Heart attack
BODY WARNS ONE MONTH BEFORE A HEART ATTACK – WARNING SIGNS YOU MUST KNOW
heart attack
Carotid endarterectomy – will you need one?
Carotid endarterectomy
Carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.
Carotid endarterectomies are carried out when one or both carotid arteries become narrowed because of a build-up of fatty deposits (plaque). This is known as carotid artery disease or carotid artery stenosis.
If a narrowed carotid artery is left untreated, blood flow to the brain may be affected. This is usually because a blood clot forms and a piece breaks off and goes to the brain. This can result in either:
a stroke – a serious medical condition that can cause brain damage or death
a transient ischaemic attack (TIA) – sometimes known as a “mini-stroke”, a TIA is similar to a stroke but the signs and symptoms are temporary and usually disappear within 24 hours
Each year around 110,000 people have a stroke in the UK and around a quarter of these are caused by a narrowing of the carotid arteries. More than 5,000 carotid endarterectomy procedures were performed on the NHS between 2011 and 2012.
Carotid endarterectomy can significantly reduce the risk of a stroke in people with severely narrowed carotid arteries. In people who have previously had a stroke or a TIA, their risk of having another stroke or TIA within the next three years is reduced by a third after surgery.
It’s now thought the operation should be performed as soon as possible after symptoms appear. It’s important to seek immediate medical advice if you experience symptoms such as:
numbness or weakness in the face, arm or leg
speech problems
loss of vision in one eye
Read more about when carotid endarterectomy is needed.
About the procedure
Carotid endarterectomy can be carried out using either local anaesthetic or general anaesthetic. The advantage of local anaesthetic is it allows the surgeon to monitor brain function while you’re awake. However, there’s no evidence that either is safer or better.
During the procedure, a 7-10cm (2.5-4 inch) cut will be made between the corner of your jaw and your breastbone. A small cut is then made along the narrowed section of artery, and the fatty deposits that have built up are removed.
The artery is then closed with stitches or a patch and your skin is also closed with stitches.
Read more about:
getting ready for carotid endarterectomy
how carotid endarterectomy is performed
What happens after the procedure
You’ll usually be moved to the recovery area of the operating theatre for monitoring. Most people are well enough to go home within about 48 hours of the procedure.
In most cases, the only problems experienced after the operation are temporary numbness or discomfort in the neck.
However, there’s a small risk of more serious complications, which can include stroke or death in around 3% of cases. Nevertheless, this risk is much lower than in people with carotid artery disease who haven’t chosen to have the operation.
Read more about:
recovering from carotid endarterectomy
risks of carotid endarterectomy
Are there any alternatives?
Carotid endarterectomy is the main treatment for narrowing of the carotid arteries, but sometimes an alternative procedure called carotid artery stent placement may be available.
This is a less invasive procedure than a carotid endarterectomy because it doesn’t involve a cut being made in the neck. Instead, a thin flexible tube is guided to the carotid artery through a small cut in the groin. A mesh cylinder (stent) is then placed into the narrowed section of artery to widen it and allow blood to flow through it more easily.
Carotid stenting is currently thought to be associated with a higher risk of stroke during the procedure, especially if it’s performed in the first few days after symptoms appear. However, it’s a useful alternative for people who may be at a higher risk of complications from an operation.
Read more about carotid artery stent placement.
World Thrombosis Day 2016 – Find out about the signs, symptoms and causes of thrombosis
1 in 4 deaths worldwide from conditions caused by thrombosis
It is estimated that every 6 seconds a person dies from VTE globally
In England alone, 25,000 people die each year from venous thromboembolism (VTE) contracted in hospital
Thrombosis is often the underlying cause of heart attack, thromboembolic stroke and VTE, the top three cardiovascular killers
World Thrombosis Day aims to increase global awareness of the often overlooked and misunderstood condition of thrombosis
Many people know about the risks for breast cancer or heart disease, but most aren’t aware that 1 in 4 people worldwide die from conditions caused by thrombosis, more commonly known as blood clots.
Many, if not most, cases of thrombosis are preventable, and yet too many patients slip through the cracks. Approximately 60 percent of VTE cases happen to patients during or after being hospitalised or undergoing surgery. In the UK alone, up to 1 in every 1,000 are affected by venous thrombosis. This figure is higher than the combined total deaths of breast cancer, AIDS and traffic accidents, and costs the NHS an estimated £640 million annually.
Thrombosis is common, but general awareness about the condition is very low. In a 2014 global survey of nine countries conducted by the International Society on Thrombosis and Haemostasis (ISTH), only 68 percent of those surveyed were aware of blood clots, much lower than awareness of other potentially life-threatening health conditions such as hypertension.
Although thrombosis can affect anyone, those who are age 60 or older are at a higher risk, as are individuals undergoing surgery or cancer treatment, people who undergo long periods of immobility and women who are pregnant. That’s why it is so important for people to understand the risks factors, be able to recognise the signs & symptoms, and ask their doctors for a VTE risk assessment if they are hospitalised.
Because 1 in 4 people worldwide are dying from conditions caused by thrombosis, it will therefore be impossible to reach the World Health Assembly’s global target of reducing premature deaths from non-communicable disease by 25% by 2025 unless we address thrombosis.
This year, more than 550 medical and health organisations from every continent will participate in World Thrombosis Day, embracing thousands of educational events and bringing together in partnership patients, healthcare professionals, policy makers, research and industry supporters to place a global spotlight on thrombosis as an urgent and growing public health problem.
Thrombosis is the formation of potentially deadly blood clots. Blood clots can form in the artery (arterial thrombosis) or vein (venous thrombosis).
Deep vein thrombosis (DVT) is when blood clots in a deep vein (most often the leg)
Pulmonary embolism (PE) occurs when a blood clot breaks loose and travels to the lungs
Collectively, DVT and PE are known venous thromboembolism – VTE.
World Thrombosis Day (WTD) focuses attention on the often overlooked and misunderstood condition of thrombosis. It embraces thousands of educational events across the world, and brings together in partnership patients, healthcare professionals, policy makers, research and industry supporters to place a global spotlight on thrombosis as an urgent and growing public health problem
World Thrombosis Day 2016
5 great ways to lower cholesterol naturally!
5 great ways to lower cholesterol naturally!
High cholesterol is the bane of the developed world. In the modern world we have more, better and much easier to prepare food than in previous centuries. But, this also means, far too many of us now have the opportunity to overindulge. (I’ll put my hands up here and say I’m one of those guilty of what I have to call greed). The problem with this kind of eating is that it does have the tendency to raise our cholesterol levels.
According to the NHS evidence strongly indicates that high cholesterol can increase the risk of:
narrowing of the arteries (atherosclerosis)
stroke
transient ischaemic attack (TIA) – often known as a “mini stroke”
peripheral arterial disease (PAD)
So I think we can all agree that we need a few ideas of reducing our cholesterol levels.
So I thought I would share the following five tips which you can use to help reduce your cholesterol with our recourse to medication.
a) Yes indeed I know healthcare professionals sound like a broken record on the subject of drink. But it is important to cut down (if you do drink) to cut a glass or two a day. Oh and make sure that you have a few drink free days each week including weekends.
b) Smoking tobacco. If you still smoke please please do give up. Please check out a previous blog post with a few tips to help you quit.
c) Now I know that many pixels have died in the cause of lecturing us about taking more exercise. But it also has numerous other benefits as this article shows!
d) Chronic stress can impact on your cholesterol levels. To have a look at these great ideas for reducing stress in your life.
e) Foods fortified with plant sterols and stanols. Foods which contain sterols and stanols include corn, coconut, olive and sunflower oils, beans, corn, peanut butter, almonds, oranges, apples, and avocados. A great way of getting down your cholesterol.
If you do have any concerns about your cholesterol levels please do speak with a medical professional as they are best able to advise on your best course of action!
And if you do have any other tips for reducing cholesterol please do share them in the comment section at the bottom of this blog post.
Air embolism – what are the signs and symptoms of the bends
Air embolism and the bends
Introduction
An air or gas embolism is a bubble that becomes trapped in a blood vessel and blocks it. This can lead to many different symptoms depending on where the blockage occurs. It’s one of the leading causes of death among divers.
An air or gas embolism can happen when a scuba diver surfaces too quickly from any depth. This can cause air to escape into the blood vessels from the lungs (pulmonary barotrauma) or bubbles of nitrogen to form in the blood vessels (decompression illness, or “the bends”).
An embolism can develop in an artery or vein. When an air bubble travels along an artery, it moves through a system of blood vessels that gradually become narrower. At some point, the bubble may block a small artery and cut off the blood supply to a particular area of the body.
Bubbles in the veins travel around the body and can cause breathing difficulties when they reach the lungs.
How serious is it?
The seriousness of the blockage depends on which part of the body the affected blood vessel supplies blood to and the size of the air bubble. For example, an air embolism in:
- the arteries to the brain can cause immediate loss of consciousness and may lead to seizures (fits) or a stroke – it can also cause confusion, dizziness and slurred speech
- the coronary arteries (which lead to the heart) may cause a heart attack or an abnormal heart rhythm
- a blood vessel to the lungs may cause a pulmonary embolism
These conditions are very serious and can be fatal, particularly if an air embolism is not recognised and treated promptly.
Even with treatment, some people who survive are left with permanent brain damage, although this is very rare.
Warning signs
Divers should always be carefully monitored by their colleagues and supervisors so any air or gas embolism can be immediately identified and treated.
Signs and symptoms of an air embolism can include:
- joint or muscle pains
- low blood pressure, which may cause dizziness
- an irregular heartbeat
- breathlessness and fast breathing
- blurred vision
- chest pain
- strong feelings of anxiety and itching of the skin
- a faint blue tone to the skin (cyanosis)
- bloody froth from the mouth
- paralysis or weakness, possibly of one or more limbs
- seizures (fits)
- loss of consciousness
If a scuba diver develops these symptoms within 10 to 20 minutes of surfacing, they probably have an air embolism and should be given 100% oxygen and transferred to hospital as soon as possible, preferably one with a recompression chamber.
Treating air embolisms
If a diver develops an air embolism, the only effective treatment is immediate recompression treatment in a special pressurised room called a hyperbaric chamber.
The diver should be given 100% oxygen and laid horizontally until they reach the hyperbaric chamber.
Recompression treatment involves lying in a hyperbaric chamber, usually for several hours, and breathing a mixture of gases and oxygen under pressure. The high pressure can restore normal blood flow and oxygen to the body’s tissues and reduce the size of the air bubbles in the body.
In cases of decompression sickness, the pressure forces the bubbles of nitrogen to dissolve back into the bloodstream.
After recompression, pressure is reduced gradually to allow the gases to leave the body without worsening the problem, similar to surfacing slowly from a dive. Treatment might be continued for several days depending on the severity of symptoms.
Preventing an air embolism while diving
The following advice can help reduce your risk of developing an air or gas embolism when diving.
- Limit the depth and duration of your dives.
- Come up to the surface slowly and always perform safety stops to allow any air in your tissues and blood vessels to escape safely. Use a dive computer or dive tables, and don’t dive again if you have broken these rules until you have had a suitable time at the surface.
- Don’t dive with a cold, cough or chest infection.
- Avoid rigorous exercise before, during and after a dive.
- Make sure you’re well hydrated before diving.
- If planning several dives, leave adequate surface intervals between dives to allow the nitrogen to leave your body.
- After diving, wait for 24 hours before flying or going to a higher altitude.
If in doubt, contact a dive professional or doctor, who can provide further advice.
Other causes of air embolisms
Air embolisms also occur during surgery or other medical procedures, but this is rare.
In hospitals and health centres, care should be taken to prevent this. For example:
- before injections, air should be removed from syringes and intravenous lines
- catheters or other tubes inserted into the body should be inserted and removed using a technique that minimises the possibility of air getting into the blood vessels
- patients should be closely monitored to help ensure air bubbles don’t form in blood vessels during surgery
Air embolisms resulting from surgery, anaesthesia or other medical procedures can be difficult to treat. Treatment is usually needed to support the heart, blood vessels and lungs.
For example, fluids may be used to treat a fall in blood pressure and oxygen may be given to reduce levels of other gases in the blood vessels