Taking care of your teeth isn't a proven way to prevent heart disease. While there appears to be some connection between oral health and heart disease, more research is needed to understand it.
Poor oral health has been debated as a possible cause of heart disease for many years. some studies have shown:
Even though oral health isn't a key to heart disease prevention, it's important to take care of your teeth and gums:
If you're concerned about heart disease prevention, ask your doctor about proven ways to reduce your risk  such as stopping smoking and maintaining a healthy weight.
World Patient Safety Day was established in 2019 to enhance global understanding of patient safety, increase public engagement in the safety of health care and promote global actions to enhance patient safety and reduce patient harm.
Heart Valve Defect
There are 4 valves in the heart- Tricuspid Valve, Mitral Valve, Pulmonary Valve, Aortic Valve. We have discussed in detail about the role of each valve. But sometimes a defect may arise in the valve of a person and that cause serious complications. First let us understand what are the defects that may arise with the valves.
Causes of Heart Valve Defects
Valve Defects can be Congenital which is basically present by birth. If the defect is small, it may cause very little or no symptom at all. But in some cases as the age progresses, the valves may degenerate over time causing the symptoms to develop and that how the problem gets detected. In acquired valve disorders, the reason can be a Streptococcus infection which releases a toxin which damages the valve of the heart.
Valve Repair and Replacement
If the valve is suffering from a Stenosis or Regurgitation, then there are two approaches to correct this. The surgeon will check if the valve can be repaired or not, otherwise the valve needs to be replaced. There are two types of Valves available for replacement- Mechanical Valve and Tissue Valve. Mechanical heart valves are made from materials such as titanium and carbon. They usually consist of two leaflets and a metal ring surrounded by a ring of knitted fabric, which is sewn onto the heart in place of the original valve. There are several different models available for aortic and mitral replacement surgeries.
Tissue valves, also known as biological or bioprosthetic valves, are composed of animal or human tissue. The valves are derived from animal tissue such as porcine (pig), bovine (cow) and equine (horse) models, and then fixed with a preserving solution that may be mounted on a flexible frame to assist in deployment during surgery. As with mechanical valves, the bottom of a tissue valve is often surrounded by a ring of knitted fabric that is sewn onto the heart.
What are the Advantages and Disadvantages of Mechanical v/s Tissue Valve?
The main advantage of Mechanical valves is that they are very durable. However, these valves provide a surface on which blood clots can form easily. As a result, anyone who has been implanted with a mechanical valve needs to be on lifelong blood-thinning medication, such as warfarin, to prevent the development of blood clots that can cause heart attack or stroke. Advantages of Tissue valves compared to mechanical valves include the avoidance of lifelong warfarin therapy to prevent the development of blood clots. A disadvantage is their relatively poor durability compared to mechanical valves, with many requiring a re-operation in 10 to 20 years.
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Congenital heart disease is one or more problems with the heart's structure that exist since birth. Congenital means that you're born with the defect. Congenital heart disease, also called congenital heart defect, can change the way blood flows through your heart. Some congenital heart defects might not cause any problems. Complex defects, however, can cause life-threatening complications.
Symptoms
Some congenital heart defects cause no signs or symptoms. For some people, signs or symptoms occur later in life. And symptoms can return years after you've had treatment for a heart defect.
Common congenital heart disease symptoms include:
Abnormal heart rhythms (arrhythmias)
A bluish tint to the skin, lips and fingernails (cyanosis)
Shortness of breath
Tiring quickly upon exertion
Swelling of body tissue or organs (edema)
Most Common Types of Congenital Heart Defects
ASD- Atrial Septal Defect. A birth defect that causes a hole in the wall between the heart's upper chambers (atria).
VSD- Ventricular Septal Defect. A heart defect due to an abnormal connection between the lower chambers of the heart (ventricles).
Patent Foramen Ovale- patent foramen ovale (PFO) is a hole in the heart that didn't close the way it should after birth. The small flaplike opening is between the right and left upper chambers of the heart (atria).
As a baby grows in the womb, the foramen ovale is present in between the right and left top chambers of the heart (atria). It normally closes during infancy. When the foramen ovale doesn't close, it's called a patent foramen ovale.
Patent Ductus Arteriosus- Before birth, an opening that connects two major blood vessels leading from the heart  the aorta and pulmonary artery  is necessary for a baby's blood circulation. The connection diverts blood from a baby's lungs while they develop, and the baby receives oxygen from the mother's circulation. After birth, the ductus arteriosus normally closes within two or three days. In premature infants, the opening often takes longer to close. If the connection remains open, it's referred to as a patent ductus arteriosus.
Teratology of Fallot- A condition caused by a combination of four heart defects that are present at birth. Tetralogy of Fallot defects cause oxygen-poor blood to flow out of the heart and into the rest of the body.
Ebstein Anomaly- The tricuspid valve  the valve between the upper right chamber (right atrium) and the lower right chamber (right ventricle) of the heart  isn't formed properly
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Causes
To understand congenital heart disease, we must know how the heart works.
The heart is divided into chambers  two upper chambers (atria) and two lower chambers (ventricles).
The right side of the heart moves blood to the lungs through blood vessels (pulmonary arteries).
In the lungs, blood picks up oxygen and then returns to the left side of your heart through the pulmonary veins.
The left side of the heart then pumps the blood through the aorta and out to the rest of the body.
Congenital heart disease can affect any of these heart structures, including the arteries, valves, chambers and the wall of tissue that separates the chambers (septum).
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Risk factors
Certain environmental and genetic risk factors might play a role in the development of congenital heart disease, including:
Genetic Predisposition: Congenital heart disease appears to run in families (inherited) and is associated with many genetic syndromes. For instance, children with Down syndrome often have heart defects. Genetic testing can detect Down syndrome and other disorders during a baby's development.
German measles (rubella): Having rubella during pregnancy may affect how the baby's heart develops while in the womb.
Diabetes: Having type 1 or type 2 diabetes during pregnancy also may affect a baby's heart development. Gestational diabetes generally doesn't increase the risk of congenital heart disease.
Medications: Taking certain medications while pregnant can cause congenital heart disease and other birth defects. These drugs are called Teratogenic. Always tell your doctor about the medications you take during pregnancy.
Alcohol: Drinking alcohol while pregnant also contributes to the risk of heart defects in the baby. These are classified as Fetal Alcohol Syndrome.
Smoking: A mother who smokes while pregnant increases her risk of having a child with a congenital heart defect.
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Complications
Congenital heart disease complications that might develop years after you receive treatment include:
Irregular heartbeats (arrhythmias): Arrhythmias occur when the electrical signals that coordinate your heartbeat don't work properly. Your heart may beat too fast, too slowly or irregularly. In some people, severe arrhythmias can cause stroke or sudden cardiac death if not treated. Scar tissue in your heart from previous surgeries can contribute to this complication.
Heart infection (endocarditis): Endocarditis is an infection of the inner lining of the heart (endocardium). It generally occurs when bacteria or other germs enter your bloodstream and move to your heart. Untreated, endocarditis can damage or destroy your heart valves or trigger a stroke. If you are at high risk of endocarditis, it's recommended that you take antibiotics one hour before dental cleanings. Regular dental checkups are important. Healthy gums and teeth reduce the risk that bacteria will enter the bloodstream.
Stroke: A congenital heart defect can allow a blood clot to pass through your heart and travel to your brain, where it reduces or blocks blood supply.
Pulmonary hypertension: This is a type of high blood pressure that affects the arteries in your lungs. Some congenital heart defects send more blood to the lungs, causing pressure to build. This eventually causes your heart muscle to weaken and sometimes to fail.
Heart failure: Heart failure (congestive heart failure) means your heart can't pump enough blood to meet your body's needs. Some types of congenital heart disease can lead to heart failure.
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More Vulnerable to Heart Attack ?
We are all rattled by the latest news of actor Sidharth Shukla leaves us at an age of 40 years due to sudden heart attack.
Cardiovascular Heart Disease is the single largest non-communicable disease contributing to the morbidity burden in India. Cardiologists say they have, over the last decade, seen an increase in persons suffering heart attacks in their 20s and 30s. Fifty per cent of all heart attacks in Indian men occur under 50 years of age and 25 per cent of all heart attacks in Indian men occur under 40 years of age. Indians have a greater genetic predisposition to heart diseases. Studies have found that Indians get heart diseases at least 10 years before people in the West.
So what are the Risk Factors?
Indians consume a lot of trans fats- the ones we often find in fried and oily foods.
Apart from that There are some risk factors like smoking, stress, alcohol and family history. Diabetes, hypertension, sedentary lifestyle, high cholesterol, obesity are the common risk factors across all age groups.
In the past few years, work culture has changed drastically. People are very stressed in their workplace and tend to eat outside a lot. They eat food that is high in sugar, salt and fat. The stress also causes youngsters to take to smoking, drinking and other unhealthy habits. Sleeplessness as another risk factor.
While a heart attack cannot necessarily be prevented, one can control the risk factors. Also, one must not ignore any new symptom just because he is in the 20-30 age group.
Things to Keep in Mind
Do not ignore symptoms like breathlessness, chest pain, excessive sweating and dizziness. Also, one should try to stop smoking and consuming too much alcohol. Have an active lifestyle and avoid fatty foods
Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.
When you develop peripheral artery disease (PAD), your legs or arms  usually your legs  don't receive enough blood flow to keep up with demand. This may cause symptoms, such as leg pain when walking (claudication).
Peripheral artery disease is also likely to be a sign of a buildup of fatty deposits in your arteries (atherosclerosis). This condition may narrow your arteries and reduce blood flow to your legs and, occasionally, your arms.
You often can successfully treat peripheral artery disease by exercising, eating a healthy diet and quitting tobacco in any form.
Symptoms
While many people with peripheral artery disease have mild or no symptoms, some people have leg pain when walking (claudication).
Claudication symptoms include muscle pain or cramping in your legs or arms that's triggered by activity, such as walking, but disappears after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.
The severity of claudication varies widely, from mild discomfort to debilitating pain. Severe claudication can make it hard for you to walk or do other types of physical activity.
Peripheral artery disease signs and symptoms include:
Pain when using your arms, such as aching and cramping when knitting, writing or doing other manual tasks
If peripheral artery disease progresses, pain may even occur when you're at rest or when you're lying down. It may be intense enough to disrupt sleep. Hanging your legs over the edge of your bed or walking around your room may temporarily relieve the pain.
Causes
Peripheral artery disease is often caused by atherosclerosis. In atherosclerosis, fatty deposits build up on your artery walls and reduce blood flow.
Although discussions of atherosclerosis usually focus on the heart, the disease can and usually does affect arteries throughout your body. When it occurs in the arteries supplying blood to your limbs, it causes peripheral artery disease.
Less commonly, the cause of peripheral artery disease may be blood vessel inflammation, injury to your limbs, unusual anatomy of your ligaments or muscles, or radiation exposure.
Risk Factors
Factors that increase your risk of developing peripheral artery disease include:
People who smoke or have diabetes have the greatest risk of developing peripheral artery disease due to reduced blood flow.
Drink enough water
Importance of proper hydration needs no introduction. It not only helps keep up the water balance in our body, but also boosts metabolism, gut health and digestion - further promoting immunity and nourishment.
Eat wholesome breakfast
Breakfast is deemed the most important meal of the day. Literally meaning breaking the fast, a wholesome morning meal refuels you with energy after night-long fasting. This subsequently, helps us kick-start the day.
Eat seasonal vegetables
Every season brings along a host of vegetables that are loaded with several essential nutrients. Adding those vegetables in our daily diet may help immune us against several seasonal diseases.
Load up on fruits
Fruits are considered superfood. They are light, fulfilling and low in calorie, making it an ideal snack to munch on in between meals.
Reduce gap between meals
If you thought starving may help you lose weight, then you are absolutely mistaken. Experts across the world suggest, it is always good to have smaller portion of meal in every 3-4 hours. This helps you digest food easily and regulate metabolism. These factors further help prevent bloating, acidity etc.
Avoid junk foods
We love pizzas, burgers and fries. Don't we? But the excess fat in each of these foods lead to different types of lifestyle diseases- obesity being one major issue. This is why it is always recommended to avoid these fatty, greasy foods as much possible; and load up on healthy alternatives instead.
Avoid sugary drinks
We agree keeping our body hydrated is the most important part of healthy diet. But that doesn't mean we can load up on colas, readymade juices, sodas et al. These drinks include high amount of sugar, which (like junk foods) lead to lifestyle problems like diabetes, obesity and more
Include healthy carbs and fats
While excess carbs and fats lead to several health issues, it can't also be denied that healthy carbs and fats are much needed to keep up a nutrient balance in our body. So, experts suggest inclusion of whole grain, fish etc in our diet to include these nutrients in the healthies way possible.
Moderate exercise
Exercise also plays an important role in healthy diet habit. Moderate exercise, brisk walking etc are important to help regulate metabolism and digest food.
Proper sleep
Another important factor affecting our diet is sleep. Studies have shown adequate amount sleep actually have positive effects on what we eat every day. Good amount of sleep helps rest our body, which further help us make the most of the nutrients we eat.
What are minerals and what do they do?
Minerals are nutrients necessary to maintain the body's health. The 13 essential minerals include calcium, magnesium, sodium, potassium and others.
Minerals are nutrients necessary to maintain the body's health. The 13 essential minerals include calcium, magnesium, sodium, potassium and others.
Essential minerals are a class of nutrients that are vital for maintaining the body’s health. They are inorganic components that play a multitude of functional roles in human cells both physiologically and biochemically. The minerals are utilized by the body’s organ systems for growth, development, movement, energy production, utilization and maintenance of internal homeostasis. Essential minerals are divided into two main groups based on the concentration required for normal body function: macrominerals and trace minerals. A balanced diet provides all the essential minerals needed to maintain good health. In case of dietary inadequacy to meet mineral requirements, supplements may also be taken.
The 13 essential minerals
Thirteen essential minerals that must be ingested for proper health. Their deficiency leads to critical health conditions.
Calcium: Calcium builds strong bones and teeth and helps in muscle contraction, blood clotting, nerve transmission, cell signaling and regulation of metabolism. The deficiency of calcium makes bone fragile and easy to fracture. Milk and dairy products, cashew, dates, broccoli, parsley and greens are good sources of dietary calcium.
Sodium: Sodium helps in muscle contraction, conducts nerve impulses and controls the fluid balance in the body. The primary source of dietary sodium is table salt. However, salt should be taken in moderation.
Potassium: Potassium plays a crucial role in maintaining fluid balance, muscle contraction and nerve impulse conduction. It supports brain health and reduces the risk of stroke. Low potassium causes irregular heartbeats, edema (swelling), brain damage, etc. Bananas, sweet potatoes, avocados, beets and dates are rich sources of potassium.
Chloride: Chloride in association with sodium maintains the normal fluid balance in the body. It is used in the formation of hydrochloric acid (stomach acid) for digestion and to sustain electrical neutrality in the body. Table salt, tomatoes, celery and lettuce are rich sources of chloride.
Magnesium: Magnesium acts as a cofactor in several enzymatic reactions and is required for the synthesis of deoxyribonucleic acid (DNA) and an antioxidant, glutathione. Green leafy vegetables, legumes, nuts, seeds and whole grains replenish dietary magnesium.
Phosphorous: Phosphorus helps build and repair bones and teeth, helps nerves function and makes muscles contract. Phosphorus deficiency leads to bone diseases and growth restriction in children. Meats, poultry, beans, nuts, seeds and dairy products are rich sources of phosphorus.
Iodine: It is the mineral used to produce thyroid hormones. It is necessary for the body’s metabolism and physical and mental development. Phosphorus deficiency leads to impaired growth in children and metabolic disorders such as goiter and mental problems and affects menstrual health and pregnancy-related issues. Iodized table salt is the main source and is easily available.
Iron: It is used in hemoglobin formation, which carries oxygen in the blood. Iron deficiency can lead to cellular hypoxia (decreased oxygen) and cell death. Green leafy vegetables and meats such as beef, chicken and pork are rich sources of iron.
Zinc: This mineral aids in cell division, immunity and wound healing. Low zinc levels impair the immune system. Oysters, red meat, poultry, beans, nuts and whole grains provide major quantities of zinc.
Copper: Copper helps in energy production and facilitates iron uptake from the gut. Chocolate, liver, shellfish and wheat bran cereals are rich sources.
Manganese: Manganese plays an important role in protein, carbohydrate and cholesterol breakdown and cell division. Along with vitamin K, it helps in blood clotting. Whole grains, nuts, soybeans and rice are rich in manganese.
Sulfur: Sulfur has antibacterial properties and helps fight acne-causing bacteria in the skin. It also repairs DNA damage. Seafood and legumes, especially soybeans, black beans and kidney beans are rich sources of sulfur.
Selenium: Selenium helps prevent oxidative damage to the cells. It is also very important for the metabolism of the thyroid hormone. Brazil nuts, seafood and organ meats are good sources of selenium
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What is Arteriovenous Fistula?
An arteriovenous (AV) fistula is an abnormal connection between an artery and a vein. Normally, blood flows from your arteries to your capillaries, and then on to your veins. Nutrients and oxygen in your blood travel from your capillaries to tissues in your body.
With an arteriovenous fistula, blood flows directly from an artery into a vein, bypassing some capillaries. When this happens, tissues below the bypassed capillaries receive less blood.
Arteriovenous fistulas usually occur in the legs, but can develop anywhere in the body. Arteriovenous fistulas are often surgically created for use in dialysis in people with severe kidney disease.
A large untreated arteriovenous fistula can lead to serious complications. Your doctor monitors your arteriovenous fistula if you have one for dialysis.
Symptoms
Small arteriovenous fistulas in your legs, arms, lungs, kidneys or brain often won't have any signs or symptoms and usually don't need treatment other than monitoring by your doctor. Large arteriovenous fistulas may cause signs and symptoms.
Arteriovenous fistula signs and symptoms may include:
A significant arteriovenous fistula in your lungs (pulmonary arteriovenous fistula) is a serious condition and can cause:
An arteriovenous fistula in your gastrointestinal tract can cause bleeding in your digestive tract.
Causes
Causes of arteriovenous fistulas include:
Injuries that pierce the skin. An arteriovenous fistula may occur if you have a piercing injury, such as a gunshot or stab wound, on a part of your body where a vein and artery are side by side.
Being born with an arteriovenous fistula (congenital). The exact reason why isn't clear, but in some babies, the arteries and veins don't develop properly in the womb.
Genetic conditions. Arteriovenous fistulas in the lungs (pulmonary arteriovenous fistulas) can be caused by a genetic disease (Osler-Weber-Rendu disease, also known as hereditary hemorrhagic telangiectasia) that causes blood vessels to develop abnormally throughout your body, but especially in the lungs.
Dialysis-related surgery. People who have late-stage kidney failure may have an arteriovenous fistula surgically created in the forearm to make it easier to perform dialysis.
Risk factors
In addition to certain genetic or congenital conditions, the following risk factors may make you more likely to develop an arteriovenous fistula:
Being female
Cardiac catheterization, especially if the procedure involves blood vessels in your groin
Certain medications, including some blood thinners (anticoagulants) and medications used to control bleeding (anti-fibrinolytics)
High blood pressure
High body mass index (BMI)
Older age
Complications
Left untreated, an arteriovenous fistula can cause complications, some of which can be serious. These include:
Heart failure. This is the most serious complication of large arteriovenous fistulas. Blood flows more quickly through an arteriovenous fistula than it does through normal blood vessels. As a result, your heart pumps harder to make up for the increase in blood flow. Over time, the increased workload on your heart can interfere with how the heart works, leading to heart failure.
Blood clots. An arteriovenous fistula in your legs can cause blood clots to form, potentially leading to deep vein thrombosis, a painful and potentially life-threatening condition if the clot travels to your lungs (pulmonary embolism). Depending on where your fistula is, it can lead to a stroke.
Leg pain. An arteriovenous fistula in your leg can cause pain in your leg (claudication), or can worsen pain you already have.
Bleeding. Arteriovenous fistulas may lead to bleeding in your gastrointestinal system.
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We all must have read the news that WHO Chief Scientist have made a statement that “India may be entering endemic stage of Covidâ€ÂÂ
So what implication does it have for us or what does it mean. For that, we need to understand few terms and terminologies. Let us understand more about the three terms- Epidemic, Pandemic and Endemic.
Epidemic is a disease that affects a large number of people within a community, population, or region. For example, when the Covid-19 was first detected and was limited to Wuhan, it was an Epidemic- which is spread across a limited region and population.
So what is the difference between Epidemic and Pandemic? A simple way to know the difference between an epidemic and a pandemic is to remember the “P†in pandemic, which means a pandemic has a passport. A pandemic is an epidemic that travels. So for example, when the Epidemic spreads out to a large scale of population across a bigger geography and demography, it is called a Pandemic.
Epidemic vs Endemic
But what’s the difference between epidemic and endemic? An epidemic is actively spreading; new cases of the disease substantially exceed what is expected. More broadly, it’s used to describe any problem that’s out of control, such as “the opioid epidemic.†An epidemic is often localized to a region, but the number of those infected in that region is significantly higher than normal. For example, when COVID-19 was limited to Wuhan, China, it was an epidemic. The geographical spread turned it into a pandemic.
Endemics, on the other hand, are a constant presence in a specific location. Example:-Malaria is endemic to parts of Africa. It means that the population has learnt to live with the disease and the level of transmission is somewhat predictable.
So what does it mean for us?
The situation in India will continue with ups and downs considering the size and heterogeneity of the population and their immunity status. Hence only the vulnerable population where there are low levels of vaccine coverage can see peaks and troughs for the next several months. So the take home message is that, vaccination is they to halt the progression of the infection. Wearing masks and social distancing are the physical precautions that needs to taken.
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