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Am I experiencing Angina ?

I have had several episodes of a tingling pain starting in my shoulder blades, running across my chest and then into my arms. It makes it almost impossible to breath when this happens. I am seeing a doctor, am taking 100 ml of Toprol, and keeping nitorglycerine with me for these attacks. I also will become nausiated out of the blue and feel like i’m gonna pass out. I have broken out in cold sweats before during the nausia. I’m scheduled for a stress test next week. By these symptoms, what do you think will be found in this test?

according to your symptoms, you might be having ischemia(only a little blood getting to your heart), or infarction(heart attack, no blood to your heart). both are bad. some people, especially women, have atypical chest pain. it does not feel like the pain everyone talks about, like an elephant sitting on your chest. some people say it feels more like a tightness in your chest rather than a “pain” you may also have:
* Sensation of indigestion or discomfort in the abdomen
* Dizziness
* Breathing difficulty
* Excessive sweatiness
* Nausea or vomiting
* Pain, pressure, or numbness in the neck, jaw, upper or mid back, or arms.
You can also break out into a cold sweat.

I don’t understand why your doctor is waiting for a stress test. You probably need a cardiac catheterization so they can visualize the blood vessels leading to your heart muscle and see if you have a blockage. If I were you, I would go to the ER immediately. A week is way too long to wait.

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Chronic Complications of Diabetes

While many who view diabetes as a simple sugar problem know the short-term effects of the disease, those who have diabetes or know someone who suffers from it are familiar with the long-term problems that can result from this ailment. Chronic complications are problems that need to be managed and dealt with over a longer period of time. Here are the long-term problems associated with diabetes.

Long-term elevation of blood glucose level leads to angiopathy, the damage of blood vessels. The endothelial cells lining the blood vessels don’t depend on insulin, so they can take in more glucose than the normal amount. They then form more surface glycoproteins than normal. This causes the weakening of the basement membrane, which grows thicker as well. In diabetes, the resulting problems are generally referred to as “microvascular disease” (referring to the damage to the small blood vessels) and “macrovascular disease” (referring to the damage to the arteries).

The damage suffered by the small blood vessels results in microangiopathy, which can cause many different health problems, such as:

* Diabetic retinopathy, growth of poor-quality new blood vessels in the retina that can break easily. It also refers to macular edema, or the swelling of the macula, which can cause severe loss of vision or even total blindness. The retinal damage caused by microangiopathy makes it the most common cause of blindness among non-elderly adults in the United States.

* Diabetic neuropathy, nerve damage and the loss of sensation, generally starts with with the feet, but it can affect other nerves in the body, and often afflicts fingers and hands. When combined with damaged blood vessels, diabetic foot can develop. Other forms of diabetic neuropathy may be mononeuritis or autonomic neuropathy. Diabetic amyotrophy, another result, is muscle weakness that develops from the neuropathy.

* Diabetic nephropathy is damage to the kidney which can lead to renal failure, eventually requiring dialysis treatment. Diabetes is the most common cause of adult kidney failure worldwide.

* Diabetic cardiomyopathy, or heart damage, can lead to diastolic dysfunction and eventually heart failure.
Macrovascular disease leads to cardiovascular disease. This can also lead to artheroscoliosis:

* Coronary artery disease, including angina or myocardial infarction – commonly referred to as a “heart attack”.

* Stroke

* Peripheral vascular disease, which contributes to severe leg and foot pain as well as diabetic foot, which leads to amputation.

* Diabetic myonecrosis

Diabetic foot results from a combination of numbness or insensitivity and vascular damage. This leads to an increases risk of skin ulcers and infection and, in serious cases, necrosis and gangrene. This is the reason why many diabetics are prone to leg and foot infections and why healing times from leg and foot wounds are so much longer. As mentioned above, it is the most common cause of adult amputation, usually of toes and or feet, that is not caused by an accident of some sort.

There are other health risks, but it is important to remember the most common long-term problems associated with diabetes. While some of these problems can be traced to a specific type of diabetes (Type 1 or Type 2), it is crucial to understand where they come from and how you can avoid them.

About the Author

Peter Geisheker is the CEO of the Independent
Pharmacy Marketing
Group. For more information on Diabetes and controlling
high blood sugar
visit
www.santalsolutions.com

Toni Braxton Off from Dancing with the Stars

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Acid Reflux Disease Medications Symptoms Anemia – Acid Reflux Like Know Natural Cures – Constant Burping Gerd Symptoms

Acid Reflux Disease Medications Symptoms Anemia

Do you suffer from heartburn? Perhaps you think that it’s just something to endure hope that it will pass and blame it on eating that curry. Or would you like to know a bit more about it and some simple remedies that can help you. This article will help to explain what heartburn is what causes it and what you can do about it. The tips contained here are simple to remember and most can be applied no matter where you are.

Jeff Martin – certified nutritionist and former heartburn sufferer teaches you his acid reflux freedom step by step success system jam-packed with a valuable information on how to naturally and permanently eliminate your heartburn from the ROOT and achieve LASTING freedom from digestive disorders.

Click Here Now To Learn How To End Heartburn For Good >>

If you are a constant heartburn sufferer then you don’t need to be told how uncomfortable distressing or acutely painful your problem can be. I know it can affect your whole life…

Will I die or this a case of indigestion? Though the question may sound unusual it is all too common. Especially amongst those who suffer from heartburn angina symptoms. Chest pain sweating vomiting dizziness lightheadedness. When these suddenly come on one may be hard pressed to sit down and think calmly: ‘now what do these symptoms indicate?’ You’re much more likely to rush yourself to the emergency room-which if it is severe may be the wisest choice. Learn what you can do to identify it and handle it both immediately and on the long term.

There is a multitude of prescription medicines available for treating acid reflux and the subsequent symptoms. Though no cure has yet been found diet change avoiding late night eating and using prescription medicines can minimize the number of episodes. All prescription drugs have to be prescribed to patients by a doctor after the doctor has made a diagnosis and knows…

Digestive problems are difficult to diagnose and even more difficult to adequately treat. There are many more home remedies and herbs and it may take trying several or combinations of them to find what works best for you.

Heartburn may be the most common physical problem known to man at least in America where we eat just about anything at anytime. This article will take a brief look at the symptoms and treatment of acid reflux disease and hopefully it will help you to…

An ordinary drug normally used as a sleep aid anti-depressant and appetite suppressant has been shown to cure ringing in the ears as well as panic attacks and chronic headaches. Would you like to learn what this miracle drug is? I thought you might.

About the Author

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what causes angina pectoris

What are the symptoms and causes of Cardiac Arrest ?

please tell me!!!!
and..what’s Angina pectoris ??
please can someone tell me !!
nevermind if you only know one of those..i need those information URGENTLY… please!
thanks a thousand in advance!! ^^

Angina Pectoris is the chest pain associated with the heart muscles not receiving sufficient blood to do their proper work. They need blood just like all the other bodily muscles, so when starved of oxygen they begin dying.

The pain is peculiar, because the heart itself has no way of indicating “pain” in the way that ,-say, a burned finger can. So the pain comes from residual mechanisms from the evolutionary process, and can vary considerably, from person to person.

However, usually the pain of angina begins somewhat like severe heartburn, and progresses (if not alleviated by medication) to a dull, cold, heavy pain seated deep in the chest, back, and shoulders. From here it radiates downwards and outwards, arms, head, neck, fingers even. Sometimes numbness, pins & needles, and sweating are present too. Usually, in its later stages, it is accompanied by a raised pulse, as the brain tries to increase the blood output.

Cardiac arrest is simply the stopping of the heart, and can be caused by many different things (trauma, for instance) . But obviously, cardiac arrest is the final stage of a heart attack, which in turn, is the final result of severe and untreated angina pectoris.

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The Missing Piece of the Jigsaw

 

Genetics is the new term in vogue, often that we here that in twenty years we will have solutions to many health conditions. What if there was something more fundamental than genetics, something that was leading to a type of genetic engineering i.e the switching on or off of genes. What if that thing were consciousness – in the words of some scientists the greatest riddle of all is understanding consciousness.

Science is about measuring things, feelings are difficult to quantify, their are different intensities which are of a subjective nature.

Did you know that conventional medicine doesn’t know the cause of 99% of illness. Often we here about this virus or that bacteria. Bird flu is the rage. We are constantly told there could be a pandemic.

Louis Pastor, the originator of the germ theory started to question the germ theory towards the end of his life. It was too late. Germs were the new enemy.

Hygiene definitely improved the lot of millions. When surgeons started wearing gloves cross infections went down. The improvement in the quality of life that sanitation bought to everyone cannot be overestimated.

Without germs life would not exist. The criteria laid down for organic food is not just the removal of pesticides but most importantly the diversity of soil organisms. They are the key determinant of the health of the land. They have multiple functions

What is Meta-Medicine?

Meta-Medicine stems from a scientific discovery that sheds new light on the cause of disease. It is essentially a diagnostic tool and represents a paradigm shift in medicine on a Copernican scale. In the eighties a German cancer specialist stumbled across the answers. The system in nature he discovered w unites all mammals in as much as they share this common biological language.

Meta-Medicine takes into account the bio-psychosocial aspects to disease. That is it looks at the emotional trauma, the physical clinical presentation and the environmental context of the patient. With these factors considered the patient gains valuable insights which could enable them to overcome the patterns which are holding them back and stopping them regain optimum health.

Who would Meta-Medicine Benefit?

Meta-Medicine benefits complementary practitioners, doctors, and patients. Chiropracters will understand what causes a herniated disc, homeopaths are more able to focus their emotional based medicines and with Dr’s it radically improves differential diagnosis

The Psyche, Brain and Organ

The Meta-medicine model unites these three aspects as a unified whole. No longer is there a dichotomy between mind and body as seen in psychiatry and medicine. When considering disease these three have to be taken into account. They work synchronously.

Part of the reason for the dichotomy is that a few hundred years ago when the church held sway permission was only granted for study of the body on condition that the mind/soul was the sole domain of the church. Desperate to do research this rule was adhered to. Knowing this, one is more understanding as to how something so vital could be overlooked

Some definitions of Psyche –

· In psychiatry – the mind as the centre of thought, emotion and behavior.

· Greek for soul.

· Mind as divided into conscious, preconscious and unconscious, Sigmund Freud

· The aspect of the spirit that provides thought and direction.

The psyche is the integrator of all functions of behavior and all areas of conflict. The conditioning of the person determines how they react to certain experiences.

The Brain

This is the main computer of all behavioural functions, conflict areas and organs. Meta-Medicine is a diagnostic tool which uses CT brain scans to inform the consultation. Like the rings of a tree give information on the trees past history the CT brain scan records the history of significant emotional events.

The brain also has direct communication with the organs and under certain circumstances will initiate changes in the organ. In scholastic medicine many diseases have the same symptoms so the Dr engages in what is called differential diagnosis. Essentially he is a detective which attempts to arrive at an accurate diagnosis. CT brain scans allow for more accurate differential diagnosis coupled with an understanding of the root cause.

So What Does Cause Disease?

For centuries man has suspected a psychic origin for disease. This is now firmly anchored as a scientific fact due to the discovery of a German oncologist. One key fact to note is that emotional trauma will only impact the body if it comes as a total surprise to the individual. These events are highly acute, dramatic, isolating and catch us totally unawares. If one breaks the word disease down it speaks for itself – dis-ease.

For What Purpose Dis-ease.

What do you do when feeling uneasy? You look for the cause and attempt to change the situation thereby bringing security and peace of mind. The Dr. happened to be a Professor of Biology and therefore could not help but look at these processes through the evolution of species. Noticing that nature was extremely conserved it was noted that all processes have a function whether man understands them or not.

An example the oncologist uses to illustrate this.

The deer loses its territory in the rutting season. It is old and lacks the vigour it used to have. Unfortunately for the deer the loss of territory means the end for him. Mother Nature enacts a special program we call disease. The main artery feeding the heart loses cells making the vessel wider. This is known an angina pectoris. This ensures increased blood flow with the accompanying nutrients and oxygen. The deer has a second fighting chance.

Everything in Nature is goal orientated or meaningful. The intelligence which crafted life doesn’t make mistakes. Humans don’t like to act in a void so while the understanding has been lacking we have developed hypothesis.

Now with Meta-medicine we have a model which accurately can trace the disease cycle from its inception. In the future the patient will become the boss and enlist a practitioners help only so as to facilitate them in their evolution as a soul.

Have you never wondered why after spending so much time and money the condition persists?

If the conflict remains unresolved the problem stays. A distinction needs to be made between psychological and biological conflict. One can have issues in their life which don’t cause disease. The conflicts only manifest in the body if they are highly acute, dramatic, isolating and shocking. We say biological as these conflicts impact our biology.

Meta-medicine coaches help explain why they have pains, what the issues are and aid them to work through these. If certain patterns keep repeating then the growth of the client is stunted and the body reminds them of this.

For more info – http://www.meta-healthsolutions.co.uk

About the Author

Tremayne Reiss is a naturopath with a passion for medicine.

http://www.meta-healthsolutions.co.uk for more info

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angina or heartburn

Are angina attacks a month after a mild heart attack a common occurence for a male in his mid 40s?

I know a guy who is 44 and had a heart attack (mild one) about a month ago. He was feeling great the first four weeks, but suddenly started having minor bouts of angina the last week or so. Nothing debilitating, just tweaks of heartburn and light-headedness, but would go away with a blast of nitro spay. Is this common? Should it be a major concern, or is it part of the healing process?

Angina is an indication that an ischemia occurs. Ischemia is a state wherein the heart does not get enough oxygen. I would say that this is not normal and is not part of the healing process. The nitro spray (nitrates) help relieve the pain because it produces an effect that increases blood flow and gives increased oxygen to the heart. Your friend better get to a doctor especially if the angina lasts more than 15 minutes – an indication that myocardial infarction has occured.

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Heart Attacks Info

A Myocardial infarction (MI or AMI for acute myocardial infarction) is more commonly known as a heart attack.Damage to the heart muscle is caused when the blood supply to part of the Heart is interrupted. This is most commonly due to occlusion (blockage) of a coronary artery following the rupture of a vulnerable atherosclerotic plaque.An unstable collection of white blood cells (especially macrophages and lipids (like cholesterol) collectively known as Athersclerotic plaque separate from the wall of an artery.The resulting ischemia (restriction in blood supply) and oxygen shortage, if left untreated for a sufficient period of time, can cause damage and/or death (infarction) of heart muscle tissue (myocardium).

Though symptoms of a Heart Attack do differ there are certain classic symptoms such as shortness of breath, nausea, vomiting, pain in the arm, back and neck, and a growing sense of anxiety (also known as impending doom). Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue.{Approximately one quarter of all myocardial infarctions are silent, without chest pain or other symptoms.|It does have to be remembered though that 25 percent of all Myocardial Infarctions occur in silence and without classic symptoms such as chest pain.Prompt treatment for a Myocardial infarction is essential if the patients chances of survival are to be maximised. To be quite honest in situations like these, minutes and seconds do matter.

It is not to be taken lightly as death from Heart Disease and attacks is one of the largest causes of death in the world.Important risk factors are previous cardiovascular disease (such as angina, a previous heart attack or stroke), older age (especially men over 40 and women over 50), tobacco smoking, diet and exercise.

As is also imagined there are considerably more factors that are actually taken into consideration such as additional medical conditions of which potential or actual diabetes is one, obesity, high blood pressure or hypertension and/or incidence of kidney disease

Included in amongst immediate treatment for a suspected or acute heart attack is increased oxygen, the introduction of aspirin and also a liquid form of nitroglycerin known as sublingual glyceryl trinitrate.The more classic form of pain relief is administered involving quite often morphione sulphate.

About the Author

Scott James regularly writes about Health issues and more on the above can be found at Treatments for Heart Disease or http://panicheartattacksymptoms.com

How and what are the factors in decreasing the level of CKMB?

My mother had a mild stroke. CKMB is its 246 (range Normal is approx. 6.2 only) .. its total MM CK and CK was normal when she was experiencing unstable angina. Nitroglycerin is effective, but the pain is still intermittent. Omeprazole had, lacidipine, atorvastatin and clopidogrel as maintenance therapy.

CKMB high frequency is due to a heart attack, but ckm1956 as indicated above, may be due to other conditions as well. A more accurate test is the troponin (Tn). Its altitude is almost always due to a heart problem usually a heart attack. Was it controlled? Enzyme (CK or Tn) elevation is due to something that occurred a few hours or days earlier. These enzymes are released by injury to the muscle cells (usually heart), and remain in the blood so long. A decrease in the level where the problem is caused liberation and the improvement of the cell ceases to injury.

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About Your Heart and Taking Care of it – Naturally!

For your information, there are thousands of miles of blood vessels in our body, and the heart must beat regularly and steadily, 70 or so times a minute, 700 000 times a week, and some 2.5 thousand million times in the average lifetime.

With only as big as a decently sized apple, the heart normally does its job with relative ease, squeezing out 4-5 liters of blood every minute and as much as 24 liters when exercise makes it necessary.  However sometimes things go wrong with this extremely important that is electrically regulated and full of muscles. The diseases that affect the cardiovascular system (comprising the veins, arteries and the heart itself) are very significant in all parts of the world, especially the developed nations. The complications arising due to these diseases are the major cause of deaths in the developed world.

Cardiovascular diseases

Some of the most common cardiovascular diseases are

• Angina Pectoris
• Arrhythmia (Cardiac Arrhythmia, Fibrillation, Ventricular Fibrillation)
• Arteriosclerosis (Atherosclerosis, Coronary artery Disease, Hardening of the Arteries) – It is the No. 1 killer in America, affecting more than 12 million Americans.
• Blood Vessel (Capillary)
• Cardiomyopathy
• Heart Diseases
• Heart Failure (Congestive Heart Failure(CHF))
• High Blood Pressure (Hypertension, Vascular Pressure)
• High Cholesterol
• Low Blood Pressure
• Poor Circulation
• Heart valve problems
• Heart defects

Natural remedies for cardiovascular diseases

Natural and holistic treatments are very effective in the treatment of cardiovascular health. Treatments such as herbal and homeopathic remedies are safe and gentle to use and improve the overall functioning of the heart, arteries and the entire cardiovascular system.

Herbs such as Crataegus oxyacantha (Hawthorn) have well known cardio-protective properties. Hawthorn is highly praised for its beneficial effects on heart health, and has been traditionally used to reduce arrhythmias. Hawthorn is known to regulate heart actions, normalize blood pressure, and strengthen the heart muscles, thus reducing the occurrence of heart related problems. It also protects against the damage caused by plaque build up in the coronary arteries.

Passiflora incarnata is a calmative herb which also relaxes blood vessels and reduces blood pressure.

Viburnum opulus (Guelder Rose bark) is a very effective cardiac tonic and muscle relaxant.

Ginkgo biloba acts as a circulatory stimulant and anti-inflammatory. These herbs also help to reduce the underlying triggers of arrhythmias such as stress, muscle convulsions and high blood pressure.

The beneficial effects of Red Yeast Rice (Monascus purpurea) on balancing blood cholesterol levels have also been clinically demonstrated in a number of double blind, placebo controlling studies involving thousands of people. These studies have demonstrated that Red Yeast Rice can cut levels of LDL (‘bad’) cholesterol by as much as 15%, which compares favorably with similar cholesterol lowering effects of prescription drugs, and that too, without any side effects!!

Recent studies have shown that gugulipid, a highly prized and well known Ayurvedic herb, can be even more effective than many prescription medications in lowering cholesterol and tryglyceride levels in the blood (between 14 and 27% reduction in cholesterol levels over a 12 week period). Even more importantly, gugulipid has also been shown to increase levels of protective HDL cholesterol. Other studies have demonstrated that regular use of gugulipid has helped to prevent the build up of plaque in the arteries and even to reverse the build up of existing plaque. It also prevents blood platelets from sticking together, thereby reducing the risk of blood clots, which often cause heart attacks. Gugulipid has powerful anti-oxidant properties, thereby providing protection and benefit to the entire system.

Unlike conventional medicines, which do not always address the root cause, natural remedies can do this without the risk of side effects or addiction.

For example, in keeping with a holistic approach to health, Naturopaths recognize that high blood pressure may be a sign or symptom of imbalance in the body and thus recommend a combination of lifestyle changes and natural remedies to remove the causes of the high blood pressure, rather than simply just treating the symptoms.

Remember to always source your natural remedies from a reputable company in order to ensure safety, efficacy, and correct therapeutic dosage.

For more information on Herbal Products visit http://www.healthherbsandnutrition.com/products.htm

About the Author

Herbal and Homeopathic Products |Herbal Products for Heart | Herbal Remedies for Blood Pressure

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Having Angina?

i am a 18 year old male, and my doctor said i have angina and she described it as a severe throat infection, the glands on my throat dont let me breathe right because they are very swollen. i do have some chest pains like a squeezing or pulling feeling. and i am very worried about my situation. i am worried because it is a lifethreatning disease and it can result as heart attacks. can this disease be cured with medicine? or only surgery. please answer my question i am very concerned

There are two kinds of angina.
1- Angina which is refered to throat infection and specially tonsil infection mostly caused by streptococci. This kind of infection is mostly seen in young people and is associated by sore throat, fever, head ache, and enlarged lymph nodes in neck. this is an easy to treat situation with proper antibiotic.
2- Angina pectoris which means chest pain or most commonly feeling chest pressure due to the fact that heart muscle can not get enough oxygen. This disease is seen in middle age people with family history of coronary artery disease , high cholesterol, diabetes, high blood pressure, and history of smoking.

Which of these risk factor do you have?

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PRE -OPERATIVE MEDICAL ASSESSMENT OF DENTAL PATIENT

PRE -OPERATIVE MEDICAL ASSESSMENT OF DENTAL PATIENT

Author:

Dr. Altaf H Malik

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.

 

Co authors: 

Dr. Ajaz A Shah

Associate Professor and Head,

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.

 

Dr. Suhail Latoo

Lecturer

Department of Oral Pathology and Microbiology,

Govt. Dental College, Srinagar.

 

Dr. Manzoor Ahmad Malik

J & K Health Services, SDH Banipora

 

Dr. Rubeena Tabasum

Resident

C.D Hospital, Srinagar.

 

Dr. Shazia Qadir

Dept. of Oral and Maxillofacial Surgery,

Govt. Dental College, Srinagar.

 

INTRODUCTION

 

Knowledge regarding the patient’s medical condition is of utmost importance in patient management and care pre and post surgically. A detailed medial history will give the practitioner all the necessary. Relevant information regarding the patient’s general condition as well as physical status

 

PHYSICAL STATUS CLASSIFICATION SYSTEM

In 1962, the American Society of Anesthesiologist adopted the ASA physical classification system. This system identifies the medical risk to a patient undergoing a surgical procedure. The classification system is as follows:

ASA I:        A patient without systemic disease; a normal, healthy patient

ASA II:       A patient with mild systemic disease

ASA III:      a patient with sever systemic disease that limits activity, but is not incapacitating

ASA IV:     a patient with incapacitating systemic disease that is a constant threat to life

ASA V:       A moribund patient not expected to survive 24 hours with or without surgery.

ASA E:       Emergency operation of any kind, E precedes the ASA number, indicating the patient’s physical status.

 

 

 

CARDIAC DISEASE.

Although all types of cardiac diseases are at high-risk of serious complications when undergoing surgical procedures under general anesthesia, certain conditions like unstable angina, congestive cardiac failure , valvular septal  defects, and myocardial infarction increase the risk four folds. A history of bypass, angioplasty or valve replacement is of significant importance. Although cardia disease is not an absolute importance. Although cardiac disease is not an absolute contraindication, the surgeon should weigh the benefits against the risks before deciding the choice of anesthesia.

 

Preoperative Investigations

1. 1.       Routine chest radiograph-posteroanterior view.
2. 2.       Electrocardiogram
3. Echocardiogram

4        Stress test

1. Blood investigations like lipid profile and bleeding time, clotting time and prothrombin time and index in case the patient is on long-term anticoagulants

 

Preoperative medications

If the patient is a case of rheumatic heart disease or has undergone valve replacements, a suitable antibiotic prophylaxis must be given. If the patient is on injection penidura every three weeks, the surgery should be scheduled immediately after the scheduled dose to reduce the risk of infective endocarditis. Patients on long term anticoagulant therapy should discontinue the anticoagulants at least 4 to 5 days prior to surgery with the physician’s consent. If discontinuation of oral anticoagulant therapy is not advisable, the patient should be shifted to intravenous anticoagulants like heparin. The patient’s bleeding time and clotting item is checked on the day of surgery after omission of the anticoagulant.

 

Intra and Postoperative management

1. All the patients should be monitored intra and postoperatively by means of ECG, pulse oximeter, and arterial line.
2. A central venous pressure (CVP) cut down may be performed if necessary.
3. The patient should be maintained on intravenous cardiac drugs till oral feeds are given
4. Fluid overload should be voided, especially in cases of congestive cardiac failure. The fluid volume can be judged by the CVP.

 

HYPERTENSION

 

Hypertension is considered to be the elevation of the blood pressure above 140/190 mm of mercury.

Uncontrolled hypertension can have the following surgical and anesthetic complications.

1. It reflects on the cardia status of the patient, thereby increasing the an aesthetic complications
2. It reflects on the cardiac status of the patient, thereby increasing the anesthetic risk to the patient.
3. It causes excessive bleeding from the operation site, thereby complicating the surgical procedure as well as significant blood loss for the patient.

 

Preoperative investigations

1. Chest radiograph-poster anterior view for detecting cardiac enlargement.
2. ECG
3. USG of the kidneys
4. Opthalmic evaluation for pailledema and retinal haemorrhage.

Renal function tests (Blood urea nitrogen serum creatinine and serum electrolyte).

 

Preoperative Medication and Management

The patient’s blood pressure should be monitored and controlled within the normal permissible limits prior to the surgical procedure. If the patient is on antihypertensive, the morning dose of medication prior to surgery must be given with sips of water.

 

Intra and Postoperative Management.

1. The blood pressure should be monitored continuously intra and postoperatively.
2. The patient’s cardiac status should also be monitored on the ECG machine and on the pulse oximeter.
3. Antihypertensive must be continued intra and postoperatively.
   1. If the patient is on diuretics, the patient must be supplemented postoperatively with intravenous potassium supplements.
   2. If the procedure is performed under local anaesthesia, then local aneasthetic without adrenaline or bupivacaline, which does not have any significant effect on the cardiac status, is to be used.

 

RESPIRATORY DISEASE

Respiratory disease can be categorized obstructive and infiltrative pulmonary diseases. Obstructive pulmonary disease includes chronic obstructive pulmonary conditions like, asthma, chronic bronchitis, pneumothorax and emphysema. Infiltrative disease is inclusive of diseases that cause inflammatory changes in the alveolar walls. Any respiratory disease is first characterized by dyspnea.

The patient with decrease in the pulmonary reserve poses a great risk for procedures under general anaesthesia. The patients should be asked for a thorough history of beedi/cigarette as well as past history of tuberculosis. If the patient is suffering from tuberculosis, then details of his / her drug regimen and duration of treatment is asked. From the surgeons point of view the most important aspect is the patient’s respiratory reserve and his ability to tolerate general anaesthesia. If the patients treated under local anaesthesia, the broncho- dilator inhaler should be kept ready for use in case of an emergency.

 

Preoperative Investigations

1. Routine chest radiograph – posteroanterior view.
2. Pulmonary function tests.
3. Blood investigations like arterial blood gases.
4. Sputum AFB / culture.
5. Bronchoscopy, if required

          The patient should be counseled to discontinue beedi / cigarette smoking prior to the procedure. Any acute infection should be treated by antibiotics. The patient should be on bronchodilators pre, intra and postoperatively. The patient must carry his / her inhaler with him / her for use in case of an emergency.

 

Intra and Postoperative Management

1. Arterial blood gas monitoring should also be carried out intra and postoperatively.
2. Avoid fluid overload
   1. Blood loss should be replaced by whole blood or packed cells to avoid decrease in the oxygen carrying capacity of blood.

 

RENAL DISEASES

Patients with renal disease like renal failure, acute glomerulonephritis, and nephrotic syndrome pose a significant surgical risk. Disturbances in the renal function leads to changes in the acid base balance, serum calcium and phosphorous levels, fluid retention, and electrolyte concentration. A patient with chronic infection may develop sepsis postoperatively. These patients also have associated hypertension secondary to fluid retention and anaemia.

 

Preoperative investigations.

1. Renal profile-blood urea nitrogen, serum cretinine, serum electrolytes.
2. Creatinine clearance test.
3. Serum calcium and phosphorous.
4. Urine analysis-physical and microscopic.
5. USG of the kidneys.
6. Renal Doppler studies.
7. Radionuclide scanning for renal clearance time

 

Intra and Postoperative Management

1. Fluid balance, acid-base balance and electrolyte balance must be closely monitored.
2. Renal profile tests must be performed intra as well as postoperatively.
3. Blood replacement is done by washed packed cells.
4. Potassium overload during fluid replacement is to be avoided.
   1. The patient should be covered with broad-spectrum antibiotics to prevent sepsis. As most antibiotics are excreted through the kidneys, only a few have been proved safe for use. Amoxycillin, doxycycline and minocycline are a few recommended antibiotics.

 

MANAGEMENT OF RENAL TRANSPLANT PATIENT

1. Renal transplant patient’s come under American society of Anaesthsiologist Risk category III (Requiring medical consultation)

2. Stressed  Reduction:

Patient should obtain proper rest the night before.

Appointments should be kept short.

Barbiturates and Benzodiazepins can be used in normal amounts.

Nitrous oxide-oxygen combination is an excellent anxiolytic.

Maintain a non-threatening environment.

Morning appointment.

Consultation with the patient’s physician for the need of additional steroids.

Steroids dose can be doubled the day before on the day of, 2 days after dental procedure.

Graft survival -> 90% at one year with overall mortality rate 5%

Patients need to immuno suppressed with a corticosteroid plus steroid sparing drug (azathioprin) cyclosprim to prevent raft rejection.

Treatment:

Those with symptoms of Cronic Renal Failure –Treatment like CRF

Immuno suppressed-> steroid + antibiotic prophylaxis.

Hepatitis common- patient kept away from source of infection

Candidiasis.- Topical nistatin, amphoterecin, miconazole

Patients on immunosuppressive therapy with renal transplantation have a risk of developing – malignant disease, (lymphoma, skin, cervical and lips cancer) leukoplakia, kaposis sarcoma

 

Drugs that can be used in Renal transmutation patients

SaferDrugs- Cloxoacillin, Penicillin, Minocycline, Erythromycin, 

                      Refampicin, Lignocaine. Chloralhydrate,Diazepam

 

Fairly Safe- Ampicicilin,amoxicillin,Benzylpencillin cotrimazole,  

                    metronidozole,codein, Barbiturates, Phenothiazins.

Less safe- Aminoglycosites cephalosporin, pracetamol, acetoaminophin,  

                 pethidine, opiods, antihistamins,

Avoid Drugs Tetracyclin , sulphonaimides, NSAID’s and Aspirin

 

HEPATIC DISEASE

1.      

 

Preoperative Investigations

1. Liver enzymes—SGOT (serum glutamic oxaloacetic transaminise),

 SGPT (serum glutamic pyruvic transaminse).

1. Total bilirubin, direct and indirect bilirubin.
2. Serum albumin.
3. Serum alkaline phosphates.
4. Bleeding time and clotting time.
5. Prothrombin time and index.
6. USG liver.
7. Australia antigen test.

 

Intra and Postoperative Management

1. Avoid unaesthetic gases that are metabolized in the liver, like halothane.
2. Correction of coagulation deficiencies by IV vitamin K, fresh frozen plasma transfusions.
3. Careful intra and postoperative management of blood volume, cardiac output, urine volume and co0mposition.
4. Potassium supplementation during fluid replacement.
5. Appropriate precautions and sterilization techniques to prevent transmission of disease in a carried of viral hepatitis.

 

DIABETES MELLITUS

Diabetes mellitus is caused by an absolute or relative deficiency of insulin in the body can be classified into type 1(insulin dependent) and type 2 (insulin dependent). Type 1 is more commonly seen in young patients and type 2 in adults. A patient can be classified as a diabetic when his fasting glucose levels are constantly above 140mg/dl.

The nature of problems faced by the surgeon during the management of a know diabetic patient are as follows.

1. Optimal blood sugar levels are to be maintained during the procedure as well as postoperatively to prevent hypoglycemia or hyperglycemia and ketoacidosis. Both the conditions may be life-threatening to the patient.
2. The patient is prone to infections and has to be given adequate pre and postoperative broad-spectrum antibiotic coverage to prevent infections.
3. The patient may have additional systemic complications like renal failure, cardiac disorders, and ophthalmic problems and generalized vascular disease due to long-standing diabetes.

          For surgical purpose a diabetic can be classified in three groups:

1. Sugar levels controlled by diet and oral hypoglycemic.
2. Sugar levels controlled by insulin.
   1. “Brittle diabetes”, usually of juvenile onset, whose metabolic needs is labile and have sequel of long-standing disease such as renal failure, retinopathy, and generalized vascular disease.

Elective surgeries can be usually performed without complications in the first two types. In the third type, although the management remains same, amore rigid control is to be exercised intra and postoperatively.

Preoperative Investigations

1. Routine chest radiograph-posteroanterior view.
2. Electrocardiogram
3. Blood investigations like:

          a. Blood sugar fasting and postprandial

          b. Glucose tolerance test

          c. Renal profile (BUN, SC,SE)

1. Urine sugar.

          If the patient is on oral hypoglycemics, he/she must be shifted to insulin on the day of surgery. The general principle for the management of the patient under general anaesthesia is to provide at least 200gm of carbohydrate with adequate insulin to cover this need.

Sugar Levels and Insulin Dose

Sugar Levels (mg %)             Insulin dose

80 – 120                                  Plain 5% dextrose (D)

120-180                                   4 units in 5% dextrose

180-250                                   8 units in 5% dextrose

250-300                                   14 units in 5% dextrose

300 and above                         14 units in normal saline

 

Intra and Postoperative Management

1. Check the patient’s blood and urine sugar levels on the morning of surgery with the help of hemoglucose strips and urostrips or glucometer.
2. Prepare a sliding insulin scale to be followed intraoperatively based on the patient’s sugar levels.
3. Pre and postoperative broad spectrum antibiotic coverage.
4. Intra and postoperative close monitoring of the bold and urine sugar levels.
5. Prevents the patient from going into ketoacidosis or hypoglycemia.

 

Signs of hypoglycemia: The patent is apprehensive restless, agitated, the skin is moist and pale and there is tachycardia. The patient then lapses in to coma.

Treatment : In a conscious patient, ora carbohydrates are given to collect the glucose levels. In an unconscious patient IV administration of 50% glucose solution restores consciousness in 5 to 10 minutes or 1mg glucogon IM restores consciousness in 15 minutes.

 

Signs of diabetic ketoacidosis : Vomiting, tachypnea, Kussmaul (deep, rapid breathing at regular intervals) breathing, dehydration and circulatory collapse.

Treatment: Administration of insulin to normalize body metabolism and restoration of body fluids and electrolytes.

 

6.Shift the patient at the earliest possible to his regular oral feeds and antidiabetic medications.

THYROID DISORDERS

Patients having disorders can be broadly divided in to 3 groups – hypothyroid, euthyroid and hyperthyroid. Out of these euthyroid patients pose no risk for any surgical procedures. In both hypo and  hyperthyroidism, elective surgery is best postponed  till the patient is euthyroid.

The sense of hypothyrodism are water and mucopolysacharide retention, slowing of metabolic process leading to bradycardia, constipation, letheargy and hypothermia. Untreated hypothyroid patients respond poorly to stress and proceed in myxedema coma.

Hyperthyrodism leads to a hypermetabolic state in the body resulting in catabolic state with tachycardia, diarrhea and heat intolerance. If this patient is subjected to stress, he goes in to what is known as “thyroid storm”, which is a state of metabolic hyperactivity lasting for 24 to 48 hours. It is a severe exacerbation of the signs and symptoms of hyperthyroidism and is usually accompanied by hyperpyrexia. The condition is life-threatening and requires control of hyperpyrexia, tachycardia and cardiac failure.

 

Preoperative investigations

1        Thyroid hormone levels – T3, T4, TSH

2        Serum electrolytes

3        Serum proteins

4        Radionuclide thyroid scan to study the gland.

 

Intra and post operative management.

1. Monitor the Hormone levels intra and postoperatively

2. Continuous monitoring of vital parameters, blood pressure, pulse and  

    Temperature.

3. Check for signs and symptoms of hypo / hyperthyroidism

4. Continuous monitoring of cardiac function, especially during thyroid crisis. Infuse thyroid hormone if the patient shows signs of hypothyroidism.

5. If the patient is in a thyroid storm, treat by cooling the patient, intravenous, infusion of glucose and IV fluids, glucose and corticosteroids

6. Use narcotic agents and anesthetic medications judiciously in hypothyroid patients as they can have a profoundly depressing effect.

 

ADRENAL DISEASE.

Two common adrenal disorders that have to be dealt with during surgical procedures are cushings syndrome (overproduction ) and addisons disease (under production)

The symptoms of cushings syndrome are diabetes, sodium and water retention, potassium excretion, hypertension and fat redistribution. the patient also has a tendency to osteoporosis, poor wound healing and purpura formation. During surgery attention must be paid in maintaining optimum levels of carbohydrates in the body, sodium and potassium ion levels and the blood pressure. There may be postoperative problems of bleeding and delayed wound healing.

          Underproduction can occur due to adrenal suppression due to exogenous steroids or due to a disease of adrenal origin (Addison’s disease).Usually any patient who has received steroids for longer than two weeks within a year prior to surgery should be considered as a candidate for adrenal insufficiency.

Preoperative investigations

1.Renal profile.

2.Serum electrolytes.

3.Fasting Blood Sugar.

4.Platletcount.

5.Coagulation profile.

Patients with adrenal insufficiency should be supplemented with adequate exogenous steroids prior to procedure to help the patient combat with stress

 

Intra and Postoperative Management.

1.Continuous monitoring of the vital sings.

2. Adequate intravenous corticosteroid supplementation to prevent adrenal crisis.

3. Maintain fluid and electrolyte balance.

4. Monitor blood sugar levels.

 

NEUROLOGICAL DISORDERS

Neurological disorders can be categorized into patients with cerebrovascualar disorders, seizure disorders and  patients with head injury. the main factors of consideration in these patients is to maintain adequate cerebral perfusion intra and postoperatively and to control any seizure episode during this period. Patients with seizure disorders usually do not pose a great problem for intra operative management except for  cases of status asthamaticus, where there can be life-threatening  complications. The surgeon should weigh the risks and benefits infarcts, aneurysms, and areteriovenous malformations are very high-risk candidates and are absolute contraindications for surgical procedures.

 

Preoperative investigations

1.Routine skull radiographs-posteroanterior and lateral views.

2.CT scan/MRI brain.

3.EEG.

4.Liver function tests.

          If the patient is an epileptics, adequate control of seizure episodes must be achieved prior to the surgical procedure. The anticonvulsant must be continued till the morning of the surgery. The morning dose is given with sips of water.

 

Intra and Postoperative Management

1.The patient should be given intravenous anti-convulsants intraoperatively.

2.Postoperatively the patient should be shifted to his normal dose of anticonvulsants at the earliest possible.

3.Throughout the procedure, hypotension/hyoxia is to be avoided and an adequate cerebral perfusion is to be maintained.

 

DISORDERS OF THE HAEMOPOLETIC SYSTEM

Disorders of the haemopoietic system can be grouped into anaemias, leucocyte disorders and coagulation factor abnormalities(haemophilia).Anamias include iron deficiency anemia, thalassaemia, sickle cell anaemia; and leucocyte disorders include leucocytosis and agranulocytosis.

Any disturbance in the haemopoietic system

1. Predisposes the patient to prolonged bleeding during any surgical procedure, which cannot be controlled by routine hemostatics.

2. May cause severe internal bleeding due to blunt injury following intubation, a condition if unnoticed may pose a life-threatening complication.

3.Leukemic and thalassemic patients may be on repeated blood transfusions and may have liver disorder due to excessive deposits of hemosiderin.

4.the rate of postoperative infection and delayed wound healing is also very high, especially in agranulocytosis, leukemia and anaemia.

 

Preoperative investigations.

1.Complete blood count

2.Bleeding time and clotting time.

3.Prothrombin time and index

4.Partial thromboplastin time.

5.Coagulation factor level assay (in case of factor abnormalities).

6.Platlet count

7.Haemoglobin.

8.Liver function tests

          Prior to the procedure, the patient’s blood counts must be built up to the normal values by transfusion of whole blood, packed cells, plasma or plasma components and clotting factors. For a hemophiliac, the factor VIII level should be raised to at least 50 to 70 percent prior to the procedure. Once the blood levels are normal, the patient can be treated as a normal patient with regards to surgical kept ready for transfusion intraoperatively, if required. In case of leukemics, the patient should be covered with broad-spectrum antibiotics pre and postoperatively.

 

Intra and Postoperative management

1. Avoid undue trauma to the tissues during any procedure performed.

2. Avoid entering deep tissue spaces blindly, thereby preventing any internal bleeding.

3. Complete hemostasis must be achieved prior to wound closure.

4. Intraoperative transfusion of blood/blood products, if found necessary.

5. Monitoring of hemoglobin, complete blood counts intra and postoperatively.

6. Maintain adequate blood volume throughout the procedure and at the same time avoid cardiac overload.

7. Monitor the vital parameters closely for any changes in the fluid volume indicated by the pulse and blood pressure.

8. Postoperatively the patient may be maintained on systemic oral coagulants like vitamin K for 3-5 days.

9. Cover the patient with adequate broad spectrum antibiotics.

10. Avoid medications that can exacerbate the  underlying condition, especially in agranculocytosis.

          In view of the rise in blood borne transmission of diseases like AIDS, hepatitis B and hepatitis C, the government has made it compulsory for testing of all the three viruses before storing the blood in the blood bank. But the decision to transfuse blood and blood products must still be made judiciously weighing the risks and benefits.

 

Management of a Hemophiliac Patient

 

Classically hemophilia is of two types, hemophilia A (factor VIII deficiency) and haemophilia B (factor IX deficiency).The disorder is a sex-linked recessive trait.Approximatley 50 percent of the female offspring’s are carriers of the disorder and 50 percent of the male offspring’s have the clotting disorder. these patients have  the clotting disorder. These patients have a tendency to bruise easily and prolonged bleeding.

The successful management of a hemophiliac is dependent on the adequate maintenance of the antihaemophilic globulin. The normal AHG level is 50 to 100 percent. In a hemophiliac, for good hemostasis, the factor level must be 20 percent above normal, though a normal level is also acceptable.

Thromboplastin regeneration time not only determines the factor VIII deficiency but also distinguishes it from factor IX deficiency. Factor VIII replacement can be provided through blood, plasma, fresh frozen plasma, and cryoprecipitate. The latter is the replacement choice as it offers only the deficient factor.

Management

1. Build up factor VIII level to 50 to 70 percent.

2. Avoid injecting into deep tissue spaces, i.e. avoid block techniques. Use infiltration anaesthesia.

3. Traumatic extraction surgical procedure.

4. Avoid unnecessary trauma to the soft tissues, avoid suturing, if not required.

 

IMMUNOCOMPROMISED PATIENTS

Immunocompromised patients can be grouped into patients having deficiency in cell mediated, humoral immunity, neutorphils complements, patients on immunosuppressive drugs like chemotherapeutic agents and steroids and patients suffering from long-standing debilitating conditions like diabetes and nutritional deficiencies.

          These patients are highly susceptible to infections and must be given

broad-spectrum antibiotic coverage for the same.

 

 

Preoperative investigations.

Complete blood count

 Liver function tests

Renal function tests

Serum proteins

Blood sugar levels.

Urine analysis.

Routine chest radiograph.

 

Intra and Postoperative Management

The management will vary according to the condition the patient is suffering from. Usually it is almost impossible to correct the causative factor and the treatment is usually supportive only.

Constant monitoring of the vital parameters.

Broad spectrum antibiotic coverage.

While handling HIV infected patients, special care must be exercised to prevent the transmission of the disease.

 

AUTOIMMUNE DISORDERS

 

The group of autoimmune disorders includes systemic lupus erythematosus, scleroderma, collagen disorders rheumatoid arthritis, Shjogren’s syndrome, polyartertis nodosa,etc. These patients may have significant cardiac, renal and bone marrow impairment, which may contraindicate elective surgery. The patients, whenever possible must be operated during their remission phase. A few of these patients may be on long-term corticosterioid therapy, therefore, precautions to prevent adrenal insufficiency must be taken.

A few of these patients have loss of flexibility in the joints, especially the thoracic cage and neck joints, thereby posing problems in intubation and ventilation. In posing problems in intubation and ventilation. In scleroderma, the patients have a restricted oral opening as well as restricted expansion of the chest wall.

Patients with collagen disorders may also have delayed postoperative wound healing.

 

PREGNANCY AND LACTATION.

 

Every female patient in the childbearing age must be asked for history of pregnancy of missed menstrual cycles. Great care must be taken when dealing with the pregnant patient since the surgeon has to treat not only the mother but also prevent any undue harm to the fetus. It is safe to perform procedures under local anaesthesia in the second trimester. In the first trimester, there is a risk of stress related abortion as well as teratogenicity, while in the third trimester there is a risk of stress induced while in the third trimester there is a risk of stress induced early labor. General anaesthesia is a contraindication in the third trimester, unless it is a life saving emergency the third trimester, unless it  is a life saving emergency procedure. In the first and second trimesters care must be taken to avoid fetal anoxia.

Again, the risks and benefits must be weighed prior to the procedure, The mother should be fully explained about the risks before performing any procedure. The mother should be fully explained about the risks before performing any procedure. teratogenic drugs like tetracyclines,salicylates, and chloramphenicol are best avoided. Amoxycillin, cloxacillin, ampicillin and paracetamol can be safely prescribed.

 

 

CONCLUSION

Concluding this chapter, a few points need to be highlighted, which will define a basic protocol to be followed during the management of a medically compromised patient.

 

A through knowledge of the patient’s medical background must be obtained.

The surgeon should also have knowledge about the medications taken by the patient and the regularity of the patient in taking the same.

A written consent for the surgical procedure has to be obtained from a specialist in the field prior to the procedure.

Adequate and necessary preoperative investigations must be performed.

The patient should be explained about the risks and benefits of the procedure with regards to his general condition and a witnessed written consent for the procedure, as well as high-risk consent should be obtained from the patient.

          The operation theater must be well-equipped with functional life support systems and an updated emergency trolley in case of an emergency. The same applies to the postoperative recovery room.

The decision of whether or not to operate lies with the surgeon and he/she must make his/her choice judicious weighing the pros and cons with respect to surgical benefits and anesthetic risks

 

About the Author

can unstable angina be diagnosed with a stress test?

No, because with unstable angina the chest pain is occurring at rest

unstable angina stress test

drugs to treat angina

What condition was the drug Viagra originally developed to treat?

a) Anxiety
b) Constipation
c) High blood pressure and angina
d) Migraines

c) High blood pressure and angina

http://www.viagrafans.com

drugs to treat angina

prinzmetal’s angina diagnosis

prinzmetal’s angina diagnosis

angina monologues

Performing Hearts Poll: Would you attend a presentation of “The Angina Monologues”?

I have the opportunity to invest in this venture and am wavering on whether or not it would be profitable.

Would you go see people talk about anginas?
Thanks.

I would go just to learn more stuff about things….

and probably some free food after too….

angina monologues

unstable angina types

Avandia Sales Fall, New Warning Surfaces

Avandia makers, GlaxoSmithKline, recently issued new safety warnings to patients who may also be suffering from heart failure and unstable angina. The company issued a warning to patients taking the drug because of safety fears surrounding an array of scientific studies that have brought to light the risks associated with taking the type 2 diabetes drug.

In Australia, the Therapeutic Goods Administration (TGA) first increased Avandia’s labeling in 2007 to a black box warning, the harshest labeling possible for a pharmaceutical drug. In the United States, the Food and Drug Administration (FDA) recommended that Avandia labels also receive the black box warning, but have declined to recall the drug from the market citing “insufficient evidence” to call for the drug’s removal, according to news reports.

About Avandia Risks

Avandia was released to the public from GlaxoSmithKline approximately nine years ago in 1999. The glycemic-controlling medication has been prescribed to nearly 6 million individuals since its release.

The New England Journal of Medicine first reported a potential increased risk of heart failure for Avandia patients, which was followed by a Swiss study that linked the drug to early onset osteoperosis and bone fracture.

It is unknown as to what will happen with the drug, but the TGA encouraged the new August 2008 warning issued for Avandia.

GlaxoSmithKline Sales Plummet

The antidiabetics market is expected to have an extreme growth over the next 10 years — from $18 billion in 2007 to $29 billion in 2017, according to Datamonitor, a research and analysis company. Additionally, Avandia sales are decreasing as GlaxoSmithKline continues to report declining profits for the drug. In 2007, GlaxoSmithKline saw a 26 percent decrease of sales and in the first quarter of 2008, they reported a 56 percent decrease of sales.

GlaxoSmithKline additionally announced they will be laying off nearly 17,000 jobs, 350 of which have already been cut from the United States. The Datamonitor report also stated that the new antidiabetic growth of sales will likely occur because of a new molecular antidiabetic medication that many companies are changing to, but GlaxoSmithKline is yet to be one of those companies.

Seeking Avandia Legal Assistance

Individuals who are one of millions suffering from type 2 diabetes who received a prescription for Avandia should consult a physician immediately if they show any signs of heart failure problems as well as bone fractures or bone density losses. If an patient of Avandia is consuming the medication and shows any of the following side effects, medical attention should be sought immediately. Side effects include:

* swollen legs or ankles

* changes in vision

* unusual tiredness

* difficulties breathing

* rapid increase of weight gain

* become pregnant or are nursing

* heart failure or heart problems

* liver problems or liver disease within medical history

It is also important for an individual victim suffering from the Avandia side effects to know the legalities surrounding their medical condition and consuming Avandia.

It is advisable for Avandia patients to consult with a pharmaceutical lawyer who will likely provide free legal consultation to better assist a victim’s understanding of developing an Avandia lawsuit, which may be necessary to receive monetary compensation as a repayment for damages incurred.

About the Author

For more information on Avandia, visit http://avandia.legalview.com or http://www.LegalView.com/. Here, users can learn about another type 2 diabetes drug with serious side effects as well as how to develop a Byetta class action lawsuit or to learn about other controversial pharmaceutical drugs including the Ketek side effects.

What is angina? Does that affect the heart badly?

I have mitral valve regurgitation and palpitations badly and a dull type of pain in the center of my chest. Also, what is unstable angina? I need more info. on that as well.
I sometimes have to take deep breaths and I have to try to relax when I do have any dull pain and my fingers get all cold and my nausea comes and goes.

Hello, Angina Pectoris is a chest pain due to a lack of oxygen because of a lack of blood supply to a certain area of the Myocardium ( Heart muscle ), and of course it will affect the Heart because if an Angina is not treated soon enough it will become a Heart Attack. When the Myocardium is not getting enough oxygen, the Heart muscle begins to die and as a result causes an Infarct ( death of tissue ). Mitral Regurgitation means leaking of the valve, so the blood that suppose to go to the left Ventricle is going back to the the left Atrium again because of the regurgitation, this is called back flow of the blood and that’s why you are experiencing palpitations, is because the Ventricle needs to pump blood according to the body demand, since there is a big blood amount of blood in the Atrium and the ventricle because of the regurgitation the Ventricle becomes exited and begins to pump faster because it has to deal with a bigger amount of blood. The treatment is usually replacement of the valve but is according to the degree of the valve opening, if it is a mild regurgitation surgery is not necessary. Unstable Angina is a condition where patients experience chest pain for a period of time, it could be prolonged up to 60 days and, if it worsen it could be fatal, it could become a MI ( Heart attack ). because is unstable is dangerous and patients need to be on medication as well for Mitral regurgitation. Hopefully this information has been helpful for you.

Update- Cardiopulmonary Reactions w. Ultrasound Micro-bubble

unstable angina types