Heartburn Medication

Heartburn Relief with Over the Counter Medicine … When it comes to heartburn relief, antacids are the most popular and least expensive choice. These products …Nonprescription (over-the-counter) omeprazole is used to treat frequent heartburn (heartburn that occurs at least 2 or more days a week) in …Proton pump inhibitors (PPIs) are a commonly prescribed class of drugs for people experiencing symptoms of heartburn. Soothe indigestion and bloating with over-the-counter finds · Best Overall: Prilosec OTC Delayed Release Acid Reducer · Best Liquid Antacid: Pepto …Medications for GERD. Other names: Acid reflux; Esophageal Reflux; Gastroesophageal Reflux Disease; Heartburn; Pyrosis; Reflux.Heartburn medications come in two forms – antacids and blockers. Antacids neutralize stomach acid. Blockers – H2 blockers and proton pump …That’s where PPIs come in. Sold under brand names like Prilosec (omeprazole) and Nexium (esomeprazole), PPIs work by curbing production of …heartburn-medicine-medication-proton-pump-inhibitor-acid-reflux. Long-term use of some heartburn medications appears to be associated with …Heartburn is a burning feeling in the chest caused by stomach acid travelling up … some medicines, such as anti-inflammatory painkillers (like ibuprofen) …

heartburn medication

Find a wide selection of heartburn medication, including antacids to help treat heartburn pain — available at Walmart.ca at everyday low …PPI medicines work by reducing the amount of acid made by the stomach and are very effective at controlling symptoms of reflux and heartburn. However, PPIs …If you suffer from heartburn, several different types of medications are available to treat your symptoms. Classes of medications most often used to treat this …There are 3 types of over-the-counter medicines that treat heartburn and acid reflux: antacids, H2 blockers and proton pump inhibitors. Nexium, or esomeprazole, relieves a number of stomach-related complaints. It works by blocking a proton pump and reducing the production of acid …Prolonged use of medications to soothe heartburn and acid reflux may result in serious health problems. Researchers from Washington University School of …An investigational drug capable of binding bile acids in the stomach hold potential to reduce the severity of heartburn symptoms in patients …Acid reflux medications are one of the most effective treatments in medicine. Whether we’re treating heartburn or healing bleeding ulcers, …

Is Heartburn a Sign of Pregnancy

Pregnancy sign: Heartburn. Digestive changes are one of the most common early pregnancy signs, says Nordahl. If you feel a burning sensation …a burning sensation or pain in the chest; feeling full, heavy or bloated; burping or belching; feeling or being sick; bringing up food. Symptoms usually come on …Is heartburn a sign of pregnancy? … Because of the rise in progesterone, the entire digestive system slows down. As a result of this, many women experience …
Symptoms of Heartburn During Pregnancy — A burning feeling in the chest just behind the breastbone (the sternum) that occurs after eating and …Heartburn. During pregnancy, your body produces more of the hormone progesterone. It relaxes smooth muscles, like the ring of muscle in your …It typically hits somewhere in the second or third trimester, and it can be miserable. Heartburn doesn’t really mean your heart is burning, but it’s good …Indigestion and heartburn in pregnancy · heartburn · reflux or regurgitation (food coming back up from your stomach) · burping · feeling heavy, bloated, or full …Heartburn is a common symptom during pregnancy. Changes in your hormones and body shape can contribute to acid reflux and heartburn. For many women, heartburn starts in the first trimester, beginning around month two, and is a pregnancy symptom that lasts throughout the …Heartburn is common during pregnancy. Pregnancy hormones can make the valve at the entrance to the stomach relax so that it doesn’t close as it should. Pregnancy increases your risk of heartburn or acid reflux. During the first trimester, muscles in your esophagus push food more slowly into the stomach and your …

is heartburn a sign of pregnancy

Heartburn during early pregnancy. Hormones can cause the valve between your stomach and esophagus to relax. This allows stomach acid to leak …Heartburn: Pressure from the growing uterus may push the stomach upward and out of its normal location, leading to symptoms of heartburn. In addition, hormonal … Feeling the burn? Tips to manage heartburn, GERD in pregnancy · Burning pain in the center of the chest, especially after eating · Sour or bitter …Indigestion is more common during pregnancy due to the pressure of the enlarging uterus on the organs of the abdomen and the action of the hormone progesterone …Initial symptoms of heartburn can appear quite early in pregnancy, even around the second month. As such, heartburn can be an early sign of pregnancy in many …The uncomfortable sensation tends to get worse as your baby grows. RELATED: Your Pregnancy Symptoms Week by Week. Heartburn usually appears . Avoid spicy, greasy, and fatty foods. If you are experiencing heartburn, there are a few natural ways to relieve the symptoms: Eat yogurt or drink a glass of … What are the symptoms of acid reflux and dyspepsia of pregnancy? · Heartburn. · Waterbrash. · Upper abdominal pain or discomfort.

Heartburn vs Heart Attack

What signs and symptoms are more likely to occur with a heart attack than with heartburn? · Pressure, tightness, pain, or a squeezing or aching sensation in your …Heartburn is a common symptom of gastroesophageal reflux disease (GERD), often called acid reflux. Acid from the stomach bubbles up into the esophagus, causing ..Despite its name, heartburn — or acid indigestion — is related to your esophagus. But because the esophagus and heart are located near each …One clue that it might be a heart attack is if your chest pain is accompanied by shortness of breath or sweating. If the chest pain persists … Is heartburn a symptom of a heart attack? … Heartburn is often a symptom of GERD, but it can also be a symptom of a heart attack. In fact, heart …Heartburn is a symptom of indigestion or acid reflux. It happens when stomach acid flows back into the esophagus, the food pipe that connects …Heartburn can closely mimic a heart attack. While a heart attack is often announced by pressure or pain in the chest, that’s not always …Heartburn tends to occur after a meal and be more painful when lying down · Antacid drugs can relieve heartburn symptoms, but won’t alleviate chest pain …Heartburn vs. Heart Attack Symptoms — Heartburn vs. Heart Attack Symptoms. Chest pain is one of the most common reasons to go to the emergency room. Heart attack vs. heartburn · Heart attack. A heart attack is when a major artery or arteries in your heart don’t get enough blood flow.

heartburn vs heart attack

If you’ve ever worried your heartburn symptoms may be a heart attack, you are not alone. Learn the similarities and differences in these two …The symptoms of a heart attack can also be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or …What Are Heart Attack Signs? · Pressure, tightness, pain or a squeezing/aching sensation in your chest or arms that may spread to your neck, jaw Heartburn usually hits with some relationship to food — either after eating or after a prolonged period of fasting. A heart attack could happen …Heartburn vs Heart Pain It can be difficult to differentiate severe heartburn from a dangerous heart attack, even for professionally trained doctors. When chest pain strikes, it’s sometimes hard to know if the cause is something you ate or a heart attack. Symptoms of heartburn and heart …Although the sensation of heartburn is different than the way traditional chest pain feels, it could be a sign of acid reflux or heart …If you’re not sure, you’re not alone. Both conditions can cause similar chest pain. In fact, heartburn can be a heart attack symptom, especially in women.

 

Inflammation Of The Pericardium (Pericarditis)

An inflammation of the pericardium – known in medicine as pericarditis – usually causes sharp pain in the chest. Find out more about the symptoms, causes, and treatment of pericardial inflammation here.

Doctors refer to pericarditis as pericarditis. The pericardium (pericardium) encloses the heart and on the one hand, delimits it to a certain extent from the free chest cavity. On the other hand, the pericardium is filled with fluid that forms a sliding layer for the movements of the underlying heart muscle (myocardium).

Pure pericardial inflammation is rather rare. Most of the time, the heart muscle itself is also affected. Cardiologists refer to this as perimyocarditis if only the upper layers of the heart are affected. Deeper-reaching inflammations involving the inner lining of the heart (endocardium) are called pancarditis.

Symptoms

Pericarditis often begins as a dry form. Doctors speak of pericarditis sicca. This is usually shown by stabbing pain behind the breastbone, which is particularly pronounced when the patient is exerted (coughing, deep breathing), but also when lying down.

Often – but not necessarily – a so-called pericardial effusion then follows. This swelling occurs when the volume of fluid in the pericardium increases due to inflammation. Doctors then speak of damp pericardial inflammation or exudative pericarditis.

The pain subsides and the heartbeat becomes quieter. Fever, panting due to shortness of breath, and severe inefficiency are further characteristic symptoms of pericarditis.

Inflammation Of The Pericardium

Cause Of Pericardial Inflammation

The cause of pericardial inflammation cannot always be identified. In up to 80 percent of cases, they are likely to be a long-term consequence of not completely cured viral infections, colds, or the flu. However, there are also non-infectious causes, for example as a result of heart attack, autoimmune diseases, radiation, or allergic reactions.

Treatment

In most cases, pericarditis is treated with medication. The focus is on anti-inflammatory drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin and ibuprofen, high-dose acetylsalicylic acid (ASA), and the autumn crocus alkaloid colchicine. Glucocorticoids such as prednisone and prednisolone or triamcinolone are used if the inflammation persists.

To relieve the heart, dehydrating drugs (diuretics such as furosemide and torasemide) and the ACE inhibitors ramipril and captopril are used.

If bacteria are responsible for pericarditis, antibiotics such as tetracycline, erythromycin, and ampicillin help. In the case of non-infectious causes, the triggering disease must be treated specifically.

High Blood Pressure

The increased pressure in the arterial blood vessels is called high blood pressure (hypertension). Doctors refer to the disease as “arterial hypertension” or hypertension. The opposite of this is mostly harmless low blood pressure (hypotension).

This is how blood pressure is created

The blood is expelled from the heart through the aortic valve into the arteries. The pressure of the flowing blood on the walls of the blood vessels (arterial walls) is called blood pressure. The level of blood pressure depends on the pumping capacity of the heart and the diameter of the vessels.

With physical exertion or excitement, blood pressure rises, while at rest it falls again. Within certain limits, this is completely normal and also desirable. Permanently high blood pressure, that is, even at rest, is unhealthy. The definition of when blood pressure is too high is set by the World Health Organization (WHO).

Measure blood pressure: systolic value and diastolic value

The blood pressure is given in numbers, for example, 120/80 mm Hg (millimeters of mercury), speaking 120 to 80.

    • The systolic value (the first, higher, value, m example 120) results when the heart contracts and the blood presses into the arteries, i.e. during the pumping phase.
    • Diastolic pressure (the second, lower value) occurs when the heart relaxes and the heart chambers refill with blood. Doctors speak of the recovery phase.

When is blood pressure too high?

Hypertension according to WHO values ​​The specification for the definition of hypertension comes from the WHO, the World Health Organization. Currently (as of 2021), according to the WHO, a systolic value of at least 140 mm Hg and a diastolic blood pressure value equal to or more than 90 mm Hg are considered hypertonic – blood pressure above 140/90 mm Hg is therefore elevated. According to this definition, however, the increase in blood pressure must be permanent and not just temporary.

Experts: Limits for blood pressure values ​​are arbitrary

Some scientists point out that the WHO hypertension values ​​are set arbitrarily. Whether a blood pressure is too high or not can only be determined by taking an overall view of the patient’s state of health. Essentially, however, the WHO perspective has prevailed in conventional medicine.

Symptoms

Increased blood pressure is often not noticeable at first. The people affected often feel particularly fit and alert. Only very high blood pressure sometimes causes symptoms. Typical symptoms of hypertension are headache (often in the morning), dizziness, nausea, flushing of the face, nosebleeds, insomnia, fatigue, and ringing in the ears (tinnitus).

High Blood Pressure Crisis (hypertensive crisis)

Extremely high blood pressure values ​​(over 230/130 mmHg) lead to a high blood pressure crisis. Then it becomes critical. High blood pressure crises cause shortness of breath and seizures, consciousness is clouded, in the worst case the affected people fall into a coma. There is also the risk of organ damage (such as acute heart failure, myocardial infarction or pulmonary edema) or brain damage (e.g. stroke and high-pressure encephalopathy), and rarely even the main artery tears (aortic dissection).

High Blood Pressure As A Risk Factor For Numerous Diseases

Longstanding hypertension can have serious consequences or complications. For example, high blood pressure is a recognized risk factor for atherosclerosis. High blood pressure in connection with being very overweight, diabetes or lipid metabolism disorders also significantly increases the risk of developing cardiovascular diseases. These diseases include:

Every second German now dies prematurely from cardiovascular disease.

Causes

In the majority of hypertensive patients, no clear cause of the increased blood pressure can be determined. Doctors call this high blood pressure “essential hypertension”. If another disease causes high blood pressure, it is called “secondary hypertension”. Increased blood pressure is also common during pregnancy (for example in pregnancy poisoning).

Risk Factors For Essential Hypertension

Essential hypertension can be triggered by a variety of factors. In addition to a genetic component, lifestyle also plays a major role. The following factors increase the risk of essential hypertension:

    • Obesity
    • Sedentary lifestyle
    • high salt consumption
    • smoking
    • excessive alcohol consumption
    • stress
    • Lipid metabolism disorders (e.g. increased cholesterol level)
    • hereditary predisposition.

The diagnosis “essential hypertension” can only be made if other causes for the increased blood pressure have been ruled out.

High Blood Pressure

Causes of Secondary Hypertension

Conditions that commonly cause high blood pressure include:

    • Kidney disease (such as glomerulonephritis, cyst kidney, diabetic nephropathies, or narrowing of the renal arteries)
    • Vascular diseases (such as arteriosclerosis or congenital malformations of the main artery)
    • Hormonal disorders (such as Cushing’s syndrome, adrenal cortex disorders, pheochromocytoma, or diabetes)
    • Sleep apnea syndrome.

Medicines such as hormonal contraceptives (birth control pills) or cortisone can also cause high blood pressure.

Examination

To avoid consequential damage and complications from high blood pressure, therapy for hypertension should begin as early as possible. High blood pressure is easily detected with a first and second blood pressure reading. If hypertension is suspected, blood pressure is measured 24 hours a day. In the further course blood tests, eye and urine tests, an electrocardiogram (EKG), and an ultrasound examination of the heart, as well as the neck and leg vessels, should be arranged.

In order to rule out other diseases as the cause of hypertension, imaging methods such as CT or MRI also help. Of course, the full spectrum of these examination methods is not always necessary for the diagnosis of high blood pressure.

Treatment

So-called antihypertensive drugs are given for drug therapy of hypertension. There are a number of antihypertensive drugs that work differently. In Germany, more than 15 million men and women take medication for high blood pressure every day.

Medicines Containing Contaminated Valsartan

In 2018, one of these active ingredients made headlines in particular. Many drugs containing the active ingredient valsartan have been withdrawn from the market because they are contaminated with the substance N-nitrosodimethylamine (NDMA). Manufacturers who obtain their valsartan from the production of the Chinese supplier Zhejiang Tianyu are affected. Here is the list of affected valsartan preparations. Later, even the smallest amounts of NDMA were detected in another active ingredient from the group of sartans. Losartan from the Indian supplier Hetero Labs is affected. The drugs with this active ingredient were immediately withdrawn from the market.

In the meantime, the European Medicines Agency completed a risk assessment process for the sartans candesartan, irbesartan, losartan, olmesartan, and valsartan in summer 2019. The impurities can form during the production of sartans with a certain ring structure (tetrazole ring) under certain conditions and when certain solvents, reagents, and other starting materials are used. Additionally, it is possible that contaminants were present in some sartans because the manufacturers accidentally used contaminated equipment or reagents in the manufacturing process.

Do sartan users have to expect an increased risk of cancer?

NDMA is classified as likely to cause cancer in humans by the International Agency for Research on Cancer of the WHO and the EU. About 900,000 people in Germany take valsartan. Whether the long-term intake of valsartan contaminated with NDMA actually increases the risk of cancer cannot yet be reliably answered. Danish researchers published a study in September 2018 [1]. It looked at data from more than 5,000 people who took valsartan between 2012 and 2017. These were men and women who had received either contaminated valsartan (approx. 11,900 patient-years) or uncontaminated valsartan (7,300 patient-years).

After analyzing the data, the scientists came to the conclusion that Valsartan contaminated with NDMA may not increase the general risk of cancer. But it is still too early for a reliable result. They also point out that in the group with NDMA contamination, a slightly higher rate of cases of colon cancer and uterine cancer was registered.

Sartans: What Should Patients Do Now?

Important for patients taking candesartan, irbesartan, losartan, olmesartan, and valsartan:

    • Not all candesartan, irbesartan, losartan, olmesartan, and valsartan medicines are affected.
    • Please do not interrupt the intake on your own.
    • If you have any questions about your treatment, talk to your pharmacist, who can tell you whether your medicine is being recalled.
    • If the medicine you are taking is affected, your doctor may prescribe a different medicine with an active ingredient that is not affected by the contamination.
    • If you are in a clinical study with valsartan and have any questions, speak to the doctor in charge of the study.
    • The sartans azilsartan, eprosartan, and telmisartan are not affected by the impurities due to their chemical structure.

Active ingredients against high blood pressure

The selection of the appropriate medication depends, among other things, on age, previous and concomitant illnesses as well as the response of blood pressure to the medication. The following antihypertensive drugs are given individually or in combination:

Dehydrating agents

So-called diuretics such as thiazide diuretics, loop diuretics, potassium-sparing diuretics and aldosterone antagonists remove water from the body. This reduces the blood volume. When less blood flows through the veins, the pressure in the blood vessels decreases, and the blood pressure automatically drops. In addition, the heart is relieved and fluid accumulations in the tissue (edema) are flushed out.

Beta-blockers such as metoprolol, propranolol, or pindolol

These drugs block so-called beta-adrenaline receptors and thus reduce the effects of the stress hormone adrenaline and the neurotransmitter noradrenaline. As a result, blood pressure drops and the heart rate drops at rest.

Calcium channel blockers

Active ingredients of the dihydropyridine type such as amlodipine, lercanidipine, or nifedipine prevent the influx of calcium into heart muscle cells, cells of the stimulus-conduction system, and muscle cells of the blood vessels. Calcium is required for the tension of the muscle walls. If there is less calcium available, the muscle walls can constrict less, and muscle contraction decreases. The blood vessels in the heart and in the body widen and the blood pressure drops accordingly.

ACE inhibitors

The antihypertensive ACE inhibitors such as captopril, enalapril, lisinopril, and ramipril act on the blood pressure regulation system (RAAS for short). They inhibit an enzyme (angiotensin-converting enzyme, ACE for short) that is required for the formation of angiotensin II from angiotensin I. Angiotensin II is the most powerful substance produced by the body. It directly increases blood pressure and indirectly inhibits the excretion of water. Without this conversion enzyme ACE, less angiotensin II is formed and the blood pressure increases less sharply.

AT-1 receptor antagonists and renin antagonists

AT-1 receptor antagonists are, for example, the sartans such as valsartan, losartan, and irbesartan: These drugs neutralize the blood pressure-increasing effect of angiotensin II (see above).

Renin antagonists such as aliskiren intervene in the blood pressure regulation system RAAS. You start at the very beginning of this cascade. This is how the hormone-like enzyme renin is bound. Renin is required for the conversion of angiotensinogen into angiotensin I. Less angiotensin I also means less angiotensin II. And the lower the angiotensin II concentration, the lower the increase in blood pressure.

2nd choice antihypertensive drugs

In addition to the drugs described, there are also second-choice active ingredients. This includes:

    • Alpha-blockers (like prazosin and tamsulosin): These drugs affect the autonomic nervous system. In this nervous system – which we cannot deliberately influence – two nerve cords act: the sympathetic and the parasympathetic. The sympathetic nervous system is active when aroused and in dangerous situations, the parasympathetic nervous system in the resting state and the recovery phase. The sympathetic nervous system is stimulated via different receptors called alpha or beta receptors. Alpha-blockers block the alpha receptors. This reduces the stimulation of the sympathetic nervous system and lowers blood pressure.
    • Potassium channel openers (such as minoxidil and diazoxide): Medicines in this group are used when other antihypertensive drugs are no longer working properly. They open the potassium channel and thus reduce the influx of potassium ions into the cells. As a result, the excitation of vascular muscle cells is reduced. The blood vessels relax and widen, and blood pressure drops.
    • Alpha-2 agonists (such as clonidine): Alpha-2 agonists or alpha-2 sympathomimetics only attack alpha-2 receptors. In this way, they dampen the activity of the sympathetic nervous system and the blood pressure drops.
    • NO donors (such as nitroglycerin and molsidomine): These organic nitrates reduce the tension in the vascular muscles. As a result, the larger arteries widen and blood pressure decreases.

Handle high blood pressure medication properly

If you have very high blood pressure, in particular, it is very helpful if you regularly check your blood pressure yourself. If you do not want to or cannot do this yourself, your pharmacist will be happy to assist you, for example. Of course, nursing services also take on this task. Ideally, you should keep a blood pressure diary in which you record the measured values ​​for systolic and diastolic blood pressure on a daily basis. In the pharmacy, you can also get blood pressure monitors that automatically record the course of the blood pressure values.

Strictly observe the dosage regulations: In order for antihypertensive drugs to work reliably, it is necessary that you strictly adhere to the intake instructions. This applies to both the dosage and the time of day. Even if your blood pressure is normal, you may not change the dosage yourself or even discontinue your antihypertensive drug. Without the medication, blood pressure could rapidly rise again and sometimes cause life-threatening cardiac arrhythmias.

Disclose complete medication: It is not uncommon for drug interactions to lead to health-endangering complications. Antihypertensive drugs are often involved, if only because they are prescribed in such large numbers. It is imperative that you disclose to your doctor or physicians if you are taking any other medication.

Medicines do not eliminate the cause

As a rule, drugs do not eliminate the cause of hypertension, but only help to keep high blood pressure within healthy limits. In addition, antihypertensive drugs have a number of side effects and interactions. It is therefore recommended that the dose of the medication be kept as small as possible.

Prevention

The best of all is not to let high blood pressure develop in the first place. You can contribute to this with simple rules of conduct, namely:

    • Do not start or stop smoking in the first place.
    • You should only drink alcohol in moderation.
    • Watch your weight and lose weight if you are overweight.
    • Make sure you have a balanced lifestyle with enough exercise and a fresh, healthy, and balanced diet.
    • Limit your salt consumption.
    • Treat or avoid lipid metabolism disorders.
    • Avoid stress and high tension and learn relaxation techniques such as autogenic training, progressive muscle relaxation, yoga or tai chi.
    • As a diabetic, you should ensure that your blood sugar level is well controlled.

Intermittent Claudication

The medical term for intermittent claudication is intermittent claudication – translated: intermittent limping. Just like the colloquial term intermittent claudication, this term indicates the typical symptoms of this condition. Those affected can only run or walk short distances painlessly. After a few meters, the pain forces patients with intermittent claudication to stand. So that this is not so noticeable, those affected like to stand in front of shop windows and look apparently interested in the displays. Actually, they are just waiting for the pain to pass and for them to continue on their way.

Intermittent claudication as stage II of PAVK

Intermittent claudication is stage II of PAVK. Information on stages I, III, and IV can be found in the paVK clinical picture.

Stage II is divided again into II a and II b. The subdivision is based on the walking distance that those affected can walk without pain. In stage II a it is more than 200 meters, in stage II b the legs already hurt at a distance of less than 200 meters.

Symptoms

In addition to the typical calf pain when walking, some patients with intermittent claudication also experience pain in the thighs and buttocks. Often there is also a feeling of weakness in the legs (tired legs). As a result of the lack of blood circulation, the skin on the lower leg sometimes appears pale and cool. Dark spots, wounds, and inflammation on the lower leg are also possible symptoms of intermittent claudication.

Intermittent Claudication

Causes

As with paVK, atherosclerosis and the resulting insufficient blood flow are the main causes of the disease in intermittent claudication. Risk factors such as smoking, diabetes, elevated blood lipid levels, and high blood pressure or metabolic syndrome increase the risk of intermittent claudication.

Treatment

Therapy for intermittent claudication consists in the treatment of peripheral arterial circulatory disorder. You can find out more about the different therapy options in the paVK guide.

Arteriosclerosis

Atherosclerosis is a pathological narrowing of the arteries that can lead to circulatory disorders and heart disease. Find out more about the causes, symptoms, and treatment of atherosclerosis here.

Medical professionals describe pathological (degenerative) narrowing of the arteries as arteriosclerosis. A similar term is or atherosclerosis. He basically means the same thing. But there is a small difference: medical professionals refer to the deposits of plaques in the blood vessels as or atherosclerosis. In colloquial language, arteriosclerosis and/or atherosclerosis are often referred to as hardening of the arteries or hardening of the arteries.

Atherosclerosis: plaques in the inner wall of the blood vessels

Healthy arteries are elastic and muscular and can adapt to different blood pressure situations. The arteries (excluding the pulmonary arteries) carry fresh, oxygen-rich blood from the heart throughout the body. In arteriosclerosis, substances dissolved in the blood (initially cholesterol, for example) are deposited in the inner wall of the blood vessels. In the further course, other substances such as calcium also accumulate at these points – so-called plaques are formed. These deposits change the inner wall of the vessel. It becomes rigid and swells. This narrows the vascular opening. The result is circulatory disorders in the areas that are supplied by the affected artery. A particular danger of atherosclerosis is that narrowed vessels can more easily be closed by a blood clot. The consequences of this are, for example, heart attacks or strokes. Men suffer from circulatory disorders more often than women.

Frequency

Atherosclerosis is a so-called widespread disease because it is particularly common. With increasing age, almost everyone is affected by a pathological narrowing of the arteries. The number of deaths caused by atherosclerosis in Germany is around 360,000 per year. At the same time, the hardening of the arteries is the most common cause of serious secondary diseases such as heart attacks or strokes.

Symptoms

The symptoms of atherosclerosis, once they become noticeable, are usually severe. The symptoms depend on where the arteries are narrowed.

Circulatory disorders in the legs

Circulatory disorders in the legs lead to so-called peripheral arterial occlusive disease (PAOD), the 2nd stage of which is known as intermittent claudication. The legs hurt at first when walking, later also when resting. The disease got its name because patients repeatedly take breaks while walking and look in shop windows, for example.

Another circulatory disorder in the legs is the so-called smoker’s leg. In the smoker’s leg, the tissue on the toes, ankles, and legs slowly dies off because the narrowed arteries do not provide enough oxygen. Amputation may be necessary under certain circumstances.

Angina and heart attack

A narrowing of the coronary arteries leads to angina pectoris, and if one of the arteries is completely blocked, it leads to a heart attack. These heart problems are among the most feared complications of arteriosclerosis. This also applies to strokes, which are often caused by a vascular blockage in the brain.

Arteriosclerosis

Stroke due to atherosclerosis

Circulatory disorders in the brain lead to declining brain functions such as memory disorders, dizziness, or confusion. Depending on which brain region is affected, other failure symptoms can also occur in other parts of the body. Examples of this are numbness in the arms or legs or impaired vision. If the vascular narrowing is very severe or if a brain vessel bursts, a stroke occurs.

Causes

Unfortunately, it cannot be glossed over: the majority of the causes of arteriosclerosis are our own responsibility. Because the risk is primarily shaped by individual behavior. The following risk factors promote the development of arterial constrictions:

    • Blood fat levels (cholesterol and other fats) are too high because fats are deposited in the blood vessels, and high LDL concentrations in particular increase plaque formation
    • High blood pressure, because the blood vessels are exposed to greater pressure and wear out faster
    • Obesity because is often linked to high blood pressure or high cholesterol
    • Smoking, as nicotine narrows blood vessels and reduces blood flow
    • Stress (which in turn can cause high blood pressure)
    • Diabetes, as blood lipids are increasingly “saccharified” and are more heavily deposited in the blood vessel walls
    • Age, because the risk of arteriosclerosis increases significantly with age
    • Lack of exercise because it promotes obesity and does not train the vascular system
    • Genetic predisposition: Genes seem to play a role as a disease risk in arteriosclerosis.

Examination

For a more precise diagnosis of a narrowing of the arteries, your doctor will first use special examination methods to determine the location and extent of the narrowing of the arteries. This diagnosis of arteriosclerosis can turn out to be quite complex if, for example, the condition of arteries has to be assessed by a catheter examination.

Treatment

For the drug therapy of arteriosclerosis, your doctor can use a whole range of active substances that relieve the blood circulation and the arteries in different ways. These are, for example, drugs that stimulate blood circulation, lower blood pressure, or thin the blood. Medicines are also available to treat high cholesterol or high levels of blood lipids. In addition, doctors usually recommend changing your diet and getting more exercise.

Surgical Therapy Of Atherosclerosis

Surgical treatment of atherosclerosis comes into play when medication and behavior change no longer help.

Stent Stabilizes Arteries

In the not-too-advanced stages of arteriosclerosis, the doctor has the option of making the affected vessels more accessible again. For this purpose, the affected artery is stabilized with a stiffener, the so-called stent, in an operation. In order to be able to place a stent, however, the artery still has to be narrowed enough so that the surgeon can reach the narrowing with an endoscope. If this is not possible, bypass surgery usually occurs.

Bypass Surgery

In particularly severe cases of atherosclerosis, there is no choice but to have surgery to detour around the narrowed or blocked artery or to replace the narrowed artery. This is called a bypass operation.

Self Help

Self-help for atherosclerosis is particularly effective if it reduces the risk factors. Eating a low-fat diet, losing excess weight, getting more exercise, and not smoking will support treatment and reduce the severity of the course of atherosclerosis.

Over-The-Counter Drugs For Atherosclerosis

    • Taking ginkgo preparations has a positive effect on blood circulation.
    • Taking garlic supplements in sufficient doses improves the flow properties of the blood and is also said to lower the cholesterol level.
    • Preparations with omega-3 fatty acids e.g. obtained from cold-water fish, reduce the risk of deposits in the arteries. They are also said to improve the flow properties of the blood and lower cholesterol levels and blood pressure.
    • Regular intake of acetylsalicylic acid (ASA) in low doses improves blood flow. Discuss this with your doctor.

Prevention

There are a number of ways you can help prevent atherosclerosis. In any case, you should do everything possible to minimize the risk factors mentioned under arteriosclerosis. In a nutshell, the best way to help yourself is to eat a low-fat, varied, and fresh diet, exercise regularly in the fresh air (as early as 20 minutes a day), consume luxury foods such as alcohol and coffee in moderation, and refrain from smoking (For tips, see quitting smoking). The following tips will also help prevent atherosclerosis:

    • Regular monitoring of blood pressure, cholesterol, and blood lipid levels.
    • If the cholesterol level is high, pay attention to a low-cholesterol diet, i.e. reduce butter, eggs and the amount of meat, especially avoid saturated fats (e.g. high-fat sausage) and trans fats (especially in fried products such as french fries or potato chips), for the diet guide with high cholesterol levels
    • Diabetics should always make sure that their sugar levels are set correctly.
    • Obese people should definitely lose weight.
    • Avoid stress and learn relaxation techniques such as autogenic training, yoga, or Jacobsen’s progressive muscle relaxation.

Cardiomyopathy

Doctors refer to a whole group of diseases as cardiomyopathies in which the heart muscle, the myocardium, is affected. The colloquial term is a heart muscle disease.

The word cardiomyopathy is derived from Greek. “Cardio” stands for heart, “myo” for muscle, and “pathie” for sick. Cardiomyopathy is a collective term for various heart diseases. A common feature of these diseases are changes in the heart muscle (myocardium), which are associated with a decline in cardiac output.

Cardiomyopathies are almost always very serious diseases which, without appropriate therapy, lead to heart failure.

Forms Of Cardiomyopathy

There are a number of cardiomyopathies. First of all, medical professionals differentiate between primary and secondary cardiomyopathies. Primary cardiomyopathies are caused by a disease or congenital malformation of the heart muscle. If other diseases affect the myocardium, doctors speak of secondary cardiomyopathies. In addition to the pure forms, there are also mixed forms.

Furthermore, medical professionals divide cardiomyopathies into four main types.

    • dilated cardiomyopathy
    • hypertrophic cardiomyopathy
    • restrictive cardiomyopathy
    • arrhythmogenic right ventricular cardiomyopathy (ARVC).

There are also other sub-forms such as

    • Non-compaction cardiomyopathy
    • Broken Heart Syndrome (Tako Tsubo Cardiomyopathy, Broken Heart Syndrome)
    • hypertensive cardiomyopathy (damage to the heart muscle caused by high blood pressure)

Frequency

By far the most common form is hypertrophic cardiomyopathy. There are around 200 cases for every 100,000 inhabitants (prevalence). The number of new cases per 100,000 inhabitants per year (annual incidence) is 19.

The second most common form is dilated cardiomyopathy, with a prevalence of 40 cases per 100,000 population and an annual incidence of 6 new cases.

Cardiomyopathies affect people of all ages. However, there are frequency peaks between 20 and 50 years on average for all forms. In men, the incidence is about twice as high as in women.

Symptoms

The common symptom of all cardiomyopathies is a more or less restricted beating and pumping power of the heart. Heart failure often occurs as the disease progresses. In the case of some heart muscle diseases, the symptoms resemble the symptoms of cardiac insufficiency at the onset of cardiomyopathy.

Complications

Cardiomyopathies are often very slow to develop and therefore often go unnoticed for many years. Without timely diagnosis and suitable therapy, the cardiac output – and with it the oxygen supply to the body – continues to decline.

The human heart is a very finely tuned system. When a component like the heart muscle itself changes, it has a variety of possible effects. An example: In the case of an emerging cardiac insufficiency, the heart compensates for the decreasing impact force by increasing the frequency and strength of the impact. This increases the mass of the heart muscle. If the heart muscle becomes too thick (heart muscle hypertrophy), mobility is restricted on the one hand. In addition, the blood flow in the heart changes. This can promote blood clots, which in turn can trigger a pulmonary embolism.

The extremely sensitive heart valves are also endangered by myocardial growth. Any heart valve defects increase the risk of heart failure.

Sometimes the heart expands as a result of the additional stress caused by cardiomyopathies, doctors speak of dilation. Then the heart chambers literally wear out. As a result, the heart’s pumping power and ejection performance drop drastically.

But cardiomyopathies also disrupt the heart’s excitation lines. This is a possible cause of cardiac arrhythmias, which can lead to ventricular fibrillation and sudden cardiac death.

Cardiomyopathy

Causes

Many primary cardiomyopathies are congenital. This does not necessarily mean that the heart muscle changes exist from birth. They can also only develop over the years. Most common, however, are primary cardiomyopathies with no apparent cause. In this case, medical professionals speak of idiopathic cardiomyopathies.

There are also acquired primary heart muscle diseases and secondary cardiomyopathies.

Acquired primary cardiomyopathies result from other diseases or are sometimes the result of pregnancy. Examples of such causes are:

    • Viral infections, such as a badly healed cold or flu, can lead to viral myocarditis. Infections with the mump pathogen during childbirth sometimes cause restrictive cardiomyopathy in children for years afterward.
    • Bacterial infections such as repeated inflammation of the inner lining of the heart also cause cardiomyopathies. Typical bacterial pathogens that cause myocardial disease are meningococci, streptococci, and diphtheria bacteria.
    • Fungi and parasites such as candida infections or toxoplasmosis
    • Tumor diseases
    • autoimmune connective tissue diseases such as scleroderma or sarcoid
    • Damage to the heart muscle due to deposits of foreign substances or metabolic products such as amyloidosis or hemochromatosis (iron storage disease)
    • Alcohol and drug abuse (toxic cardiomyopathy)
    • increased stress from pregnancy or competitive sport
    • Postmenopause or increased emotional stress (stress cardiomyopathy or, colloquially, broken heart syndrome).

Many other causes are conceivable, depending on the type of cardiomyopathy.

Secondary cardiomyopathies are mostly caused by other conditions. These can be congenital or acquired. Cause here are, for example, toxic substances, storage diseases, endocrine functional disorders, neurological and neuromuscular changes, autoimmune processes, drugs (especially chemotherapeutic agents), or malnutrition.

Examination

General practitioners, cardiologists, or internists usually suspect cardiomyopathy on the basis of declining physical performance. In pronounced cases, shortness of breath, blue discoloration of the skin (cyanosis), or water retention in the legs (edema) speak for themselves.

The diagnosis of cardiomyopathy is initially confirmed by an electrocardiogram (EKG, recording of heart activity), an X-ray of the chest, and an ultrasound examination of the heart (echocardiography). If the initial suspicion is confirmed, a cardiac catheter examination usually follows. During this procedure, a small piece of myocardial tissue is secured (biopsy) in order to better determine the exact type of cardiomyopathy.

Imaging methods such as computer and magnetic resonance tomography, stress tests, and rhythm diagnostics provide additional insights.

Treatment

Once the cause of the cardiomyopathy can be identified, the first step in therapy is to eliminate the causes. Often, however, therapy for heart muscle disease is limited to relieving symptoms and stopping the progression of cardiomyopathy.

Medical therapy

One of the most important goals of drug therapy for cardiomyopathies is to prevent the development or progression of cardiac insufficiency. For this purpose, drugs are used that relieve and strengthen the heart. It is not uncommon for several active ingredients to be combined.

Beta Blockers

The most commonly used active ingredients for the symptomatic therapy of heart failure come from the group of beta-blockers. Beta-blockers block activating hormones like adrenaline and northern adrenaline. Among other things, this causes the heart’s resting frequency to normalize and the blood vessels to expand. This lowers blood pressure, improves blood circulation and oxygen supply, and relieves the heart. They also reduce the excitability of the heart muscle.

Many used beta-blockers are bisoprolol and metoprolol.

Beta Blockers

ACE inhibitors block the action of the angiotensin-converting enzyme (ACE). This enzyme plays a key role in regulating blood pressure and water balance. ACE inhibitors such as benazepril, captopril, ramipril or zofenopril relieve the heart by widening blood vessels and thus lowering high blood pressure. At the same time, they help promote water excretion. This reduces the blood volume and the heart is relieved.

The excretion-promoting effect of ACE inhibitors is in many cases insufficient to relieve the heart of blood volume and to flush out edema caused by cardiac insufficiency. This task is carried out by the so-called water tablets (diuretics) such as hydrochlorothiazide, spironolactone and furosemide.

Antiarrhythmics

Antiarrhythmics are agents that normalize the heartbeat. As a rule, the aim is to slow down an accelerated heartbeat (tachycardia). Active ingredients such as ajmaline, flecainide, or phenytoin achieve this effect, among other things, by blocking the flow of sodium ions into the cells.

Other antiarrhythmics include potassium channel blockers such as amiodarone and sotalol and calcium channel blockers such as diltiazem and verapramil.

Anticoagulants

Anticoagulants such as Phenprocoumon or Eliquis, Pradaxa, and Xarelto are used in cardiomyopathies to prevent blood clots from forming in the heart. This is because these clots pose a significant risk. They can trigger pulmonary embolisms, for example.

Operative Therapy

If drug therapy for cardiomyopathies does not relieve the symptoms, surgery is another option. For example, damaged heart valves are replaced, parts of the heart muscle are removed or pacemakers are implanted.

The heart transplant remains the last possibility and the only causal therapy option.

Forecast

The prognosis for the course and life expectancy of cardiomyopathies depends on the type and extent of the heart muscle damage and the general state of health. In mild forms of blood pressure-related (hypertrophic) cardiomyopathy, for example, those affected have a normal life expectancy if the high blood pressure is consistently treated.

Dilated and restrictive cardiomyopathies, on the other hand, are often recognized very late and can then often hardly be treated effectively. Up to 80 percent of those affected die within 5 years of diagnosis.

Prevention

Cardiomyopathies are very often the result of cardiovascular disease. To reduce the risk of these diseases, you should lead a heart-healthy lifestyle. Above all, exercise keeps the circulation and the heart fit.

A fresh and varied diet provides the body with all the necessary nutrients and also helps to avoid obesity.

Lung and heart health are closely related. Quitting smoking is, therefore, a cornerstone in the prevention and accompanying treatment of heart muscle disorders. Regular consumption of alcohol is also harmful to the heart.

Finally, the prevention of cardiomyopathies also includes having favorable diseases (see causes) treated consistently.

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