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Mitral Valve Prolapse : Barlow's Syndrome , Floppy Mitral Valve Syndrome

Mitral Valve Prolapse

(Barlow’s syndrome, Floppy Mitral Valve Syndrome)

#MitralValveProlapse

#BarlowsSyndrome

#FloppyMitralValveSyndrome

#Degeneration

#Tissue

#Causes

#Abnormality

Causes

Primary or classic mitral valve prolapse (MVP) is an idiopathic valvular abnormality characterized by myxomatous degeneration of the mitral valve leaflets and subvalvular apparatus in the absence of any recognizable systemic connective tissue disorder.

It can be inherited as an autosomal dominant phenotype with incomplete penetrance.

Secondary MVP occurs in the setting of known connective tissue disorders, including Marfan’s syndrome, Ehlers–Danlos syndrome, pseudoxanthoma elasticum, and osteogenesis imperfecta.

MVP is also frequently associated with atrial septal defects and Ebstein’s anomaly.

One can also see acquired leaflet prolapse (i.e., functional MVP) in ischemic heart disease and dilated cardiomyopathy.

Overall prevalence is approximately 2% and is similar in men and women

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Pathophysiology

Pathophysiology

#Pathophysiology

#LeftAtrium

#Diastole

#Hypertension

#Atrial

#Fibrillation

Elevated left atrium (LA) pressure is required to drive blood through the narrowed mitral valve orifice during diastole, leading to pulmonary venous hypertension and exertional dyspnea.

Secondary pulmonary arterial hypertension leads to right ventricular (RV) hypertrophy and failure.

LV systolic function is preserved but as filling is impaired, adequate cardiac output (CO) cannot always be maintained, especially with exercise and tachycardia.

Onset of atrial fibrillation (AF) is associated with abrupt clinical deterioration due to both the loss of atrial systole and the fast heart rate, which shortens the diastolic filling period.

Clinical features

• Dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea.

• Acute pulmonary edema may be precipitated by uncontrolled AF, exercise, pulmonary infection, anesthesia, and pregnancy.

• AF increases the risk of thromboembolism. Systemic embolism occurs in 20%–30% and usually originates in the dilated LA and LA appendage.

• Fatigue is due to reduced cardiac output reserve.

• Hemoptysis can occur for a variety of reasons: alveolar capillary rupture (pink frothy pulmonary edema); bronchial vein rupture (larger hemorrhage); blood-stained sputum of chronic bronchitis; pulmonary infarction (low CO, immobile patient).

• Chest pain similar to angina may occur in patients with pulmonary hypertension and RV hypertrophy, even with normal coronaries.

• The enlarging LA may compress surrounding structures, producing hoarse voice (left recurrent laryngeal nerve compression—Ortner’s syndrome), dysphagia (esophageal compression), and left lung collapse (left main bronchus compression).

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Aortic Dissection : Management

Aortic Dissection : Management

#AorticDissection

#Management

#Stabilization

#Treatment

#Diagnosis

Stabilize the patient

• If the diagnosis is suspected, transfer the patient to an area where full resuscitation facilities are readily available.

• Secure venous access with large-bore cannulas.

• Take blood for CBC, chemistries, and cross-match (10 units).

• When the diagnosis is confirmed or in cases with cardiovascular complications, transfer to ICU, insert an arterial line (radial unless the subclavian artery is compromised when a femoral line is preferred), central venous line, and urinary catheter.

• Immediate measures should be taken to correct blood pressure (see below).

• Give adequate analgesia (morphine 2.5–10 mg IV and metoclopramide 10 mg IV).

Plan definitive treatment

This depends on the type of dissection and its effects on the patient. General principles are as follows:

• Patients with involvement of the ascending aorta should have emergency surgical repair and BP control.

• Patients with dissection limited to the descending aorta are managed initially medically with aggressive blood pressure control.

However, this may change in the near future with emerging encouraging data from deployment of endovascular stent-grafts. Indications and principles for surgery

• Involvement of the ascending aorta

• External rupture (hemopericardium, hemothorax, effusions)

• Arterial compromise (limb ischemia, renal failure, stroke)

• Contraindications to medical therapy (AR, CHF)

• Progression (continued pain, expansion of hematoma on further imaging, loss of pulses, pericardial rub, or aortic insufficiency)

The aim of surgical therapy is to replace the ascending aorta, thereby preventing retrograde dissection and cardiac tamponade (the main cause of death). The aortic valve may need reconstruction and resuspension unless it is structurally abnormal (bicuspid or Marfan’s), when it is replaced.

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Hypertensive Emergencies : Management

Hypertensive Emergencies : Management

#Hypertension

#Emergencies

#Diagnosis

#Priorities

#LongTermTreatment

Priorities in management are as follows :

1. Confirm the diagnosis and assess the severity.

2. Identify those patients needing specifi c emergency treatment.

3. Plan long-term treatment.

Diagnosis and severity

• Ask about previous BP recordings, previous and current treatment, sympathomimetics, antidepressants, nonprescription drugs, and recreational drugs.

• Check the blood pressure yourself, in both arms, after a period of rest and, if possible, on standing.

• Examine carefully for clinical evidence of cardiac enlargement or heart failure, peripheral pulses, renal masses, or focal neurological deficit.

Always examine the fundi—dilate if necessary.

All patients should have the following tests:

• CBC Microangiopathic hemolytic anemia with malignant hypertension • Chemistries Renal impairment and/or dK+ (diffuse intrarenal ischemia and secondary hyperaldosteronism)

• Coagulation screen Disseminated intravascular coagulation (DIC) with malignant hypertension

• CXR Cardiac enlargement Aortic contour (dissection?) Pulmonary edema

• Urinalysis Protein and red cells ± casts Other investigations depending on clinical picture and possible etiology include the following:

• 24-hour urine collection Creatinine clearance Free catecholamines, metanephrines or vanilmandellic acid (VMA)

• ECHO LVH, aortic dissection

• Renal US and Doppler Size of kidneys and renal artery stenosis

• MR renal angiogram Renal artery stenosis

• CT/MR brain Intracranial bleed

• Drug screen Cocaine, amphetamine, others Indications for admission

• Diastolic blood pressure persistently t120 mmHg

• Retinal hemorrhages, exudates or papilledema

• Renal impairment

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Birth Control Pills : Heart Attack

Birth Control Pills : Heart Attack

#Heart

#Birth

#Control

#Pills

#HeartAttack

Studies show that women who use high-dose birth control pills (oral contraceptives) are more likely to have a heart attack or stroke because blood clots are more likely to form in the blood vessels.

These risks are lessened once the birth control pill is stopped. Using the pill also may worsen the effects of other risk factors, such as smoking, high blood pressure, diabetes, high blood cholesterol, and overweight.

Much of this information comes from studies of birth control pills containing higher doses of hormones than those commonly used today. Still, the risks of using low-dose pills are not fully known.

Therefore, if you are now taking any kind of birth control pill or are considering using one, keep these guidelines in mind:

Don’t mix smoking and the “pill.”

If you smoke cigarettes, stop smoking or choose a different form of birth control. Cigarette smoking raises the risk of serious health problems from birth control pill use, especially the risk of blood clots.

For women over 35, the risk is particularly high. Women who use birth control pills should not smoke. Pay attention to diabetes.

Levels of glucose, or blood sugar, sometimes change dramatically in women who take birth control pills.

If you are diabetic or have a close relative who is, be sure to have regular blood sugar tests if you take birth control pills. Watch your blood pressure.

After starting to take birth control pills, your blood pressure may go up. If your blood pressure increases to 140/90 mmHg or higher, ask your doctor about changing pills or switching to another form of birth control.

Be sure to get your blood pressure checked at least once a year. Talk with your doctor. If you have heart disease or another heart problem, or if you have suffered a stroke, birth control pills may not be a safe choice.

Be sure your doctor knows about these and any other serious health conditions before prescribing birth control pills for you.

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New Risk Factors ? Healthy Heart

New Risk Factors? Healthy Heart

#New ❤️

#RiskFactors 🤎

#Health 💛

#Heart 🩷

#Treatment 💚

#Cholesterol 🩵

#BloodPressure 🧡

We know that major risk factors such as high blood cholesterol, high blood pressure, and smoking boost heart disease risk. Researchers are studying other factors that might contribute to heart disease, including inflammation of the artery walls. Several emerging risk factors have been identified.

We don’t know for sure yet whether they lead to heart disease or whether treating them will reduce risk. While these possible risk factors are not recommended for routine testing, ask your doctor whether you should be tested for any of them. C-reactive protein (CRP).

High levels of CRP may indicate inflammation in the artery walls. A simple blood test can measure the levels of CRP in the blood. In many cases, a high CRP level is a sign of metabolic syndrome.

Treatment of the syndrome with lifestyle changes—weight loss and regular physical activity—can often lower CRP. Homocysteine. High blood levels of this amino acid may increase risk for heart disease.

It may be possible to lower elevated levels of homocysteine by getting plenty of folic acid and vitamins B6 and B12 in your diet. Lp(a) protein. This lipoprotein may make it easier for blood clots to form. Niacin, a cholesterol-lowering drug, may help to lower Lp(a) protein levels.

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https://drbhishmacardiologist.com/heart-disease-treatment

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Mineral Medicine

Mineral Medicine

Mineral Medicine :

#Minerals 💛

#Control 💜

#BloodPressure ❤️

#Heart 🩵

#Health 💚

Another Way To Control Blood Pressure Certain mineral-rich foods can help keep blood pressure levels healthy.

For example, a diet rich in potassium can help to both prevent and control high blood pressure. A potassium-rich diet not only blunts the effects of salt on blood pressure, but may also reduce the risk of developing kidney stones, and possibly decrease bone loss with age.

But be sure to get your potassium from food sources, not from supplements. Many fruits and vegetables, some dairy foods, and fish are rich sources of potassium. Calcium and magnesium are two other minerals that may help to prevent high blood pressure, as well as improve health in other ways.

Low-fat or fat-free milk and milk products are rich sources of calcium, while magnesium is found in many whole-grain products; dark green, leafy vegetables; fish; and dry beans.

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#Myth

#Fact

#HighBloodPressure

#Symptoms

#BloodPressureTest

Patients With High Blood Pressure Always Have Visible Symptoms

Meet Our Experienced Interventional Cardiologist

DR. BHISHMA CHOWDARY DONDEPUDI

Interventional Cardiologist

AIG Hospitals, Gachibowli, Hyderabad

For Appointment: +91 90003 52998

#DrBhismachowdarydondepudi

#Interventionalcardiologist

#AIGHospitalsgachibowli

#HeartTreatment

#CardiologyCare

#HyderabadHealthcare

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Makar Sankranti 2025

Happy Makar Sankranti 2025

#Happy 💛

#Successful 🤎

#Peaceful 💜

#Prosperous 💚

#HappyMakarSankranti ❤️

Wishing you a colorful and joyful

Makar Sankranti!

May this year and years ahead bring you happiness, prosperity, and good health. 🪁✨

#MakarSankranti2025 🩵

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Rheumatic Fever And Rheumatic Heart Disease

Rheumatic Fever and Rheumatic Heart Disease

#Rheumatic 💛

#Fever 🤎

#RheumaticFever 💜

#RheumaticHeartDisease 💚

#Worldwide ❤️

#Cardiac 🩷

#Disease 🩵

Acute rheumatic fever and rheumatic heart disease are leading causes of acquired cardiac disease in developing countries, with between 5 and 30 million children and young adults affected worldwide and a mortality rate of 1% to 10%.94 .

In the United States, the availability of antibiotics to treat streptococcal pharyngitis has markedly reduced the incidence of this disease but sporadic cases still occur.95 In children, the peak incidence occurs between 5 and 14 years of age.

Rheumatic fever results from infection by particular strains of group A β-hemolytic Streptococcus or Streptococcus pyogenes. Both cellular and humoral immune responses to the bacterial antigens cross react with native tissues to result in a multisystemic infl ammatory disorder.

The incubation period for most strains of group A β-hemolytic Streptococcus is typically 3 to 5 days, although some children will present with a more remote history of pharyngitis.

The diagnosis of rheumatic fever is made clinically based on the modifi ed Jones criteria.96 Major criteria include carditis, polyarthritis, chorea, subcutaneous nodules, and erythema marginatum. Evidence of a prior streptococcal infection along with two major or one major and two minor criteria are required to make the diagnosis in children without prior history of rheumatic fever or echocardiographic evidence of typical valvular involvement. Fever and arthritis are common symptoms.

The polyarthritis has a migratory pattern, typically aff ecting large joints. Cardiac involvement or carditis occurs in nearly 50% of children with their fi rst attack of rheumatic fever.

Rheumatic heart disease represents a sequela of the acute process, aff ecting the mitral and aortic valves most frequently. Primary prevention of rheumatic fever and rheumatic heart disease begins with prompt recognition and appropriate treatment of the initial streptococcal infection.97,98 Secondary prevention, with ongoing therapy in individuals with a known history of rheumatic fever, has been shown to be extremely effective at preventing recurrent attacks.

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Heart Disease Treatment Options

Heart Disease Treatment Options

#HeartDisease

#Treatment

#Medication

#LifeStyleChanges

#Surgical

#Procedural

#Interventions

Treating heart disease effectively often involves a mix of medications, lifestyle changes, and sometimes surgery or procedures. Let's break down each of these options to understand how they contribute to better heart health. Medications Medications play a critical role in managing heart disease. They help control symptoms, improve heart function, and reduce the risk of future complications. Statins: These help lower cholesterol levels, reducing the risk of plaque buildup in arteries.

Beta blockers: These reduce heart rate and blood pressure, making it easier for the heart to pump blood. ACE inhibitors: These relax blood vessels, lowering blood pressure and reducing strain on the heart. Calcium channel blockers: These prevent calcium from entering heart and blood vessel walls, lowering blood pressure.

Lifestyle Changes

Adopting healthier lifestyle habits can significantly impact heart health and complement other treatments. Diet: Eating plenty of fruits, vegetables, and whole grains while limiting sugar, salt, and saturated fats is essential.

Exercise: Regular physical activity, such as walking or cycling, can be as effective as medication in some cases. Aim for at least 30 minutes most days.

Smoking cessation: Quitting smoking is crucial, as tobacco use is a major risk factor for heart disease. Stress management: Techniques like mindfulness and support groups can help reduce stress, which affects heart health. Sleep: Ensuring 7–9 hours of quality sleep each night supports overall well-being.

Surgical and Procedural Interventions When medications and lifestyle changes aren't enough, surgical options may be necessary. Angioplasty: Also known as Percutaneous Coronary Intervention (PCI), this procedure opens blocked arteries using a small balloon and may include placing a stent.

Coronary Artery Bypass Grafting (CABG): This surgery uses healthy blood vessels to bypass blocked arteries, improving blood flow to the heart. Heart transplant: In severe cases of heart failure, a transplant may be considered.

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Understanding Heart Disease

#Understanding

#Heart

#Disease

#Symptoms

Understanding Heart Disease

Heart disease is a broad term for a range of conditions that affect the heart's structure and function. Let's explore the symptoms associated with heart disease.

Symptoms

Heart disease symptoms can vary widely depending on the specific condition. Some common signs include:

Chest pain or discomfort: Often described as a feeling of pressure or squeezing, this can be a sign of coronary artery disease.

Shortness of breath: This may occur with exertion or at rest and can indicate heart failure.

Fatigue: Unusual tiredness might suggest that the heart isn't pumping efficiently.

Irregular heartbeat: Feeling like your heart is skipping beats or fluttering can be a sign of arrhythmia.

Swelling in the legs, ankles, or abdomen: Known as edema, this can indicate heart failure.

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Heart Disease Treatment: Your Path to Better Health

Heart Disease Treatment: Your Path to Better Health

#Heart 💛

#Disease 💜

#Treatment 💚

#Health 🩵

Heart disease treatment is crucial in maintaining optimal health and longevity, especially for those with a family history of cardiovascular issues like Rajesh from Hyderabad. This condition affects millions worldwide and encompasses a range of heart-related problems, including coronary artery disease, heart failure, and arrhythmias. Effective treatment options, personalized to individual needs, are essential for managing symptoms and improving quality of life.

Quick Overview of Heart Disease Treatment:

Medications : Beta blockers, ACE inhibitors, statins, and more.

Lifestyle Changes : Healthy diet, regular exercise, smoking cessation.

Surgical Procedures : Coronary angioplasty, bypass surgery, minimally invasive options.

Personalized Care: Custom plans based on symptoms and medical history.

Finding a trustworthy cardiologist, like Dr. Bhishma in Hyderabad, ensures access to advanced cardiovascular care. Personalized treatment plans are key, addressing specific risk factors and needs for each patient. From lifestyle adjustments to state-of-the-art procedures, a comprehensive approach can make all the difference in heart health.

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Minimally Invasive Cardiac Surgery

MINIMALLY INVASIVE CARDIAC SURGERY

#MinimallyInvasiveCardiacSurgery 💛

#MinimallyInvasiveSurgery 💜

#Surgery 💚

#Cardiology ❤️

#Heart 🩷

WHAT IS MINIMALLY INVASIVE CARDIAC SURGERY?

Most cardiac operations today are performed through a full sternotomy, which involves splitting the breastbone along its entire length.

This approach provides excellent exposure to the heart and is used for the vast majority of cardiac operations. In recent years, however, less invasive approaches for heart surgery have been developed that use much smaller incisions that involve splitting only a portion of the breastbone or that avoid splitting the breastbone entirely.

Minimally invasive incisions measure about 2 inches compared to 8 to 10 inches required for standard sternotomy incisions. Specialized handheld instruments are used to project the dexterity of the surgeon’s hands through these small incisions to safely perform the operation on your heart.

WHAT ARE THE POTENTIAL BENEFITS OF MINIMALLY INVASIVE CARDIAC SURGERY?

There is early evidence that such minimally invasive approaches translate into:

• Better cosmetic appearance of the wound.

• Fewer wound-healing complications.

• Reduced hospital stays.

• Reduced recovery time.

• Reduced physical activity precautions.

The smaller incisions associated with minimally invasive cardiac operations have subjectively resulted in smaller scars and, in certain cases, scars in locations that are routinely covered with clothing (e.g., bra, bikini top).

Since less tissue is disrupted with smaller incisions, there is a significant reduction in wound-healing complications, including infections.

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Get Moving !

Get Moving !

#Get 🩷

#Moving 💜

#Physical 💚

#Activity ❤️

#Heart 💛

Regular physical activity is a powerful way to reduce your risk of heart disease. Physical activity directly helps prevent heart problems.

Staying active also helps prevent and control high blood pressure, keep cholesterol levels healthy, and prevent and control diabetes.

Plus, regular physical activity is a great way to help take off extra pounds—and keep them off. Regular physical activity has a host of other health benefits.

It may help prevent cancers of the breast, uterus, and colon. Staying active also strengthens the lungs, tones the muscles, keeps the joints in good condition, improves balance, and may slow bone loss.

It also helps many people sleep better, feel less depressed, cope better with stress and anxiety, and generally feel more relaxed and energetic

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If You "Slip" : Heart : Smoking

If You “Slip” : Heart : Smoking

#Heart 💜  #Slip ❤️  #Smoking 🩵  #Quit 💚 

A slip means that you’ve had a small setback and smoked a cigarette after your quit date. Most smokers slip three to five times before they quit for good. To get right back on the nonsmoking track: 

■ Don’t be discouraged. Having a cigarette doesn’t mean you can’t quit smoking. A slip happens to many people who successfully quit. Keep thinking of yourself as a nonsmoker. (You are one.) 

■ Learn from experience. What was the “trigger” that made you light up? Were you driving home from work, enjoying a glass of wine at a party, feeling angry with your boss? Think back on the day’s events until you remember what the trigger was. 

■ Take charge. Write a list of things you will do the next time you face that particular trigger situation — and other tempting situations as well. Sign a new contract with your support person to show yourself how determined you are to kick the habit. You’re on your way

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