First Live Tissue Artery Transplant
A United Kingdom patient suffering from arterial disease has become the first person in the country to receive a life saving artery transplant using live human artery tissue flown in specially from the United States.
John Young suffered years of ill health and three major cardiac operations due to suffering from arterial disease which left him close to death. Mr Young required a replacement of the Aorta, which is the main artery coming from the base of the heart and the two branches coming from it which feed the left and right hand side of the body.
In an interview broadcast on British television today, Mr young stated ‘sometimes when you’re in hospital and they clean up wounds you scream out – but i never felt like that. I felt down, and I didn’t feel well, but I wasn’t in violent pain’. This is a little known, and interesting insight into the type of pain that arterial disease causes.
Normally, surgeons would use use synthetic material to replace damaged arteries, but in this case that was not possible, for medical reasons. Instead, live human tissue donated from a donor in America was flown in specially, and was used in a ground breaking 9 hour operation at St. Richard’s Hospital in Chichester, England – the first of it’s kind in the country.
In an interview given to the BBC, the Consultant Vascular Surgeon who led the British operation, Mr. Hany Hafez commented ‘I feel privileged to have received the necessary support to allow us to do this. Without the system supporting the team, it would not have worked’.
Just two weeks after the operation, the patient is back at home and well on the road to recovery.
The operation cost over $150,000, but is seen as being ‘well worth it’ as Mr Young would have almost certainly died imminently without it.
Alcohol and Heart Health
Alcohol – a balanced point of view
Alcohol statisics for the United States make for sobering reading – each year more than 100,000 people die from alcohol related conditions and the effects of alcohol consumption. But is it all bad news where alcohol and heart disease is concerned ?
Every one in the adult population has different alcohol consumption habits and patterns, ranging from those who drink no alcohol at all, to those who are classed as chronic alcoholics. Alcohol can be both good and bad for our health, and our heart health, and the main difference between the two is the amount consumed.
After many years of alcohol statistics research involving nearly one million people, it would appear that many people who drink moderately, which is classed as not more than one or two drinks per day, live longer lives than either heavy drinkers, or those who are teetotal. (A drink is defined as one 12 oz. glass of beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.)
Alcohol heart health problems
Heavy drinking has been proven to have a directly negative effect on heart health. Ethanol is the active ingredient in alcoholic beverages, and it is this chemical that can wreak havoc on the body’s internal organs when consumed in excessive quantities. There are a number of different illnesses that can result from alcohol abuse :-
- Drinking too much alcohol can raise the levels of some types of fat known as triglycerides in the blood
- Alcohol consumption increases the body’s calorie intake, and has very little nutritional value. Regular excess calorie intake can in turn lead to obesity and consequently a greater risk of developing diabetes
- Excessive alcohol consumption on a regular basis can lead to high blood pressure, enlargement of the heart which is known as dilated cardiomyopathy, and heart failure, which is the inability of the heart to pump sufficient blood around the body
- Binge drinking where vast amounts of alcohol are consumed, for example twenty drinks in one evening, can lead to abnormal heart rhythms know as arrhythmia, stroke or even sudden cardiac death
- Drinking too much alcohol also increases the risk of non-heart related illness such as alcoholism and breast cancer, and also death by misadventure due to alcohol-related accidents and even suicide
It is important to note that heart problems in women may be caused by less alcohol consumption than men – the recommended daily alcohol intake for women is approximately one quarter less than that for men.
Potential benefits of moderate alcohol consumption to health
There have been many studies that have concluded that small amounts of alcohol could help to protect the heart against the causes of coronary heart disease, heart attack and stroke, specifically in men over 40 years of age and postmenopausal women. This may be due to a combination of factors including :-
- Increased levels of High Density Lipoprotein (HDL) cholesterol which is the ‘good’ cholesterol, although regular exercise, and dietary niacin supplements can also produce this increase
- Reduced ‘stickiness’ of the blood, due to the presence of resveratrol (an anti-clotting agent) which may help to prevent platelets from forming which could turn into blood clots, increasing the risk of heart attack or stroke
- Potential benefits of certain compounds such as flavonoids and other antioxidants in reducing heart disease risk. Red wine has been singled out as a particularly rich source of these compounds, although they can be obtained from other natural non-alcoholic food sources such as fruit and vegetables
- Most sensible drinkers tend to have healthy lifestyles in other areas of their lives. For instance they are more likely to eat a healthy diet, maintain a healthy weight, take regular heart exercise and get sufficient sleep. They are also more likely to have more relaxed lifestyles, better social lives and increased emotional and physical happiness.
Serious immediate warnings concerning alcohol and heart health
You should not drink any alcohol whatsoever if you are pregnant, as this can seriously harm your unborn baby, and may potentially cause birth defects.
According to advice published by the American Heart Association, if you are taking long term aspirin medication (prescribed by your physician) to reduce the possibility of blood clotting, you should not be drinking any alcohol, and should continue to take your prescribed aspirin dosage.
Alcohol Advice for newly diagnosed Heart Disease patients
The US Food and Drug Administration (FDA) advice is that If you have been newly diagnosed with a heart disease condition you should stop drinking alcohol.
Best advice is not to drink alcohol to achieve health goals
According to advice from the British Heart Foundation it is not advisable for anyone to target drinking alcohol specifically to protect against heart disease. Their advice is that there are better options – starting with taking more physical heart exercise, stopping smoking, consulting with your physician about lowering your cholesterol and blood pressure, controlling your weight, and following a healthy diet.
This is reinforced by the fact that there is currently no scientific proof that drinking red wine or any other alcoholic beverage can replace these more traditional health measures.
Deep Vein Thrombosis
DVT Definition (Deep Vein Thrombosis)
DVT is a disease of the circulation, often associated with air travel. The medical term for a DVT is a venous thromboembolism. Our blood needs to be able to clot in order to provide the necessary protection for the body against severe loss of blood from an injury to a vein or an artery. However, blood can sometimes form clots whilst inside a blood vessel, which is the definition of a Deep Vein Thrombosis (DVT).
What causes DVT?
DVT causes can be many and varied. Blood flow through the deepest veins in the legs is relatively slow. This presents an increased risk of a solid clot forming, which can cause a partial or complete blockage in the vein. Although Deep Vein Thrombosis (DVT) can sometimes occur spontaneously in normal veins, without any obvious underlying cause, the risk of developing DVT is increased by the following surprisingly high numbers of risk factors :-
* Inactivity or Immobility
* Previous blood clots or DVT in the leg, or vein damage
* Medical and genetic conditions
* Major Surgery
* Broken leg
* Pregnancy
* Contraceptive pill use
* Hormone replacement therapy (HRT)
* Obesity
* Smoking
* Age – over 40 years
* Cancer
* Varicose veins
* Family history of DVT
* Paralysis
* Air travel
DVT Symptoms
Quite often there are no Deep Vein Thrombosis symptoms at the onset of the condition, although where they do appear, they may develop rapidly. The problem may only become apparent when a crisis develops into a medical emergency, and the blood clot reaches the lungs, where it becomes what is known as a pulmonary embolism. A DVT usually, although not always, affects only one leg. The thrombosis symptoms of a DVT in the leg include:-
* swelling – suddenly and in one leg
* pain in the leg
* warm skin
* tenderness
* redness, particularly at the back of the leg, below the knee.
Occasionally some of the surface veins become more visible through the skin, and there may also be some pain on flexing the foot upwards.
How is DVT diagnosed?
There can be many causes of a painful or swollen leg, which means that it can be difficult for a doctor to successfully perform a first time DVT diagnosis. If you have some of the DVT risk factors listed above, and your doctor suspects that you may have a DVT, they will usually recommend that you have some urgent tests performed, which will normally be carried out in a hospital, or possibly a specialist anti-coagulation clinic.
DVTs are usually detected by ultrasound, which is capable of detecting even the smallest blood clots. If a doctor suspects a DVT he or she will usually request an urgent ultrasound test, and a follow-up blood test. There is a special blood test known as the D-dimer test, which is capable of detecting fragments of a blood clot that have broken up, and present within the blood stream. This gives a reliable indication that a person may have developed a DVT.
If the results of an Ultrasound and D-dimer test cannot confirm a diagnosis of DVT, a venogram might be used. This is a more detailed test that involves a contrast dye being injected into the vein in your leg. An X-ray is then used to see whether the dye is flowing through your vein, or if it is blocked by a blood clot.
Is DVT dangerous?
DVTs themselves are not dangerous, but they are associated with complications which can become life threatening, or prove fatal. The most common serious complication is a pulmonary embolism, which occurs in approximately 30% of cases of DVT. This is where a part of the blood clot in the leg vein breaks off and travels through the blood stream to the lung, where it becomes lodged, causing chest pain and severe breathing difficulties.
Pulmonary embolism, is a common cause of sudden, unexpected death. A severe pulmonary embolism can cause the lungs to collapse, and result in heart failure. If left untreated, 10% of people die from pulmonary embolism.
More rarely, a part of the clot may also lodge in other organs including the brain, where it can lead to a stroke.
Deep Vein Thrombosis Treatments
Two thirds of people diagnosed with a DVT require initial treatment at a hospital, or possibly an anticoagulation clinic. The aim of the DVT treatment is to dissolve the blood clot and prevent further clots from forming. The primary DVT therapy is with anticoagulant medicines such as Heparin or Warfarin which thin the blood, allowing it to flow more freely. Inactivity and bed rest is discouraged and patients are encouraged to move around as much as possible. Regular blood tests are performed monitor the effectiveness of the treatment and to reduce the risk of a haemorrhage.
Painkillers and heat applied to the area may also be advised for relief of symptoms of a DVT, and compression stockings are often worn to cover the length of the whole leg to give support to the veins and reduce swelling.
As well as wearing compression stockings, you may be advised to raise your leg while you are resting, as this helps to reduce the pressure in the veins of the leg, and also helps tp prevent blood and fluid from gathering in the leg.
Occasionally a doctor may recommend dvt surgery to remove a deep vein clot. The procedure is called venous thrombectomy. This is usually necessary only in the case of a severe form of DVT called phlegmasia cerulea dolens, which does not respond to the non-surgical treatments described above. Phlegmasia cerulea dolens, if not adequately treated, can cause gangrene, which is when the tissues do not receive sufficient oxygen, and subsequently die. Gangrene is a very serious condition that may result in the amputation of the affected limb.
It should be noted that Aspirin is not used to prevent DVT. (Aspirin is widely used to help prevent blood clots in arteries which can cause strokes and heart attacks. However, aspirin does not seem to be very effective at preventing blood clots in veins.)
DVT Prevention – How to avoid getting a DVT, especially when travelling by Air
Prophylaxis is a medical term used for ‘prevention’. DVT prophylaxis is always preferable than having to deal with consequences of developing the condition. There are certain precautions that you can take to avoid getting a DVT.
If possible, avoid long periods of immobility such as sitting in a chair for many hours to avoid the blood ‘pooling’, and to get the circulation in the legs moving.
Major surgical operations are known to be a risk for a DVT – particularly operations to the hip, lower abdomen, and leg. You may be given an anticoagulant such as a heparin injection just before having an operation to help prevent a DVT. An inflatable sleeve connected to a pump to compress the legs during a long operation may also be used. It is also common practice to get you up and walking as soon as possible after an operation.
If you are planning to travel by air, especially on a long-haul flight, the the following specific tips can significantly reduce your chances of developing a flight or travel related DVT :-
* drink plenty of water
* avoid excessive alcohol as it can lead to dehydration
* avoid taking sleeping pills as it can cause immobility
* perform simple leg exercises, such as regularly flexing your ankles. Most airlines provide information on suitable exercises to do during your flight
* take occasional short walks, when in-flight advice suggests it is safe to do so
* take advantage of refuelling stopovers where it may be possible to get off the plane and walk about
* wear elastic compression stockings.
After DVT
After a DVT has been diagnosed, persistent symptoms may occur in the affected part of the leg. In order to minimise the risk of further complications you may be advised to wear a compression stocking for many months or even years. Also, by following some simple additional steps, you can further minimise the possibility of longer term problems as follows :-
* Raise your leg when you are resting to reduce the pressure in the veins in the affected leg.
* Raise the lower end of your bed by a few inches so that your foot and calf are slightly higher than your hip whilst you are sleeping.
Hypertension
Definition of Hypertension
Hypertension disease is defined as when a persons blood pressure is constantly higher than the recommended level. The United Kingdom hypertension statistics make for alarming reading, with approximately one quarter of the adult population suffering from this condition, which has been labelled as ‘the silent killer’.
If you have undetected high blood pressure, you run the risk of developing serious complications, including a higher risk of having a heart attack or a stroke. Over an extended period of time it can cause the heart to become enlarged, or it’s ability to pump blood around the body to become less effective, which is known as heart failure. Other organ damage may result, such as kidney failure or eye damage.
Because Hypertension symptoms are rarely noticeable, and seldom make people actually feel unwell, the only way of knowing whether or not you may be suffering from it is to have your blood pressure tested regularly. A worrying statistic is that over a third of people with hypertension remain undiagnosed and are not receiving treatment for it, and this is putting their heart health and life at risk.
Important Note :-
Hypertension is a serious condition
It can represent a very real long term threat to your life
What is blood pressure?
Blood pressure is caused by the pumping action of the heart forcing the blood to flow through the arteries (which are the blood vessels that transport blood from the heart to the rest of the body). A certain amount of pressure in the arteries is normal and is necessary for normal circulation. However, if the blood pressure becomes consistently too high it becomes a health hazard, as it can damage the arteries, by causing them to thicken and become less elastic. This, in turn, limits the flow of blood and may cause permanently raised blood pressure.
What causes Hypertension?
In over 90% of cases there is no single underlying cause for elevated blood pressure. However there are certain known hypertension risk factors which should be avoided, as they can all contribute to the hypertension cause. The major risk factors are :-
- Drinking too much alcohol
- Being overweight or obese
- Eating too much salt
- Not doing enough exercise
- Not eating enough fruit and vegetables
- excessive anxiety
- Certain types of medications – your doctor will always ask you if you are taking any type of medication when you visit
High blood pressure can also be hereditary, as it does tend to occur in families, and in a very small number of cases it can be attributed to a single cause, such as kidney disease.
How do I know if I have hypertension ?
There are few symptoms of hypertension, so potential hypertension patient education is very important. All adults should have their blood pressure checked at least once every five years, but preferably more often, especially as you get older, as blood pressure usually rises with age. Hypertension diagnosis will usually be given by your physician.
Your doctor will know your medical history, and will make the diagnosis from a succession of blood pressure readings. This is given as two numbers, which represent millimetres of mercury or mmHg.
The first number is called the systolic pressure, which is the force of the blood as the heart contracts to pump it around the body.
The second number is called the diastolic pressure, which is the force while the heart is relaxing and filling with blood again in preparation for the next contraction.
A normal reading for an adult should generally be no higher than 140/85mmHg. People with certain medical conditions, such as diabetes, should aim for a blood pressure even lower than this – around 130/80mmHg or below.
Several readings should be taken over a period of time to get an accurate measurement as blood pressure can fluctuate and one high reading does not necessarily mean a person has hypertension.
Is there a cure or treatment for Hypertension ?
Hypertension cure may be a misleading term. If you have high blood pressure, it is essential to control it, but this will require constant vigilance and treatment on your part. But this will pay big health dividends, as reducing your blood pressure by 5mmHg can lower your risk of having a heart attack by about 20%. There are many lifestyle changes a person can make to reduce their risk of hypertension or help to lower their blood pressure if it is already high. To reduce your blood pressure, or prevent it from getting high, you can follow some or all of the following hypertension guidelines :-
- Do more physical activity
- Keep to a healthy weight
- Cut down on your salt intake
- Cut down on alcohol
- Eat more fruit and vegetables
- learn to control your anxiety and stress levels
Also your doctor may prescribe hypertension drugs to help reduce your blood pressure and protect your heart. Various types of hypertension medications are available to help lower blood pressure, including ACE inhibitors, beta-blockers, calcium channel blockers and diuretics. Doctors and heart specialists often prescribe a combination of these.
Whilst Smoking is not a direct risk factor for high blood pressure, it does increase the chance of suffering a heart attack, heart failure or a stroke. If you quit smoking, then within two years, your risk of suffering a heart attack is halved.