THIS IS A TEMPORARY POST .
MAKING A COMMENT IN THE COMMENT COLUMN IS IMPOSSIBLE - AS IT WILL BE TOO LONG .
THE PREVIOUS POST ON LONELINESS IS INCOMPLETE - JUST 50% OVER.
XXX
April 1, 2015 at 4:38 PM
Hi Captain,
This is a great blog. Very detailed and informative. I am a big fan of yours.
Sir, as you are very knowledgeable, I need your expert advise and help for my problem.
My father has irregular heart beats which was found out recently . But he has been feeling it since 25 years whenever he is under pressure, tension or feeling depressed.
Recently we consulted a leading doctor from XXX Hospital in XXX. He is a Electrophysiologist. Even before seeing the reports, he scared us out of our minds by firstly saying that its a very complex issue and my father has a high risk of brain stroke.
He also said it can be genetic as my father's mother had a very rare disorder where the muscles become week over a period of time. So he asked us to consult a neurologist and under go lot of tests which also included muscle biopsy .
He also said that this may be because of Atrial Fibrillation or because of improper functioning of Sinus node in the heart.
So he suggested that my father should first undergo AF Ablation which would cost us around 3-4 lakhs. But even after this procedure, if the heart beats are not regular then he is supposed to under go one more surgery to insert a pacemaker which again will cost us around 3-4 lakhs.
My father is very health consious and has been working out regulary for more than 15 years. But since a year he has stooped gyming and has been doing yoga and pranayama for 2 hours every day. He dose surya namaskar, sirsasana, sarvangasan and many other asanas. He also has a very healthy diet too. His chelostrol level is also normal.
So we were really tensed by the the doctor's behaviour. We are not sure if we should go ahead and get the surgery done.
I have been following your blog for quite a time and know how knowledgeable you are.
So wanted to know your views and suggestion on this.
I will be really greatful for you for your help.
Thanks and Regards
XXX
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Replies
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Capt. Ajit Vadakayil
April 1, 2015 at 7:57 PM
Hi XX,
the comment will be too long.
i will put a temporary post
TAKE A SECOND OPINION -- TO CHECK OUT IF ABLATION / PACE MAKERS IS INDEED A MUST
capt ajit vadakayil
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I must tell you the time, when I myself was declared a heart patient. And I kicked the 85 lakh donation party doctors on their “you know where “.
A couple of years ago, my neighbor ( a school mate ) died of heart attack after evening dinner . I left for joining my ship 4 hours earlier. I told my wife- he would NOT have died if I had left for my ship the next day.
Every body whose parents have a heart problem must know the basics of on man CPR. You do it well , your parent may survive for the next 20 years .
Below: At sea we do 15 compressions and 2 blows
Below: In this modern age , you must know how the heart works. In Kerala people started getting heart attacks only after they stopped using VIRGIN COCONUT OIL OR COOKING .
Below: The heart needs to get electrically impulsed. On the ship we have huge electrical alternators to produce electricity. In case there is a engine room fire , these generators cannot be stated unless they are EXCITED by a 9V DC battery.
Once I met an engineering superintendent , in my company apartment at Singapore- he was going to revive a dead engine room after a fire-- and I asked him, if he knew how to excite the alternator-- he had NO dang idea !
Just because your heart palpitates, it does NOT mean you are gonna die.
Your heart is made up of four chambers — two upper chambers (atria) and two lower chambers (ventricles). The rhythm of your heart is normally controlled by a natural pacemaker (the sinus node) located in the right atrium. The sinus node produces electrical impulses that normally start each heartbeat. From the sinus node, electrical impulses travel across the atria, causing the atria muscles to contract and pump blood into the ventricles.
The electrical impulses then arrive at a cluster of cells called the atrioventricular node (AV node) — usually the only pathway for signals to travel from the atria to the ventricles.
The AV node slows down the electrical signal before sending it to the ventricles. This slight delay allows the ventricles to fill with blood. When electrical impulses reach the muscles of the ventricles, they contract, causing them to pump blood either to the lungs or to the rest of the body.
In a healthy heart, this process usually goes smoothly, resulting in a normal resting heart rate of 60 to 100 beats a minute. Conditioned athletes at rest commonly have a heart rate less than 60 beats a minute because their hearts are so efficient.
Heart palpitations are a feeling that your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.
Most of the time they are NOT serious or harmful, and they go away on their own. Most of the time, they're related to stress and anxiety or to consumption of stimulants such as caffeine, nicotine, or alcohol.
However seek immediate medical attention if along with palpitations, you experience shortness of breath, dizziness, chest pain, or fainting.
When a obese person sits down on his haunches for a long time doing something on the ground , or even squatting in an Indian style toilet reading a book (or whatever ? ) , and he suddenly gets up—he may feel a bit faint due to sudden lack of blood in the brain.
Many things can cause heart palpitations.
Non-heart-related causes of palpitations include:-------
A person whom you are in LOBE- nay – love with is suddenly encountered.
Strong emotions such as anxiety, fear, or stress; palpitations often occur during panic attacks –or even when you see a reared up cobra eye balling you rom close quarters .
Vigorous physical activity- you lifted more than what you can to impress somebody
You had excessive stimulants like alcohol, or illegal street drugs such as cocaine and amphetamines
You have medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration.
A female having hormonal changes during menstruation, pregnancy, or the perimenopausal period; sometimes, palpitations during pregnancy are signs of anemia.
Medications, including diet pills, decongestants, asthma inhalers, and some drugs used treat an underactive thyroid.
Certain herbal and nutritional supplements.
Abnormal electrolyte levels ( potassium , sodium etc )
Eating heavy meals super charged with carbohydrates, sugar , ajinomoto etc which is NOT a normal thing for you .
Now-
"Arrhythmia" means your heartbeat is irregular. It doesn't necessarily mean your heart is beating too fast or too slow. It just means it's out of its normal rhythm. If you are diagnosed with an arrythmia, don’t panic. Not all arrhythmias are life threatening or cause health complications. Arrhythmias may not cause any signs or symptoms. In fact, your doctor might find you have an arrhythmia before you do, during a routine examination. Noticeable signs and symptoms don't necessarily mean you have a serious problem.
It may feel like your heart skipped a beat ( you saw you old childhood sweet heart ) , added a beat, is "fluttering," or is beating too fast (which doctors call tachycardia) or too slow, because you are lonely (called bradycardia).
Or, you might not notice anything, since some arrhythmias are "silent."
Doctors classify arrhythmias not only by where they originate (atria or ventricles) but also by the speed of heart rate they cause:
Tachycardia refers to a fast heartbeat — a resting heart rate greater than 100 beats a minute.
Bradycardias refers to a slow heartbeat — a resting heart rate less than 60 beats a minute.
Not all tachycardias or bradycardias mean you have heart disease. For example, during exercise it's normal to develop a fast heartbeat as the heart speeds up to provide your tissues with more oxygen-rich blood. During deep sleep or times of deep relaxation, it's not unusual for the heart beat to be slower. During REM sleep the beat will be higher.
Although a heart rate below 60 beats a minute while at rest is considered bradycardia, a low resting heart rate doesn't always signal a problem. If you're physically fit, you may have an efficient heart ( a super –athelete ) capable of pumping an adequate supply of blood with fewer than 60 beats a minute at rest. Certain medications used to treat other conditions, such as high blood pressure, may lower your heart rate.
If SLOW heartbeats (bradycardias) don't have a cause that can be corrected, doctors often treat them with a pacemaker because there aren't any medications that can reliably speed up your heart.
You could have an arrhythmia even if your heart is healthy— but there are 85 lakh donation party doctors who will insist that you need an expensive pacemaker –so that he can sing all the way to the bank.
Some people with arrhythmias require no treatment. For others, treatments can include medication and making lifestyle changes. Stay away from stimulants used in cough and cold medications which contain ingredients that promote irregular heart rhythms.
When symptoms of an arrhythmia occur, they may include:--
Palpitations ( feeling that your heart is "running away").
Pounding in your chest.
Dizziness or feeling light-headed.
Fainting.
Shortness of breath.
Chest discomfort.
Weakness or fatigue .
A slow heart rhythm due to an abnormal SA (sinus) node. Significant sinus node dysfunction that causes symptoms is treated with a pacemaker. A pacemaker is a device that sends small electrical impulses to the heart muscle to maintain a suitable heart rate. Pacemakers primarily prevent the heart from beating too SLOWLY .
Sick sinus syndrome ( sinus node dysfunction) — is the name for a group of heart rhythm problems (arrhythmias) in which the sinus node , the heart's natural pacemaker, doesn't work properly. The sinus node is an area of specialized cells in the upper right chamber of the heart that controls the rhythm of your heart. Normally, the sinus node produces a steady pace of regular electrical impulses. In sick sinus syndrome, these signals are abnormally paced.
A person with sick sinus syndrome may have heart rhythms that are too fast, too slow, punctuated by long pauses — or an alternating combination of all of these rhythm problems. Sick sinus syndrome is relatively uncommon, but the risk of developing sick sinus syndrome increases with age.
Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm.
Most people with sick sinus syndrome initially have few or no symptoms. In some cases, symptoms may come and go.
When they do occur, sick sinus syndrome symptoms may include:--
Slower than normal pulse (bradycardia)
Fatigue
Dizziness or lightheadedness
Fainting or near fainting
Shortness of breath
Chest pains
A sensation of rapid, fluttering heartbeats (palpitations)
Many of these signs and symptoms are caused by reduced blood flow to the brain when the heart beats too fast or too slowly.
Types of sick sinus syndrome and their causes include:---
Sinoatrial block. Electrical signals move too slowly through the sinus node, causing an abnormally slow heart rate.
Sinus arrest. The sinus node activity pauses.
Bradycardia-tachycardia syndrome. The heart rate alternates between abnormally fast and slow rhythms, usually with a long pause (asystole) between heartbeats.
Sick sinus syndrome may also be set off by medications, such as calcium channel blockers or beta blockers used to treat high blood pressure, heart disease or other conditions. However, in many cases, the sinus node doesn't work properly because of age-related wear and tear to the heart muscle.
An implantable cardioverter-defibrillator (ICD)is a sophisticated device used primarily to treat ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms
The ICD constantly monitors the heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to the heart muscle to cause the heart to beat in a normal rhythm again. There are several ways the ICD can be used to restore normal heart rhythm. They include:
Anti-tachycardia pacing (ATP). When the heart beats too fast, a series of small electrical impulses may be delivered to the heart muscle to restore a normal heart rate and rhythm.
Cardioversion. A low energy shock may be delivered at the same time as the heart beats to restore normal heart rhythm.
Defibrillation. When the heart is beating dangerously fast or irregularly, a higher energy shock may be delivered to the heart muscle to restore a normal rhythm.
Anti-bradycardia pacing. Many ICDs provide back-up pacing to maintain heart rhythm if it slows too much.
Catheter Ablation is a procedure where , high-frequency electrical energy is delivered through a catheter to a small area of tissue inside the heart that causes the abnormal heart rhythm. This energy "disconnects" the pathway of the abnormal rhythm. Ablation is used to treat most PSVTs, atrial flutter, atrial fibrillation, and some atrial and ventricular tachycardias.
In Catheter ablation procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.
There can be a delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. The level of the block or delay may occur in the AV node. The heart may beat irregularly and, often, more slowly. If serious, heart block is treated with a pacemaker.
Tests used to diagnose an arrhythmia or determine its cause include:--
Electrocardiogram
Holter monitor
Event monitor
Stress test
Echocardiogram
Cardiac catheterization
Electrophysiology study (EPS)
Head-up tilt table test
A variety of drugs are available to treat arrhythmias. These include:-
Drugs that control heart rate and include beta-blockers.
Anticoagulant or antiplatelet therapy or blood thinners to reduce the risk of blood clots and stroke. .
Because everyone is different, it may take trials of several medications and doses to find the one that works best for you.
Atrial Fibrillation (AF) is a disorganized heart rhythm occurs in the upper chambers of the heart. It is the most common arrhythmia. Atrial fibrillation occurs when many unstable electrical impulses misfire, or quiver out of control. AF can increase the heart rate to 200 or more beats per minute (BPM). Atrial fibrillation is caused by chaotic electrical impulses in the atria. These signals result in rapid, uncoordinated, weak contractions of the atria.
The chaotic electrical signals bombard the AV node, usually resulting in an irregular, rapid rhythm of the ventricles. Atrial fibrillation may be temporary, but some episodes won't end unless treated. Atrial fibrillation can cause blood pooling in the heart. Blood clots are more likely to form when blood flow through the heart is altered in any way. A blood clot can break loose and travel to the brain, causing a stroke.
Atrial flutter. Atrial flutter is similar to atrial fibrillation. The heartbeats in atrial flutter are more-organized and more-rhythmic electrical impulses than in atrial fibrillation.
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Atrial flutter may also lead to serious complications such as stroke. Atrial flutter happens most often in people with heart disease
Atrial flutter may also lead to serious complications such as stroke. Atrial flutter happens most often in people with heart disease
DEADLY Ventricular Fibrillation (VF) is an abnormal rhythm can stop the heart from beating and cause cardiac arrest. It occurs in the ventricles, where blood is pumped out to the body and brain. VF is a serious condition that may cause DEATH if it is not immediately treated.
An erratic, disorganized firing of impulses occurs from the ventricles. The ventricles quiver and are unable to contract or pump blood to the body. This is a medical EMERGENCY that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation as soon as possible.
VF causes pumping chambers in your heart (the ventricles) to quiver uselessly instead of pumping blood. Without an effective heartbeat, blood pressure plummets, cutting off blood supply to your vital organs. A person with ventricular fibrillation will collapse within seconds and soon won't be breathing or have a pulse.
An ECG measures the timing and duration of each electrical phase in your heartbeat. Before we join a ship we have a thread mill test.
For sporadic arrhythmias, you keep a portable ECG device ( event monitor ) attaching it to your body and pressing a button when you have symptoms. This lets your doctor check your heart rhythm at the time of your symptoms.
There are Yoga manoevers to stimulate the Vagus nerve.
You can stop an arrhythmia that begins above the lower half of your heart (supraventricular tachycardia) by holding your breath and straining, dunking your face in ice water, or coughing. This affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow. Vagal maneuvers don't work for all types of arrhythmias.
Medications used to treat high blood pressure or heart disease — such as beta blockers or calcium channel blockers — can worsen abnormal heart rhythms. In some cases, adjusting these medications can relieve symptoms.
Accessory pathway tachycardias. You can get a rapid heart rate because there is an extra pathway between the heart's upper and lower chambers. It's just like if there was an extra road on your way home as well as your usual route, so cars can move around faster. When that happens in your heart, it can cause a fast heart rhythm, which doctors call tachycardia. The impulses that control your heart rhythm travel around the heart very quickly, making it beat unusually fast.
AV nodal reentrant tachycardia. A rapid heart rate due to more than one pathway through the AV node. It can cause heart palpitations, fainting, or heart failure. In many cases, it can be terminated using a simple maneuvers, such as breathing in and bearing down, and others performed by a trained medical professional. Some drugs can also stop this heart rhythm.
We do NOT want this comment to go too long.
GO FOR SECOND EXPERT OPINION—
ASK THE DOCTOR FOR A BRIEF CONDIION EXPLANATION -
THE ABOVE INFO ONLY SERVES TO UNDERSTAND WHAT A SPECIALIST DOCTOR SAYS.
Capt Ajit Vadakayil
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