Health Benefits of Brewers' Yeast

[ Extracted from the webpage of http://www.associatedcontent.com]

Brewers' yeast has been used traditionally for centuries for the purpose of brewing beer and some winemaking. But although the product has been used for centuries, many are not aware of the remarkable health benefits imparted by brewers' yeast, which have earned it the suitable moniker of 'nature's wonder food',

Many people in the health community or those seeking a healthier diet with an abundance of nutritional element are turning to brewers' yeast as a daily addition. Because it is also low in fat, sodium, calories, and carbohydrates, it is also beneficial for those with diabetes and hypoglycemics.

Brewers' yeast is a natural source of Vitamin B complex and highly concentrated amounts of protein, as well as a wonderful spectrum of other healthy vitamins and minerals.

Brewers' yeast is usually recovered as a by-product of the brewing process, absorbing the chemicals, vitamins and nutrients from the other ingredients utilized in brewing beer, mainly grain, malt and hops. The resulting product, though quite healthy, is usually quite bitter. Many brands of brewers' yeast are labeled as debittered, but this process, which makes the yeast more flavorful, can also serve to remove some of the nutritional content.

A high nucleic acid count, a valuable commodity in regards to cell development, is present in brewers' yeast, as well as ample amounts of folic acid, potassium, thiamin, niacin, chromium (needed for the body to produce insulin), and much more.

The simplest way to add brewers' yeast to your daily diet is to add a tablespoon to fruit juice and drink it, but it can also be added to meals such as meat loaf, salads, casseroles, cereal, soup, and other foods. If possible, add the yeast at the end of the cooking process, or the vitamin B complex will be destroyed.

Consumption of brewers' yeast is also attributed to several health benefits, such as reduced stress, better metabolism and lower cholesterol. It can also help provide restful slumber and ease fatigue.

Brewers yeast can usually be found in health food and nutrition stores in both pure form and debittered, though remember, the debittered yeast will not have all the valuable vitamins and nutrients of pure brewers'
yeast, and will most likely be absent of chromium.

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[Further explained in the webpage of http://www.luminescents.co.uk]

Brewers yeast (Saccharomyces cerevisiae) is a natural ingredient produced from the spent yeast grown during the production of beer. The spent yeast is washed, recovered and dried at a controlled temperature stopping biological activity whilst maintaining its unique nutritional properties.

Brewers yeast contains a natural mixture of high-grade protein, vitamins and minerals and therefore is an excellent cost effective way to enhance the nutritional value of basic foodstuffs.

It is one of the most concentrated natural sources of the B group vitamins, including riboflavin, (Vitamin B1) and thiamin (Vitamin B2) but not B12. Brewers yeast contains a minimum of 40% high-grade protein and therefore the amino acids essential for good health, one of them being lysine.

Brewers yeast also provides a natural source of minerals such as phosphorus, calcium and potassium. Brewers yeast contains approximately 36% carbohydrate and more specifically oligosaccharides, which are considered to have a prebiotic effect.

It has been use to combat diarrhea and to help with cholesterol reduction.

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Historical Uses of Brewer’s Yeast and How it Works:

• Burn treatment
• Cholesterol (High)
• Cholesterol-induced heart disease
• Diabetes (Adult-onset Type II, Regulation of blood sugar levels)
• Diarrhea (infectious)
• Eczema
• Immune system improvement
• Increased energy
• Nervous disorders (because it’s high in B-Vitamins)
• Reduces wrinkling and helps treat skin challenges
• Skin detoxifier (topical application)
• Stress relief (Again because of the high B-Vitamin content)
• Wound healing agent
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Properties of Brewer’s Yeast: Brewer’s yeast is a splendid source of B-complex vitamins, thiamine, riboflavin, protein (essential amino acids which make up about 50% of its weight) and several important minerals, in particular; calcium, iron, potassium, selenium and chromium. Brewer’s yeast may change bacterial flora in the large intestine.

What Is Chloasma ?

 [Extracted from www.wisegeek.com & http://health.hpathy.com]

Chloasma, also commonly referred to as melasma, is a skin condition that occurs primarily on the face. It causes dark brown discoloration, mostly in small patches across the face. The condition is not necessarily dangerous, but it can be treated for cosmetic purposes.

Estrogen and progesterone, two female sex hormones, are thought to be one of the main causes of chloasma. Changes in estrogen and progesterone hormones make a woman more likely to develop the skin condition. These hormone level changes can be a result of pregnancy, oral contraceptives, or hormone replacement therapy for women after menopause. The condition does not occur solely in women, it can affect men as well. When female hormone levels aren’t the culprit of the skin condition, it is thought that excessive skin exposure is the cause.

The main symptom of chloasma is dark brown speckles or patches across the facial skin. It tends to develop most often on the forehead, nose, cheeks, or above the upper lip. When the dark brown areas occur on the face, it is usually symmetrical and appears nearly identical on both sides of the face. The discoloration is not a health concern, but can make a person feel self-conscious about his or her appearance.

There are a variety of chloasma treatment options to reduce or eliminate the dark brown pigmentation on the facial skin. If the condition is the result of pregnancy, it will usually subside without treatment after the woman gives birth. For other mild cases of the skin condition, prescription topical creams that contain kojic acid, azelaic acid, tretinoin, or certain steroids, which may be able to lighten parts of the skin. Chemical peels, a skincare treatment performed in spas or salons that uses the application of chemicals to remove the outer skin cells, may also be used to help reduce the darkened skin patches. Lasers can also be implemented to remove dark skin pigment, but it is a serious and expensive procedure that is typically only recommended if other treatment options have not worked. 
Certain measures can be taken to help prevent chloasma or keep it from worsening or reoccurring. People who know they are at risk for the condition, such as pregnant or menopausal women, women taking birth control pills, or people who live in tropical climates, can attempt to limit their sun exposure. When out in the sun, they can wear lightweight clothing, hats, and use sunscreen with a high sun protection factor.

Causes, incidence, and risk factors for Melasma/Chloasma

*  Melasma is a very common skin disorder. Though it can affect anyone, young women with brownish skin tones are at greatest risk. Chloasma is especially common in women aged 20-40. It is more common in dark skins than in fair skins.

*  Melasma is often associated with the female hormones estrogen and progesterone. It is especially common in pregnant women, women who are taking oral contraceptives ("the pill"), and women taking hormone replacement therapy during menopause.

*  Sun exposure is also a strong risk factor for melasma. It is particularly common in tropical climates.

*  Melasma develops due to a combination of genetic, hormonal and sun related factors

*  Melasma has been referred to as the mask of pregnancy because it often develops during pregnancy.  Because of melasma’s relation to pregnancy and oral contraceptives, it is thought that estrogen contributes to its development in predisposed persons.

*  Estrogen is not essential to the development of melasma, however, as men may also be affected.

*  A factor that does seem to be essential to the development of melasma is sunlight.

*  Both ultraviolet A (UVA) and ultraviolet B (UVB) are believed to contribute to the formation of melasma in predisposed persons.

*  It may develop in association with menopause, hormonal imbalance and ovarian disorders.

*  Melasma may also be triggered by a medication called Dilantin (phenytoin).

*  It is thought that female sex hormones causes melanocytes or the pigment-producing cells to produce and deposit excess pigments.

*  Chloasma usually affects women but occasionally is seen in young men who use after-shave lotions, scented soaps, and other toiletries.

*  Chloasma is more pronounced during the summer months as a result of sun exposure. It usually fades a few months after delivery. Repeated pregnancies, however, can intensify the pigmentation.

*  Chloasma also occurs as a side-effect of taking contraceptive pills and injected depot contraceptive preparations. It may also be noticed in apparently healthy, normal, non-pregnant women where it is presumed to be due to some mild and harmless hormonal imbalance.

*  Sun exposure, following the use of deodorant soaps, scented toiletries, and various cosmetics can also produce this mottled pigmentation. This is called a phototoxic reaction and is due to ultraviolet radiation being absorbed by the chemical substance on the skin.

*  Deficiency of Folic Acid during pregnancy can also lead to development of Melasma.

Health Benefit of Watercress

[Extracted from the webpage of  http://guide2herbalremedies.com/watercress-health-benefits/ and http://hubpages.com/hub/Health-Benefits-of-Watercress]

Watercress is a leaf vegetable which we can find in our markets and grocery stores, but it grabs our attention quite rarely. Unfortunately, this is one of the most underestimated veggies, which has very high nutritional value. Like his healthy, nutritious and commonly used relatives, broccoli and cabbage, it has numerous health benefits and known as one of the oldest green vegetables used since the times of Egyptian Pharaohs.

Watercress has a wide variety of culinary applications and can be added to soups and salads, used for sandwiches and so on.

Watercress livens up raw salad and it also makes a valuable juice. Watercress juice is a green juice and must not be consumed alone. It also tastes bitter and is much easier to swallow if mixed with carrot, potato, and a little parsley or carrot, spinach, and turnip leaves. For optimal health benefits, eat watercress raw and as fresh as possible.


This herb is very low in calorie and rich in iron, iodine, sulfur, zinc, potassium, phosphorus, magnesium, Vitamins C and A, folic acid and other phytonutrients. It can improve the function of your thyroid gland and can be used for its expectorant and diuretic properties. Researches showed that watercress health benefits include also its anti-cancer powers as this herb has a high content of antioxidants. The specialists say that regular consumption of this herbal remedy is linked to lower risks of lung and breast cancer.

Watercress has very strong antibiotic powers and can be called a natural antibiotic. Remember that in order to enjoy these health benefits of watercress, it is important to consume freshly harvested herb as the majority of the elements can be found in watercress juice. The juice of this plant is also very effective toxin removal remedy, and it is recommended for treatment of such ailments as asthma, cold and bronchitis. For this purpose, watercress juice should be taken in the amount of 2-3 tablespoons a day.

One of the most important health benefits of watercress is the one of preventing various heart problems, as heart disease or coronary artery disease. This property is attributed to a high content of leutin and zeaxanthin, natural carotenoids that prevent arterial plague formation. In addition, these two carotenoids help preserving our vision and preventing the occurrence of such diseases as cataract and macular vision degeneration.

It is hardly possible to mention all watercress health benefits on this only webpage. This herbal remedy can normalize blood pressure and lower cholesterol levels in your blood, slow down aging, improve your mental function and memory. It is very rich in calcium and is useful for our dental health and bone strength. As an excellent source of fiber, watercress can fix the function of your digestive system and regulate bile flow. Please, give it a good thought when you see this miraculous veggie in the market, and do not miss your chance to improve and strengthen your health.

Health Benefits :

• it contains anticancer properties.
• it helps protect the eyes because it contains a high level of two carotenoids, lutein and zeaxanthin.
• it helps to normalize cholesterol and blood pressure.
• it increases sexual energy and enhances fertility.
• it can help improved memory, mental function and to retard ageing.
• it is a powerful cleanser of the body, especially the bloodstream.
• it can help increase production of breast milk.

• it is low in calories and high in potassium which is valued for weight loss, as its diuretic action draws excess fluid down and out of the body.
• it helps improve digestion by regulating the flow of bile.
• it is valued for clearing and improving the complexion.
• its chlorophyll-rich leaves are chewed to absorb breath odors.
• Chewing raw watercress leaves can cure bleeding gums.
• its leaves are used as a poultice for the relief of enlarged prostate gland. The poultice can also treat swollen feet and sprained ankles.
• it is a good source of iodine, which is important to the function of the thyroid gland.
• it is rich calcium which can strengthen the bones and teeth.
  
  
  
  

Watercress is a spicy, peppery salad green that is often a refreshing alternative to lettuce in salads and a popular addition to sandwiches. High in vitamins, Watercress is also a favorite in soups, stir-fry dishes and as a garnish. Watercress is a member of the mustard family and has small, dark green, rounded leaves. Available year-round, choose crisp, deep-colored sprigs, free of brown spots and yellowed leaves. To store, rinse with cold water and shake dry. Refrigerate Watercress in a plastic bag (or stems down in a glass of water covered with a plastic bag) for up to five days. Remove any tough stems and use only the leaves and tender stems when preparing.

Types of Heart Beat

[Extracted from the webpage of www.dilseindia.org]

Slow Heart Beat or Bradycardia

Slow Heart Beat or in medical terms called Bradycardia means that your heart beats very slowly. When the heart beats slower, then the body does not receive the optimum blood and can prove to be fatal for the patient. For most people, a heart rate of 60 to 100 beats a minute, while at rest, is considered normal. If your heart beats less than 60 times a minute, your doctor may diagnose bradycardia. In other people, bradycardia is a sign of a problem with the heart’s electrical system. It means that the heart's natural pacemaker is not working right or that the electrical pathways of the heart are disrupted. In severe forms of bradycardia, the heart beats so slowly that it does not pump enough blood to meet the body's needs. This can be life-threatening. Slow Heart Beat or Bradycardia can be caused by : Changes in the heart that are the result of aging. Diseases that damage the heart's electrical system These include : coronary artery disease heart attack infections such as endocarditis and myocarditis. Conditions that can slow electrical impulses through the heart. Examples include having a low thyroid level (hypothyroidism) or an electrolyte imbalance, such as too much potassium in the blood. Some medicines for treating heart problems or high blood pressure, such as beta-blockers, antiarrhythmics, and digoxin

What are the symptoms ?

A very slow heart rate may cause you to : Feel dizzy or lightheaded. Feel short of breath and find it harder to exercise. Feel tired. Have chest pain or a feeling that your heart is pounding or fluttering (palpitations). Feel confused or have trouble concentrating. Faint, if a slow heart rate causes a drop in blood pressure.

How is bradycardia diagnosed ?

Your doctor may be able to diagnose bradycardia by doing a physical exam, asking questions about your past health, and doing an electrocardiogram (EKG or ECG). An EKG measures the electrical signals that control heart rhythm, so it is the best test for bradycardia. But bradycardia often comes and goes, so a standard EKG done in the doctor’s office may not find it. An EKG can identify bradycardia only if you are actually having it during the test.

How is it treated ?

How bradycardia is treated depends on what is causing it. Treatment also depends on the symptoms. If bradycardia does not cause symptoms, it usually is not treated. If damage to the heart’s electrical system causes your heart to beat too slowly, you will probably need to have a pacemaker. A pacemaker is a device placed under your skin that helps correct the slow heart rate. People older than 65 are most likely to have a type of bradycardia that requires a pacemaker. If another medical problem, such as hypothyroidism or an electrolyte imbalance, is causing a slow heart rate, treating that problem may cure the bradycardia. If a medicine is causing your heart to beat too slowly, your doctor may adjust the dose or prescribe a different medicine. If you cannot stop taking that medicine, you may need a pacemaker. The goal of treatment is to raise your heart rate so your body gets the blood it needs. If severe bradycardia is not treated, it can lead to serious problems. These may include fainting and injuries from fainting, as well as seizures or even death. **************************************************** Fast Heart Beat or Tachycardia Tachycardia is a fast or irregular heart rhythm, usually more than 100 beats per minute and as many as 400 beats per minute. At these elevated rates, the heart is not able to efficiently pump oxygen-rich blood to your body causing dizziness, lightheadedness, or a fluttering in the chest. It can occur in either the upper heart chambers (atrial tachycardia) or lower heart chambers (ventricular tachycardia). There are many types of tachycardia, but the most common and most severe form of tachycardia is ventricular tachycardia. What causes Tachycardia ? high blood pressure or hypertension poor blood supply to the heart muscle due to coronary artery disease (atherosclerosis) heart valve disease heart failure heart muscle disease (cardiomyopathy) tumors or infections other medical conditions such as thyroid disease certain lung diseases electrolyte imbalance alcohol or drug abuse Emotional stress or drinking large amounts of alcoholic or caffeinated beverages Nervousness Anxiety High Blood Pressure Congestive heart failure Prior heart attack Asthma Anemia Panic attack Panic disorder Potassium deficiency Vitamin B deficiency Excessive dieting What are the symptoms ? Shortness of breath Dzziness and fainting due to the interruption of blood flow to the brain Sudden weakness Fluttering in the chest Lightheadedness Fainting How is Tachycardia diagnosed ? In diagnosing tachycardia, the patient may be asked about the presence of or tested for conditions that may trigger tachycardia, such as heart disease or a thyroid problem. Treatment Treatments for tachycardia may include medication and/or surgical procedures. In some cases, an implanted defibrillator may be inserted in the patient's chest in order to regulate the heart rate. The decision for medical treatment, and the method selected, can be made only after a comprehensive diagnosis. Depending on the cause and severity of the tachycardia, treatment may include : Nonsurgical procedures (catheter radiofrequency ablation) Medical devices — Implanted pacemakers, defibrillators Surgery Medications Intravenous medications, in emergency care Prevention The most effective way to prevent tachycardias is to reduce your risk of developing heart disease. If you already have heart disease, monitor it and follow your treatment plan to lower your tachycardia risk. ******************************************************** Irregular Heart Beat / Arrhythmia An arrhythmia is an abnormality in the heart's rhythm, or heartbeat pattern. The heartbeat can be too slow, too fast, have extra beats, skip a beat, or otherwise beat irregularly. Arrhythmias are deviations from the normal cadence of the heartbeat, which cause the heart to pump improperly. The normal heartbeat starts in the right atrium, where the heart's natural pacemaker (the sinus node) sends an electrical signal to the center of the heart to the atrioventricular node. The atrioventricular node then sends signals into the main pumping chamber to make the ventricle contract. Arrhythmias occur when the heartbeat starts in a part of the heart other than the sinus node, an abnormal rate or rhythm develops in the sinus node, or a heart conduction "block" prevents the electrical signal from traveling down the normal pathway. Middle-aged adults commonly experience arrhythmias but these are harmless. As people age, the probability of experiencing an arrhythmia increases. Arrhythmias often occur in people who do not have heart disease. In people with heart disease, it is usually the heart disease which is dangerous, not the arrhythmia. Arrhythmias often occur during and after heart attacks. Some types of arrhythmias, such as ventricular tachycardia, are serious and even life threatening. Slow heart rates (less than 60 beats per minute) are called bradycardias, while fast heart rates (more than 100 beats per minute) are called tachycardias. Bradycardia can result in poor circulation of blood, and, hence, a lack of oxygen throughout the body, especially the brain. Tachycardias also can compromise the heart's ability to pump effectively because the ventricles do not have enough time to completely fill. Arrhythmias are characterized by their site of origin: the atria or the ventricles. Supraventricular arrhythmias occur in the upper areas of the heart and are less serious than ventricular arrhythmias. Ventricular fibrillation is the most serious arrhythmia and is fatal unless medical help is immediate. Causes and symptoms In many cases, the cause of an arrhythmia is unknown. Known causes of arrhythmias include heart disease, stress, caffeine, tobacco, alcohol, diet pills, and decongestants in cough and cold medicines. Symptoms of an arrhythmia include a fast heartbeat, pounding or fluttering chest sensations, skipping a heartbeat, "flip-flops," dizziness, faintness, shortness of breath, and chest pains. Treatment Many arrhythmias do not require any treatment. For serious arrhythmias, treating the underlying heart disease sometimes controls the arrhythmia. In some cases, the arrhythmia itself is treated with drugs, electrical shock (cardioversion), automatic implantable defibrillators, artificial pacemakers, catheter ablation, or surgery. Supraventricular arrhythmias often can be treated with drug therapy. Ventricular arrhythmias are more complex to treat. Drug therapy can manage many arrhythmias, and the common drugs for suppressing arrhythmias include beta-blockers, calcium channel blockers, quinidine, digitalis preparations, and procainamide. Because of their potential serious side effects, stronger, desensitizing drugs are used only to treat life-threatening arrhythmias. All of the drugs used to treat arrhythmias have possible side effects, ranging from mild complications with beta-blockers and calcium channel blockers to more serious effects of desensitizing drugs that can, paradoxically, cause arrhythmias or make them worse. Response to drugs is usually measured by ECG, Holter monitor, or electrophysiologic study. In emergency situations, cardioversion or defibrillation (the application of an electrical shock to the chest wall) is used. Cardioversion restores the heart to its normal rhythm. It is followed by drug therapy to prevent recurrence of the arrhythmia. Artificial pacemakers that send electrical signals to make the heart beat properly can be implanted under the skin during a simple operation. Leads from the pacemaker are anchored to the right side of the heart. Pacemakers are used to correct bradycardia and are sometimes used after surgical or catheter ablation. Automatic implantable defibrillators correct life-threatening ventricular arrhythmias by recognizing them and then restoring a normal heart rhythm by pacing the heart or giving it an electric shock. They are implanted within the chest wall without major surgery and store information for future evaluation by physicians. Automatic implantable defibrillators have proven to be more effective in saving lives than drugs alone. They often are used in conjunction with drug therapy. Ablation a procedure to alter or remove the heart tissue causing the arrhythmia in order to prevent a recurrence, can be performed through a catheter or surgery. Supraventricular tachycardia can be treated successfully with ablation. Catheter ablation is performed in a catheterization laboratory with the patient under sedation. A catheter equipped with a device that maps the heart's electrical pathways is inserted into a vein and is threaded into the heart. High-frequency radio waves are then used to remove the pathway(s) causing the arrhythmia. Surgical ablation is similar in principle but it is performed in a hospital, using a cold probe instead of radio waves to destroy tissue. Ablation treatments are used when medications fail. Maze surgery treats atrial fibrillation by making multiple incisions through the atrium to allow electrical impulses to move effectively. This is often recommended for patients who have not responded to drugs or cardioversion

Tinnitus and its causes

 [Extracted from the web page of  www.emedicinehealth.com on Tinnitus]

Tinnitus is a ringing, swishing, or other type of noise that seems to originate in the ear or head. Most of us will experience tinnitus or sounds in the ears at some time or another.

Tinnitus can be extremely disturbing to people who have it. In many cases it is not a serious problem, but rather a nuisance that may go away. However, some people with tinnitus may require medical or surgical treatment. Twelve million Americans have tinnitus, and one million experience it so severely it interferes with their daily activities.

Tinnitus can arise in any of the four sections of the hearing system: the outer ear, the middle ear, the inner ear, and the brain. Some tinnitus or "head noise" is normal. A number of techniques and treatments may be of help, depending on the cause.

• Some of the most common include a sound of crickets or roaring, buzzing, hissing, whistling, and high-pitched ringing.
  
  
• Other types of tinnitus include a clicking or pulsatile tinnitus (the noise accompanies your heartbeat).
  
  
• The most common type of tinnitus is known as subjective tinnitus, meaning that you hear a sound but it cannot be heard by others.
  
  
• A much more uncommon sort is called objective tinnitus, meaning your doctor may sometimes actually hear a sound when he or she is carefully listening for it.
  
  
  Tinnitus Causes

Tinnitus is not a disease in itself but rather a reflection of something else that is going on in the hearing system or brain.

• Probably the most common cause for tinnitus is hearing loss. As we age, or because of trauma to the ear (through noise, drugs, or chemicals), the portion of the ear that allows us to hear, the cochlea, becomes damaged.
  
  
  • Current theories suggest that because the cochlea is no longer sending the normal signals to the brain, the brain becomes confused and essentially develops its own noise to make up for the lack of normal sound signals. This, then is interpreted as a sound, tinnitus.
    
    
  • This tinnitus can be made worse by anything that makes our hearing worse, such as ear infection or excess wax in the ear.
    
    
  • Tinnitus caused by ear trauma is usually noticed in both ears, because both ears are usually exposed to the same noises, drugs, and other influences
    
  • Loud noise exposure is a very common cause of tinnitus today, and it often damages hearing as well. Unfortunately, many people are unconcerned about the harmful effects of excessively loud noise from firearms, high intensity music, or other sources.
    
    Ten million Americans have suffered irreversible noise-induced hearing loss, and 30 million more are exposed to dangerous noise levels each day, according to the NIDCD.

• Other causes of tinnitus include drugs such as aspirin (if overused), aminoglycoside antibiotics (a powerful form of infection-fighting drug), and quinine.

• Meniere's disease includes dizziness, tinnitus, and fullness in the ear or hearing loss that can last for hours, but then goes away. This disease is actually caused by a problem in the ear itself. The tinnitus is merely a symptom.

• A rare cause of subjective tinnitus includes a certain type of brain tumor known as an acoustic neuroma. The tumors grow on the nerve that supplies hearing and can cause tinnitus. This type of tinnitus is usually only noticed in one ear, unlike the more common sort caused by hearing loss usually seen in both ears.

• Causes of objective tinnitus are usually easier to find.

• Pulsatile tinnitus is usually related to blood flow, either through normal or abnormal blood vessels near the ear. Causes of pulsatile tinnitus include pregnancy, anemia (lack of blood cells), overactive thyroid, or tumors involving blood vessels near the ear. Pulsatile tinnitus can also be caused by a condition known as benign intracranial hypertension-an increase in the pressure of the fluid surrounding the brain.

• Clicking types of objective tinnitus can be caused by jaw joint misalignment (TMJ) problems or muscles of the ear or throat "twitching."
  

  Tinnitus Symptoms

  With tinnitus, you hear a noise that no one around you hears. This noise is usually a buzzing or ringing type sound, but it may be a clicking or rushing sound that goes along with your heartbeat. The sound is sometimes accompanied by hearing loss and dizziness in a syndrome known as Meniere's disease.

  When to Seek Medical Care

  Most newly noticed tinnitus should be evaluated by a physician. Because tinnitus is usually a symptom of something else, if it begins suddenly, see your doctor. This is particularly important if the tinnitus is only heard on one side.
  
  Although the majority of cases of tinnitus are not caused by any acute problems, certain symptoms need to be evaluated to determine whether or not a more serious medical condition is causing the symptoms.
  
  
• Any time that tinnitus comes on suddenly, particularly in one ear or is associated with hearing loss, seek an immediate evaluation. Sudden hearing loss is often accompanied by tinnitus, and there are medications that may help to restore that hearing. Also certain types of tumors can cause sudden hearing loss and tinnitus that warrant an evaluation.

• Tinnitus that is pulsatile (in rhythm with your heartbeat) and comes on suddenly should also be checked relatively rapidly. In very rare instances, this sort of tinnitus can develop because of an aneurysm (a bulging of the wall of a blood vessel) near the ear or because of the sudden onset of very high blood pressure.

• Any time tinnitus is noticed in association with changes in personality, difficulty speaking or walking, or with any other movement problem, you should be evaluated for the possibility of a stroke.
  

  Medical Treatment

  Treatment for tinnitus depends on the underlying cause of the problem.
  
  
• In the majority of cases, tinnitus is caused by damage to the hearing organ. In these cases, there is normally no need for treatment other than reassurance that the tinnitus is not being caused by another treatable illness.

• In the very rare instance where the tinnitus is extremely bothersome, there are a number of treatment options.

• Some of the most helpful include antianxiety or antidepressant medication and sometimes maskers-small devices like hearing aids that help to block out the sound of the tinnitus with "white noise."

• For people who are bothered by tinnitus only when trying to sleep, the sound of a fan, radio, or white noise machine is usually all that is required to relieve the problem.

• Most people with tinnitus find that their symptoms are worse when under stress, so relaxation techniques can be helpful.

• Avoiding caffeine is advised, as it may worsen symptoms.
  
• Biofeedback may help or diminish tinnitus in some patients.
  
• Avoid aspirin or aspirin products in large quantities

• Hearing loss worsens the effect of tinnitus, so protection of hearing and avoiding loud noises is very important in preventing worsening of the symptoms.

• In cases where the tinnitus is caused by one of the other rare problems (such as a tumor or aneurysm), treatment of the tinnitus involves fixing the main issue. Although this does not always resolve the tinnitus, some people note relief of their symptoms. Only a very few cases of tinnitus are caused by identifiable, repairable medical conditions.
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  From the Editor Desk
  
  I have been treating my patients, who are experiencing tinnitus with Acupuncture and when necessary, I will accompany my treatment with 'moxibustion' too. In TCM, we diagnose tinnitus and relate it to the weak or dyfunctions of the kidneys because the meridian of the Kidney/Urinary Bladder is connected to the ears. In most cases, we also include boiled herbal formulas to boost up the functions of the kidneys, added with some 'yeast' supplements to nourish the nerves serving the ears. Often, it is found that patients who are having running/stuffy nose will trigger such problem more rapidly. Such problem will be further aggravated should patients have been taking antibiotics to counter against their common cold, or in the event of any external or internal injuries, the patients might be consuming anti-inflammatory medications.
  
  Nevertheless, acupuncture will help effectively, in lessening such teething nuisance especially at night when the patients will not be able to sleep. One must seek the help of a good acupuncturist and not only will it resolve the problem, the patients can be made calm, as well as continuing with a better health.
  
  
  

How is Heart Failure defined ?

As been explained in the webpage of www.dilseindia.org, I found the article written by the said Author indeed very informative and I would like to share with all my friends ......

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Heart failure is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. The condition may affect the right side, the left side, or both sides of the heart. Right-sided heart failure means the right ventricle of the heart loses its pumping function. Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body. Heart failure is often classified as either systolic or diastolic. Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well. Diastolic heart failure means that your heart's pumping chamber does not fill up with blood. The most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. Other heart problems that may cause heart failure are : Congenital heart disease Heart valve disease Some types of abnormal heart rhythms (arrhythmias) Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failure

What are the symptoms ?

Heart failure can be chronic — meaning your condition is ongoing — or acute, meaning your condition has started suddenly. Chronic heart failure symptoms Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness

Acute heart failure symptoms Symptoms similar to those of chronic heart failure, but more severe and start or worsen suddenly Sudden fluid buildup Rapid or irregular heartbeat (palpitations) Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain, if your heart failure is caused by a heart attack

Surgery and medical devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments being studied and used in certain people include

Coronary bypass surgery

If severely blocked arteries are contributing to your heart failure, your doctor may recommend coronary artery bypass surgery. In this procedure, a vein from your leg, arm or chest replaces a blocked vein in your heart to allow blood to flow through your heart more freely.

Heart valve repair or replacement

If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons also can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty). Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged valve is replaced by an artificial (prosthetic) valve.

Implantable cardioverter-defibrillators (ICDs)

An ICD is a device implanted under the skin and attached through the veins in your chest to your heart with small wires. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to shock it back into normal rhythm.

Cardiac resynchronization therapy (CRT) or biventricular pacing

A biventricular pacemaker sends timed electrical impulses to both of the heart's lower chambers (the left and right ventricles), so that they pump in a more efficient, coordinated manner. As many as half the people with heart failure have problems with their heart's electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.

Heart pumps (left ventricular assist devices, or LVADs)

These mechanical devices are implanted into the abdomen or chest and attached to a weakened heart to help it pump. Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who aren't eligible for or able to undergo heart transplantation or are waiting for a new heart

Heart transplant

Some people have such severe heart failure that surgery or medications don't help. They may need to have their diseased heart replaced with a healthy donor heart. Heart transplants can dramatically improve the survival and quality of life of some people with severe heart failure. However, candidates for transplantation often have to wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or device therapy and can be removed from the transplant waiting list.

Prevention

The best way to prevent heart failure is to : Lower your risk of getting heart disease by making lifestyle changes; Control certain health problems, such as high blood pressure and diabetes; To reduce your risk : Don't smoke. If you smoke, quit. Smoking greatly increases your risk for heart disease. Avoid secondhand smoke too; Lower your cholesterol. If you have high cholesterol, follow your doctor's advice for lowering it. Eating a heart-healthy diet-such as the TLC diet -exercising, and quitting smoking will help keep your cholesterol low; Control your blood pressure. High blood pressure raises your risk of getting heart disease. Studies show that lowering blood pressure to normal levels in people who have high blood pressure could reduce the cases of heart failure by half. Exercising, limiting alcohol, and controlling stress will help keep your blood pressure in a healthy range; Get regular exercise. Exercise will help control your weight, blood pressure, and stress. Controlling these things will help keep your heart healthy. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.3 One way to do this is to be active at least 10 minutes 3 times a day, 5 days a week. Talk to your doctor before starting an exercise program; Control diabetes. Take your medicines as directed, and work with your doctor to make a diet and exercise plan to control diabetes; Limit alcohol. If you drink alcohol, drink moderately. This means no more than 2 drinks a day for men and 1 drink a day for women. Heavy consumption of alcohol can lead to heart failure.

Complications Irregular heart rhythms (can be deadly) Pulmonary edema Total heart failure (circulatory collapse)

What is warfarin ?

 Coumadin (01 Mg)

[Extracted from the website of www.drugs.com]

Warfarin is an anticoagulant (blood thinner). Warfarin reduces the formation of blood clots by blocking the formation of certain clotting factors.

Warfarin is used to prevent heart attacks, strokes, and blood clots in veins and arteries.

Warfarin may also be used for purposes other than those listed in this medication guide.

Warfarin Tablet (01 Mg)

Important information about warfarin

Warfarin can harm an unborn baby or cause birth defects. Do not use warfarin if you are pregnant or may become pregnant. Never take a double dose of this medication or take it together with other products that contain warfarin or coumarin. You should not take warfarin if you have a bleeding or blood cell disorder, blood in your urine or stools, an infection of the lining of your heart, stomach bleeding, bleeding in the brain, recent or upcoming surgery, or if you need a spinal tap or spinal anesthesia (epidural).

Warfarin may cause you to bleed more easily, especially if you have: a history of bleeding problems, high blood pressure or severe heart disease, kidney disease, cancer, surgery or a medical emergency, a disease affecting the blood vessels in your brain, a history of stomach or intestinal bleeding, if you are 65 or older, or if you are severely ill or debilitated.

Many drugs (including some over-the-counter medicines and herbal products) can cause serious medical problems or death if you take them with warfarin. It is very important to tell your doctor about all medicines you have recently used. Ask your doctor before taking any medicine for pain, arthritis, fever, or swelling. These medicines may affect blood clotting and may also increase your risk of stomach bleeding. Any doctor, dentist, surgeon, or other medical care provider who treats you should know that you are taking warfarin. Avoid making any changes in your diet without first talking to your doctor.

Before taking warfarin

You should not take warfarin if you are allergic to it, or if you have :

• hemophilia or any bleeding disorder that is inherited or caused by disease;
  
• a blood cell disorder such as anemia (lack of red blood cells) or a low level of platelets in your blood;
  
• blood in your urine or stools, or if you have been coughing up blood;
  
• an infection of the lining of your heart (also called bacterial endocarditis);
  
• stomach or intestinal bleeding or ulcer;
  
• recent head injury, aneurysm, or bleeding in the brain;
  
• if you have recently had or will soon have any type of surgery (especially brain, spine, or eye surgery); or
  
• if you undergo a spinal tap or receive spinal anesthesia (epidural).
  

You should not take warfarin if you cannot be reliable in taking it because of alcoholism, psychiatric problems, dementia, or similar conditions.

Warfarin may cause you to bleed more easily, especially if you have :

• a history of bleeding problems;
  
• high blood pressure or severe heart disease;
  
• kidney disease;
• cancer;
  
• surgery or a medical emergency;
  
• a disease affecting the blood vessels in your brain;
  
• a history of stomach or intestinal bleeding;
  
• if you are 65 or older; or
  
• if you are severely ill or debilitated.
  

Warfarin can cause birth defects or fatal bleeding in an unborn baby. Do not take warfarin if you are pregnant or may become pregnant. Use effective birth control and tell your doctor right away if you become pregnant while taking warfarin.

If you have any of these other conditions, you may need a dose adjustment or special tests :

• liver disease;
• celiac sprue (an intestinal disorder);
  
• diabetes;
  
• congestive heart failure;
  
• overactive thyroid;
  
• a connective tissue disorder such as Marfan Syndrome, Sjogren syndrome, scleroderma, rheumatoid arthritis, or lupus; or
  
• if you have ever had low blood platelets after receiving heparin.
  

Warfarin may pass into breast milk and cause bleeding problems in the nursing baby. Do not use warfarin without telling your doctor if you are breast-feeding a baby.

What is meant by Heart Failure ?

[An article found in the website of http://www.dilseindia.org. Yet brief and precise, I hope the information attached below, is good to clear anyone's doubts] Heart failure  is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. The condition may affect the right side, the left side, or both sides of the heart. Right-sided heart failure means the right ventricle of the heart loses its pumping function. Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body. Heart failure is often classified as either systolic or diastolic. Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well. Diastolic heart failure means that your heart's pumping chamber does not fill up with blood. The most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. Other heart problems that may cause heart failure are : Congenital heart disease Heart valve disease Some types of abnormal heart rhythms (arrhythmias) Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failure

What are the symptoms ?

Heart failure can be chronic, meaning your condition is ongoing or acute, meaning your condition has started suddenly. Chronic heart failure symptoms : Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness

Acute heart failure symptoms : Symptoms similar to those of chronic heart failure, but more severe and start or worsen suddenly Sudden fluid buildup Rapid or irregular heartbeat (palpitations) Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain, if your heart failure is caused by a heart attack

Surgery and medical devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments being studied and used in certain people include

Coronary bypass surgery

If severely blocked arteries are contributing to your heart failure, your doctor may recommend coronary artery bypass surgery. In this procedure, a vein from your leg, arm or chest replaces a blocked vein in your heart to allow blood to flow through your heart more freely.

Heart valve repair or replacement

If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons also can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty). Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged valve is replaced by an artificial (prosthetic) valve.

Implantable cardioverter-defibrillators (ICDs).

An ICD is a device implanted under the skin and attached through the veins in your chest to your heart with small wires. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to shock it back into normal rhythm.

Cardiac resynchronization therapy (CRT) or biventricular pacing.

A biventricular pacemaker sends timed electrical impulses to both of the heart's lower chambers (the left and right ventricles), so that they pump in a more efficient, coordinated manner. As many as half the people with heart failure have problems with their heart's electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.

Heart pumps (left ventricular assist devices, or LVADs).

These mechanical devices are implanted into the abdomen or chest and attached to a weakened heart to help it pump. Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who aren't eligible for or able to undergo heart transplantation or are waiting for a new heart

Heart transplant.

Some people have such severe heart failure that surgery or medications don't help. They may need to have their diseased heart replaced with a healthy donor heart. Heart transplants can dramatically improve the survival and quality of life of some people with severe heart failure. However, candidates for transplantation often have to wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or device therapy and can be removed from the transplant waiting list.

Prevention

The best way to prevent heart failure is to : Lower your risk of getting heart disease by making lifestyle changes. Control certain health problems, such as high blood pressure and diabetes. To reduce your risk : ** Don't smoke. If you smoke, quit. Smoking greatly increases your risk for heart disease. Avoid secondhand smoke too. Lower your cholesterol. If you have high cholesterol, follow your doctor's advice for lowering it. Eating a heart-healthy diet-such as the TLC diet -exercising, and quitting smoking will help keep your cholesterol low. Control your blood pressure. High blood pressure raises your risk of getting heart disease. Studies show that lowering blood pressure to normal levels in people who have high blood pressure could reduce the cases of heart failure by half. Exercising, limiting alcohol, and controlling stress will help keep your blood pressure in a healthy range. Get regular exercise. Exercise will help control your weight, blood pressure, and stress. Controlling these things will help keep your heart healthy. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.3 One way to do this is to be active at least 10 minutes 3 times a day, 5 days a week. Talk to your doctor before starting an exercise program. Control diabetes. Take your medicines as directed, and work with your doctor to make a diet and exercise plan to control diabetes. Limit alcohol. If you drink alcohol, drink moderately. This means no more than 2 drinks a day for men and 1 drink a day for women. Heavy consumption of alcohol can lead to heart failure.

Complications Irregular heart rhythms (can be deadly) Pulmonary edema Total heart failure (circulatory collapse)

What is meant by Blood Clots ?

[There is an interesting article in 'www.medicinenet.com' which I think many readers should be aware of. I have extracted it and posted below for your reading pleasure. Many are still confused by what blood clots are all about, how they actually happened and what are the dangers should they block our blood arteries or veins]

************************************

Blood is a liquid that flows within blood vessels. It is constantly in motion as the heart pumps blood through arteries to the different organs and cells of the body. The blood is returned back to the heart by the veins. Veins are squeezed when muscles in the body contract and push the blood back to the heart.

Blood clotting is an important mechanism to help the body repair injured blood vessels. Blood consists of:

• red blood cells containing hemoglobin that carry oxygen to cells and remove carbon dioxide (the waste product of metabolism),
  
• white blood cells that fight infection,
  
• platelets that are part of the clotting process of the body, and
  
• blood plasma, which contains fluid, chemicals and proteins that are important for bodily functions.

Complex mechanisms exist in the bloodstream to form clots where they are needed. If the lining of the blood vessels becomes damaged, platelets are recruited to the injured area to form an initial plug. These activated platelets release chemicals that start the clotting cascade, using a series of clotting factors produced by the body. Ultimately, fibrin is formed, the protein that crosslinks with itself to form a mesh that makes up the final blood clot.

The medical term for a blood clot is a thrombus (plural= thrombi). When a thrombus is formed as part of a normal repair process of the body, there is little consequence. Unfortunately, there are times when a thrombus (blood clot) will form when it is not needed, and this can have potentially significant consequences.

What does a blood clot look like ?

What causes blood clots ?

Blood clots form when there is damage to the lining of a blood vessel, either an artery or a vein. The damage may be obvious, such as a laceration, or may occur on the microscopic level. As well, blood will begin to clot if it stops moving and becomes stagnant.

Venous thrombosis or blood clots in a vein occur when a person becomes immobilized and muscles are not contracting to push blood back to the heart. This stagnant blood begins to form small clots along the walls of the vein. This initial clot can gradually grow to partially or completely occlude or block the vein and prevent blood from returning to the heart. An analogy to this process is a slow moving river. Over time, weeds and algae start to accumulate along the banks of the river where the water flows more slowly. Gradually, as the weeds start to grow, they begin to invade the center of the river because they can withstand the pressure of the oncoming water flow.

Arterial thrombi (blood clots in an artery) occur by a different mechanism. For those with atherosclerotic disease, plaque deposits form along the lining of the artery and grow to cause narrowing of the vessel. This is the disease process that may cause heart attack, stroke, or peripheral artery disease. If a plaque ruptures, a blood clot can form at the site of that rupture and can completely or partially occlude the blood flow at that point.
Blood clots in the heart. In atrial fibrillation, the atrium or upper chamber of the heart does not beat in an organized manner. Instead, it jiggles, and blood tends to become stagnant along the walls of the atrium. Over time, this may cause small blood clots to form. Clots can also form in the ventricle after a heart attack when part of the heart muscle is injured and unable to contract normally. Since the damaged area doesn't contract with the rest of the heart, blood can start to pool or stagnate, leading to clot formation.

Blood leaking out of a blood vessel.  Blood clots can form when blood leaks out of a blood vessel. This is very beneficial when a person gets a cut or scrape wound, because the clot helps stop further bleeding at the wound site. The clotting mechanism works well following trauma as well. Broken bones, sprains and strains, and nosebleeds all result in bleeding that is controlled by the body's clotting mechanism.

Blood clots causing other medical problems. Sometimes, normal blood clotting can cause medical problems because of its location. For example, if bleeding occurs in the urine from any of a variety of reasons (such as infection, trauma, or tumor) clots may form and prevent the bladder from emptying, causing urinary retention. Clot formation in the uterus may cause pain when the clots are passed through the cervix and can lead to vaginal bleeding, either as part of menstruation or as abnormal vaginal bleeding (menorrhagia, dysmenorrhea).

What are the risk factors for blood clots ?

The risk factors for arterial clots are those that are common to all diseases that cause narrowing of blood vessels, cholesterol plaque formation, and plaque rupture.

• High blood pressure
  
• High cholesterol levels
  
• Diabetes
  
• Smoking
  
• Family history

Venous clots are formed due to one of two main reasons :

1) immobility, and
2) genetic errors in the clotting mechanism.

1. Immobility : Most commonly, when the body stops moving, the risk of blood clots increases, since muscle movement is required to pump blood towards the heart. Stagnant blood in a vein is prone to clot.

• This may occur when a person is hospitalized or bedridden after illness or surgery.
  
  
• It may also occur with long trips (such as in a car, train, or plane) where hours may pass without a person getting up to walk or stretch.
  
  
• Orthopedic injuries and casting also put the person at risk.
  
  
• Pregnancy is a risk factor for forming blood clots in the legs and pelvis, since the growing uterus may slow blood flow back to the heart to a sufficient extent that blood clots may form. 

2. Genetic errors in the clotting mechanism: There may be a genetic or inborn error in the clotting mechanism, making a person hypercoagulable (hyper=more + coagulation= clotting) and at greater risk for forming clots.
   
   

   What types of conditions are caused by blood clots ?

   Blood clots may cause life-threatening medical conditions, and are always considered in the differential diagnosis of any symptoms or signs. Differential diagnosis is the list of potential causes of a patient's condition, that is considered by the health care practitioner when caring for a patient.
   *
   Deep venous thrombosis and pulmonary embolism
   Deep venous thrombosis may lead to a pulmonary embolism. If there is a blood clot or thrombus in a deep vein, it has the potential to break off (embolize) and flow through the veins back through the heart, and into the lung where it can become lodged in a small blood vessel, which prevents the lung from functioning. Pulmonary embolism is a medical emergency and can cause serious illness or death.
   
   
   
   An embolus is the medical term for a blood clot that has moved with the bloodstream to a different location. With pulmonary embolus (pulmonary embolism), two issues occur.
   
   1. The lungs' blood supply is comprised and the affected area of lung tissue may infarct, or die.
   
   2. Because of the blockage, the ability of the lung to provide oxygen to the body is decreased and hypoxia (decreased levels of oxygen in the blood and throughout the body) may occur.
   

Even if venous blood clots do not embolize, they may cause significant local problems with swelling and pain. Since blood cannot return to the heart if a vein is blocked by a clot, the limbs may chronically swell and have decreased function in a condition called chronic thrombophlebitis.

Arterial thrombus
An arterial thrombus stops the blood supply to the tissues beyond the blockage, depriving cells of oxygen and nutrients. This quickly leads to tissue death. Arterial thrombus is the mechanism that causes :

• heart attack (when it occurs in the coronary arteries that supply blood to the heart)
  
  
• stroke (when it occurs in arteries within the brain), or
  
  
• peripheral vascular disease (occurring in the arteries of the legs).
  

Atrial fibrillation
In atrial fibrillation, small clots may form along the walls of the atrium or the upper chambers of the heart. Should one of these clots break off, it may embolize, or travel in the bloodstream to the brain, blocking an artery and causing a stroke. Other arteries may also be involved by this process, including those that supply the bowel. This can cause mesenteric ischemia (mesentery=lining of the bowel + ischemia=loss of blood supply) and potential necrosis (tissue death) of the intestine. Clots can also affect blood supply to fingers and toes.

Blood should clot anytime it becomes stagnant. This also means that clots will form when blood leaks out of blood vessels.

Examples include some of the following :

• With bleeding peptic ulcers, patients may vomit liquid blood mixed with clot.
  
  
• Patients with rectal bleeding may also have clot mixed with the bloody stool if there has been time for the clot to form.
  
  
• Sometimes patients with urinary tract or bladder infections develop associated bleeding in their urine, and small clots can form. On occasion these clots may be so big that they cannot be passed and block the urethra, preventing urination and causing urinary retention.
  
  
• Vaginal bleeding is a normal event for most women in the reproductive years and occasionally, blood can pool in the vagina and form clots before being expelled. If clots form in the uterus, they may cause significant pain and pressure as they pass through the cervix while being expelled.
  

What are the symptoms of blood clots ?

Venous clots do not allow blood to return to the heart and symptoms occur because of this damming effect. Most often occurring in the legs or the arms, symptoms include :

• swelling,
  
• warmth,
  
• redness, and
  
• pain.

Arterial clots do not allow blood get to the affected area. Body tissue that is deprived of blood and oxygen begins to die and becomes ischemic (isch=to restrain + emia = blood)

• Pain is the initial symptom of the ischemia, or oxygen deprivation due to loss of blood supply.
  
  
• Other symptoms depend upon the location of the clot, and often the effect will be a loss of function. Heart attack and stroke are self-explanatory.
  
  
• In an arm or leg, in addition to pain, the limb may appear white, and weakness, loss of sensation, or paralysis may occur.
  
  
• If the blood supply is lost to an area of the bowel, in addition to intense pain, there may be bloody diarrhea.
  

How are blood clots diagnosed ?

The initial step in making the diagnosis of a blood clot is obtaining a patient history. The blood clot itself does not cause a problem. It's the location of the blood clot and its effect on blood flow that causes symptoms and signs. If a blood clot or thrombus is a consideration, the history may expand to explore risk factors or situations that might put the patient at risk for forming a clot.

Venous blood clots often develop slowly with a gradual onset of swelling, pain, and discoloration. Symptoms of a venous thrombus will often progress over hours.

Arterial thrombi occur as an acute event. Tissues need oxygen immediately, and the loss of blood supply creates a situation in which symptoms begin immediately.

There may be symptoms that precede the acute artery blockage, that may be warning signs of the potential future complete occlusion of the blood vessel.

• Patients with an acute heart attack (myocardial infarction) may experience angina in the days and weeks prior to the heart attack.
  
  
• Patients with peripheral artery disease may have pain with walking (claudication), and a TIA (transient ischemia attack, mini-stroke) may precede a stroke.

Physical examination can assist in providing additional information that may increase the suspicion for a blood clot.

• Venous thrombi may cause swelling of an extremity. It may be red, warm, and tender; sometimes the appearance is difficult to distinguish from cellulitis or an infection of the extremity. If there is concern about a pulmonary embolus, the clinician may examine the lungs, listening for abnormal sounds caused by an area of inflamed lung tissue.
  
  
• Arterial thrombus symptoms are much more dramatic. If a leg or arm is involved, the tissue may be white because of the lack of blood supply. As well, it may be cool to touch and there may be loss of sensation and movement. The patient may be writhing in pain.

Arterial thrombus is also the cause of heart attack (myocardial infarction) and stroke (cerebrovascular accident) and their associated symptoms.
*
How are blood clots treated ?

Depending upon their location, blood clots may be aggressively treated or may need nothing more than symptomatic care.

Venous blood clots
Venous thrombosis in the leg may occur in the superficial or deep systems of veins.

Clots in the superficial system are often treated symptomatically with warm compresses and acetaminophen or ibuprofen since there is no risk for clots in the superficial veins to embolize to the lung. They are connected to the deep system by perforator veins that have valves that act like a sieve to strain and prevent any clots form getting to the lung.

Deep venous thrombosis usually requires anticoagulation to prevent the clot from growing and causing a pulmonary embolus. Initial therapy with injectable enoxaparin (Lovenox) is used to immediately "thin" the blood. Meanwhile, warfarin (Coumadin) is prescribed as an anti-coagulation pill. It takes a few days for warfarin to reach therapeutic levels and in this time frame, both the injectable and oral medications are used. Most often, patients with DVTs are treated as an outpatient and taught how to give themselves enoxaparin (Lovenox) injections. Occasionally, depending upon circumstances, patients may be admitted to the hospital for an unfractionated heparin intravenous (IV) injection.

Blood clots below the knee are at lower risk for embolization to the lung, and an alternative to anti-coagulation treatment is serial ultrasound examinations to monitor the clot to see if it is growing or being resorbed by the body.

Pulmonary emboli are treated similarly to deep venous thrombosis, but depending on the severity of the symptoms, amount of clot formation, and the underlying health of the patient, admission to the hospital for treatment and observation may be needed. This is especially the case if lung function is compromised and the patient is short of breath or is experiencing hypoxia, or low oxygen levels in the blood.

Arterial blood clots
Arterial blood clots are often managed more aggressively. Surgery may be attempted to remove the clot, or medication may be administered directly into the clot to try to dissolve it. Alteplase (Activase, TPA) or tenecteplase (TNKase) are examples of medications that may be used in peripheral arteries to try to restore blood supply.

This is the same approach that is used for heart attack. If possible, cardiac catheterization is performed to locate the blocked blood vessel and a balloon is used to open the occluded area, restore blood flow, and place a stent to keep it open. This is a time-sensitive procedure and if a hospital is not available to do the procedure emergently, TPA or TNK is used intravenously to try to dissolve the thrombus and minimize heart damage.

Stroke is also treated with TPA if the patient is an appropriate candidate for this therapy.
*
What are the complications of blood clots ?

Blood clots prevent proper circulation of blood.

Deep vein thrombosis of the leg or arm may cause permanent damage to the veins themselves and cause persistent swelling of the extremity. The life-threatening issue that may arise from deep venous clots is a clot that breaks off and embolizes to the lungs (pulmonary embolus), causing problems with lung function and oxygenation of the blood.

Arterial thrombus often is a life- or limb threatening event, since organs and cells do not get enough oxygen.

How can blood clots be prevented ?

Prevention is key in thrombosis or clot formation.


Arterial thrombosis

• For arterial thrombosis, the most likely precipitating event is a plaque rupture with clot formation in the artery.
  
  
• Minimizing the risk of vascular disease requires life-long attention to the risk factors that lead to plaque buildup and "hardening" of the arteries.
  
  
• Blood pressure and cholesterol control, diabetes management, and refraining from smoking all minimize the risk of arterial disease.
  
  
• Although family history is an important risk factor, one needs to be even more vigilant about the other risk factors if there is a family history of early heart attack or stroke.

Deep vein thrombosis

The main risk factor for deep vein thrombosis risks is immobilization. It is important to move around routinely so that blood can circulate in the venous system. On long trips, it is recommended to get out of the car every couple of hours and in an airplane routinely get up and stretch.

Physicians and nurses work hard at getting people moving after surgery or while in the hospital for medical conditions. Enoxaparin (Lovenox) can also be used in low doses to prevent clot formation. Patients are often given tight stockings to promote blood return from the legs and prevent pooling of blood.

In patients with atrial fibrillation, warfarin (Coumadin) is used to prevent clot formation and minimize the risk of embolus and stroke.