2001. Researchers obtained medical history, physical examinations and laboratory assessments of vascular risk factors. They also obtained medical records related to cardiovascular disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Overall, 28 percent of individuals had levels of vitamin D below 15 ng/mL and 9 percent had levels below 10 ng/mL. Although levels above 30 ng/mL are considered optimal for bone metabolism, only 10 percent of the study sample had levels in this range, researchers said.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During follow-up:</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 120 participants developed a first cardiovascular event including fatal and nonfatal coronary heart disease;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 28 participants had fatal or nonfatal cerebrovascular events such as non hemorrhagic stroke;</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 19 participants were diagnosed with heart failure; and</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">• 8 had occurrences of claudication, fatigue in the legs during activity.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">“Low levels of vitamin D are highly prevalent in the United States, especially in areas without much sunshine,” Wang said. “Twenty to 30 percent of the population in many areas has moderate to severe vitamin D deficiency.”</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Most of this is attributed to lack of sun exposure, pigmented skin that prevents penetration of the sun’s rays, and inadequate dietary intake of vitamin D enriched foods, researchers said.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">“A growing body of evidence suggests that low levels of vitamin D may adversely affect the cardiovascular system,” Wang said. “Vitamin D receptors have a broad tissue distribution that includes vascular smooth muscle and endothelium, the inner lining of the body’s vessels. Our data raise the possibility that treating vitamin D deficiency via supplementation or lifestyle measures could reduce cardiovascular risk.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">“What hasn’t been proven yet is that vitamin D deficiency actually causes increased risk of cardiovascular disease. This would re-quire a large randomized trial to show whether correcting the vitamin D deficiency would result in a reduction in cardiovascular risk.”</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Therefore, Wang doesn’t recommend physicians check for vitamin D deficiency or that those with a known vitamin D deficiency be treated to prevent heart disease at this time.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">During the past decade, researchers have studied several other vitamins that initially showed promise in reducing heart disease. But the vitamins didn’t reduce heart disease in subsequent large randomized trials.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">“On the flip side, just because other vitamins haven’t succeeded doesn’t preclude the possibility of finding vitamins that might pre-vent cardiovascular disease,” Wang said. “This is always an area of great interest. Vitamins are easy to administer and in general have</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">few toxic effects.”</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The American Heart Association recommends that healthy people get adequate nutrients by eating a variety of foods in moderation, rather than by taking supplements. Food sources of vitamin D include milk, salmon, mackerel, sardines, cod liver oil, and some fortified cereals. Vitamin or mineral supplements aren’t a substitute for a balanced, nutritious diet that limits excess calories, saturated fat, trans fat, sodium, and dietary cholesterol. This dietary approach has been shown to reduce coronary heart disease risk in healthy people and</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">those with coronary disease.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Co-authors are: Michael J. Pencina, PhD; Sarah L. Booth, PhD; Paul F. Jacques, DSc; Erik Ingelsson, MD, PhD; Katherine Lanier, BS; Emelia J. Benjamin, MD; Ralph B. D’Agostino, PhD; Myles Wolf, MD; and Ramachandran S. Vasan, MD.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The National Institute of Health, U.S. Department of Agriculture, and American Heart Association funded the study.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 49.5pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Statements and conclusions of study authors that are published in the American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-69620219860157788192011-09-06T23:37:00.000-07:002012-02-06T10:16:16.819-08:00Vitamin E 70.5<span style="font-family: 'Times New Roman', serif; font-size: 9pt; line-height: 200%;">Excerpted from “Vitamin E Fact Sheet,” by the Office of Dietary Supplements (ODS, ods.od.nih.gov), part of the National Institutes of Health, May 4, 2009.</span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-6RREZVIGhcM/Tw7FZWp_sqI/AAAAAAAAAEM/2h8r_YAfVLk/s1600/4.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-6RREZVIGhcM/Tw7FZWp_sqI/AAAAAAAAAEM/2h8r_YAfVLk/s1600/4.jpeg" /></a></div><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Vitamin E is found naturally in some foods, added to others, and available as a dietary supplement. Vitamin E is the collective name for a group of fat-soluble compounds with distinctive antioxidant activities.</span><br />
<span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Antioxidants protect cells from the damaging effects of free radicals, which are molecules that contain an unshared electron. Free radicals damage cells and might contribute to the development of cardiovascular disease and cancer. Unshared electrons are highly energetic and react rapidly with oxygen to form reactive oxygen species (ROS). The body forms ROS endogenously when it converts food to energy, and antioxidants might protect cells from the damaging effects of ROS. The body is also exposed to free radicals from environmental exposures, such as cigarette smoke, air pollution, and ultraviolet radiation from the sun. ROS are part of signaling mechanisms among cells.</span><br />
<div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Vitamin E is a fat-soluble antioxidant that stops the production of ROS formed when fat undergoes oxidation. Scientists are investigating whether, by limiting free-radical production and possibly through other mechanisms, vitamin E might help prevent or delay the chronic diseases associated with free radicals.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In addition to its activities as an antioxidant, vitamin E is involved in immune function and, as shown primarily by in vitro studies of cells, cell signaling, regulation of gene expression, and other metabolic processes. Vitamin E inhibits the activity of protein kinase C, an enzyme involved in cell proliferation and differentiation in smooth muscle cells, platelets, and monocytes. Vitamin-E–replete endothelial cells lining the interior surface of blood vessels are better able to resist blood-cell components adhering to this surface. Vitamin E also increases the expression of two enzymes that suppress arachidonic acid metabolism, thereby increasing the release of prostacyclin from the endothelium, which, in turn, dilates blood vessels and inhibits platelet aggregation.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><br />
</div><div class="MsoNormal" style="line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;"></span></b><br />
<a name='more'></a><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">Vitamin E and Coronary Heart Disease</span></b></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Evidence that vitamin E could help prevent or delay coronary heart disease (CHD) comes from several sources. In vitro studies have found that the nutrient inhibits oxidation of low-density lipoprotein (LDL) cholesterol, thought to be a crucial initiating step for atherosclerosis. Vitamin E might also help prevent the formation of blood clots that could lead to a heart attack or venous thromboembolism.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Several observational studies have associated lower rates of heart disease with higher vitamin E intakes. One study of approximately 90,000 nurses found that the incidence of heart disease was 30% to 40% lower in those with the highest intakes of vitamin E, primarily from supplements. Among a group of 5,133 Finnish men and women followed for a mean of 14 years, higher vitamin E intakes from food were associated with decreased mortality from CHD.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">However, randomized clinical trials cast doubt on the efficacy of vitamin E supplements to prevent CHD. For example, the Heart Out-comes Prevention Evaluation (HOPE) study, which followed almost 10,000 patients at high risk of heart attack or stroke for 4.5 years, found that participants taking 400 IU [international units]/day of natural vitamin E experienced no fewer cardiovascular events or hospitalizations for heart failure or chest pain than participants taking a placebo. In the HOPE-TOO followup study, almost 4,000 of the original participants continued to take vitamin E or placebo for an additional 2.5 years. HOPE-TOO found that vitamin E provided no significant protection against heart attacks, strokes, unstable angina, or deaths from cardiovascular disease or other causes after 7 years of treatment. Participants taking vitamin E, however, were 13% more likely to experience, and 21% more likely to be hospitalized for, heart failure, a statistically significant but unexpected finding not reported in other large studies.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The HOPE and HOPE-TOO trials provide compelling evidence that moderately high doses of vitamin E supplements do not reduce the risk of serious cardiovascular events among men and women over 50 years of age with established heart disease or diabetes. These findings are supported by evidence from the Women’s Angiographic Vita-min and Estrogen study, in which 423 postmenopausal women with some degree of coronary stenosis took supplements with 400 IU vitamin E (type not specified) and 500 mg vitamin C twice a day or placebo for more than 4 years. Not only did the supplements provide no cardiovascular benefits, but all-cause mortality was significantly higher in the women taking the supplements.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The latest published clinical trial of vitamin E’s effects on the heart and blood vessels of women included almost 40,000 healthy women 45 years of age and older who were randomly assigned to receive either 600 IU of natural vitamin E on alternate days or placebo and who were followed for an average of 10 years. The investigators found no significant differences in rates of overall cardiovascular events (combined nonfatal heart attacks, strokes, and cardiovascular deaths) or all-cause mortality between the groups. However, the study did find two positive and significant results for women taking vitamin E: They had a 24% reduction in cardiovascular death rates, and those 65 years of age or older had a 26% decrease in nonfatal heart attack and a 49% decrease in cardiovascular death rates.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">The most recent published clinical trial of vitamin E and men’s cardiovascular health included almost 15,000 healthy physicians 50 years of age or older who were randomly assigned to receive 400 IU synthetic alpha-tocopherol [vitamin E] every other day, 500 mg vitamin C daily, both vitamins, or placebo. During a mean followup period of 8 years, intake of vitamin E (and/or vitamin C) had no effect on the incidence of major cardiovascular events, myocardial infarction, stroke, or cardiovascular morality. Furthermore, use of vitamin E was associated with a significantly increased risk of hemorrhagic stroke.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">In general, clinical trials have not provided evidence that routine use of vitamin E supplements prevents cardiovascular disease or reduces its morbidity and mortality. However, participants in these studies have been largely middle-aged or elderly individuals with demonstrated heart disease or risk factors for heart disease. Some researchers have suggested that understanding the potential utility of vitamin E in preventing CHD might require longer studies in younger participants taking higher doses of the supplement.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: 45.0pt;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Further research is needed to determine whether supplemental vitamin E has any protective value for younger, healthier people at no obvious risk of CHD.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014tag:blogger.com,1999:blog-4901702274937124068.post-854664470911636732011-08-30T23:36:00.000-07:002012-02-06T10:13:51.299-08:00Quitting Smoking: Why to Quit and How to Get Help<div class="MsoNormal" style="color: orange; line-height: 200%; text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Times New Roman', serif; font-size: 16pt; line-height: 200%;">What health problems are caused by smoking?</span></b><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;"> </span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-9rCvqeWju7U/Tw7GEtE4nnI/AAAAAAAAAEU/phwgXVvLsY8/s1600/5.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-9rCvqeWju7U/Tw7GEtE4nnI/AAAAAAAAAEU/phwgXVvLsY8/s1600/5.jpeg" /></a></div><div style="color: black;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Smoking harms nearly every organ of the body and diminishes a person’s overall health. Smoking is a leading cause of cancer and of death from cancer. It causes cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia.</span></div></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Smoking also causes heart disease, stroke, lung disease (chronic bronchitis and emphysema), hip fractures, and cataracts. Smokers are at higher risk of developing pneumonia and other airway infections. A pregnant smoker is at higher risk of having her baby born too early and with an abnormally low weight. A woman who smokes during or after pregnancy increases her infant’s risk of death from sudden infant death syndrome (SIDS).</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Millions of Americans have health problems caused by smoking. Cigarette smoking and exposure to tobacco smoke cause an estimated average of 438,000 premature deaths each year in the United States. Of these premature deaths, about 40 percent are from cancer, 35 percent are from heart disease and stroke, and 25 percent are from lung disease. Smoking is the leading cause of premature, preventable death in this country.</span></div><div class="MsoNormal" style="line-height: 200%; text-align: justify; text-indent: .5in;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%;">Regardless of their age, smokers can substantially reduce their risk of disease, including cancer, by quitting. Excerpted from text by the National Cancer Institute (NCI, <a href="http://www.cancer.gov/">www.cancer.gov</a>), part of the National Institutes of Health, August 17, 2007.</span></div>dewi Yuniantihttp://www.blogger.com/profile/16563517681908489605noreply@blogger.com0Amerika Serikat37.09024 -95.71289100000001310.850828 -156.01284500000003 63.329652 -35.412937000000014