Medical Health Information

Lumbar puncture involves inserting a thin needle into the lower back and into the spinal canal to extract some of the fluid that surrounds the spinal cord to the survey.

Central Nervous System
The central nervous system consists of the brain and spinal cord. These two parts are connected. While the brain is protected by the skull, the spinal cord is protected by vertebrae. The spine consists of vertebrae (bones), ligaments and membranes, cerebrospinal fluid and spinal cord with nerves.

Between each of the vertebrae of the spine is an intervertebral disc on the "inside" of the spinal cord. Strong ligaments around and along the spine holding it together. Intervertebral discs act as cushions so that your back is flexible and can "flow" when we are moving.

The spinal cord is a channel in the spine, spinal canal (spinal canal), protected by bone tissue and cerebrospinal fluid (CSF really, cerebral meaning brain) is the aqueous fluid surrounding the spinal cord. From the spinal cord, nerves that make up the nerve supply to the body below the head (see illustration). The nerves are in pairs, one right and one left, corresponding to each level of the spine.

Spinal fluid
Cerebrospinal fluid (CSV) is a clear, colorless liquid that forms inside the brain cavity (see drawing of cerebral below). Daily manufactured approx. 500 ml CSF, but at any given time there are only 120 to 150 ml of fluid in the system by an adult. CSV circulates slowly from the ventricle and into the space around the brain and spinal cord.

The fluid acts as a hydraulic shock absorber so shaken by strikes and blows to the head are muted, and serious damage to the brain and spinal cord avoided. In addition, CSV to control the pressure inside the skull, the supply of nutrients to the nervous tissue and removes waste products.

CSV has a different chemical composition than the blood fluid (plasma). Illness may change the composition of CSV. For example, red and white blood cells come into CSV due respectively bleeding and meningitis.

There is no direct connection between blood and CSV. Blood-brain barrier represents the control and filtration goes with substances in blood plasma before going over to CSV and on to the brain.

What is lumbar puncture?
As part of the study of disorders of the central nervous system has sometimes necessary to drain off some of the cerebrospinal fluid. This is achieved by a lumbar puncture. A needle is inserted then inserted between the vertebrae and into the space around the spinal cord where the spinal fluid is. Spinal fluid can then be drained.

Typically, the insertion site of lumbar, or what in technical terms is called lumbaldelen, hence the name lumbar puncture (puncture means to prick, puncture).

What examined?
At lumbar puncture can measure the pressure in the spinal fluid. Man inspecting appearance - CSV should be crystal clear and colorless. By chemical methods analyze the content, and you can microscope to look for cells.

When done lumbar puncture?
In connection with the diagnosis of conditions such as meningitis , cerebral hemorrhage ( SAH ), cancer of the central nervous system and multiple sclerosis usually performed lumbar puncture. In some cases, lumbar puncture is done to introduce anesthesia ( spinal anesthesia and epidural anesthesia ), drugs or contrast agents in conjunction with X-ray examination of the spinal cord ( myelography ).

Lumbar puncture
Before the doctor stick you in the back, he or she will look into the eye scratch yours. At high pressure in the cerebrospinal fluid could give the typical changes in the eye bottom. Make such findings, your doctor may refrain from performing lumalpunksjon.

The puncture is on the side with his back bent well. The site at washed and cleaned thoroughly to prevent bacteria are introduced into the spinal canal. The doctor will then cause the thin and long needle inserted through the skin between two vertebrae and into the spinal canal. CSV will trickle out of the needle when it is in place in the spinal space. It can relieve the discomfort of breathing deeply associated with stings no.

Sometimes the doctor does not hit right at the insertion of the needle, and that it should be pierced. In connection with this, you can experience lancinating pains down in one leg. Then the doctor stuck a nerve. At the doctor then pull the needle back a little, the needle will be where it should.

When sufficient CSV is taken out, pull the needle out.

After lumbar puncture
After lumbar puncture can be instructed to lie flat on your back or stomach for 4-8 hours. You may want to turn from side to side while the body is held horizontally. The reason you have to lie flat, that you otherwise may have severe headache. Drinking plenty can be helpful, it also prevents headaches. However, new information suggests that it is unnecessary to lie after lumbar puncture.

Side effects of lumbar puncture
After experiencing lumbar puncture every 3 to 4 person headache. It is caused by leakage of cerebrospinal fluid through the hole in the sleeve around the spinal space (dura). The headache usually occurs first a day after the procedure, and it is diffuse and may be accompanied by malaise and dizziness. The headache worsens in portrait and improved in the supine position. The symptoms will return by itself within a few days. If necessary, take painkillers. Exceptionally, doctors must close the hole by inject some of your own blood into the cavity.

Back pain may occur at the injection site. The pain can be treated with anti-inflammatory agent.

Neck & back stiffness can occur with spinal blodtilblanding in the room, but does not require any special treatment.

Other serious complications are very rare.

Printed in CSV can by blockages in CSV system increase.

Procedure performed by means of X-ray


With iliac stent inserted
Radiologists performing an increasing number of treatments as part of their investigations. Often it is about to loose out a narrow or closed vein, bile duct, ureter. Whether pierce the area directly, or it can be reached via a catheter passed through the blood vessels, bile ducts, urinary tract, etc. Less frequent surgery may involve drain an abscess or any other edema, or it could be taking a tissue sample from an internal organ.

The intervention occurs during pictorial guidance by X-ray fluoroscopy, contrast injection into the vein (angiography), ultrasound, CT or MRI. The intervention takes place usually in local anesthesia. Examples of such treatments is angioplasty, therapeutic embolization, vein-catheterization for infusion, insertion of blood this years Centre and filters, needle biopsy, drainage of abscess, drainage of urinary tract and drainage of the biliary tract.

Angioplasty
The procedure involves the "repair" of an artery (artery) that are too tight or totally clogged. After local anesthesia of the skin sticking to that rule a needle tip in the artery in the groin. The catheter is inserted through the needle tip, which is then removed. By injecting small amounts of X-ray contrast you can see where you are, and the catheter is pushed to the destination. A stiff wire or wire (guide wire) located inside the catheter, used to pierce the narrow or clogged artery. A balloon catheter is inserted into the stricture of the artery. The artery is opened or pressed upwards by pumping up the balloon with a mixture of contrast media and saline. The procedure is performed especially in narrow blood vessels to the heart ( coronary angioplasty ), feet and kidneys. The procedure is most successful when the narrow portion of the vein is short. To prevent the artery from closing again quickly, inserts a stent, a kind of stiff wire, to prevent the artery clogging fast again.

Therapeutic embolization
Bleeding in an artery (artery) can be stopped by plugging holes. Arteriography localize the site of bleeding, which can then be sealed (embolised). It takes place at the radiology doctor leads into various types of materials through a catheter placed where the vein is damaged. Small metal coils coated with a gelatin foam, plastic particles, or special purpose glue that is converted into a solid mass when it comes into contact with blood are examples of various materials used in the therapeutic embolization (coiling). The treatment is particularly relevant in subarachnoid hemorrhage . The method is also used in cancer treatment to reduce blood supply to a tumor before surgery, and as part of palliative treatment of tumors that can not be removed. By cutting off the blood supply alleviated pain and tendency to bleeding is reduced.

Blood vessel-catheterization for infusion
The method is used especially in the treatment of cancer tumors. An arterial catheter can be placed accurately injecting chemotherapy directly into the tumor. Thereby achieves high concentration of toxin in the tumor, while less toxic substance comes in other places where it can cause side effects or complications. A catheter can also be placed on a fresh blood clot so that one can inject a substance that dissolves the clot, called thrombolysis .

Blood Center this years and Filters
Stents are expandable metal cylinders which are folded together so that they can be inserted through an artery or vein.Balloon  spander viable stents are rigid and placed by pumping up a balloon stent is about. Self-Expandable stents is folded in a plastic sleeve and folds itself out when the sheath is withdrawn.

Blood vessel Filters can be placed in large veins in the abdomen to capture blood clots (emboli) from the legs and pelvis. The treatment used very infrequently and is most appropriate for patients at risk of blood clots to the lungs which can not be treated satisfactorily with blood thinning medication.

Percutaneous needle biopsy
Needle biopsy is particularly useful in the diagnosis of tumors. Under the guidance of ultrasound, fluoroscopy or CT insert the needle through the skin (percutaneously) into the tumor. By cytology (Pap smear) is sucked tissue through the needle as it is moved gently inside the diseased tissue. When biopsy (removal of tissue samples) are needle usually connected to a spring mechanism that the release cut out a small tissue samples. Thin cytology measures can be inserted through the blood vessels and most other organs without the risk in patients not using blood thinning medication. When using thicker biopsy needles should hollow-shaped organ and the major blood vessels avoided. The advantage of this method is the need to operate the patient to get sampled tumor. Complications are rare with thin needles. Use coarse needles increases the risk for complications, especially bleeding.

Percutaneous drainage of abscesses and other fluid collections
The method involves insertion through the skin with a needle and a catheter to a boil (abscess) or fluid (eg. The pulmonary membrane cavity). The size of the catheter depends on what is to be drained. The introduction usually guided by X-ray fluoroscopy, ultrasound or CT. If drainage of abscesses is often a double-barreled catheter that allows to rinse pus cavity.

Drainage of the urinary tract
Such intervention may be appropriate at shutdown (obstruction) of the urinary tract. Eg. may be placed a stent from the bladder into the renal pelvis, usually in conjunction with cystoscopy. The procedure performed by urologists, specialists in urinary tract diseases. Alternatively, the catheter / stent is inserted through the skin (percutaneous nefrostomi / pyelostomi).

Drainage of the biliary tract
Drenasjerørene (stents) may be inserted through the skin or through the endoscope. It is used stents, plastic or metal mesh. The method is particularly useful in tumors of the "head part" of the pancreas that shuts off the bile duct. The procedure is most often done endoscopically in conjunction with ERCP where the ball through the catheter (cannulated) bile duct opening and causes the stent through the bile duct and tumor.

What is cardiology?
Cardiology is a medical specialty that deals with the signs and diseases of the heart and great vessels. The most prominent diseases are coronary artery disease (blood vessels that supply the heart with industry, has become too narrow), heart failure, valvular, rhythm errors (irregular heart beats), and risk condition hypertension.

Cardiologists with expertise in cardiovascular medicine. Although some cardiologists running a private practice, the vast majority employed in hospitals. Much of the study of heart disease takes place therefore at hospital outpatient clinics.

Cardiac examination

Heart Survey consists in preparing medical history, body examination, laboratory tests and imaging.

Medical history
Medical history will Cardiologist track of through interviewing you. The content of the call is determined course of your current ailments. The overall goal of the physician is to obtain a clear representation of the nature of the symptoms and how they have evolved over time. Prominent symptoms include chest pain, breathlessness, palpitations, restless heart, fainting.

Your doctor during a call asking you out on what plagues consists, when symptoms started, how they evolved, what aggravates, what soothes, how is your fitness, endurance, past illnesses, have you tried medications and how these worked , how does the job and / or in daily, and other more detailed questions related to your problems.

Consider these questions before meeting the doctor. It can make it easier for you to answer questions, and you can provide more accurate information. This will in turn help the doctor more easily locate the correct diagnosis and treatment.

Body Survey
The physical examination focuses on the heart and lungs. The doctor considers you - eg. Looking for the heavy breathing, if you are overweight - know the pulse, tap your chest to see if it's seals in your lungs, and listening with the stethoscope over the heart and lungs to form an impression of whether signs of disease of the heart. The doctor measures your blood pressure and also considering the rest of your body, for example. look for swelling in the legs, considering the arteries in your neck, feeling the stomach, feeling the pulse in the legs.

Laboratory Tests
Your doctor may choose from a wide range of tests and examinations. Generally, you will have some blood tests, ECG is very often taken, in some cases taken ECG associated with physical exertion (usually while riding on a bicycle ergometer). On suspicion of arrhythmia, they put on you electrodes and a small computer that can go with you in a day. Similarly, if you are uncertain about your blood pressure, be attached an automatic blood pressure device on you as you carry on you in a day - blood pressure when measured several times during the day.

Imaging
Radiographs of the lungs can provide information about how the heart works. Ultrasound examination of the heart, known as echocardiography, has become an important examination of the heart. To map the blood vessels to the heart, coronary arteries, is done in many cases contrast examination. Man sticking when a needle is inserted into your groin, causes a thin plastic catheter through the artery up to the heart where the X-ray contrast is injected into the coronary arteries and taking x-rays (coronary angiography). Other tests may also be appropriate, depending on what ails you.

Echocardiography is ultrasound examination of the heart. The survey provides information about the heart's structure and function. That is, the heart's position, size, movement of the flaps and ventricular walls, and the speed at which the blood flows through different parts of the heart. Various ultrasound methods used for imaging the heart. Especially to be mentioned Doppler technique: This is a method to determine blood flow, ie how fast blood flows at specified locations. Furthermore, color techniques and counter-tin injections enhance the production of images. The methods are still under development.

A normal echocardiogram shows normal location and size of the heart and normal motion of the heart valves and the ventricle walls.

What is ultrasound?
Ultrasound is sound waves into the body of a probes. The sound waves have such a high frequency that they are not audible to the human ear. When sound waves hit the body tissue occurs an echo. The echo allows the sound waves return to the probes, which captures these tones. After processing in a computer, the received audio signals vivid black and white images on a screen. By Doppler echocardiography is commonly used ultrasonic device that displays color images, in addition is also a signal through the device speakers which reflects blood flow speed, this acoustic signal is used as a tool for finding the best measurement locations.

Different types of tissues in the body have different densities. Audio signals (echoes) is returning to probes will therefore vary according to the organ or tissue types ultrasound beam. As an example, bone and fatty tissue of different echo or audio signals. The various tissues and organs can therefore usually be separated from each other in the images are interpreted as ultrasound scan is in progress.

It is not known that ultrasound has harmful side effects and there is no radiation risk in radiology. Ultrasound in contrast to X-ray the advantage that images can be produced also by the body's soft organs. Air-filled organs such as the lungs, however, no or unsatisfactory images.

Apparatus
Echo cardiograph consists of a simplified probes, a computer and a monitor. Probes are recognized in the patient's chest while it emits ultrasound. In order to improve the quality of sound transmission grease a jelly mass on the skin, which also makes it easier to lead probes across the chest. Probes not only emits ultrasound, but it also receives reflected sound echoes from the heart. Audio signals are analyzed by a computer presents results on a screen. The computer can also add color to certain signals so that the display shows color images.

Heart
The heart consists of two atria (atria) and two ventricle (ventricles). Oxygen-poor blood flows back to the heart in the right atrium and then into the right ventricle. From the right ventricle to pump blood to the lungs where it disposes of the waste gases and oxygen is supplied again. The blood is then collected in the left atrium and enters the left ventricle. From here, blood is pumped into the body's major cycle through the main artery (aorta) and the other arteries. Between the atria and hjerekamrene the heart valves that prevent blood flowing back freaking way. Between the chambers of the heart and pulmonary circulation / the wide circulation it is also heart valves with the same function. The heart is covered with an outer membrane, the pericardium. Exterior of the heart we find the heart's own arteries, coronary arteries, which supply the heart muscle with blood.

When done echocardiography?
There are various reasons to do echocardiography. One of them is to assess cardiac structure and function. An enlarged heart may be an indication of a failing heart. Study of heart failure is thus one of the most frequent reasons for doing echocardiography.

Other indications are assessment of the heart valves, fluid in the pericardium (pericardial), direction and speed of blood flow, monitoring of cardiac patients and aortic aneurysm (ballooning of the aorta).

Survey
The survey covers that said different techniques. The two most common are so-called two-dimensional sector scanning and Doppler technique. In addition, the patient can swallow down a small probes that emit and detects signals from the esophagus ( transesophageal echocardiography ). Stess Echocardiography is ultrasound examination of the heart after the patient has strained sharply, a survey can help reveal areas of the heart that makes for poor oxygen supply and thus wiser "looser" muscle.

Two-dimensional sector scanning
The study is based on signals from probes located in two main positions: Along with the sternum and the heart downward over the left chest. The image appears as a fan-shaped "slice", a cross-section of the heart in motion. The findings appear on a screen as the investigator watching, and they can be stored on video or as individual images. Angling the probes in different directions, the "blade" of the heart that is produced, moved through the heart so that the applicant can make a mental three-dimensional image of the heart.

Doppler echocardiography
Doppler technique makes it possible to calculate the speed of blood flowing in. The precision of the measurement depends on the angle between the ultrasound beam and blood flow. Is the blood stream directly in line with the beam, the most accurate measurements. The survey is used to measure the pressure difference across the narrow and calcified heart valves, blood flow, the amount of blood the heart pumps out per minute, or if there is leakage of blood from the left to the right ventricle through the hole in the heart, or the heart valves fail so that blood leaks back. Color Doppler makes it easier to assess the direction and magnitude of blood flow at specific anatomical locations.

How is the survey?
The study is done with the patient lying partially on the side. Gel applied to the skin to ensure the best possible quality of the ultrasound beam transmitted into and reflected from the body. Probes placed over different areas of the chest and upper abdomen to get the desired images of the heart. The examination lasts 30-45 minutes.

Patient Preparation
The survey requires no special preparation of the patient. There is no pain or discomfort associated with the survey.

What to do?
Echocardiography is the best examination of valvular disease. Each of the four heart valves may be considered separately, best photos you get of the mitral valve and aortic valve.

In coronary heart disease in which there is decreased blood supply to the heart muscle, most have normal echocardiogram. For some people, however, find reduced muscle strength in areas of decreased blood flow.

Heart failure may show impaired pump function, or enlarged heart. In patients with high blood pressure can be found thickened wall of the left ventricle. Perikardsykdom can show changes in the area between the myocardium and the outer retina heart, pericardium. CT and MRI can provide even better images of perikardforandringer.

A number of rarer conditions can also be detected by echocardiography.

Definition of pruritus
Pruritus is the medical term to describe the itching of the skin, which leads to scratching to soothe discomfort. The "Scratch'n" is due to the stimulation of certain nerve receptors in the skin, by substances such as histamine. This local release of excitatory substances is not always obvious cause: pruritus can exist without dermatological lesion.

Causes itching due to pruritus

Skin lesion
Itching may accompany a skin lesion. It is "sufficient" to the patient or the doctor, to recognize it for the cause of pruritus and treated accordingly. The most common situations are atopic eczema, hives (food allergy, contact, drug, or insect bites), skin by fungi (dermatophytes) infections, scabies (a highly contagious disease caused by the mite and favored by poor hygiene), sunburn (summer light eruption), insect bites, or allergies to certain drugs (drug toxidermia) finally chickenpox.

Liver disease
In the absence of skin lesions, a search for other general organic causes, such as liver disease. Hepatic cholestasis (bile blocked, badly produced and poorly drained to the intestine) causes the accumulation of bile salts in the blood, accumulation is expressed by pruritus and jaundice of the skin. Kidney disease, certain cancers, leukemia or lymphoma, thyroid disease or parathyroid glands, HIV infection, or parasitic infections also cause itchy skin.

Dry skin
If all organic causes have been eliminated, we note a dry skin (xerosis), especially during the advance in age the skin aging (senile) reacts more often with itching all kinds of aggression.

Psychological
Finally, as a last resort, it evokes a "psychogenic pruritus", that is to say, due to psychological stress. This is not the easiest to treat ...

Note: acne and rash illness of the child (except chicken pox) are not itching.

Itching: What are the risks?
The first risk is the appearance of itching skin wounds due to scratching, which can become infected (i mpétigo, erysipelas). Over time, the skin may thicken to form what doctors call lichenification. It can change color (depigmentation) or ulcerate (destruction with abrasions, ulcers).
The most serious, but not the most common risk is to ignore a general disease in pruritus without visible injury. We must therefore talk to your doctor quickly enough when the itching persists, especially when it occurs everywhere on the body.

What to do in case of itching
1 - In all cases, clean and disinfect the skin lesions if any, to prevent infection.

2 - Apply an emollient cream (which protects the skin) to protect dry or senile skin.

3 - Do not "play doctor" by applying another type of cream that you do not know the effect, or take any medication without prescription, at the risk of aggravating the situation.

4 - The right treatment is always that the exact cause: only the correct diagnosis ensures the right treatment.

When to see a doctor?
Consult your doctor if the itching persists with or without skin lesions. This avoids neglect of any serious systemic disease. Does not recognize skin lesions responsible for scratching, it will send you to a dermatologist, who will then make a diagnosis and propose a treatment that eliminates scratching himself.
In some cases, the doctor simply prescribe antihistamine tablets that do not treat disease but attenuate the skin reaction to histamine, thus scratching.

Brain

CT image of brain hemorrhage
The brain is well protected inside the skull, cranium. The brain consists of big brain (cerebrum) consisting of two halves (cerebral hemispheres) and cerebellum (cerebellum) and brainstem (see figure ). Cerebral hemispheres represent nearly 90% of brain tissue. Each hemisphere measures approx. 15 cm in length and ca. 11 cm in total width. The outer part of the cerebrum characterized cortex (cortex) and include areas that control our movements, thoughts, feelings, etc (see figure ). The surface of the cortex consists of a series of folds of nerve tissue, so that the total surface area is quite large. The cerebellum, which controls coordination of muscles located under the rear part of the hemispheres. Also cerebellum consists of nerve cells and is divided into two hemispheres. The brain stem, which is about 75 mm long, connects the rest of the brain with the spinal cord and contains nerve centers that control automatic functions such as. breathing and heartbeat. Inside the brain, there are four cavities (ventricles) which are connected with each other and which are filled with fluid, cerebrospinal fluid (see figure ). Ventricles has an open connection with the long, thin cavity that runs down the spinal canal and the cavity between the soft brain tissue and skull (see figure ). All these cavities containing.

What is CT?
CT stands for Computed Tomography. CT images are formed by the same type of x-rays by plain radiographs. CT technique differs from the X-ray by the use of a more sophisticated method for registering jets than usual film, and a computer is used to translate the data into a picture. X-ray sources and the parts that capture the rays, x-recipients or detector move around the area being imaged, enabling the production cross section and three dimensions. The advantage of this method is that it can detect very small changes and can produce images of soft tissue, unlike X-rays which can primarily produce bone tissue.

Radiation burden is larger than a regular X-ray examinations of the head, but you weigh this up against the diagnostic yield, which is usually larger - one gets simply better pictures.

CT of the brain
CT of the brain termed the technical term for cerebral CT. The pictures taken are used to produce brain tissue, membranes and blood vessels inside the head. Soft tissue of different densities can be separated from each other and in the brain may eg. cortex and brain marrow (gray and white matter) separated from the spinal fluid.

The survey is the brain divided into many "slices". Routine involves a CT scan of the brain 12 to 16 horizontal cross section of the brain. Supply of X-ray contrast via the blood can give better image details.

The images appear in different shades of gray. The lighter the shade, the higher the density tissue or structure. Bones are white, while the air is black. Large blood vessels can be fabricated by injection of contrast in years.

When done CT of the brain?
CT performed for suspected disease or abnormalities in the brain. This is particularly true in the study of stroke cases or to assess whether there may be a brain tumor. CT is also made in the study of fuzzy head ailments such. prolonged headache.

Survey
CT can be performed in two different ways: As a series of single images or as a continuous image recording by so-called spiral CT.

Series of individual images
The organs under study is depicted in many horizontal slices, called slices. One and a cross-sectional view is taken. While traditional X-rays provide a "flat" two-dimensional image in which organ in the anterior part of the body is the body further back, manufactures CT images without ghosting bodies of underlying organs. The processing of the image signals in a computer can translate the sections together in a three-dimensional image. Supplemented with contrast injection, tumors and inflammatory diseases produced by visible blood supply.

Spiral CT
Spiral CT is a new type of CT where the patient is moved continuously through the radiation field so that the circular motion of the X-ray source and the detector creates records in a spiral. In this way information is stored as a continuous volume on a computer. This means that larger areas can be imaged in a single pass over shorter time. Volume data is then used by the computer to create images cut and possibly three-dimensional images.

How is the survey?
This can vary from the X-ray department to the radiology department. The information sent from the radiology department can be examined is the one that applies. Mostly going investigation as explained below.

You examined lying on a motorized table that moves you into a "donut-like" opening. You need to lie very still during the examination of the images will not be blurred.

Apparatus, x-ray sources and receivers, the "donut" moving around you while the pictures are being taken. The images are displayed simultaneously on a screen. If it is necessary to prepare an area brighter, administered a contrast injection into the bloodstream. Many experience a feeling of warmth throughout the body when the contrast is injected, a few react with malaise, nausea and possibly vomiting. By breathing slowly and deeply can reduce the discomfort.

Patient Preparation
Generally recomend you to fast 2-4 hours before the test if there is to be contrast. This is to reduce any discomfort from contra tin spraying.

If you are pregnant, you should notify basis because they are reluctant to do CT during pregnancy. Both the referring physician and the radiology department will review the necessary survey.

Claustrophobic reactions may occur, but the vast majority are subject to investigation without major problems. Patients who are very anxious, you can get a soothing spray. Patients with severe pain may get painkillers.

Metal objects such as earrings, hairpins, jewelry, etc. must be removed from the study area.

By any use of contrast
Do you have allergies, radiology department must be notified so that they can both assess the need for the use of any contrast and / or take preventive measures. This particularly applies if you have allergic reactions to contrast injection before.

If you have diabetes, diabetes, using medicines Glucophage / Metformin / Orabet and it will be given contrast in conjunction with CT scanning, you will be told to stop taking tablets for kidney function (creatinine) are examined one of the first days after the survey .

Also, patients with renal impairment or disease multiple myeloma requires a special set of x-ray department.

Sources of error
Hemorrhagic strokes can be difficult to see, especially if it's been some time (days, weeks) since the bleeding occurred. A blood clot in the brain (making a stroke) can be overlooked if it has gone for a short time, ie a few hours since the injury occurred. Patient motion reduces the quality of the images.

What to do?
A wide range of changes in the brain can be detected by CT. The most frequent diseases one can find is brain damage from stroke (bleeding or blood clots, thrombosis), tumors, proliferation of cancer elsewhere in the body, inflammation, dementia changes and different damage after TBI.

What is CT?

CT stands for Computed Tomography. CT images are formed by the same type of x-rays by plain radiographs. CT technique differs from the X-ray by the use of a more sophisticated method for registering jets than usual film, and a computer is used to translate the data into a picture. X-ray sources and the parts that capture the rays, X-rays receivers or detectors, moving around the area being imaged, enabling the production cross section and three dimensions. The advantage of this method is that it can detect very small changes and that it can differentiate soft tissue with very similar densities.

CT images are black and white. The organs are represented in shades of gray. Tissues with low density, for example. air-filled cavities appear as dark or black sections. Tissues with higher density appear in lighter shades. The higher the density, the lighter. Bone produced white.

Radiation burden is larger than most conventional X-ray, but you weigh this up against the diagnostic yield, which is usually larger - you can simply more information from the images.

CT of the chest
Since CT can distinguish between different internal organ, so-called soft tissue, then CT of the chest (thorax) provide detailed cross-sectional images and three-dimensional images of the lungs, bronchi (air tubes) pleura (pleura), structures in the central part of the chest (mediastinum), the heart . The images appear in different shades of gray. The lighter the shade, the higher the density tissue or structure. Bone produced white, while air is made black. Image quality can be improved by concomitant administration of contrast injection.

When taken CT of the chest?
CT of the chest cavity is used primarily in the study of conditions in which other diagnostic methods are insufficient. Especially for the detection of tumors and inflammation in the lungs and bronchi, or blood clots in the pulmonary arteries.

Survey

CT can be performed in two different ways: As a series of single images or as a continuous image recording by so-called spiral CT.

Series of individual images
Chest with chest depicted in many horizontal slices, called slices. One and one cross-sectional image is captured. While traditional X-rays provide a "flat" two-dimensional image in which organ in the anterior part of the body is the body further back, manufactures CT images without ghosting bodies of underlying organs. The processing of the images in a computer can put the slices together in a three-dimensional image. Supplemented with contrast injection, tumors and inflammatory diseases often produced better through making visible blood supply.

Spiral CT
Spiral CT is a new type of CT where the patient is moved continuously through the radiation field so that the circular motion of the X-ray source and the detector creates records in a spiral. In this way information is stored as a continuous volume on a computer. This means that larger areas can be imaged in a single pass over shorter time. Volume data is then used by the computer to create images cut and possibly three-dimensional images.

How is the survey?
This can vary from the X-ray department to the radiology department. The information sent from the radiology department can be examined is the one that applies. Mostly going investigation as explained below.

You examined lying on a motorized table that moves you into a "donut-like" opening. You need to lie very still during the examination of the images will not be blurred. During image capture, you will be told to hold your breath.

Apparatus, x-ray sources and receivers, the "donut" moving around you while the pictures are being taken. The images are displayed simultaneously on a screen. If it is necessary to prepare an area brighter, administered a contrast injection into the bloodstream. Many experience a feeling of warmth throughout the body when the contrast is injected, a few react with malaise, nausea and possibly vomiting. By breathing slowly and deeply can reduce the discomfort.

Patient Preparation
Generally recomend you to fast four hours before the examination if there is to be contrast. This is to reduce any discomfort from contra tin spraying.

If you are pregnant, you should notify basis because they are reluctant to do CT during pregnancy. Both the referring physician and the radiology department will review the necessary survey.

Do you have allergies, radiology department must be notified so that they can both assess the need for the use of any contrast and / or take preventive measures. This particularly applies if you have allergic reactions to contrast injection before.

If you have diabetes, diabetes, using medicines Glucophage / Metformin / Orabet and it will be given contrast in conjunction with CT scanning, you will be told to stop taking tablets for kidney function (creatinine) are examined one of the first days after the survey .

Also, patients with renal impairment or disease multiple myeloma requires a special set of x-ray department.

Claustrophobic reactions may occur, but the vast majority are subject to investigation without major problems. Patients who are very anxious, you may get a sedative. Patients with severe pain may get painkillers.

Metal objects such as buttons, zippers, belts, jewelry, etc. must be removed from the study area.

What to do?
The study provides a good representation of opacities, nodules, tumors and cysts in both lung tissue and the tissue around and between the lungs. CT can detect a number of changes which overlooked on plain radiographs. Contrast inserts injections in the blood can improve the image quality.

What is high blood pressure?

High blood pressure ( hypertension ) means that the pressure in the body's blood vessels is higher than what is defined as normal. High blood pressure is not considered a disease in itself but is a stressful factor for heart and carries a risk of long-term development including stroke and heart attack .

Blood pressure is the force exerted by blood as it flows through the arteries. Blood pressure is indicated by two numbers separated by a slash. Over pressure is the pressure in the arteries (arteries) when the heart contracts (systolic pressure). Under pressure is the pressure in the arteries between heartbeats (diastolic pressure). A blood pressure of 150/90 therefore means that the pressure is 150 at the highest, and 90 at the lowest.

Measurement of blood pressure
Blood pressure is set in a unit called millimeters of mercury (mm Hg). To get as complete as possible results of blood pressure study measured pressure usually three times if the pressure is increased or if you are going to control blood pressure treatment. Average of the last two measurements is usually stated.

Ideally, blood pressure should be around 120/80. At most there will be higher with age. When the pressure is 140-150 or under pressure is 90-100 call it mild hypertension. If the pressure is from 160 to 180, or under pressure is 100-110, it is called moderate hypertension. Even higher pressure as severe hypertension. Moderate and severe hypertension should almost always be treated with blood pressure medications.

Blood pressure rises and drops quickly when we are active. Before blood pressure measurement should therefore sit at rest for at least 10 minutes, preferably longer. Coffee can increase your blood pressure and you should not drink coffee in the hours before a blood pressure reading.

Stress and anxiety can increase blood pressure significantly in some. These may have a very high blood pressure during the survey, although it is normally disabled. This is often called "office blood pressure", as it occurs in the doctor's office. People with office blood pressure can take in a blood pressure device and make measurements even under safe circumstances at home. For some, it may also be necessary to make a so-called 24-hour measurement. This is done by a blood pressure device is connected to your arm and automatically performs measurements through an entire day.

Angiography showing cramped party in artery

Angiography is an X-ray examination of blood vessels. Larger veins are divided into two groups:

• Arteries (blood vessels), which carry oxygen-rich blood out to the body from the heart
• Veins (collecting veins), which carries oxygen-poor blood back to the heart

Angiography can roughly be divided into arteriography and venography, depending on the vessel being examined. To prepare a vein on X-ray, it must inject contrast dye into the vein. The contrast makes the artery visible and one can examine whether there are changes in the hearth.

The most common arteries being examined, the coronary arteries (arteries, see coronary angiography ), carotid arteries (carotids), arteries in the brain, arteries arising from the aorta (aortic) and arteries in the legs and feet.

The survey makes it possible to detect damage, stenosis, obstruction, aneurysms (aneurysms) in years, and also shows blood flow to the organs or areas of the blood vessels supplying.

When done arteriography?
Arteriography be suspected circulation problems. Whether in the form of decreased arterial circulation or as a result of blockage of blood flow in veins. The blood vessels in the neck (carotids) examined sometimes associated with seizures or "drip", where one suspect confined areas in the neck arteries, or blood clots, which can detach from these arteries and clog the small arteries in the brain. However, ultrasound of the neck vessels of the preferred survey.

At the special type of brain hemorrhage called subarachnoid hemorrhage , where there are gaps in the ballooning of the blood vessel (aneurysm), used arteriography. Arteriography is also used to investigate aneurysms in other arteries such as the aorta (aortic). It may also be necessary to make arteriography before surgery of a tumor, so that the surgeon knows where the important blood vessels are located. Bleeding in the digestive tract can be difficult to locate, arteriography can make it easier to find the source of bleeding.

Normally, by arteriography find arteries (or veins) of normal size and appearance, no sign of narrowing (atherosclerosis) and with a normal course.

Patient Preparation
It can range from X-ray department to the radiology department how to conduct the survey. You need to follow the instructions you receive from your radiology department. The following describes how the study is often performed.

Are you allergic, especially if you've responded to the contrast dye before, you must notify the radiology department. Likewise, it is important that the radiology department know know if you have kidney failure, diabetes, or multiple myeloma. You are also very careful to make such an inquiry if you are pregnant. Before the study can kidney function checked with a blood test (creatinine). If you take warfarin, one would measure INR.

Do not eat or drink in the past four hours before the examination. This is to prevent nausea and vomiting during the study. When contrast is injected into the vein, you can feel heat spreading in the body. Nausea and discomfort may occur. The investigators rely on you to collaborate and include is silent when pictures are taken.

Survey
Arteriography is usually performed with inserts in the large artery in the groin. From the site recognized a catheter (thin plastic tube) until the blood vessel to be examined. From this position sprayed ionic contrast media through the catheter and into the artery. Contrast fluid followed both by X-ray fluoroscopy on a screen and shooting.

The survey takes place under sterile conditions with sterile equipment, cleaning the skin with disinfectant liquid and cover the surrounding skin with sterile sheets. It is given a local anesthetic before the needle is inserted into the artery and the catheter is inserted. The catheter, which contains a soft metal wire (wire) is inserted into the appropriate blood vessel or the heart. Once the catheter is in place, remove the guide wire and catheter connects to contrast the syringe or device that provides injection of contrast in the right doses at the right time. X-rays are taken. After the examination is taken out and the catheter insertion site in the groin covered. To prevent bleeding from the hole in the artery, vein clamped for approx. 10-15 min, or until the bleeding has stopped.

In certain arteriography where it is demonstrated narrowing of the artery, made ​​so-called angioplasty . Using the guide wire will then try to get through the narrowed or clogged party. Then use a small balloon filled with liquid, to open up the artery, i.e. expand the stricture. You can also insert a reinforcement of metal mesh (stent).

Monitoring by the survey
After arteriography should be flat, or with the body somewhat raised, for 4-6 hours. This is to prevent bleeding from the site. For the same reason, do not bend or stretch the leg in a few hours, do not lift your leg off the ground. Sometimes it can form a blood clot under the skin, called a hematoma. Therefore, using in many places a sandy bag over the puncture site to prevent the development of hematoma.

You must notify by should you get sudden pain or be numb leg man stuck in. Once in a while it may in fact cause blood clots. It is important to drink plenty after such examination. You should drink at least 2 liters of liquid the first day.

What to do?
The most common found at arteriography is narrow arteries, artery, caused by atherosclerosis (atherosclerosis). In some cases it is found that year is quite dense. The need for further investigation of ways to do CT , MRI , ultrasound, MR angiography.

ECG

ECG, normal
Electrocardiogram ( ECG ) records the electrical impulses that are sent through the heart. The impulses can be detect / measure outside the heart, for example. the arms, the legs, the chest wall. In connection with the taking of ECG electrodes attached therefore the arms, feet and chest wall. If the purpose of taking an ECG was only studying the electrical rhythm, it had been enough to measure only one location. However, by the measurement at several places, doctors at the damage to the heart muscle identify where the damage is located.

An exercise ECG is used primarily to acquire knowledge about the existence of signs of coronary artery disease in you. That is, if the blood vessels are so narrow that the supply of oxygen that comes with the blood becomes too small during physical exertion. The two main coronary diseases, angina pectoris and myocardial infarction.


ECG in coronary artery disease
If you have angina, you will usually have chest pain at rest. Although blood flow in the narrow coronary artery is reduced, it is still sufficient for the heart is getting enough oxygen when you exert yourself (see illustration of angina ). During exercise, however, blood flow be too bad. Therefore, ECG taken during exertion in order to be able to confirm or deny whether you have angina (see video of load ECG ).

When an area of ​​the heart muscle has a poor blood supply, it changes on ECG. It appears in the part of EKG'et termed ST segment. Oxygen deprivation in an area of ​​the heart muscle will appear as a subscript ST segment. By investigating which leads ST-sinking occurs in, one can say where the problem sits about and perhaps also the coronary artery is narrow.

How is the survey?
Exercise ECG is a test where you are exposed to increased physical load during ECG monitoring. It is almost always because you are cycling on a stationary bicycle. During cycling recorded EKG'et your whole time and measuring blood pressure several times.

The ride starts at very low load. As the load increases by approx. 4-6 minutes. The test continues until either you are so tired that you can not anymore, until you observe special ones or you say you've had enough.

Is it required special preparation?
No, the study does not require any special preparation. Since you are going to ride and effortless bare-chested, it might make sense to bring a tracksuit.

What to do?
That said, what is primarily concentrates on is to look for changes in the ECG ST segment as a sign of coronary artery disease. However, such changes are not clear. This means that the result of the survey is not 100% reliable.

Firstly, it is assumed that the test only captures 60% of those with coronary artery disease (test sensitivity). In the second 10% of those without coronary artery disease have an abnormal ECG (test specificity). This means that labor EKG'et is abnormal in patients with low likelihood of coronary artery disease, it is often an expression of a so-called false positive findings. You need not have coronary artery disease although labor EKG'et say it. Among patients with a high probability of coronary artery disease, an abnormal exercise ECG in most cases be a correct result.

Under the strain of you will investigators also consider other things as exercise capacity, heart capacity - what is your maximum heart rate, blood pressure potential changes and how quickly your heart rate drops after completion of the test. These observations are also important when investigators to draw their conclusions.

Is it dangerous to take an exercise ECG
No, for most people this is an innocent investigation. But very occasionally happens that a patient with a severe underlying heart disease, can get triggered a heart attack under load. Therefore, those who carry out such studies, always prepared to deal with such unexpected events. Doctor is often present or easy to summon if a problem occurs.

What are congenital heart defects?
Congenital malformations of the heart or major blood vessels surrounding the heart, is not uncommon. Many of these will be so small that they will never give any problems. For such a deformity to be called a congenital heart defect, it must be of such a nature or magnitude that it will be able to give importance to quality of life or life expectancy. Congenital heart defects are formed when the heart is formed, that is, in the first part of pregnancy. However, it is not unusual that the error first discovered a few years out in the child's life.

There are a number of different types of heart failure. For most of them will also be the degree or magnitude of the individual errors could vary. Combinations of several types of heart failure also occurs. Congenital heart defects are among the most common "birth defects" and is the most common cause of death due to inborn errors.

How does the heart?

Heart
The heart is a muscle that acts as a pump and supply the body with blood. It is divided into four cavities or "chamber". We have two atria and two ventricle, one of each on the right and one of each on the left side. Atria release blood into the heart chamber, and it is heart chamber which has the main power and pumps blood out to the body (left side) or the pulmonary circulation (right). Between the chambers are valves or flaps. These work in the way that they just do not have the blood through in one direction and prevents blood from flowing back where it came from.

Cycle
Blood circulation through the body is an endless circle. We can start in the heart's right side, and from there goes to the lungs and the blood is enriched with oxygen. The oxygen rich blood has a clear red color (when bleeding blood will always be red, because the blood when in contact with air) and are now transported back to the heart. The heart's left side (which is the strongest part of the heart muscle) carry the blood through the arteries (arteries) to the body's tissues and organs. Arteries is a common term for the blood vessels that carry oxygen-rich blood out to the body. As oxygen is used up blood becomes darker. The dark bluish blood back then transported to the heart's right side through the veins (of the body's blood vessels that carry oxygen-poor blood back to the heart), and then we are back to the starting point where the cycle continues.

What is abnormal heart valves?
Children can be born with heart valves that are narrower than normal, closed or blocked, or otherwise prevents the blood from flowing uninterrupted. In most cases, surgeons can repair these valves or replace them with artificial valves. It is not unusual that these conditions can be corrected by inflating a balloon in the stricture, so that surgery is unnecessary (balloon is inserted through a vein up to the heart).

What is the cause of congenital heart defects?
The nearly 500 children born with congenital heart defects each year. Only in a small number of these can say with certainty what causes heart disease.

Some diseases of genetic systems (genetic diseases) is linked to heart failure. The most common is Down syndrome . Third of children with Down syndrome have heart defects.

It also seems that the inheritance may play a role. If parents or siblings have heart failure, the risk of having a new child with heart failure increased.

There are also environmental / external factors that can cause heart failure. The most common are some viruses and some drug. Mothers who get rubella in the first part of pregnancy are at increased risk of giving birth to children with heart defects.

Some medicines may increase the risk of developing heart disease if they are taken during pregnancy - especially if taken in the first third of pregnancy. Use of alcohol during pregnancy increases the risk of heart failure. Especially children who are born with so-called "fetal alcohol syndrome" are more likely to have congenital heart defects. Also the use of cocaine during pregnancy increases the risk that the child will be born with malformations of the heart.

Some chronic diseases in the mother increases the risk of heart defects in the baby. This includes diabetes . The risk in diabetics can be reduced and it is negligible if your blood sugar is well controlled before and during pregnancy. Mothers with the rare disease phenylketonuria or Follings disease is likely to have children with heart defects, unless they follow a carefully balanced diet before and during pregnancy.

How will doctors and hospitals investigate child?
Most heart defects detected by routine inspections unless the child has shown no signs of heart disease. It is often detected a "murmur" when the doctor listens to heart. Children with normal hearts may also have heart murmurs, but it will often be necessary to have further tests to find out if there is something wrong in the heart causing the murmur.

If your child has symptoms of their heart defects may take the form of increased incidence of respiratory infections. In infants, a brand that they have difficulty breathing when they eat, they will often also have lower weight gain than one would expect. Swelling in the legs, abdomen or around the eyes can also occur and is a sign of poor cardiac function.

Some heart defects cause a blue-pale coloring of the skin, a symptom called cyanosis. This detects an often soon after birth, but in some cases it will not appear until later in childhood. The cause of blueing is that blood does not contain enough oxygen. Children with cyanosis become easily tired, short of breath and can faint - especially during exertion. A typical characteristic of children with this type of heart failure is that they are much squatting, as this makes it easier to breathe.

In suspected heart defect baby will be thoroughly examined in hospital. It can be done a lot of research, but ultrasound generally provides the most information. This survey is called echocardiography, and is not dangerous or uncomfortable. It shows us how the heart looks like, and the direction and speed of blood pumped through the heart.

Other studies done in the hospital, blood pressure measurement, measurement of the amount of oxygen in the blood, ECG and a survey called cardiac catheterization

How are congenital heart defects?
Man has come a long way when it comes to the treatment of congenital heart defects. Today, there are treatment options that make the most with heart disease can live a full or near-normal lives. Treatment can take the form of surgery, medicines or aid as artificial heart valves and pacemakers. What type of treatment given depends on its nature and size. Advances in surgical technique allows heart surgery can now be done much earlier than before, more than half now operated before 2 years of age.

How is long-term prospects?
This will be different for each case. Most can be treated, but there are also cases where heart failure is so large or complex that one can not do anything about it.
Because the differences are so large you have to ask the specialist about the outlook for your child.

What are congenital heart defects?

Congenital malformations of the heart or major blood vessels surrounding the heart, is not uncommon. Many of these will be so small that they will never give any problems. For such a deformity to be called a congenital heart defect, it must be of such a nature or magnitude that it will be able to give importance to quality of life or life expectancy. Congenital heart defects are formed when the heart is formed, that is, in the first part of pregnancy. However, it is not unusual that the error first discovered a few years out in the child's life.

There are a number of different types of heart failure. For most of them will also be the degree or magnitude of the individual errors could vary. Combinations of several types of heart failure also occurs. Congenital heart defects are among the most common "birth defects" and is the most common cause of death due to inborn errors.

How does the heart?

Heart
The heart is a muscle that acts as a pump and supply the body with blood. It is divided into four cavities or "chamber". We have two atria and two ventricle, one each on the right and one each on the left side. Atria release blood into the heart chamber, and it is heart chamber which has the main power and pumps blood out to the body (left side) or the pulmonary circulation (right). Between the chambers are valves or flaps. These work in the way that they just do not have the blood through in one direction and prevents blood from flowing back where it came from.

Cycle
Blood circulation through the body is an endless circle. We can start in the heart's right side, and from there goes to the lungs and the blood is enriched with oxygen. The oxygen rich blood has a clear red color (when bleeding blood will always be red, because the blood when in contact with air) and are now transported back to the heart. The heart's left side (which is the strongest part of the heart muscle) carry the blood through the arteries (arteries) to the body's tissues and organs. Arteries is a common term for the blood vessels that carry oxygen-rich blood out to the body. As oxygen is used up blood becomes darker. The dark bluish blood back then transported to the heart's right side through the veins (of the body's blood vessels that carry oxygen-poor blood back to the heart), and then we are back to the starting point where the cycle continues.

What is coarctation of the aorta?
The aorta is the main artery that runs from the heart and supplies the body with blood. A relatively common congenital malformation of this is a narrowing in the chest portion of the aorta. This leads to more resistance as the heart must pump against, and that the blood does not flow as undisturbed as desired. There are a variety of ways to treat this. The surgeon may remove the narrow section and either replace the removed part with a bit of a different vein from the body, if necessary. with an artificial vein. Is the narrow area short, one can only remove it and sew the two ends together afterwards. In some cases it will be possible to insert a small balloon into the aorta which is inflated in the narrow area and thereby extends this.

What is the cause of congenital heart defects?
The nearly 500 children born with congenital heart defects each year. Only in a small number of these can say with certainty what causes heart disease.

Some diseases of genetic systems (genetic diseases) is linked to heart failure. The most common is Down syndrome . Third of children with Down syndrome have heart defects.

It also seems that the inheritance may play a role. If parents or siblings have heart failure, the risk of having a new child with heart failure increased.

There are also environmental / external factors that can cause heart failure. The most common are some viruses and some drug. Mothers who get rubella in the first part of pregnancy are at increased risk of giving birth to children with heart defects.

Some medicines may increase the risk of developing heart disease if they are taken during pregnancy - especially if taken in the first third of pregnancy. Use of alcohol during pregnancy increases the risk of heart failure. Especially children who are born with so-called "fetal alcohol syndrome" are more likely to have congenital heart defects. Also the use of cocaine during pregnancy increases the risk that the child will be born with malformations of the heart.

Some chronic diseases in the mother increases the risk of heart defects in the baby. This includes diabetes . The risk in diabetics can be reduced and it is negligible if your blood sugar is well controlled before and during pregnancy. Mothers with the rare disease phenylketonuria or Follings disease is likely to have children with heart defects, unless they follow a carefully balanced diet before and during pregnancy.

How will doctors and hospitals investigate child?
Most heart defects detected by routine inspections unless the child has shown no signs of heart disease. It is often detected, a "murmur" when the doctor listens to heart. Children with normal hearts may also have heart murmurs, but it will often be necessary to have further tests to find out if there is something wrong in the heart causing the murmur.

If your child has symptoms of their heart defects may take the form of increased incidence of respiratory infections. In infants, a brand that they have difficulty breathing when they eat, they will often also have lower weight gain than one would expect. Swelling in the legs, abdomen or around the eyes can also occur and is a sign of poor cardiac function.

Some heart defects cause a blue-pale coloring of the skin, a symptom medicine called cyanosis. This detects an often soon after birth, but in some cases it will not appear until later in childhood. The cause of blueing is that blood does not contain enough oxygen. Children with cyanosis become easily tired, short of breath and can faint - especially during exertion. A typical characteristic of children with this type of heart failure is that they are much squatting, as this makes it easier to breathe.

In suspected heart defect baby will be thoroughly examined in hospital. It can be done a lot of research, but ultrasound generally provides the most information. This survey is called echocardiography, and is not dangerous or uncomfortable. It shows us how the heart looks like, and the direction and speed of blood pumped through the heart.

Other studies done in the hospital, blood pressure measurement, measurement of the amount of oxygen in the blood, ECG and a survey called cardiac catheterization.

What is the treatment?
The aim is to detect the condition early so that proper treatment is given and the patient can avoid serious complications in the short and long term. In severe heart failure in infants with coarctation is prompt medical stabilization important in anticipation of surgery. Surgical correction is the most important treatment to ensure good long-term prospects for the patient. In children without symptoms recommended surgical correction planned for 3-5 years of age.

Various surgical methods have been developed. From ancient surgical removal of the involved segment of aorta has been the preferred technique with high success rate. More recently, balloon dilation (blasting of the stricture) and placement of endovascular stent become common to perform - especially in those who are unfit for surgery. Surgery is still considered as the best method of treatment of infants with critical coarctation.

For many years it was believed that the operation was healing and without the need for regular monitoring. Later settlement of patient materials have shown that many patients received long-term complications such as new coarctatio, aortic aneurysm, accelerated atherosclerosis and hypertension.

How is long-term prospects?
For those who survive surgery at a young age, living good prospects.

Congenital heart defects

What is hypoplastic left heart syndrome?

Hypoplastic left heart syndrome (hypoplastic left heart syndrome - HLHS) is a very serious congenital heart disease in which the left heart is underdeveloped (hypoplastic). There are different degrees of HLHS. The syndrome is relatively rare, and the cause is usually not known. Girls with Turner syndrome have an increased incidence of HLHS.

What are the symptoms of the condition?
Pregnancy and childbirth extends generally normal. Symptoms usually occur within 1-2 days after birth. Because of heart failure can not child's heart to pump adequate amounts of blood throughout the body, and it is gråblekt, limp and have trouble sucking milk. The organs do not get enough oxygen and quickly takes damage unless treatment is started early. The consequences can include being kidney failure, damage to the intestines, seizures, heart attacks and death.

How the diagnosis?
It is important that the diagnosis is made quickly. The suspicion of serious heart defects arise when newborn few days after birth suddenly becomes poor. The main technique for detecting HLHS is ultrasound examination of the heart ( echocardiography ). This survey is completely harmless and takes place at the ultrasound device is placed on the child's chest. The doctor will then submit a picture of your child's heart and see if it has serious flaws.

Ultrasound scanning in pregnancy can often prove HLHS. The advantage of detecting the condition during pregnancy is that the birth may be prepared and treatment is initiated quickly.

What treatments are available?
Children with hypoplastic left heart disease need immediate treatment to survive. In the first place it involves oxygen and various medications. It may be necessary to use the respirator for the baby to get enough oxygen. If conditions are right for it, the child as soon as possible transferred to a hospital with surgical expertise to operate such errors. This at the hospital. It is a very demanding operation called Norwood-Fontan method and for the result to be successful, it must be done in three steps. Second step is done when the child is 4-6 months old, and the last step is accomplished by 1.5-2 years of age. Sometimes the error is of such a nature that the operation is useless, and the child must be allowed to die as peacefully as possible.

How is long-term prospects?
The prognosis depends partly on the extent of heart failure is and how quickly treatment is started. For the group as a whole, ca. half of the children born with HLHS, survive all three steps of Norwood-Fontan method. For these are relatively good prognosis.

Children who have surgery for HLHS are at increased risk of getting inflammation of the choroid in the heart ( endocarditis ) in connection with subsequent surgical treatment. This also applies to engagement of the mouth, such as tooth extraction. It is therefore important to inform physicians and dentists so that you get prophylactic antibiotic treatment in such situations.