Atrial Contractions

Michael Ozner, Md, Facc, Faha asked:


You’ve seen that medical therapy and lifestyle changes can prevent or halt the progression of coronary atherosclerosis, and even potentially reverse it. You’ve seen that they have been shown to help prevent heart attacks and prolong life.

You’ve also seen that much of the testing and surgery done today in response to heart disease is not only unnecessary but also downright dangerous to the patient. Angioplasty and stents don’t “fix” patients. They’re the equivalent of cosmetic surgery for the arteries: they may make them look good, but they don’t do anything but cover up the problem. Heart bypass surgery is rarely the answer either. It doesn’t do anything to change the underlying issue that created the need for surgery in the first place.

But you’ve also seen how you can drastically reduce your odds of developing cardiovascular disease, cancer, diabetes, hypertension, and stroke, as well as other illnesses related to unhealthy diet and lifestyle.

The Ozner Ten-Step Prevention Plan:

l. Follow a Mediterranean Diet. The Mediterranean diet has been consumed by the peoples of the Mediterranean basin for thousands of years, and is the only diet that has ever received so much scientific scrutiny and validation: carefully documented scientific research conducted over the past six decades has conclusively proven that this diet drastically reduces your risk of cardiovascular disease. It’s also the basis for the diet I have successfully used in my preventive cardiology practice for over twenty years. It features vegetables, fruits, whole grains, legumes, nuts, red wine, minimal lean meat, extra virgin olive oil as the primary source of fat, plenty of fish, and ideally, no processed foods, refined carbohydrates, or trans fats.

2. Exercise Regularly. Studies show that exercise doesn’t have to be excessive, and it doesn’t even have to take place all at once, but one way or another, you need to get at least thirty minutes of it daily to maintain optimum cardiovascular health. Forget the excuses. It doesn’t require an expensive gym membership (although gym memberships are fine, if used) or an investment in bulky or expensive exercise equipment. A simple pair of comfortable walking shoes should be sufficient to start you on the road to more energy and better health.

3. Manage Your Stress. Relentless stress is toxic to the mind and body. Take time to invest in relaxation. Practice yoga or tai chi, take anger management classes, laugh it up with friends, practice meditation, or find a relaxing and engaging hobby. Do whatever it takes to catch your breath, calm down, and disconnect from the hustle and bustle of your busy life on a routine basis. The world won’t come to an end if you do. And if you don’t, you may well come to an abrupt end.

4. Take Command of Your Blood Pressure. Monitor and control your blood pressure. Follow a diet and lifestyle that keeps your blood vessels flexible, and your blood pressure below 120/80 mmHg.

5. Control Your Cholesterol. Monitor and control your cholesterol level. Follow a diet and lifestyle that keeps HDL cholesterol high and LDL cholesterol and triglycerides low.

6. Reduce Free Radicals and Oxidative Stress. There is a war going on in your body between free radicals and antioxidants. Fight free radicals, and the oxidative stress and disease that results, by giving your body’s natural antioxidants plenty of reinforcements in the form of fresh fruits and vegetables. Avoid toxins, including cigarette smoke, to keep free radical production as low as possible.

7. Avoid Chronic Inflammation. Control inflammation by following the anti-inflammatory Miami Mediterranean diet and consuming plenty of omega-3 fatty acids in the form of cold water fish, and certain vegetable and grain sources. Proper dental hygiene and regular dental cleaning and check-ups help to guard against a frequent cause of chronic inflammation, chronic periodontal disease. Treating other conditions that lead to chronic inflammation, such as chronic bronchitis, prostatitis, and arthritis, also helps to quell the fires of inflammation.

8. Prevent Metabolic Syndrome and Diabetes. Prevent and reverse metabolic syndrome and its frequent end result, type 2 diabetes, by following prudent diet and lifestyle recommendations.

9. Have an Annual Physical Exam with Comprehensive Lab. An ongoing relationship with your personal treating physician is important. Have an annual physical exam and discuss prevention strategies with your doctor — even if you are healthy and feel well. In addition, have an advanced lipid profile done. Specifically; make sure your doctor tests for three things: particle number, hs-CRP, and LP(a). These laboratory tests provide greater insight into the specific cardiovascular disease risk factors that may impact your individual situation.

10. Avoid Unnecessary Diagnostics Tests and Procedures. Routine cardiovascular screening with CAT scans are not recommended for healthy people — they are expensive (and not covered by insurance), and they deliver a significant dose of ionizing radiation that may increase the risk of cancer. Nuclear stress tests also result in radiation exposure and can usually be replaced by a stress echo (ultrasound) study. Cardiac catheterization is not always as safe or simple a procedure as you may be led to believe. Since it often leads to simultaneous procedures, such as balloon angioplasty and/or stent placement, you may end up with far more than you bargained for. Don’t let yourself be talked into coronary bypass surgery unless it’s truly indicated. Seriously weigh the pros and cons before submitting to any of these procedures. And do not hesitate to seek a second opinion if your physician is unwilling to discuss risks, benefits, and alternatives.

You can prevent, halt, or even reverse heart disease. The choice to do so is up to you.

The above is an excerpt from the book The Great American Heart Hoax

by Michael Ozner, MD, FACC, FAHA

Published by BenBella Books;  December 2008;$24.95US/$27.95CAN; 978-1-933771-54-0

Copyright © 2008 Michael Ozner, MD, FACC, FAHA

Author Bio

Michael Ozner, MD, FACC, FAHA, is one of America’s leading advocates for heart disease prevention. Dr. Ozner is a board-certified cardiologist, a Fellow of the American College of Cardiology and of the American Heart Association, medical director of Wellness & Prevention at Baptist Health South Florida and a well-known regional and national speaker in the field of preventive cardiology. He is the medical director of the Cardiovascular Prevention Institute of South Florida and symposium director for “Cardiovascular Disease Prevention,” an annual international meeting highlighting advances in preventive cardiology. He was the recipient of the 2008 American Heart Association Humanitarian Award. Dr. Ozner is also the author of the BenBella Books title The Miami Mediterranean Diet.



Sheila

Dada Dharmavedananda asked:


A rich man is sleeping in his house. Suddenly he is awakened by the burglar alarm.

“Ach! These stupid systems never work properly!” he exclaims, rubbing his eyes and struggling to stand up. He goes downstairs and, still cursing the system, turns off the alarm. Going back to his bedroom he quickly falls asleep again.

The burglars can’t believe their good luck, as they take their time to carefully find and steal every available expensive item in the house.

The health situation of most people in the meat-eating nations of the world is analogous to that rich man’s condition. Usually when people experience uncomfortable symptoms and sickness, they turn to doctors and medicines to turn off the symptoms so that they can again be comfortable. Just like the rich man who believes he is safe falls back asleep, so most people, under the illusion of recovered health go back to eating the wrong food, and resume other bad habits. Meanwhile, the cause of the suppressed symptoms remains and gets worse. Over time the person becomes more and more sick.

The physical cause of more than 90% of human sickness is the same: too many toxins in the body. Most of these toxins are located in the stomach, intestinal system, organs and circulation system. As an example let’s look at the common cold. Here the symptoms are a running nose, fever, sore throat, sneezing, and so on. The use of medicine turns off these “problems”. Unfortunately they are alarms, not problems. They are also the means for the body to rid itself of the real problem — excess toxins. The increased flow of mucous provides a channel for toxins to flow out. The fever causes sweat, which is also a medium for elimination. At the same time the message of the sore throat and the sneezing is: “Stop eating! Drink more and more!” Because they go on eating even though they are not hungry, most people who catch colds are compelled to continue suffering for many days or even weeks at a stretch. If they were simply to fast on water or lemon water (with a little salt, not sugar), the cold almost always fulfills its purpose and stops within one or two days.

In this case, what is the reason for the effectiveness of fasting? To answer this question we should understand a most fundamental principle of our digestion system. The digestive system has two functions: 1) abstract energy from the food and immediately pass the waste matter out of the body and 2) clean itself of old static waste matter that has clung to the walls of the intestines and other organs for days, years, or even decades. The first function is well known to everyone. The second function is also known, but essentially ignored, by most conventional doctors. They especially neglect the fact that when the digestive system becomes clean, the body next directs its cleaning efforts at any other organs or systems which contain toxins.

The two functions of the digestion system are basically non-simultaneous. That is, whenever the body is busy in digesting newly consumed food, then no energy remains for deep cleaning activity. It is only when the stomach and intestines are more or less empty of fresh food, then those organs will automatically start cleaning themselves. The toxins causing the cold are rapidly eliminated, the symptoms stop, and the person can resume eating. Hopefully s/he is wiser due to having been sick, and is more careful to avoid over-toxifying the body.

From which foods does toxification more likely occur? Here the principle is easy to understand: food which is more difficult to digest is more likely to not be fully digested. When any food enters one’s mouth, digestive juices start secreting in the mouth, esophogaus, and stomach. When the food reaches the stomach, the digestive acids try to quickly break it down into small particles. Easy-to-digest food requires less acid secretion, difficult-to-digest food requires more acid. The process continues as the food solids and liquids are worked upon by the liver, the kidneys, the small intestine, the large intestine and other organs. Acids, fats and other toxic substances also pass into the blood stream, polluting the circulation system and adhering to the walls of the arteries and other blood-carrying channels. Thus, the difficult-to-digest foods are called acid-forming, while easy-to-digest foods are classified as alkaline. In the case of some extremely alkaline foods, such as juicy fruits, they contribute their own fruit acids which may help in the digestion of other foods. There are a few foods, like sugar, tea and onion which are not difficult to digest but are classified as acidic because they contain elements which greatly disturb the equilibrium of the body. These elements are mildy poisonous.

Here is a list of foods categorized from most alkaline to most acid-forming. (As one reads down the list, each succeeding item is somewhat more acid-forming.):

1) Lemon water

2) Herb tea

3) Honey (a little)

4) Citric fruit juice

5) Other fruit juices

6) Vegetable juice

7) Citric fruits

Juicy fruits

9) Other fruits (except banana)

10) Non-starchy vegetables *

11) Buckwheat

(up to here all items are relevant for “graduated fasting”)

12) Yoghurt

13) Starchy vegetables and banana *

14) Fresh tofu

15) Nuts

16) Raw sugar

17) Whole grains

18) Beans

19) Refined grains

20) Refined sugar

21) Tea, coffee

22) Fried foods

23)Milk varies according to personal situation **

Avoid extremely acidic food: 24)mushrooms, 25)onion, 26)garlic, 27)fish, 28)meat, 29)eggs

* Non-starchy vegetables may also be considered as salad-vegetables, i.e. they may be eaten raw. Starchy vegetables, like potato, are difficult to eat raw. Banana is much more starchy then most other fruits (unless it is extremely ripe, in which case its classification become more alkaline).

** Depending on the condition of one’s liver, and also on the functioning of milk-digestion enzymes, people differ in their capacity to digest milk and milk products. For some people milk is a medicine, e.g. certain patients of ulcer. For many, milk causes gas formation, and may thus be recognized as being highly acid-forming. Non-homogenised milk is much easier to digest than homogenised milk because when fats are forcibly mixed with the rest of the milk such that separation does not occur, such globules of “whole milk” become strenuous for the liver.

Items numbered from 1 to 11 generally have a cleansing effect on the body. If a person thus restricts his diet for any length of time to those initial items, the body will undergo a gradual or radical cleansing process. The higher up on the list the restriction is made, so the faster the cleansing will occur. In this regard, the most extreme method of cleaning the body is to neither eat nor drink anything, not even water. But such a method, though appropriate for some people for a short time, is dangerous for most people.

In any case we may thus clearly understand that if an individual uses simple natural means to keep the body relatively clean from toxins, and if there is a regular intake of a reasonable amount of nutrition (not too much and not too little), then there is the greatest possibility that such a person will maintain a high degree of health.

Of course many factors enter into “keeping the body relatively clean from toxins”. It is not only a matter of food and fasting. These factors include exercise, bathing, sleep, mental activity, purity of air and water, presence or absence of chemicals in the food, hormonal inbalances of the glands, and inborn genetic peculiarities. But of all these, food and fasting remain the foremost important for most people.

Thus we come to the main statement of this article: a vegetarian diet is better than a non-vegetarian diet for our all-round health. For the moment we are looking only at the physical aspect, and later will deal with the psychic and spiritual aspects. Vegetarianism is preferable for the bodily health because it consists of items which are easier to digest and thus much more alkaline than fish, meat and eggs.

The human body system has exactly the same food-eating and digesting characteristics as other vegetarian mammals (like cows, monkeys, deer and elephants), and totally different from the meat-eating mammals (like tigers, lions, wolves, dogs and cats). These characteristics include:

1) Vegetarian mammals including man have flat rear molar teeth for grinding their food. Meat-eaters do not have flat molars, and instead have sharp front teeth for tearing food.

2) Vegetarian mammals have an intestinal tract 10 to 12 times their body length. The intestines of meat-eaters is only 3 times their body length so that rapidly decaying meat can pass out quickly.

3) The stomach acid of vegetarians is 20 times less strong than that of meat-eaters.

4) Vegetarians have no claws, whereas meat-eaters have claws to catch and kill their prey.

5) Vegetarians perspire through their skin. Meat-eaters have no skin pores, and instead perspire through their tongues.

6) Vegetarian mammals require high-fiber diets (available in fruits, vegetables and whole grains) or else they eventually become constipated. Meat-eating mammals remain perfectly healthy even when their diets include very little fiber. Constipation is usually the first cause of digestion-related diseases in humans.

7) Meat-eaters can easily digest foods containing a high quantity of cholestorol and saturated fat. Vegetarians have a very limited capacity to deal with these same elements. For example laboratory experiements show that if dogs are gradually given more and more butter fat, even 250 grams every day, they show no increase in their serum cholesterol level. On the other hand, if vegetarian mammals eat much fat a great strain is first placed on the liver, fatty deposits develop on the inner walls of the arteries, and gradually the heart weakens through over-work, causing heart attacks and blood clots.

It is clear that human beings are bound to face difficulties in the digestion of meat, fish and eggs. Furthermore, humans who regularly eat such heavy foods gradually experience weakening of their digestive systems such that they are unable to rapidly eliminate waste matter, and thus their bodies get less and less time to perform self-cleaning.

Regarding heart disease, the cause of more than half of the deaths in the USA, the American Medical Association states that more than 90% of all heart disease could be prevented by vegetarian diet.

The editor-in-chief of the prestigious “American Journal of Cardiology” and a foremost expert on heart disease, DrWilliam Roberts, wrote: “When we kill animals to eat them, they end up killing us because their flesh was never intended for human beings, who are naturally herbivores.”

The reader may be interested in my own experience of low-protein diets. Not only have been a strict vegetarian for the last 25 years of my life, but numerous times for months at a stretch I have also eliminated from my diet milk products, grains, beans and starchy vegetables. During those periods, which continued for as long as 9 months at a time, I ate only fruit and salad. Without any major source of protein I felt stronger and better than during any other times of my life. Indeed I would maintain such a diet always, except that I prefer to be able to eat together with other people. Also, this sort of diet is awkward or even impossible in very poor societies where the climate is cold, such as in Mongolia and Russia (where I am presently working). Thus, only due to circumstances, not due to physical need, I eat a diet containing some high protein foods. Still, I prefer that my meals predominantly consist of fruits and salad-type vegetables.



Manuel

Andrea Schroeder asked:


A challenge awaits the physician who has had enough of the frustrating inefficiencies, financial penalties, and antiquated practices associated with maintaining a paper-based medical office. So the decision is made to digitize the practice. Any initial enthusiasm quickly wanes once an initial search for medical software uncovers hundreds of products and vendors. It doesn’t take long before the 300 or so electronic medical records system screenshots and feature/benefit grids begin to look remarkably similar. The sheer number of vendors occupying the EMR (electronic medical records) market is unmanageable without a basic product assessment/elimination strategy.

For physician practices with limited time and resources, the selection process can appear overwhelming. Fortunately, physicians can begin to narrow down potential systems by eliminating uncertified products, as well as those built upon dated technology architectures.



Eliminate products not certified by the CCHIT® (Certification Commission for Healthcare Information Technology).

By confining research only to CCHIT-certified EHR (electronic health record) products, a substantial number of systems are quickly eliminated. As of this writing, 53 ambulatory EHR systems have successfully met the 2007 standards, while only 18 have met the more rigorous 2008 criteria. Using CCHIT certification as an initial benchmark is prudent for a variety of reasons: The CCHIT is the leading Healthcare I.T. certification organization, and is publicly endorsed by the American Academy of Family Physicians; the American Academy of Pediatrics; the American College of Cardiology; and the American Medical Association, among others. In addition, a CCHIT Certified designation ensures that a product has met the basic requirements for functionality; interoperability; and security and privacy.

A 2008 CCHIT certification warrants the product’s utilization of standard formats enabling the exchange information with other systems – known as interoperability. The exchange of patient information on a regional or national level is the underpinning of a more efficient and less costly healthcare system. Future tax incentives and Medicare reimbursements may be tied not only to utilization of digital medical records in general – but specifically benefiting practices with CCHIT-certified EHR systems.

Eliminate products that do not operate on a shared database for billing and patient charting.

As little as five years ago, “interfaced” practice management/billing and patient charting systems were the norm. Today, “interfaced” systems are technologically inferior to medical software that has been developed from the ground up by a single vendor, on a single platform, and utilizing a single database – described as ‘integrated’ or ‘unified’ electronic medical records and practice management systems.

Interfaced systems are still sold today, so it is a “buyers beware” market. In the past several years, there have been a number of mergers and acquisitions between vendors having market share in one side or the other (scheduling and billing or charting/EMR) but desired a comprehensive solution to offer physicians. As a result, there are products currently marketed as a “suite,” but were developed by disparate vendors on different platforms, tied together using a separate application. Although generally transparent to the practice, there may be questions of data integrity; patient safety (for example, a patient’s practice management/billing record does not match the clinical record and lab results get overlooked in the mess); and even the vendor’s long-term maintenance of the system.

Unfortunately, uncovering if a system is integrated or interfaced is not always straightforward and may require the buyer to conduct some detective work. The first step is to ask the vendor questions about the product’s history – which company developed it, does it utilize a common database, and is there a single login for billing and charting? Some interfaced systems require users to log in separately to access the practice management/billing and the clinical portions of the software.

Following the elimination of uncertified products with dated technology, the pool of suitable products begins to shrink and the specific needs of the practice should be defined and considered.

Establish a Budget. Medical software systems vary widely in cost. By establishing a flexible budget early in the process, practices can avoid wasted time looking at systems that are too expensive or potentially not robust enough to meet the needs of the practice. Ask questions about ongoing maintenance costs and what the maintenance covers, just as a buyer would ask when making decision to purchase a car.

Specialty-Specific Content. Not all EMRs accommodate all specialties – regardless of what the sales rep claims. For example, some leading vendors have well-developed content for family practice; ob/gyn; internal medicine; and ear, nose, and throat; but may not fare as well in specialties such as oncology or chiropractic. By asking the vendor to demonstrate the product’s performance in a specific specialty, the number of potential candidates will decrease.

Scalability. Just as not all electronic medical records systems accommodate all specialties, most are geared toward a specific practice size – with features and cost typically reflecting the product’s expansion capacity. In general, if the practice expects to add providers or additional locations over time, it is important to start with a product that is stable and feature-rich enough to handle the workflow of a larger practice - even if the product’s features may not be fully leveraged early in the product’s lifecycle.

Finally, it is time to ask questions about the vendor’s service and support – the most ambiguous, but arguably most important aspect in the decision making process. After all, you can purchase an electronic medical records software system with every bell and whistle, but if the implementation is disorganized; the training inadequate; or the post-installation support lacking – productivity will drop; providers and staff will be frustrated; cash flow may be interrupted, or worse.

Take stock of in-house I.T. (information technology) resources.

Does the practice have a staff I.T. department or a trusted medical office I.T. company? If not, it’s important to ensure that the software vendor offers I.T. services. Improperly installed hardware or inaccessible support personnel can have a detrimental effect on the success of the training and implementation.

Some smaller practices opt for a web-based installation to decrease the cost of hardware and eliminate the need to maintain servers and other equipment. Web-based installations are known as SaaS (Software as a Service) and are delivered by an ASP (Application Service Provider). The electronic medical record ASP hosts the software in a secured data center, and the end-user (the practice) simply accesses the system using a web browser. All that is required is a high-speed internet connection and a workstation. Access to the data is dependent upon the internet connection, so mission-critical applications are not appropriate in a SaaS environment under most circumstances.

The alternative to a web-based installation is Client/Server, requiring an onsite server and regular maintenance of the system by the vendor. Both types of installations have advantages and disadvantages, so it is important to discuss installation with potential vendors.

Assess technological skills of clinicians and administrative staff. Ensure the vendor’s project planning and implementation staff can aid the practice in choosing who the functional area “champions” will be.

Training, EMR implementation, and “go-live” support expenditures account for a substantial portion of the total initial system cost, and careful planning is essential for a smooth implementation. The vendor should provide a project coordinator that will help the practice make critical decisions and schedule the project timeline. Most practices utilize a combination of web-based and on-site training prior to go-live (the days or weeks dedicated to using the new system). In addition, the vendor should provide onsite support for the practice during the go-live. The number of training days, go-live days, and the delivery (web-based or onsite) is determined by the size of the practice and the skill levels of the staff. Follow-up sessions to reinforce original training or introduce advanced concepts is important for continuity.

To keep costs down, some practices may utilize a heavier web-based training plan for the bulk of the staff with designated superusers who attend advanced training. For practices with less technologically savvy staff, more handholding through onsite training may be the best option. In addition to improperly installed I.T. (hardware, networking, security, workstations), insufficient training or post-implementation technical support are prominent failure points in medical software implementations.

Who supports the practice following the go-live? The original training and implementation staff, or a separate call center?

Not only does unresponsive medical software technical support frustrate and discourage users, it fosters lost productivity when users struggle with denied claims; unanswered questions; or broken functionality. Still, large vendors often outsource support to overseas call centers – lowering vendor overhead at the expense of high-quality, timely, and knowledgeable support.

By asking relevant questions, evaluating the needs and culture of the practice, and systematically eliminating unsuitable products and vendors – practices can enjoy the host of current and future financial and patient safety benefits that an electronic health records system provides.



Sara

Mitesh Janiyani asked:


Coronary angiography in India is one of the cost effective solutions for the international patients who wish to have their Coronary angiography at affordable cost. Hospitals of Coronary angiography in India are providing special affordable packages to abroad patients for Coronary angiography in India. India is one of the world’s leading destinations for medical tourism. The country has the best super specialty hospitals that offer the best in terms of cardiology and treatment of heart ailments. The Hospitals in India , , has state of the art cardiac care facilities, and offers excellent preventive and intervention care that is at par with the best in the world. Coronary angiography is offered by most super specialty hospitals in India. This is an effective method for taking x Rays of the veins and arteries, or the more inaccessible chambers of the heart. In this procedure, a catheter tube is inserted into the heart or arteries close to it, and a fluorescent dye is injected into the bloodstream, which is picked up by x ray machines. The x ray photograph thus obtained is known as an angiogram.

Cornory Angiography:

Coronary angiography is an X-Ray procedure to show up the arteries that supply blood to the heart muscle (the coronary arteries). If these are narrowed or blocked they can result in angina or heart attack (myocardial infarction), and coronary angiography enables us to better work out how to treat the patient.

The procedure involves putting a tube into the heart via an artery in the arm or leg, and injecting a liquid into the coronary arteries which shows them up when viewed with X-Rays.

Who is an ideal candidate for Coronary angiography?

Your doctor may recommend that you undergo coronary angiography if:



You have symptoms of coronary artery disease, such as chest pain (angina)

You have unexplained pain in your chest, jaw, neck or arm, and other testing has been inconclusive

You have new or increasing chest pain (unstable angina)

You don’t have symptoms, but other tests have suggested you may have heart abnormalities

You’re going to have surgery unrelated to your heart, but you’re at high risk of having a heart problem during that surgery

You’re planning to have heart valve surgery

You have congenital heart disease

You have congestive heart failure

You have certain other heart or blood vessel problems or certain traumatic chest injuries



Because of its risks, angiography often is done only after certain other heart tests have been performed, such as an electrocardiogram, an echocardiogram or a stress test.

The cost of coronary angiography in India is very affordable as compare to other western countries. Many international patients are turning to India for affordable Coronary angiography, with the help of medical tourism in India these patients are getting best medical services at very low cost. Hospitals of coronary angiography in India are located at Delhi, Mumbai, Chennai and Hyderabad; Indian hospitals combine the latest innovations in medical electronics with unmatched expertise in leading cardiologists and cardo-thoracic surgeons of India. Medical centers in India have the distinction of providing comprehensive cardiac care spanning from basic facilities in preventive cardiology to the most sophisticated curative technology. The technology is contemporary and world class and the volumes handled match global benchmarks. They also specialize in offering surgery to high risk patients with the introduction of innovative techniques like minimally invasive and robotic surgery. For more details visit on http://www.forerunnershealthcare.com and enquiry@forerunnershealthcare.com



Caroline

♥мαи∂ιѕ♥ asked:


What kind of degree’s are required?
How many years of College Education?

Clifford

Dheeraj asked:


Cardiac care has become a speciality in India They combine the latest innovations in medical electronics with unmatched expertise in leading cardiologists and cardo-thoracic surgeons. These centres have the distinction of providing comprehensive cardiac care spanning from basic facilities in preventive cardiology to the most sophisticated curative technology. The technology is contemporary and world class and the volumes handled match global benchmarks. They also specialise in offering surgery to high risk patients with the introduction of innovative techniques like minimally invasive and robotic surgery. Renowned Indian cardiac hospitals are equipped to handle all phases of heart diseases from the elementary to the latest clinical procedures like interventional cardiac catherisation and surgical cardiac transplants. Their success rate at an average of 98.50% is at par with leading cardiac centres around the world. Leading heart centres have cardiac care units with sophisticated equipment and investigative facilities like echocardiography with coloured Doppler, nuclear scanning and coronary angiography.

What is an Atrial Septal Defect?

The heart is divided into four separate chambers. The upper chambers, or atria, are divided by a wall called the septum. An atrial septal defect (ASD) is a hole in that septum. Atrial septal defects are one of the most common heart defects seen. When an atrial septal defect is present, blood flows through the hole primarily from the left atrium to the right atrium. This shunting increases the blood volume in the right atrium, which means more blood flows through the lungs than would normally. If left untreated, atrial septal defect may cause problems in adulthood. These problems may include pulmonary hypertension (which is high blood pressure in the lungs), congestive heart failure (weakening of the heart muscle), atrial arrhythmias (which are abnormal rhythms or beating of the heart) and an increased risk of stroke.

What Causes an Atrial Septal Defect?

ASDs occur during a baby’s development in the mother’s womb and are present at birth. Before birth, the heart develops from a large tube, dividing into sections that will eventually become its walls and chambers. If a problem occurs during this process, a hole in the wall that divides the left atrium from the right may result. For most people with an ASD, no one knows exactly why it happens. In some cases, the tendency to develop an ASD may be inherited, or genetic.

Types of Atrial Septal Defects:

There are many types of atrial septal defects. They are differentiated from each other by whether they involve other structures of the heart and how they are formed during the developmental process during early fetal development.

Ostium secundum Atrial Septal Defect:

The ostium secundum atrial septal defect is the most common type of atrial septal defect, and comprises 6-10% of all congenital heart diseases. The secundum atrial septal defect usually arises from an enlarged foramen ovale, inadequate growth of the septum secundum, or excessive absorption of the septum primum. 10 to 20 percent of individuals with ostium secundum ASDs also have mitral valve prolapse.

Ostium primum Atrial Septal Defect:

The ostium primum atrial septal defect (also known as an endocardial cushion defect) is a defect in the atrial septum at the level of the tricuspid and mitral valves. This is sometimes known as an endocardial cushion defect because it often involves the endocardial cushion, which is the portion of the heart where the atrial septum meets the ventricular septum and the mitral valve meets the tricuspid valve.

Endocardial cushion defects are associated with abnormalities of the atrioventricular valves (the mitral valve and the tricuspid valve). These include the cleft mitral valve, and the single atrioventricular valve (a single large, deformed valve that flows into both the right ventricle and the left ventricle). Endocardial cushion defects are the most common congenital heart defect that is associated with Down’s syndrome.

Sinus venosus Atrial Septal Defect:

A sinus venosus ASD is a type of atrial septum defect in which the defect in the septum involves the venous inflow of either the superior vena cava or the inferior vena cava. A sinus venosus ASD that involves the superior vena cava makes up 2 to 3% of all intraatrial communications. It is located at the junction of the superior vena cava and the right atrium. It is frequently associated with anomalous drainage of the right-sided pulmonary veins into the right atrium (instead of the normal drainage of the pulmonary veins into the left atrium).

What does the surgical repair for Atrial Septal Defect involve?

Atrial Septal Defect is most commonly closed by open-heart surgery. Due to worsening of symptoms with age, children suffering from atrial septal defect should be operated upon between 3 - 6 years of age. The term open-heart surgery is used for surgical procedures performed on the heart where the heart is stopped and is connected to a heart-lung machine, which oxygenates the blood and circulates it throughout the body. The surgeon makes an incision in the middle of the chest through the breast bone (sternotomy) to expose the heart. The heart is stopped and its function is completely taken over by the heart-lung machine. The atrial septal defect is either stitched (if small) or patched with a special mesh to close the hole. Once the procedure is complete, the heart is re-started and the chest incision is sutured. The open-heart surgery to correct atrial septal defect is considered a major surgery and is performed under general anesthesia.

After surgery of Atrial Septal Defect Surgery:

After ASD surgery, child will spend a few days in the intensive care unit or in a regular hospital room. Most children go home within 4 days after the surgery. While in the hospital, child will be given medicines to reduce pain or anxiety as needed. The doctors and nurses at the hospital will teach patient how to care for him at home.

They will talk to patient about:

·Avoiding blows to the chest incision as it heals

·Limiting activity for patientr child while he or she recovers

·Bathing

·Returning to school

·Scheduling follow-up appointments with patientr child’s doctors

·Administering medicine to patientr child at home, if needed

Outcomes of Atrial Septal Defect Surgery:

Surgical closure of atrial septal defects is complication free in over 99 percent of cases. Although the Amplatzer device has only been utilized for several years, its success rate also appears to be very high. After ASD closure in childhood, the heart size returns to normal over a period of four to six months. Following closure of an atrial septal defect, there should be no problems with physical activity and no restrictions. Regular follow-up appointments will be made with a cardiologist.

Why travel to India for Atrial Septal Defect Surgery:

Cardiology in India is a well-developed field, with treatments ranging from coronary angiography, angioplasty and bypass surgery to grafting being offered at the premier super specialty hospitals in India. They arrange and offer all such treatments at the premier hospitals in India. The Cardiac Centers in India offers the latest in terms of cardiac treatments, including surgery, medication and pre and postoperative care. Apart from state of the art cardiac treatments, the hospitals also offer regular check ups to prevent heart disease, or check the disease in the initial stages. Heart disease is increasingly a bane of the Western world, as well as developing countries, including India. With changing dietary habits and sedentary lifestyles, cardiac diseases now number among the leading causes of death of people worldwide. Keeping this in mind we have tied with the leading Cardiac Centers of India to offer medical tourists facilities ranging from echocardiography, stress testing and holter monitoring to electrophysiological studies, arrhythmia ablation and implantation of single and double chamber pacemakers.

To know more about affordable and low cost atrial septal defect surgery in India-please visit the Website => http://www.forerunnershealthcare.com

Important Details:

Medical Tourism to India - http://www.forerunnershealthcare.com

International Patient Experiences - http://www.forerunnershealthcare.com/international.php

Email- enquiry@forerunnershealthcare.com

Contact Number- 0091-98607-55000.



Ana

Michael Ozner, Md, Facc, Faha asked:


Although standard blood cholesterol tests (measuring total cholesterol, LDL, HDL, and triglycerides) have helped doctors to accurately assess heart disease risk in many patients, recent advances in medical science have demonstrated that conventional cholesterol testing provides only limited insight into the multiple factors that underlie cardiovascular disease. In fact, these tests identify only 40% of those at risk for coronary heart disease.

The good news is, scientists have developed a more advanced blood test that can far more accurately gauge your risk of heart disease. The Vertical Auto Profile (VAP) test augments the standard cholesterol profile with additional measurements that can identify the risk of cardiovascular disease.

Best of all, the VAP test not only offers a comprehensive assessment of cardiovascular risk, but also supplies vital information that can help you and your doctor formulate a customized disease-prevention program and measure its progress over time. This powerful diagnostic tool can help you take the steps necessary to avoid preventable health catastrophes — like heart attack and stroke — today.

The baby-boom generation understands that as they age, their risk for heart attacks, strokes, and other cardiovascular events continues to increase. Not content to succumb to disease and disability, this population is embracing a proactive, preventive approach to health care that includes advanced techniques of risk assessment such as the Vertical Auto Profile (VAP) cholesterol test.

Awareness of the VAP test is important for anyone who wants to stop cardiovascular disease in its tracks, even before signs and symptoms manifest. The VAP test is performed just like a traditional cholesterol panel: a technician or nurse draws blood and submits it to a laboratory. At reasonable cost, the VAP test provides more information than routine cholesterol tests and expands on this data. The comprehensive information derived from the VAP test enables physicians to more accurately predict their patients’ risk of heart disease, and to customize more aggressive, patient-specific treatment plans.

Even if your doctor’s office does not yet regularly utilize the VAP test, it is very likely that your physician will recognize the value of this advanced cholesterol screening tool, and will use the more detailed information it provides to devise the best treatment program to reduce your cardiovascular risk.

How the VAP Test Works

Routine cholesterol tests provide only the four following measurements:

1. Total cholesterol

2. Triglycerides

3. Low-density lipoprotein (LDL, the “detrimental” lipid), determined by a mathematical calculation, not by direct measurement

4. High-density lipoprotein (HDL, the “beneficial”lipid).

The standard lipid panel above is what physicians have relied on for years to assess their patients’ risk of cardiovascular disease. It has been a successful tool, helping physicians to lower patient cholesterol levels using a variety of medical therapies, including statin drugs, and motivating people to make lifesaving changes in their diet and lifestyle.

However, there are serious limitations to relying solely on the standard cholesterol panel. Most important, it can identify only about 40% of patients at risk for coronary heart disease.2 The truth is, many risk factors are involved in the development of heart disease, and for some people, high cholesterol may or may not be one of them. The well-known Framingham Study illustrated that the higher the cholesterol, the higher the statistical risk of a heart attack.3 Nonetheless, a frightening number of heart attacks still occur every day in people whose cholesterol values are seemingly normal. In fact, the American Heart Association reports that 50% of men and 64% of women who died suddenly of coronary heart disease had no previous symptoms!

Heart disease can lurk silently within, hidden and unsuspected. However, the additional information provided by the VAP test can help identify at-risk patients more accurately than routine cholesterol tests.

The expanded information from the VAP test includes:



More accurate, direct measurement of LDL.

Measurement of LDL pattern density. This is important because small, dense LDL (”Pattern B”) triples the likelihood of developing coronary plaque and suffering a heart attack.4

Measurement of lipoprotein subclasses, which include HDL2 and HDL3, intermediate-density lipoprotein (IDL), very-low-density lipoproteins (VLDL1, VLDL2, VLDL3), and lipoprotein(a) [Lp(a)], a particularly dangerous lipoprotein that can lead to heart attacks and strokes.



Patients who test “normal”in a routine cholesterol panel often are found to be at risk for heart disease after taking the VAP test. This is crucially important, not only to diagnose a number of lipid disorders and optimize the choice of medications, but also for tracking improvement when patients are working to reduce their numbers, whether with drugs or lifestyle changes. Clearly, more information means more effective treatment, and thus better health outcomes.

In addition, VAP is the only cholesterol profile that tests for all the present and emerging risk factors identified in the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) cholesterol guidelines.

Prevention Is Key to Cardiovascular Health

I have performed a VAP test for the first time on many patients who have already had heart attacks or strokes, or who have undergone heart procedures such as bypass surgery or placement of a coronary stent. The results have often led me to think that if a VAP test had been performed earlier, maybe the heart attack or stroke could have been prevented, or the surgery would not have been necessary.

Too often in the United States, medical care is reactionary. A heart attack or stroke occurs, the sufferer rushes to the emergency room, and then doctors desperately try to rise to the rescue. All the physicians and patients I know appreciate that this is not the best approach. Part of the beauty of the VAP test is that it can help reduce the likelihood of this scenario occurring. Identifying risks for cardiovascular disease — and then working to correct them in order to prevent heart and vascular disease — is a better choice than costly surgical interventions.

Baby boomers, who have taken more hands-on responsibility for their health than any previous generation, can be even more strongly motivated to adopt wellness strategies when they better understand the specific risks facing them. It is one thing to tell patients that their cholesterol is high and they need to reduce it by changing their diet and lifestyle or by taking medication. It is something else to tell them that they can decrease their risk of heart attacks and emergency room visits by implementing strategies to adjust their cholesterol particles. The more definitively a health threat can be identified, the greater the patients’ compliance with treatment will be.

Since the National Cholesterol Education Program recommends people begin regular cholesterol testing at age 20, young adults can take a VAP test to learn about their cardiovascular disease risk early in life. This will allow them to take aggressive steps now — including diet and exercise — to maintain a healthy heart for life. Taking a VAP test now makes infinitely more sense than waiting until a cardiovascular catastrophe occurs, and then wondering if the event might have been prevented if a more complete cholesterol profile had been obtained earlier.

VAP Cholesterol Testing: What You Need to Know



Cardiovascular disease is America’s number-one cause of premature death. As adults age, their risk for heart attacks, strokes, and other cardiovascular events escalates.

Cardiovascular risk assessment using conventional lipid panels (measuring LDL, HDL, total cholesterol, and triglycerides) detects only about 40% of those at risk for a cardiovascular event. An advanced form of lipoprotein testing, the Vertical Auto Profile (VAP) cholesterol test, detects far more patients at risk of heart disease. The VAP test measures all the components of a standard lipid profile, as well as all cholesterol subclasses known to contribute to cardiovascular risk.

The data provided by a VAP test allows physicians to detect cardiovascular risk long before symptoms manifest, and to use this data to develop personalized prevention and treatment protocols for patients of all ages. Early intervention can help prevent costly hospitalizations and invasive surgery later in life.

All individuals who wish to fully and accurately understand their cardiovascular risk should consider a VAP test. In particular, adults at high risk — due to family history, previously diagnosed cardiovascular disease, or conditions such as high blood pressure, diabetes, obesity, or known lipid abnormalities — should undergo VAP testing.

The advanced data provided by the VAP test allow doctors and patients to proactively implement strategies to prevent cardiovascular events and mortality.



Should Everyone Take the VAP Test?

This question is still being debated in the medical community. It is more expensive than routine cholesterol panels, but it provides more information. It is simply the best way for physicians to learn more about their patients and identify heart disease risk earlier. As time goes by, more physicians are recognizing the limitations of conventional lipid assessment and turning to advanced lipoprotein testing for better answers.

Certainly anyone who has reason to believe he or she may be at high risk for cardiovascular disease—because of family history, previously diagnosed coronary or vascular disease, or factors such as high blood pressure, diabetes, obesity, any measure of coronary plaque, or identified abnormalities in cholesterol or triglycerides — should strongly consider VAP testing. Even if you are simply concerned about heart disease, you can proactively encourage your doctor to perform this advanced test. It is now widely available in diagnostic laboratories around the country.

Being proactive means being eager to learn about ways to improve your health, and working with your doctor to create a personalized prevention and treatment plan. However, when it comes to tests that involve risk — such as imaging procedures that deliver radiation — I caution you to be wary. Sometimes, being proactive can lead you down that slippery slope to unnecessary surgical intervention. Fortunately, the VAP test has the distinct advantage of providing added information without added risk.

©2008 Michael Ozner, MD, FACC, FAHA

Author Bio

Michael Ozner, MD, FACC, FAHA, is one of America’s leading advocates for heart disease prevention. Dr. Ozner is a board-certified cardiologist, a Fellow of the American College of Cardiology and of the American Heart Association, medical director of Wellness & Prevention at Baptist Health South Florida and a well-known regional and national speaker in the field of preventive cardiology. He is the medical director of the Cardiovascular Prevention Institute of South Florida and symposium director for “Cardiovascular Disease Prevention,” an annual international meeting highlighting advances in preventive cardiology. He was the recipient of the 2008 American Heart Association Humanitarian Award. Dr. Ozner is also the author of the BenBella Books title The Miami Mediterranean Diet.



Calvin

sssss asked:


how many years of college are there in usa.after 4 years what do i do to become a doctor in medicine.

Tony

InSearchOfLight asked:


- Address & contact details would also be appreciated

Richard

kingpin943 asked:


Particularly the differences in what they do and what they specialize.

Gail