Many studies in the past decade have demonstrated diurnal variation in the onset of acute cardiovascular disorders in hypertensive patients, such as acute coronary syndrome like heart attack, angina etc and ischemic and hemorrhagic stroke occurring in the morning (6:00AM to noon) after a nadir in these events during the night.

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Coronary Angiography Video

Are you going for Coronary Angiography. A coronary angiogram is a procedure that uses X-ray imaging to see the inside of blood vessels of your heart. Coronary angiograms are part of a general group of procedures known as cardiac catheterization.

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EECP- Now You Can  Avoid Heart Surgery
EECP is an enhanced external counterpulsation. It is cost effective, non invasive, non surgical, non pharmaceutical, out patient therapy for Angina, Heart attack and heart failure patients. It is FDA (USA) and NHS (UK) approved.

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How to perform CPR at Home. Watch this Video

If your loved one’s heart or breathing stopped, would you know what to do? Now it’s easy to learn CPR and choking first aid in your own home, at your own pace. C.P.R stand for cardio pulmonary resuscitation, but do you know how to perform it on someone? If not, then watch this how to video to learn this basic life saving skill. Our host shows you how to perform CPR on an adult, baby, and child

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What can I expect during an echocardiogram?
Often when you visit a Cardiologist, your doctor suggests you for echocardiography of your heart. It is basically the ultrasound of Heart to diagnose various diseases of heart. With the help of sound waves moving picture of heart can be taken.

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An Echocardiography is actually the Ultrasound of Heart, this ultrasound produces sound waves and one can have moving picture of heart. This procedure does not involve any radiations and it gives more detail than X-ray. It is a good diagnostic tool for Valvular heart diseases, evaluating pumping function of heart, i.e ejection fraction, in heart attack patients. It is also a good screening test for certain heart disease. However, there are some situations or diseases that one should have an echocardiography test.

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Pathophysiology of Acute Coronary Syndrome

* in most of ACS cases syndrome occurs when an atherosclerotic plaque ruptures, fissures or ulcerates and precipitates thrombus formation. This results in sudden total or near-total arterial occlusion. Alternatively thrombus may break off from a ruptured plaque and occlude smaller vessels like coronary arteries.
* systemic factors and inflammation also play role  in changing haemostatic and coagulation pathways and may play a part in the initiation of the intermittent thrombosis that is a characteristic of unstable angina. Inflammatory acute phase proteins, cytokines, chronic infections and catecholamine surges may enhance production of tissue factor, procoagulant activity or platelet hyperaggregability.
* in the case of Q wave Mycardial infarction results in a spreading area of necrosis that reaches epicardium in 4-6 hours – full thickness infarction
* in rare cases may be due to coronary artery occlusion by embolism, congenital abnormalities, coronary artery spasm and a wide variety of systemic (particularly inflammatory) diseases
* initially infarcted muscle is softened leading to an increase in ventricular compliance but, as fibrosis takes place, compliance of heart muscles decreases
* poor correlation between angiographic severity of coronary stenosis and chance of acute occlusion
* Other causes of reduced myocardial blood flow include mechanical obstruction (e.g. air embolus), dynamic obstruction (e.g. vessel spasm), and infection or inflammation.

Patient may feel sensation of chest pressure or heaviness, which is reproduced by activities or conditions that increase myocardial oxygen demand.
* Not all patients experience chest discomfort. Some present with only neck, jaw, ear, arm, or epigastric discomfort.
* Other symptoms, such as shortness of breath breathlessness or severe weakness, may represent anginal equivalents.
* A patient may present to the Emergency department because of a change in pattern or severity of symptoms.
* Other associated features are weakness, lightheadedness, diaphoresis, or nausea and vomiting.
* Patients may complain of the following:
*
o Palpitations tachycardia or bradycardia
o Pain, which is usually described as pressure, squeezing, or a burning sensation across the precordium and may radiate to the neck, shoulder, jaw, back, upper abdomen, or arms
o Exertional dyspnea breathlessness that resolves with pain or rest
o Diaphoresis (increased perspiration) from sympathetic discharge
o Nausea from vagal stimulation
o Decreased exercise tolerance
o Patients with diabetes and elderly patients are more likely to have atypical presentations and offer only vague complaints, such as weakness, dyspnea, lightheadedness, and nausea.

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Types of Acute Coronary Syndromes – or heart attacks

Acute Coronary Syndrome is a name given to three types of coronary artery diseases that are associated with sudden rupture of plaque inside the coronary artery: Unstable angina, Non-ST segment elevation myocardial infarction or heart attack (NSTEMI), or ST segment elevation myocardial infarction or heart attack (STEMI).

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An acute coronary syndrome (ACS) is a set of signs and symptoms usually a combination of chest pain and other features like sweating vomiting, interpreted as being the result of abruptly decreased blood flow to the heart muscles(cardiac ischemia); the most common cause for ACS is of atherosclerotic plaque in any of coronary arteries.

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