Beyond the Beat - Heart Newsletter (February 2023)

BEYOND THE BEAT BEYOND THE BEAT

IINTRODUCTION NTRODUCTION TTO O

HEART HEALTH HEART HEALTH

Hearts are the symbol of Love.

When they beat, they serve as a tangible proof of the affection we hold for others. But when our hearts can barely beat for ourselves, how can they beat for the ones we love?

The heart is a vital organ that beats over 100,000 times a day, pumping approximately a gallon and a half of blood each minute and supplying all organs with the oxygen and nutrients they need. Hence, Heart Health is a key component for overall health.

As we age, the risk of developing cardiovascular diseases becomes prominent. So, maintaining a healthy heart and healthy blood vessels is essential and possible by acting from an early age. Preventative measures include engaging in physical activity, adopting a healthy diet, limiting alcohol consumption, not smoking, and complying with pharmacological and non-pharmacological management of conditions that predispose to cardiovascular diseases.

TO

CARDIOVASCULAR CARDIOVASCULAR DISEASES DISEASES

Cardiovascular diseases are the leading cause of death globally, accounting for more than 17 million deaths each year. In Lebanon, and according to a study done on the Burden of Disease and Risk Factors, Ischemic Heart Disease was the leading cause of death in 2010.

There are many risk factors for cardiovascular diseases

High Blood Pressure and High Cholesterol

High blood pressure can damage the lining of arteries, making them susceptible to the buildup of plaques, which narrow them. LDLcholesterol can also build up in the walls of arteries and limit blood flow to the heart, brain, kidneys among other organs. Eating a healthy diet low in sodium, being physically active, maintaining a healthy lifestyle, and taking medications as recommended are ways to maintain cardiovascular health

Diabetes

Smoking and Secondhand Smoke Exposure

Obesity, Unhealthy Diet and Physical Inactivity

Adults with diabetes are twice as likely to suffer from a heart disease or a stroke Over time, high blood sugar can damage and block blood vessels in the heart Also, more than 2 in 3 people with diabetes have high blood pressure Diabetes also raises triglycerides and LDL-cholesterol

Smoking can damage the body several ways:

Raising triglycerides and lowering high-density lipoprotein (HDL) cholesterol.

Making blood sticky and more likely to clot. Damaging cells that line the blood vessels. Increasing the buildup of plaques (fat, cholesterol, calcium, and other substances) in blood vessels

Causing thickening and narrowing of blood vessels

People who are overweight or obese are at an increased risk of heart diseases and stroke and their risk factors, including high blood pressure, high LDL cholesterol, low HDL cholesterol, high triglycerides, and type 2

diabetes

Fringe Properties

Finding a Broker

KAWASAKI KAWASAKI DISEASE DISEASE

THE MUCOCUTANEOUS LYMPH NODE SYNDROME

Kawasaki Disease (KD), also known as Kawasaki Syndrome, is an acute febrile illness of unknown cause that primarily affects children under 5 years. The disease was first described in Japan by Tomisaku Kawasaki in 1967, and the first cases outside of Japan were reported in Hawaii in 1976

Risk factors for Kawasaki Disease include:

Being under 5 years old. Being a male.

Being of Asian or Pacific Island descent (Japanese or Korean heritage).

SIGNS AND SYMPTOMS

Clinical signs and symptoms include fever, rash, swelling of the hands and feet, irritation and redness of the whites of the eyes, swollen lymph glands and inflammation of the mouth, lips, and throat.

If left untreated , KD can lead to serious complications such as dilated coronary arteries and aneurysms, inflammation of blood vessels and of the heart muscle as well as heart valve problems.

KAWASAKI KAWASAKI DISEASE DISEASE

THE MUCOCUTANEOUS LYMPH NODE SYNDROME DIAGNOSIS

The diagnosis of KD can be done using

Blood and urine tests. Echocardiogram. Electrocardiogram.

The disease shares similar symptoms with "Multisystem Inflammatory Syndrome," which has emerged in children with COVID-19. Thus, children with these symptoms will likely undergo testing for COVID-19 as well.

TREATMENT

Incomplete Kawasaki Disease occurs when children have a high fever lasting five or more days and fewer than four of the previously mentioned symptoms. These children are still at risk of complications and must receive treatment within 10 days of disease onset.

Intravenous Immunoglobulin and Aspirin are the mainstays of treatment.

After receiving treatment, most children make a full recovery and do not require follow-up care. However, children with aneurysms or other complications require lifelong monitoring by a cardiologist.

CARDIAC CARDIAC SYNDROME SYNDROME X X

Cardiac Syndrome X (CSX) is identified by chest pain resembling angina but no visible signs of significant blockage in the coronary arteries on angiography. It is considered a form of ischemic heart disease and is most common in perimenopausal women. Some experts refer to the disease as Microvascular Angina (MVA), as it is characterized by a reduction in the capacity of the coronary arteries to supply blood to the heart without a blockage in the larger epicardial arteries.

RISK FACTORS

The exact causes of CSX are still unclear, but it may associated with:

Reduced levels of Estrogen that usually helps protect blood vessels.

Hyperalgesia or increased sensitivity to cardiac pain. Insulin resistance and high glucose levels.

Long-term inflammation with high levels of C-reactive protein

Problems in vascular and nonvascular smooth muscle function.

SIGNS AND SYMPTOMS

The symptoms of CSX resemble those of angina and include

A feeling of tightness or pressure in the chest that can radiate to the arms, neck, jaw, back, or stomach. Shortness of breath

Nausea and vomiting

Sweating Lightheadedness

Half of CSX patients experience recurring angina-like chest pain episodes that are longer than usual However, the main difference between CSX chest pain and angina chest pain is that the former does not respond to sublingual nitroglycerin.

CARDIAC SYNDROME X CARDIAC SYNDROME X

It is recommended to perform routine laboratory tests as well as tests for cholesterol and inflammatory markers in individuals suspected to have CSX

Measuring Vitamin D levels may be beneficial as low levels of Vitamin D have been linked to a higher risk of developing endothelial dysfunction and microvascular angina due to increased inflammation. Research has found that individuals with CSX tend to have lower levels of serum Vitamin D compared to those without the condition.

DIAGNOSIS TREATMENT

The management of patients suspected of having CSX is challenging as its etiology is not entirely understood. To date , there are no specific guidelines to treat CSX and management should be individualized.

Patients with CSX and chest pain should be started on Sublingual Nitrates, which, alongside Beta Blockers (propranolol, nebivolol, and carvedilol), are currently the mainstay of treatment

Calcium Channel Blockers (nifedipine, verapamil, diltiazem) are alternatives to beta-blockers if a response is not achieved.

Ranolazine, a recent antianginal agent indicated for chronic angina and used in patients with refractory angina, as well as Statins and ACE Inhibitors, have also been reported to be effective alternatives

Analgesics such as Xanthine Derivatives (adenosine receptor blockers), Aminophylline, as well as neural electrical stimulation have been proposed in select patients.

Antidepressants such as Tricyclic Antidepressants (TCAs) and Selective Serotonin Reuptake Inhibitors (SSRIs) have also been proposed

Psychotherapy Cognitive and Group Therapy has demonstrated positive outcomes in reducing incidences of chest discomfort over a 3-6 month period

Lifestyle Changes Adjustments include exercise training, smoking cessation, weight loss, and dietary changes.

BRUGADA SYNDROME BRUGADA SYNDROME

Brugada Syndrome is a rare but potentially fatal inherited cardiac disease that predisposes patients to fatal cardiac arrhythmias.

Mutations in the SCN5A gene, which creates sodium channels in the heart muscle cells, cause this disorder. Even if inherited, affected individuals may demonstrate variability in the clinical signs and symptoms of the disease. Additionally, many environmental and genetic factors may influence the phenotype, including temperature, medications, electrolyte abnormalities and cocaine use

RISK FACTORS

Risk factors of the disease include:

Family History: Brugada Syndrome is an inherited cardiac disease

Race: Asian descent, particularly Japanese and Southeast Asian ancestry.

Sex: Males are at a higher risk than females as testosterone is thought to contribute to the disorder.

SIGNS AND SYMPTOMS

Brugada syndrome often does not cause any noticeable symptoms and many individuals do not know they have it Nonetheless, an irregular electrocardiogram (ECG) is a major sign of the syndrome. Other signs include:

Dizziness and fainting

Palpitations

Difficulty breathing and gasping, particularly at night

Extremely fast and chaotic heartbeat

Seizures

Brugada Syndrome can be extremely dangerous and may result in death, especially during sleep or rest. The disease has been known as "Sudden, Unexplained Nocturnal Death Syndrome" because people with it can often die in their sleep

BRUGADA SYNDROME BRUGADA SYNDROME

The treatment of Brugada Syndrome depends on the risk of having a serious arrhythmia and focuses on controlling it Patients at a high risk are those with a personal history of serious arrhythmias or fainting and those who have survived a sudden cardiac arrest.

If there are no symptoms, Brugada Syndrome may not need special treatment. It is advised, however, to take precautions to lower the risk of arrhythmias such as:

Treating a fever aggressively. Avoiding drugs that may trigger an irregular heartbeat. Avoiding playing competitive sports.

IMPLANTABLE CARDIOVERTERDEFIBRILLATOR (ICD)

Is the mainstay of treatment in Brugada Syndrome patients

It is a small battery-powered device inserted into the chest to continuously track the heartbeat. When necessary, it administers electrical shocks to regulate erratic heartbeats

Current recommendations are to perform ICD placement in those who survived cardiac arrest and those who can have Brugada ECG findings on drug challenge tests.

QUINIDINE

Is useful in patients with an ICD who experience multiple shocks and in those who have contraindications for ICD placement

RADIO FREQUENCY ABLATION

Of the anterior part of the right ventricular outflow tract is a new, emerging therapy with a promising prognosis.

TTRUNCUS RUNCUS ARTERIOSUS ARTERIOSUS

Truncus arteriosus is a rare, congenital, cyanotic heart defect characterized by a ventricular septal defect (VSD), a single truncal valve, and a common ventricular outflow tract (OT). In other words, one large blood vessel leads out of the heart, instead of two and the ventricular septal defect reduces oxygen delivery to the rest of the body.

This condition is life-threatening and surgery is generally successful in affected babies especially if done before the age of 1 month.

RISK FACTORS

Viral illness during pregnancy

Poorly controlled diabetes during pregnancy.

Certain chromosomal disorders.

Smoking during pregnancy.

Alcohol consumption in pregnancy

Obesity.

TA is the result of impaired embryological processes that fail to create a truncoconal septal wall that divides the single truncal root into separate aortic and pulmonic outflow tracts.

There is association with the 22q11 genetic mutation.

SIGNS AND SYMPTOMS

Symptoms of TA usually occur in the first few days of life and include:

Blue or grey skin due to low oxygen levels.

Excessive sleepiness.

Poor feeding and poor growth

Pounding heartbeat.

Tachypnea and dyspnea.

TRUNCUS ARTERIOSUS TRUNCUS ARTERIOSUS

TREATMENT

Infants with truncus arteriosus need surgery to improve blood flow and oxygen levels Many surgeries may be needed, especially as the child grows, and medications may be given before surgery to help improve heart health.

Loop and thiazide diuretics

Improve Left Ventricular failure by reducing excess volume, filling pressure and pulmonary congestion. Improve Right Ventricular failure by maintaining control of systemic venous congestion.

Patients in respiratory distress may require additional positivepressure support (CPAP, SiPAP, endotracheal intubation) Avoid supplemental oxygen as this may worsen pulmonary overcirculation

Correct any metabolic derangements, electrolyte abnormalities, hypoglycemia, and anemia to prevent worsening heart failure.

Prostaglandin Infusion

Promotes ductal patency if there is a concurrent aortic arch anomaly.

Procedure for TA without truncal valve or aortic arch abnormality Mobilization of pulmonary arteries from the truncus to the right ventricle with conduit-based right ventricular outflow tract reconstruction

Closure of the ventricular septal defect with a patch. Aortic arch abnormalities and the truncal valve should also be fixed.

Primary palliation with pulmonary arterial banding and delayed surgical repair may be required to allow the infant to grow.

BARLOW’S SYNDROME BARLOW’S SYNDROME

Also known as Mitral Valve Prolapse (MVP), Barlow's Syndrome is the most common valvular abnormality targeting the mitral valve. It is characterized by the bulging of one or both mitral valve flaps or leaflets into the left atrium during contraction, allowing the mild backflow or regurgitation of blood and resulting in an abnormal sound due to turbulent blood flow, also known as a murmur.

The syndrome of click-murmur was first described in the late 1800’s, but it was in the early 1960’s that its association with mitral regurgitation was demonstrated by Dr. John Barlow and colleagues. After that, the mechanism of regurgitation was correctly identified as a posterior leaflet prolapse due to excess leaflet motion, which explains the naming “mitral valve prolapse”.

CAUSES

The cause of Barlow’s Syndrome seems to be unknown, but the syndrome is sometimes linked to heritable disorders, which classifies the condition as either primary or secondary:

Primary MVP Caused by abnormal mitral leaflet tissue in the absence of an identifiable connective tissue disease. It may be sporadic or familial.

Secondary MVP

Associated with an identifiable connective tissue disorder such as Marfan syndrome or with a congenital heart disease such as Ebstein abnormality.

BARLOW’S SYNDROME BARLOW’S SYNDROME

Patients with Barlow’s Syndrome are generally around the age of 50 and usually asymptomatic Symptoms appear due to either

Significant mitral regurgitation from the progression of the condition, or An associated complication such as a cardiac arrhythmia, a stroke, or endocarditis

Symptoms common during progression of the illness are fatigue, dyspnea, palpitations, and progressive signs of chronic heart failure

SIGNS AND SYMPTOMS TREATMENT

Specific treatment for MVP is based on the patient’s signs and symptoms, progression of the condition and medical history

If asymptomatic, the patient should be reassured about the good prognosis. Initial echocardiography should be performed to assess the condition and the patient should be encouraged to pursue a normal, unrestricted lifestyle with vigorous exercise.

Patients with autonomic dysfunct should restrain from stimulants such caffeine, alcohol, and cigarettes. Th may use an ambulatory 24-hour Hol Monitor to detect supraventricu and/or ventricular arrhythmias

Patients with moderate to seve mitral regurgitation and l ventricular enlargement shou undergo surgical repair befo deterioration of left ventricu function.

Antithrombotic therapy may recommended in patients with history of systemic embolism, ischemic stroke, or atrial fibrillation

TETRALOGY OF FALLOT TETRALOGY OF FALLOT

The Tetralogy of Fallot is a birth defect that affects normal blood flow through the heart It occurs due to malformation of the heart during development of the baby during pregnancy. The condition features four key defects:

Ventricular septal defect, which is a hole in the wall between the ventricles

Right ventricular outflow tract (RVOT) obstruction.

Aorta dextroposition (overriding aorta) where the aortic valve sits directly on top of the ventricular septal defect.

Right ventricular hypertrophy.

This heart defect can greatly reduce oxygen levels in the blood, leading to cyanosis This occurs as episodes called “tet spells, ” or a sudden development of deep blue skin, nails and lips after crying or feeding, or when agitated. This puts babies at a high risk of endocarditis, arrhythmias, dizziness, fainting and delayed growth and development

CAUSES

The causes of this defect are unknown, but genetic factors play a role in its development

Prenatal factors that result in a higher incidence of the defect include:

Maternal rubella (or other viral illnesses) during pregnancy

Poor prenatal nutrition

Maternal alcohol use

Maternal age older than 40 years

Maternal phenylketonuria and diabetes

TTETRALOGY ETRALOGY OF FALLOT OF FALLOT

SIGNS AND SYMPTOMS

Infants suffering from the condition display the following:

Difficulty feeding.

Delayed growth and development.

Tet Spells, or episodes of bluish-pale skin during crying or feeding.

Exertional dyspnea that worsens with age.

Clinical features in an adult suffering from the Tetralogy depend on the severity of the anatomic defects and include

Lack of exercise endurance

Palpitations

Gradual decline in bodily functions

Tetralogy of Fallot can be treated by surgery soon after birth. There are two types of surgeries: shunt operation or complete repair surgery. Patients may undergo one or both surgeries in their lifetime in order to:

Relieve right ventricular outflow tract obstruction. Completely separate the pulmonary and systemic circulations. Preserve right ventricular function.

Minimize post-procedure pulmonary valvular incompetence

For complete repair of the defect, the surgeon works on widening the pulmonary valve and enlarging the passage to the pulmonary artery to relieve the obstruction of the blood flow to the lungs, as well as closing the ventricular septal defect with a patch.

A shunt operation, on the other hand, is done for temporary improvement in blood flow to the lungs. It involves using a shunt sewn between the aorta and the pulmonary artery. When complete intracardiac repair is done, the shunt can be removed

After both types of surgery, regular follow-up with a cardiologist specialized in congenital heart defects is required to monitor progress

From the From the Perspective Perspective of an Expert of an Expert

Amal Nehmeh, MD Cardiologist | Echocardiography Fellow at University of Ottawa Heart Institute

ANehmeh@ottawaheart.ca

Cardiovascular diseases remain worldwide We cannot see our he to neglect it. Not to mention how under-diagnosed and under-tre health. Raising awareness on cardiovascular diseases is crucial. I encourage people of all ages to commit to a healthy lifestyle and create habits that get them moving, eating healthier and managing stress in ways that fits their life.

Practical experience and interactions with patients is extremely important but it is equally important for myself and other healthcare providers to find time to keep up with advances in medicine.

The American College of Cardiology (ACC) 2023 meeting will start next Saturday. A platform like ACC is a window into the world of cardiovascular disease where top experts debate and discuss the outcomes of the trials and find out how it all fits into our practice. A few of my top 5 ACC trails are the following:

CLEAR Outcomes Trial: Bempedoic Acid and Cardiovascular Outcomes in Statin Intolerant Patients at High Cardiovascular Risk

Statins to Prevent the Cardiotoxicity From Anthracyclines: The STOP-CA Trial

Efficacy and Safety of the Oral PCSK9 Inhibitor, MK-0616, A Macrocyclic Peptide, in the Treatment of Hypercholesterolemia: A Phase 2b Randomized PlaceboControlled Clinical Trial

Vigorous Exercise in Individuals With Hypertrophic Cardiomyopathy (HCM): Primary Results of the Prospective, Multinational Lifestyle and Exercise in HCM (LIVE-HCM) Study

Return-to-Play For Elite Level Athletes With Sudden Cardiac Death Predisposing Genetic Heart Diseases

HEART DISEASES HEART DISEASES

POLYPILLS POLYPILLS

POLYPILLS: CAN THEY TREAT HEART DISEASES?

A patient suffering from a heart disease inevitably suffers from other comorbidities and thus is on many medications simultaneously. In that case, polypills, which are a combination of many drugs in one pill, may be the best way to simplify the patient's drug regimen and enhance his/her compliance.

WHAT ARE THE DRUGS INCLUDED?

The combination of drugs in polypills was developed by the Spanish National Center for Cardiovascular Research (CNIC) and Ferrer, and is still under study. Typically used to prevent subsequent cardiovascular events after a myocardial infarction, the drugs included are:

An antiplatelet agent such as Aspirin.

An ACE-inhibitor such as Ramipril or a similar drug to control blood pressure.

A lipid-reducing drug, such as a statin

The purpose of developing the pill is to resolve the problem of adherence that many patients recovering from a heart attack face, since less than 50% of patients consistently adhere to their medication regimen

HEART DISEASES HEART DISEASES &

POLYPILLS POLYPILLS

The CNIC team launched the SECURE study, an international randomized clinical trial with 2,499 patients from seven European countries suffering from hypertension, diabetes, or having a history of smoking, with the average age being 76 years. The polypill analyzed contained aspirin (100 mg), Ramipril (2.5, 5 or 10 mg), and Atorvastatin (20 or 40 mg), and was commercialized under the name "Trinomia"

The study was found successful in improving the adherence of patients to the treatment and the polypill was found to be an integral element to prevent recurrent cardiovascular events in patients who have had a heart attack.

WHAT ARE THE DISADVANTAGES OF POLYPILLS?

Even though the polypill helps improve patients' adherence to treatment, there is still vast concern regarding the different side effects of this combination

However, recent clinical trials have shown lower rates of side effects with polypills compared to individual medications.

In addition, the doses of each medication in the polypill cannot be adjusted, but having more than one type of polypill can fix this issue.

FDA- APPROVED DEVICES FDA- APPROVED DEVICES FOR HEART DISEASES FOR HEART DISEASES

Automated External Automated External Defibrillators (AEDs) Defibrillators (AEDs)

Portable and automatic, they can help restore normal heart rhythm in patients whose hearts suddenly and unexpectedly stop pumping, an event called a cardiac arrest.

Cardiac Ablation Cardiac Ablation

Catheters Catheters

Long, thin and flexible tubes that are threaded into or onto the heart to treat abnormally rapid heartbeats. They work by modifying small areas of the heart tissue that are causing abnormal heart rhythms.

Cardiovascular Angioplasty Devices Cardiovascular Angioplasty Devices

Long, thin, flexible tubes that are threaded into a heart or other blood vessel to open narrowed or blocked vessels.

FDA- APPROVED DEVICES FDA- APPROVED DEVICES FOR HEART DISEASES FOR HEART DISEASES

Cardiac Pacemakers Cardiac Pacemakers

Small and battery-powered pacemakers implanted into the heart. They are used when the heart beats abnormally to monitor electrical impulses and, when needed, deliver electrical stimulation to regular the heart beat

Prosthetic (Artificial)

Prosthetic (Artificial) Heart Valves Heart Valves

Replace diseased or dysfunctional heart valves, which usually direct blood flow through the heart. They are available in two forms:

Mechanical Valves, made of synthetic material.

Bioprosthetic Valves, made from tissue taken from animals or human cadavers.

HEART DISEASES HEART DISEASES AND AND PSYCHOSOMATICS PSYCHOSOMATICS

Your thoughts, attitudes and emotions can speed up the onset of heart diseases and even impede your ability to prevent them.

KEEP ON READING TO DISCOVER HOW!

HEART DISEASES HEART DISEASES AND AND PSYCHOSOMATICS PSYCHOSOMATICS

For years, philosophers and scholars thought that the mind and the body were separate entities. In fact, it was Descartes who claimed that “the mind and the soul of the man are entirely different from the body”.

Nowadays, however, neuroscientists recognize that there is a deep correlation between the mind and the body and one cannot be studied without the other. The body and psyche are two mirrors facing each other and the struggle of one reflects on the other. From here emerges the field of Psychosomatics, which comes from the two words “psycho” for the psyche or the mind and “ soma ” for the body.

WHAT IS THE CORRELATION BETWEEN PSYCHOSOMATICS AND HEART DISEASES?

Surprisingly enough, a bigger risk factor for heart diseases than smoking, high blood pressure and high cholesterol may be how one handles stress.

HEART DISEASES HEART DISEASES AND AND PSYCHOSOMATICS PSYCHOSOMATICS

The link between depression and heart diseases is still not fully understood Some people who have never experienced depression do so after having a heart attack Also, others who have depression but no history of heart disease develop heart problems at a higher rate than that of the overall population.

This can be correlated to the biologic effects of depression such as autonomic nervous system dysfunction, high cortisol levels, and heightened inflammatory markers as well such as poor adherence to diet, exercise, and medications and a higher prevalence of smoking

Depression Depression

Anxiety Anxiety

Anxiety disorders are prevalent in individuals with cardiovascular diseases and precipitate poor cardiovascular health, including the onset and progression of Coronary Artery Disease and Heart Failure.

Autonomic dysfunction, inflammation and platelet aggregation are few examples that lead to negative cardiac outcomes

Psychosocial factors such as stress at work, family, financial challenges and life events have direct physiological consequences and lead to catecholamine release, which in turn increases blood pressure, heart rate and inflammation.

People who are stressed typically have an unhealthy lifestyle In comparison to patients without psychosocial issues, such patients smoke and drink more, have an unhealthy diet and are typically sedentary.

Stress or Stress or PostPostTTraumatic raumatic Stress Stress Disorder Disorder

HEART DISEASES HEART DISEASES AND AND PSYCHOSOMATICS PSYCHOSOMATICS

Panic Disorders are characterized by unpredictable, intense emotions of fear accompanied by palpitations and sweating. Chest pain is frequently present and may resemble angina

Panic Panic Disorders Disorders

In some patients, panic disorders have been linked to coronary artery spasm and sympathetic nervous system activation.

Also, they cause the release of adrenaline by the sympathetic nerves of the heart, leading to ventricular arrhythmias

Bipolar disorder patients typically have more cardiovascular risk factors such as obesity, hypertension, diabetes, and hyperlipidemia than patients without the disorder

The medications prescribed in such a disorder may increase the risk of cardiovascular diseases themselves:

Lithium can lead to weight gain and have a negative impact on glucose metabolism.

Valproic Acid also causes weight gain and insulin resistance.

Second generation antipsychotics increase the risk of diabetes mellitus and are also associated with insulin resistance and hyperlipidemia

SchizoSchizophrenia phrenia

Bipolar Bipolar Disorders Disorders

Research indicates that individuals suffering from schizophrenia are at much higher risk of cardiovascular morbidity and mortality as the condition has been linked to increased cortisol levels, which contribute to atherosclerotic plaque formation.

Moreover, decreased Heart Rate Variability (HRV) occurs in such disorders, and it is established that decreased HRV is an independent risk factor for cardiac mortality.

and Medicinal Plants and Medicinal Plants

Used in Heart Diseases Used in Heart Diseases

A number of medicinal plants and herbs have shown great efficacy in preventing or treating CVDs:

Many flavonoids from beverages, spices, vegetables, fruits and medicinal plants have been reported to have beneficial effect on CVD. Their antioxidant effect is well documented and believed to lower the risk of cardiovascular diseases

Are mainly found in vegetables, cereals, pieces of bread, margarine and vegetable oils. A plant-based diet is commonly believed to lower the incidence of CVD by reducing many risk factors.

Found in the Papaveraceae, Acanthaceae, Apocynaceae, and Solanaceae families of plants, some alkaloids have been shown to have cardioprotective properties, such as an ability to reduce cholesterol levels as well as antioxidant and anti-inflammatory potential.

Sulfur containing plants include garlic, onion, leek, broccoli, cabbage, cauliflower and kale. The main plant sulfur compound is sulforaphane and exhibits anti-inflammatory properties that prevent CVD, especially atherosclerosis.

1. FLAVONOIDS

2. PLANT STEROLS

3. ALKALOIDS

4. PLANT SULFUR COMPOUNDS

The Psychological Impact The Psychological Impact of Heart Diseases of Heart Diseases

A patient's mental health status may be a main cause of heart disease. However, heart diseases themselves are also important triggers of many psychological illnesses

Truly, one of the most common mental disorders among cardiac patients is depression and patients struggle everyday with fear of sudden death, mood swings, anxiety, stress and low self-esteem, which creates obstacles in their lives and in the workplace, and makes it difficult for them as well as their families to lead a normal life Quality of life is also impacted as these patients often suffer from severe fatigue, shortness of breath and angina while carrying out their daily activities. When taking care of such patients, family members also suffer from the burden of the disease and may develop psychological symptoms themselves.

"I've put off making big plans for the future as I could be gone tomorrow I don't have that sense of security about life anymore " said one patient with cardiovascular disease.

Game Time! Game Time!

Match the cardiovascular disease to its definition. Match the cardiovascular disease to its definition.

Angina Angina

Congenital Congenital Heart Disease Heart Disease

Heart Heart Failure Failure

Myocardial Infarction Myocardial Infarction (Heart Attack) (Heart Attack)

Coronary Coronary Heart Disease Heart Disease

Arrhythmia Arrhythmia

Valvular Heart Valvular Heart Disease Disease

Coronary arteries

Coronary arteries narrow narrow and cannot supply enough and cannot supply enough blood to the heart. blood to the heart

Inability of the heart to Inability of the heart to pump blood properly. pump blood properly

Chest pain or discomfort

Chest pain or discomfort occurring when blood occurring when blood supply to the heart is supply to the heart is rrestricted estricted

Existence of a damaged Existence of a damaged or diseased valve in the or diseased valve in the heart. heart

Interruption or Interruption or dysregulation in the dysregulation in the electrical signals of the electrical signals of the heart. heart

A structural defect A structural defect involving the heart of a involving the heart of a developing fetus developing fetus.

The myocardium gets The myocardium gets stretched, thickened or stretched, thickened or sstiff. tiff

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