Medical Health Information

INFARCTION - Pain squeezed in the chest, jaw and arm, are the most common heart attack symptoms. But in women, coronary accidents occur with other signs. Follow the leader.

Infarction does not affect men between 50 and 60 years who smoke, do some exercise and are overweight. It is also a female disease: one in three women will die of cardiovascular disease. By comparison, a twenty-five succumb to breast cancer. And while cases of myocardial infarction have been declining in men, the reverse is true among women over 55 years. Follow our tips to recognize that cardiovascular accident.

► Smoking and stress, know the risk factors

The risk factors are smoking, high blood pressure (and stress), cholesterol, obesity, physical inactivity and alcohol. As for the man. But they do not have the same effect on the arteries of the woman, told MetroNews Professor Claire Mounier-Vehier, first vice-president of the Federation of Cardiology (FC).

The reason is physiological. The arteries of women are thinner and tear more easily. In addition, five years after menopause, the protective effect of natural estrogen, allowing the arteries to be flexible, dilated and prevent clots, disappears. In parallel, the rate of triglycerides and bad cholesterol increase. Result: "The arteries thicken, stiffen and are dirty."

► Stomach pain and shortness of breath, recognize the symptoms

Now that you know that myocardial also affects women, learn to recognize the symptoms . The most common is chest pain, the feeling of grip in the chest. But women also develop other symptoms such as stomach pain may suggest a gastric ulcer, vomiting, shortness of breath on exertion or palpitations. Well beware, they may also reflect cardiac risk.

► Call 15 and follow a cardiac rehabilitation

What worries the vice-presidency of the (FC) is that women are "sitters." When one of them has symptoms of heart attack, it takes an hour longer than a man before calling the ambulance. But it is important to act quickly to unclog arteries and limit the extent of infarction. To do this, you'd better call the ambulance, which will take the patient directly to a cardiology department.

Another problem, "we must give them kicking butt so they follow a rehabilitation after stroke, whereas it reduces the risk of recurrence. " In fact, only one in ten women following rehabilitation. A glimmer of hope remains: "Women become informed vectors prevention among their friends and colleagues." Have a ball.

First aid for acute chest pain

Acute chest pain may be a sign of an acute myocardial infarction. A life-threatening condition that requires hospitalization immediately.

Background

• A heart attack caused by a blockage, typically a blood clot which is formed inside an artery (artery) that bring blood to part of the heart muscle

• The blockage results in this part of the heart muscle loses blood supply and the consequences of blockage depends on the amount of heart muscle that deprived blood supply. Whatever occurs in the majority of cases, acute chest pain

• The most serious complication of a heart attack is that there is an error in the heart rhythm - asystole or ventricular fibrillation - which leads to cardiac

• If you suspect a heart attack, ask the patient rest and make sure they come to the hospital as quickly as possible

Typical symptoms and signs

    Chest pain, constricted end, may radiate into the jaw and into the arms
    Clammy and cold sweating
    Nausea and vomiting
    Any breathing difficulty
    Alternatively, dizziness and fainting
    Alternatively blue lips

First

• Get the person to sit down

        It is best if you get that person to lean back and rest your back against a wall or chair back so that the head and shoulders is supported and your knees are bent

• Call 113 or call for otherwise acute medical care

•     Do you live far from the hospital or doctor, it can sometimes be quicker to get the patient into a car and drive to the nearest hospital

•        Alternatively, it may be necessary to use air ambulance

•         If you have a heart attack, never drive themselves

•     Take one tablet salicylate

•         Eg. Dispril, Albyl, Aspirin - chew it to accelerate uptake

•         If the patient has angina medicine nitroglycerin, should be taken

•     Begin CPR

•         If the patient is unconscious, it may be that the emergency medical center calling (113) instructs you to start CPR

•         Even if you have no training in it, can you explain how to do it

•         Keep doing this until help arrives

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 (myocardium) with blood. When coronary artery disease is narrowing and closing of sections of coronary arteries to the heart muscle is insufficient oxygen supply.What is imaging?

What is imaging?
Scintigraphy is a survey in which the body is supplied small amounts of radioactive substances (radiofarmakon or isotopes). The study takes place in two stages. First, the injected radioactive substances directly into the bloodstream. These drugs are designed so that they primarily concentrated in the organs of the body you wish to examine. This may take some time, so there is no waiting time between injection and image recording. Using a device that detects the radiation from substances, it forms a picture - a scintigram. The image is a collection of points. Computer technology can be used to create information-rich images that professionals can interpret.

What is a myocardial perfusion scan?
Scintigraphy of the heart is a bloodless isotopunder survey heart. The study carried out with the use of computer technology that makes it possible to make cut images of the heart (computed tomography). The images show how the radioactive elements are distributed in heart muscle. How do you get pictures of the blood supply to the different areas of the heart muscle, and any areas with reduced blood supply can be detected. The method also makes it possible to assess and measure the function of the heart.

When done myocardial scintigraphy?
This is a special examination performed on patients with fuzzy heart disease (angina pectoris or myocardial infarction). There may be patients with abnormal exercise ECG without chest pain, patients with typical chest pain and patients with angina pain but with normal exercise ECG. There may be patients suspected of having a heart attack, but the usual tests do not provide a clear answer about the condition. Sometimes used the study to clarify whether proven narrow coronary arteries is of importance. The survey can also identify the extent of damage after a heart attack. In some cases, doing research for heart surgery to assess the risks of the procedure. The survey can also be used to assess how successful PTCA has been, or whether a bypass vein is clogged.

Survey
The radioactive substance is administered blood through intravenous injection. Thallium is concentrated in heart muscle cells and uptake by the cells is proportional to blood flow. That is, the areas of the heart with reduced blood flow appear as areas of reduced uptake. The test is performed during physical load on the cycle ergometer or treadmill, or by administering a drug. New pictures taken after a few hours of rest. Location and extent of areas with decreased blood flow assessed, and it can distinguish between areas that have transient or permanent renal blood flow by comparing images taken during exercise and at rest.

The survey may also be used to measure blood flow through the heart. The images used to calculate how well the heart empties. The survey can be useful in patients with valvular disease and suspected renal force of the heart muscle, heart failure. One can also analyze the motion of the heart wall in patients with angina pectoris or myocardial infarction, and identify areas with reduced mobility or with signs of ballooning of the heart (aneurysm).

Patient Preparation
Follow the instructions that apply to your hospital. In broad terms, however, apply the following:

Ideally, you should be fasting for 8 hours before the test, but you can possibly drink some water. If you are charged on an exercise bike, it may be an advantage if you have taken a light meal a few hours prior to the test.

Should you be tested with the drug adenosine, it is important that before the survey have not been drinking tea, coffee, cocoa or other caffeinated drinks, or you've eaten chocolate or taken asthma medicine theophylline. Should you be tested with the drug dobutamine, have stopped any treatment with beta blockers after appointment with your doctor. You should not have taken Viagra in the past day.

Chest

Normally radiograph of the chest
Chest includes chest (thorax) with ribs, lungs with pulmonary sac (pleura), bronchi, and chest partition (mediastinum) that contains the heart, large blood vessels, trachea and esophagus. In technical terms described X-ray of the chest as chest X-ray.

What is X-ray of the chest?
Chest X-ray images lung, lung sack, heart and aorta (aortic arch), mediastinum and the bony parts of the chest. Although this is the most commonly performed x-ray examination, it can be one of the most difficult investigations to interpret. In normal examination are normal appearance and normal position of the organs.

When done x-ray of the chest?
The assessment of possible disease of the lungs, mediastinum and bone. The investigation used to diagnose lung diseases, tuberculosis, cancer, changes in the mediastinum and in the bony parts of the chest. X-rays are also taken as part of the monitoring of lung and heart disease. The survey makes it possible to follow the development of a lung disease over time. The study may also provide valuable information about heart failure and other cardiovascular diseases. In critically ill chest X-ray is used also to control the position of the embedded tube, catheter or other equipment.

Survey
No preparation is required. You must be stripped top and necklaces must be removed. Routine examination consists of two images: Image Front and side picture. Images are preferably with the patient standing. Photos of lying patient is of lower quality and more difficult to interpret. You will be asked to breathe deeply and hold their breath while the image is taken. You must stand still. The survey takes only a few minutes.

What to do?
Routinely evaluated lungs, the middle part of the chest, diaphragm, heart, position of the heart and mediastinum, ribs, vertebrae. X-ray Doctor looking for masses of air spaces, convergence of lung tissue, round shades (including neoplasms), widespread small shadows (cancer spread, metastases), signs of fluid or disease of the lung cavity, enlarged lymph nodes or tumors of the mediastinum. A significant number of diseases can be detected, among the most important is pneumonia in different varieties, foreign bodies in the airways (eg. Among infants), tumors, air leakage into the pleural space (pneumothorax), pulmonary tuberculosis, sarcoidosis, dust lung diseases in the bony part of the rib cage , enlarged heart, heart failure, signs of valvular disease of the heart. Further evaluation of unclear pulmonary findings will usually be bronchoscopy , CT or MRI .

What is X-ray of the heart?
This is a relatively rough survey and provide any detailed information about the heart. The study assessed cardiac size and shape.

When X-rays of the heart?
The study used less today than before because plain radiographs of the chest shows the impact of heart disease on the lungs and lung caves, and because echocardiography provides better information about the heart's appearance and function.

Survey
The survey requires no preparation. You must be stripped top and necklaces must be removed. The image is taken as a normal lung image. The front image and a side image is taken while standing, inhale and hold your breath. Front image must be properly exposed to x-ray the doctor can see calcifications inside the heart and any abnormal contours. Your height and weight must be stated that the radiology doctor will be able to calculate the size of the heart. The survey takes only a few minutes.

What discoveries can be made?
The heart may be enlarged, it may have changed shape, there may be calcification of the heart valves or heart lining (pericardium) outside the heart. Sometimes it can also be seen changes in the main artery that runs from the heart.

What is Positron Emission Tomography?
Positron emission tomography (PET or PET scan) the diagnostic tests available physiological images, the detection of positrons by an example of the activity of cell and tissue images can be generated. Positrons emitted from a radioactive substance administered to the patient is small particles. PET, ie, (emissions) radioactive detection of qualitative and quantitative understanding of the organization preparing the way for a nuclear medicine scan. Images obtained with this technique are used to investigate a variety of diseases.

What is the procedure?
Most commonly used PET to detect cancer, pre-staging of the cancer and to examine the effects of cancer treatment on cancer tissue. While other imaging methods such as X-rays, CT and MRI only shows pictures of the "appearance" of a cancer, PET can show if the tumor is active or inactive - that distinguish scar tissue from active tumor tissue. Such knowledge may be crucial for the further treatment of a patient. The survey can also be used to find the source of a cancer that has spread, distinguishing between benign and malignant tumors. Especially useful PET has proven to be lung cancer, malignant melanoma, esophageal cancer, cancer of the head and neck region, thyroid cancer, breast cancer, cancer of the colon and rectum, ovary cancer, lymphoma.

The picture taken of the entire body. Often combined PET and CT images in order to achieve a more precise localization of the changes that had to be demonstrated. PET images of the brain can be used to assess patients with memory disorders of unknown cause, suspected of having a brain tumor who have epilepsy (seizures) that do not improve with medication and who may be candidates for surgery.

PET images of the heart can be used to determine blood flow to the heart muscle and can help in the assessment of coronary artery disease (angina pectoris and myocardial infarction). PET images of the heart can also be used to identify the areas of the heart that have reduced function, is still alive or if it is just scar tissue from previous heart attack. PET may help to distinguish non-functional cardiac muscle from muscles that may benefit from a treatment such. angioplasty or coronary by-pass, treatments that can improve blood flow and cardiac function. PET is particularly useful for this purpose in overweight, because fat tissue to a small extent the radiation.

What happens during the PET examination?
Before starting the test system and the body's general cyclotron radioactive material substance, most commonly glucose (blood sugar), but sometimes water or ammonia, "attachment" and called the drug is injected into the patient, the drug's specific body sites and detected by the PET scanner.

Different colors or degrees of light intensity of a PET image representing different amounts of tissue or organ function. For example, healthy tissue using glucose as energy source and some of the radiolabeled glucose will appear on the PET images. Cancerous tissue, which uses more glucose than normal tissue, will absorb more of the radioactive substance and appear as brighter than normal tissue on the PET images.

How do I prepare for the examination?
PET is usually performed, ie in patients who are not admitted to hospital. Your doctor will give you detailed instructions on how to prepare for the examination. Wear comfortable, not too tight clothes. You should not have eaten the last four hours before the test, but you are encouraged to drink water. You need to keep you nice and warm in the hours preceding the survey, for "frost in the body" may interfere with the interpretation. Your doctor will advise you about the use of any regular medication prior to the study.

What does the "PET machine" out?
PET scanner has a hole in the middle and looks like a large donut. Inside the machine there are many rings that records sent (emitting) of positrons from the radioactive substance is injected into your body, and makes it possible to produce an image of the body. While lying on the examination table, the table is moved into the hole in the machine. The images displayed on a screen of a computer in the control room where the examination takes place.

How is the survey?
A nurse or techniques will take you into the examination room. You lie down on the examination table and get a shot of the radioactive substance is inserted directly into the bloodstream (intravenously). It will then take about. 30-60 minutes where the radioactive material flows around the body and is taken up into the tissue to be examined. During this period you will be asked to relax, the lighting is dim, you screened for chatting and you'd better be at rest - so avoid that the localization of the radioactive substance affected.

So start recording image. It takes an additional 25 minutes. Usually there are no restrictions after the investigation is completed, but you are encouraged to drink plenty to flush out the radioactive substance from your body.

Will I notice anything during the exam?
The injection of the radioactive substance is like a conventional syringe prick. You lie and relax. During the shooting, you have to be at rest. Some might feel a little tendency to claustrophobia, and for some it can be difficult to remain completely still so long. You will not feel any discomfort due to radioactivity in the body. The radioactive substance will quickly disappear after investigation and involves no health risk for you.

Who interprets the results?
Usually it is a radiologist with specialized training in interpreting PET images considering the pictures and make a report to the doctor who referred you. Usually it takes only a few days before results are available.

What are the advantages and disadvantages of the survey?
Because PET allows study of body function, it can help physicians detect changes in the biochemical processes that suggest disease before changes in anatomy, for example. CT or MRI.

Because radioactivity is very short, the radiation exposure is very low. The radiation is so small that it does not affect the normal processes of the body.

The radioactive substance may expose the fetus to radiation if you are pregnant or may get into breast milk if you are breastfeeding. The risk to the fetus or child must be weighed against the potential benefit of PET study.

What limits the PET?
PET can give false results if your chemical balance is abnormal. This applies particularly diabetics or patients who have eaten the last hours before the test, because it can affect your blood sugar and insulin levels in the body. Since the radioactive substance decays quickly and seems only a short time, it must be produced in a laboratory near the PET machine. It is important that you arrive on time to the study.

PET performed by a physician who specializes in nuclear medicine, and who has experience with PET. In July 2005, installed the first full PET machine. In December 2005, also installed a machine at the hospital.

The utility of PET images increases when they are part of a larger diagnostic evaluation. In particular, comparisons with other imaging methods such as CT and MRI are useful. As already mentioned, a combination study of PET and CT to provide more accurate information about the location of any findings.

There is still some uncertainty about the accuracy of PET, ie the risk of making false positive and negative findings.

What is MRI?
Magnetic resonance imaging MRI shortened. MRI machine consists of a powerful magnet, a radio transmitter, a radio receiver (antenna) and a computer. These components work together in such a way that it produces images of the interior of the body. The machine is open at both ends and is well lit. When the investigation is done, you're inside the machine and are in a strong magnetic field. The machine simultaneously transmits radio waves towards the area to be examined. Depending on the tissue in the body these radio waves hit, different amounts of radio waves captured, absorbed. In the strong magnetic field detected by this antenna / radio receiver in your computer. The signals in this way is captured, sent to the computer which produce images.

Computer technology makes it possible to produce images in many planes as well as in three-dimensional images. There are many variations and special techniques which can be used to affect the MRI signal to emphasize specific types of tissues. Procedures for image acquisition varies from center to center. MRI is still under development and improvement.

In contrast to CT and X-rays are not radioactive radiation. There is no evidence of harmful effects on humans of the magnetic field and radio waves used for the MRI.

MRI of the heart
Among the imaging methods, MR is the one who can provide the most comprehensive information about the heart's structure (anatomy) and function. Without sticking needles or catheters into you, and without the use of radioactive rays, MRI can provide important and often unique contributions in the diagnosis of both congenital and acquired heart disease by.

MRI scan of the heart can provide excellent images of the heart seen in different planes. In addition, MRI can provide information on several aspects of cardiac function, eg.

• how well the heart contracts and work - the heart or parts of the heart
• how well the heart valves work
• how well the heart pumps blood into cycles
• how freely and quickly blood flows through the heart
• how good is the blood supply to the heart muscle (myocardium) at rest and under stress

There are signs of damage to the heart muscle
Each of these issues, however, requires separate, specific human rights record and to avoid unnecessary investigation takes a long time, it must be tailored to the individual patient.


Patient Preparation
Usually it is not required dietary measures or other preparations. Patients with pacemakers, cochlear implant (apparatus of the middle ear) and metal clip attached to the blood vessels in the brain after surgery for subarachnoid hemorrhage ( bleeding in the brain ) can not be performed MR. The same may be true for patients with implanted drug pumps and nerve stimulators. Should you, for example. a metal splinter in your eye, you know. Do you have other metal implants, you should ask your doctor or nurse if it has any significance.

Hearing aids, dentures, jewelry, piercing, hair pin, wig, etc. must be removed before the survey. Certain types of cosmetics (mascara) contains bits of metal and can cause discomfort - you should not wear make-up before the study.

Survey
Most MRI machines are tunnel-shaped with an opening at both ends. Modern magnets are shorter and wider than the older versions. As a result, claustrophobia become a minor problem in MR investigations. During the survey stock machine high bank sounds. Earplugs and / or headphones where you hear music, routinely used to suppress the noise. If only a small area as required depicted (eg heart), added an antenna that captures radio wave signals directly to the skin of the part to be examined.

Although modern MRI machines are more open and less frequent and claustrophobia than older versions, there are some patients who experience survey uncomfortable. To mitigate claustrophobia feeling may in some patients be necessary to give a sedative. Bidirectional communication with the investigators created - you can thus talk to them even if they are sitting in a control room adjacent to the examination room. Try and relax as best you can. The survey is painless.

You lie on a specially designed motorized bench. When you are comfortable, move the bench into the machine. It is very important that you lie still during the examination, so that images are sharp. Because heart constantly moving, be the capture is synchronized with the heartbeat. In some cases given contrast medium into a vein to enhance the images. Study time varies, but usually takes 30-45 minutes.

What changes are sought after?
In congenital heart disease, MRI of the heart to help identify heart failure and cardiac function. MRI can also be used for control after a heart operation.

At present (2004) have cardiac MRI some important place in the study of patients with narrow coronary arteries (coronary artery disease - angina pectoris and myocardial infarction), but it is expected that the investigation in the future will be very important in this area. It appears that the method can provide very reliable information about the blood supply to the different areas of the heart without having to do cardiac catheterization. The method also seems to provide good information about functioning and non-functioning heart muscle, information that is important when considering the extent of damage after a heart attack.

At the heart muscle (cardiomyopathy) also appear MRI to provide better images than the methods that are commonly used today. Otherwise, cardiac MRI is used to assess valvular abnormalities, disease of the heart lining (pericardial disease), and other rarer diseases.

Future Perspectives
MR is going to be an important method in the diagnosis of heart disease. The various MRI techniques are also steadily improved, they are faster and gives better picture quality. With further improvements may also coronary arteries could be made well enough that MRI can replace cardiac catheterization.

MRI in the assessment of cardiovascular disease is not prevalent in this country. This is due partly to a lack of capacity - most of the country's many MRI machines are in continuous use in investigations of the central nervous system and musculoskeletal system. It depends, however, on the lack of expertise. For most of our radiology departments and institutes, cardiovascular diagnostics limited to x-ray of the chest (thorax), while lack of experience with more advanced imaging of the heart.

Good reasons to do a scan of the heart can be congenital heart disease , coronary artery disease , weakening of the heart muscle ( cardiomyopathy and some other myocardial diseases), valvular abnormalities, diseases of the heart lining (pericardial disease) and tumor in and around the heart.