Health Zone

Cardiac Arrest - How To Recognize the Signs

2011-01-19T00:32:00.000-08:00

Cardiac arrest is a ticking time bomb that can explode at any time. Many people confuse heart attacks with cardiac arrest, but they aren't the same thing. While someone having a heart attack is suffering damage to the heart muscle, usually because of a blockage of the blood flow to the heart, when someone suffers cardiac arrest, the heart completely stops working. It is for this reason that cardiac arrest is often fatal if immediate attention is not available. We will take you through a few of the symptoms you need to look for.

Don't get too caught up in the signs or symptoms of cardiac arrest as it can happen without any of the more common signs. If you are obese or have diabetes, for example, you have a greater than average chance of suffering from a variety of heart problems, including cardiac arrest. Recreational drug use can cause cardiac arrest by crating irregularities in the heart. Celebrity deaths that are drug related are often the result of overdoses that cause the heart to stop working.

You may not see any signs before the person becomes unconscious. While people can lose consciousness for a variety of reasons, cardiac arrest must always be considered as a possibility, as this requires immediate attention. When this occurs, there is a lack of a pulse and CPR or the use of a defibrillator must be applied if the person's life is to be saved.

It is a good idea to call an ambulance but a bad idea to wait for it to arrive before you start CPR. Because it can be a sign of cardiac arrest it's important to consider all loss of consciousness as life threatening.

Cardiac arrest is a sudden, often fatal, condition where the heart stops, but in most cases there are signs that can predict the likelihood of this happening. You probably won't see symptoms first which is why seeing a doctor regularly is so important. One of the main risk factors of cardiac arrest is coronary artery disease (CAD) which often is not diagnosed in time. High cholesterol is the first and most major sign of CAD although there are other tests that can detect it. If you are diagnosed with high cholesterol or CAD there is a lot you can do to reduce your chances of cardiac arrest. The majority of CAD sufferers don't ever know it.

If you have a family history of heart problems you are at a greater risk of cardiac arrest. Reduce the likelihood of cardiac arrest by talking to your doctor today.

What are the Signs of Cardiac Arrest?

2011-01-19T00:23:00.001-08:00

It's important to know the warning signs of cardiac arrest, one of the leading causes of death, so you can save your life or that of a loved one. Cardiac arrest is when the heart actually stops beating and can be caused by many factors, including many long term heart diseases. The following are some key signs of cardiac arrest to be aware of.

One symptom that is difficult to miss is chest pain. Chest pain is often associated with heart attacks, which, if they are severe enough, can lead to cardiac arrest. It is important for you to seek immediate attention for any chest pain you may have since it could be a sign of a heart attack or other condition. Although cardiac arrest often occurs without warning or pain in some cases chest pain may occur. Before going into cardiac arrest, some people experience dizziness or nausea. These symptoms in a person at risk for heart disease are a cause for concern even though they have other causes. Any symptoms of heart problems need to be taken seriously as heart problems can occur in young people and those who appear healthy. Some people have reported feeling lightheaded when having a heart attack. Because the heart doesn't generally stop during a heart attack, this is not the same as going into cardiac arrest. However, various heart conditions, including a heart attack, can lead to cardiac arrest, which is why it's essential to treat any heart related symptoms promptly.

There are many cases in which the only real risk factor for cardiac arrest is a family history. Your risk of a heart attack is greatly increased if one or more members of your family have some sort of heart abnormality or have gone into cardiac arrest. This is no guarantee that you'll share the same fate but it's a good idea to consult with your doctor about preventative treatments. It's possible your doctor will have access to medications designed to reduce your risks.

Cardiac arrest remains a very real threat to human health despite amazing advances in recent years in the medical field. While there are sometimes signs that can be observed, and there are risk factors that make it more likely, in some cases someone simply becomes unconscious with no warning signs or symptoms. A heart that is no longer beating is the one sure sign of cardiac arrest - this is why stimulation, to get the heart beating again, is needed immediately in these situations. Paying attention to the signs above might help you accurately gauge the risk factors and perhaps even identify cardiac arrest when it happens.

How Cardiac Defibrillators Work and Why Some People Need Them

2011-01-19T00:18:00.000-08:00

Defibrillators are starting to become part of the common vocabulary. But do you actually know what one does and why you would need it?

The popular notion is that a defibrillator is required to help "re-start" a heart that has stopped. Technically, that is not true. Defibrillators deliver electricity to the heart to restore a faulty heart rhythm. The name for this situation is called "sudden cardiac arrest" or even "sudden cardiac death." That last name is rapidly falling out of favor (and you can no doubt see why), but they are actually two terms that mean the same thing. And, yes, many people (about 20%) who have "sudden cardiac death" survive it.

Sudden cardiac arrest typically occurs when the heart starts to beat dangerously fast. A rapid heart rate can be appropriate when the body is exercising or highly stressed. But sometimes the heart tries to beat at rates that are overly fast 200 or even 300 times a minute.

The healthy heart at rest beats about 60 times a minute or once a second. If you make a fist (which is about the size of your heart) and open and close it to simulate pumping action, you can see that the heart is pumping at a pretty good clip to maintain a normal rhythm.

Now imagine the heart trying to beat 120 times a minute an appropriate rate for mild exercise. To achieve this rate, you now have to open and close your fist two times per second. The heart is still efficient at this rate, but it's hard work.

But let's double it 240 times a minute or four times a second. If your heart ever tried to beat 240 times a minute, it would no longer be able to pump efficiently. Try it with your fist and you see that you just can't keep up. Your movements have to become abbreviated. That's what happens during sudden cardiac arrest. Your heart is trying to beat so rapidly that it can no longer really pump. The heart muscle just quivers. Blood sloshes around in the heart instead of being pumped out.

In medical terms, your cardiac output drops to zero in a matter of seconds. This heart condition is usually attributable to a rhythm disorder called ventricular fibrillation (VF). But no matter what it is called, it is a sudden and potentially lethal heart rhythm.

Left untreated, a person with VF can die in as few as four minutes.

Sudden cardiac arrest from VF is not the same thing as a heart attack. A heart attack is essentially a "plumbing problem" of the heart, a situation where blockage in the "pipes" or blood vessels prevents blood flow. Other plumbing problems that can occur in the heart relate to the valves or the ability of the heart muscle to pump.

Cardiac rhythm disorders are electrical problems. They occur because of disorders in the heart's electrical system and they can happen in a person who has an otherwise "healthy heart."

The heart generates electricity to make it beat. That electricity flows through the heart along established conduction pathways. But sometimes an electrical impulse gets "stuck" on the pathway and makes endless loops, faster and faster, causing the heart to try to contract and relax to keep up with the electrical signals.

Defibrillators act by delivering a large amount of electrical energy in a very short time to the heart; think 700 volts in a fraction of a second. The electrical system of the heart responds to electrical energy.

VF occurs when an electrical accident causes the heart to try to beat too rapidly. A sudden influx of a large amount of electricity literally captures the attention of every single heart cell and gets them all "reset" or back on the same page.

The defibrillator delivers a large jolt of energy to the heart, usually in a fraction of a second. This gets the attention of every single cell in the heart. For a moment, even a couple of seconds, the heart stops beating altogether.

Then the heart resumes generating electricity and conducting it normally.

External defibrillation relies on special equipment and two large paddles that send the electricity through the chest. This is the defibrillation you see in the movies when the doctor yells, "Clear!" and then a jolt of energy travels from a generator through one paddle to the other.

Defibrillation equipment is standard in hospitals, many clinics, and it is increasingly common in airports, schools, and other public places. The reason for this is obvious: sudden cardiac arrest comes on suddenly, without warning, and there is often not enough time to get the victim to a hospital.

That was why a physician named Michel Mirowski invented an implantable defibrillator.

Dr. Mirowski's best friend died of sudden cardiac arrest because he could not get rescue defibrillation in time to save his life. Dr. Mirowski theorized that if a defibrillator could be implanted in the body, people could survive sudden cardiac arrest even if it happened when they were far from a hospital or an external defibrillator.

That was back in the 1980s and, believe it or not, Dr. Mirowski found many physicians who insisted what he wanted to do was technologically impossible and medically unethical. It was neither. Mirowski devoted his life to designing and developing defibrillators which he saw come to commercial use as early as 1988.

Today, implantable defibrillators are common. Most of them contain "built-in" pacemakers so that the pacemaker-defibrillator device is a standard of care.

The pacemaker paces a heart that beats too slowly or too erratically. The defibrillator shocks a runaway rhythm back to normal.

Defibrillators are in widespread use all over the world. Studies have proven that they not only help save lives, they actually work better than most drug therapy for people prone to electrical problems of the heart. This does not mean that defibrillator patients do not have to take drugs; many physicians recommend what doctors called "adjunctive therapy," which is a fancy way of saying "belts and suspenders." Thus, a person who gets a defibrillator implanted has the device implanted in his chest to rescue him, should a potentially life-threatening rhythm disorder occur. But that same person will also continue to take heart medicine to help prevent such rhythm disorders from occurring in the first place.

Vitamins for cardiac health and Heart Tonic for Heart Disease

2011-01-19T00:16:00.000-08:00

The most important group of vitamins specifically for heart health is the B Vitamin Family. These vitamins serve specific functions that can significantly reduce your risk of developing heart disease.

The B Vitamins, specifically folic acid (Vitamin B9), Vitamin B6 and Vitamin B12 are all responsible for helping the body remove homocysteine from the blood. High levels of homocysteine can cause artery damage. Meat is a good source of B vitamins, which is why vegetarians have an increased risk of dangerous homocysteine levels. It is especially important that they supplement these important vitamins for cardiac health.

Vitamin B3, known more commonly as niacin, may also reduce cholesterol in high concentrations, although further testing is needed to prove this conclusively. As far as other heart vitamins are concerned, Vitamin E and Vitamin C work in conjunction with each other to prevent heart disease and other ailments through their antioxidant abilities.

Apart from vitamins for cardiac health, antioxidants are substances that remove toxic byproducts of chemical reactions in the body. That's why you hear so much about antioxidants - they are responsible for clearing out highly reactive chemicals that circulate in the body, making sure they don't cause cell and tissue damage. It is this damage that is believed to cause heart disease, cancer and premature aging.

Other vitamins for cardiac health include folic acid and other B vitamins reduce the risk of coronary heart disease and stroke, according to a detailed analysis of more than three dozen scientific studies.

These nutrients work by quenching homocysteine, an amino acid in the blood that attacks blood vessel walls and promotes cardiovascular disease.

Homocysteine (pronounced ho´-mo-sis´-teen) has emerged after 25 years of research as the "new cholesterol," and researchers estimate that it is a major risk factor in 10 to 40 percent of heart attacks and strokes in the United States. Under normal circumstances, this amino acid is a short-lived byproduct of methionine metabolism, but a diet short on B vitamins prevents its breakdown.

The latest study, published in the Journal of the American Medical Association, analyzed 38 previous studies on homocysteine, folic acid, and cardiovascular diseases. Researcher Shirley A. A. Beresford, PhD, of the University of Washington, confirmed that high blood levels of homocysteine were clearly associated with cardiovascular diseases and that folic acid lowered levels of the amino acid. Other studies have reported that vitamins for cardiac health also include B6, B12, and choline also lower homocysteine levels.

High blood levels of homocysteine, also known as hyperhomocysteinemia, pose a risk of cardiovascular disease independent of other risk factors, such as cholesterol, triglyceride, smoking, and so forth. Beresford estimated that up to 50,000 coronary heart disease deaths could be prevented by increasing folic acid intake-by eating more fruit and vegetables, fortifying foods with the vitamin, or taking supplements.
Diet for cardiac health

When the cardiac diet is prescribed as part of a treatment plan, it is often individualized for the patient by a dietician and follows basic guidelines that promote good cardiac health.

1. Reduce the intake of food which contains animal fat

2. Use trans fat free margarine instead of butter

3. Eat more fruits and vegetables

4. Reduce sodium intake.

5. Add fish to the diet

6. Eliminate caffeine

7. Eat foods that contain plant stanols

How to Identify Signs and Symptoms of Cardiac Arrest

2011-01-19T00:11:00.001-08:00

Sudden Cardiac Arrest is a common cause of death and can happen suddenly or as the final consequence of a multitude of symptoms. When cardiac arrest occurs the heart stops pumping blood to the brain and other major organs. Immediate treatment through CPR or a defibrillator is the only means of treating cardiac arrest. Check out these signs that can sometimes signal cardiac arrest on the horizon.

Cardiac arrest can happen without displaying any of the usual suspects when it comes to signs or symptoms. If you are obese or have diabetes, for example, you have a greater than average chance of suffering from a variety of heart problems, including cardiac arrest. Recreational drug usage leads to irregularities in the heart which may cause cardiac arrest. Celebrity deaths that are drug related are often the result of overdoses that cause the heart to stop working.

Perhaps the most lethal detail about cardiac arrest is how quickly it happens. Noticing the warning signs for what they are can help you save someone's life. For people with a history of heart problems, shortness of breath and heart palpitations should not be overlooked as anything other than signs of cardiac arrest. While it is true that these can be symptoms of many different things you should not be too quick to rule out cardiac arrest either. The sooner help is given in such situations, the better the chances of survival. The decision to call an ambulance when you aren't certain it is or is not cardiac arrest could be a life or death decision.

Cardiac arrest is most often associated with an electrical problem in the heart like ventricular fibrillation. While cardiac arrest is something that occurs suddenly, doctors can tell you about risk factors that make this event more likely.Your doctor may tell you about irregular heartbeat and arrhythmia which are risk factors for cardiac arrest although many have them and life normal lives. Certain types of medications may be prescribed to protect the heart in these cases. Some helpful ways to prevent cardiac arrest are lifestyle changes and a healthy diet. You need to visit with a cardiologist regularly to determine your risk factors.

We have been looking at some common signs and risk factors for cardiac arrest. You may not be able to eliminate all potential risks but you can definitely reduce the odds.

Cardiac Tumors/Myxoma surgery Abroad At Affordable Cost- Cardiac Tumor

2011-01-19T00:09:00.000-08:00

What are cardiac tumors ?

Cardiac tumors are growths that arise in the heart’s inner lining, its muscle layer, or the surrounding pericardium. Although cardiac tumors can be benign (non-cancerous) or cancerous, the majority of cardiac tumors – approximately 70% – are non-cancerous.

Benign Cardiac Tumors

Myxoma : -

The most common type of benign cardiac tumor is the myxoma, which extends in to the heart’s chambers and accounts for 50% of primary cardiac tumors. Left untreated, these tumors can interfere with the function of cardiac valves; they can obstruct blood flow and small fragments of tumors can break off...

Rhabdomyoma : -

Accounting for approximately 20% of benign cardiac tumors, rhabdomyomas form in the myocardium—the muscle layer of the heart. Rhabdomyomas are the most common cardiac tumor of infants and children. These tumors can cause arrhythmias and heart failure...

Other Types of Benign Cardiac Tumors

These more rare benign cardiac tumors include : -

* Fibroma
* Hemangioma
* Lipoma
* Lymphangioma
* Neurofibroma
* Papillary Fibroelastoma

Cancerous Cardiac Tumors

Cancerous cardiac tumors can originate in the heart (primary tumor), or can spread to the heart from another site in the body (secondary tumor), especially the lung and breast.

Cardiac Sarcoma

Cardiac sarcoma is the most common primary malignant cardiac tumor. Because most cardiac tumors are not malignant, cardiac sarcomas are relatively rare. The most common type of cardiac sarcoma is the angiosarcoma, which usually begins in the right atrium (right upper chamber) of the heart, or on the pericardium (outer surface) of the heart...

Other Cancerous Tumors of the Heart

These include : -

* Fibrosarcoma
* Liposarcoma
* Rhabdomyosarcoma

How are cardiac tumors diagnosed ?

The methods for diagnosing cardiac tumors vary, to some degree, on the symptoms present. In addition to a complete medical history and physical examination, diagnostic procedures for cardiac sarcoma may include the following : -

* Echocardiogram
* Electrocardiogram (ECG)
* Computed tomography (CT or CAT scan.)
* Magnetic resonance imaging (MRI)
* Chest x-ray
* Coronary arteriogram (or angiogram)

Treatment for Cardiac Tumors in Abroad

Specific treatment for cardiac sarcoma will be determined by the physician based on : -

* Your age, overall health, and medical history
* Extent of the disease
* Your tolerance for specific medications, procedures, or therapies
* Expectations for the course of the disease
* Your opinion or preference

Benign cardiac tumors that are small and cause no symptoms can be closely monitored, and may require no treatment. However, surgery is indicated if, for example, the tumor is causing an arrhythmia or is obstructing blood flow through the heart. Depending on the type of tumor, outcomes can vary...

We Care Core Values

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Having the industry’s most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at each partner hospital, we provide you the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to five patients our patient care standards are unmatched across the sub continent.

The effect of thrombolytric drugs on cardiac enzymes, Creatine Phospho kinase and Creatine Kinase -MB, in myocardial Infarction”

2011-01-18T21:40:00.000-08:00

MYOCARDIAL INFARCTION

Myocardial infarction refers to a dynamic process by which one or more regions of the heart muscle experience a severe and prolonged decrease in oxygen supply because of insufficient coronary blood of subsequently, necrosis or death to the myocardial tissue occurs.

The onset of the myocardial infarction process may be sudden or gradual and the progression of the event to complete takes approximately 3 to 6 hours.

Read more: http://www.articlesbase.com/diseases-and-conditions-articles/the-effect-of-thrombolytric-drugs-on-cardiac-enzymes-creatine-phospho-kinase-and-creatine-kinase-mb-in-myocardial-infarction-1014246.html#ixzz1BSNgEOqu
Under Creative Commons License: Attribution

PREVALENCE

Myocardial infarction is the leading cause of death in the United States (US) as well as in most industrialized nations throughout the world. Approximately 800,000 people in the US are affected and in spite of a better awareness of presenting symptoms, 250,000 die prior to presentation to a hospital.4 The survival rate for US patients hospitalized with MI is approximately 90% to 95%. This represents a significant improvement in survival and is related to improvements in emergency medical response and treatment strategies.

In general, MI can occur at any age, but its incidence rises with age. The actual incidence is dependent upon predisposing risk factors for atherosclerosis, which are discussed below. Approximately 50% of all MI's in the US occur in people younger than 65 years of age. However, in the future, as demographics shift and the mean age of the population increases, a larger percentage of patients presenting with MI will be older than 65 years.

Men are more susceptible than women, but the risk is more in female than in male after menopause.

CORONARY ARTERIES

The coronary arteries supply the capillaries of the myocardium with blood

The right coronary artery (RCA) supplies the right atrium and ventricle, the inferior portion of the left ventricle, the posterior septal wall and the SA and AV nodes

The left coronary artery (LCA) consists of two major branchiate left anterior descending (LAD) and the circumflex (LCX).

The LAD artery supplies below the anterior wall of the left ventricle, anterior ventricular septum and the apex of the left ventricle.

The LCX artery supplies blood to the lateral and posterior surfaces of the left ventricle.

CARDIAC ENZYMES

Levels of cardiac markers rise overtime. Hence, enzymes are drawn in a serial pattern usually on admission and over 6-24 hrs until 3 samples are obtained.

Enzymes commonly evaluated include CK, CKMB, LDH, TroponinT & I.

CK-MB ratio indicates the extent of damage of the cardiac muscle. The more the ratio, the more the damage of the cardiac muscle. Troponins are preferred markers of myocardial injury or they are very cardiac specific & are thought to rise before permanent injury develops.

Increased troponin concentrations should not be used by themselves to rule out a heart attack. Troponin will remain high for 1–2 weeks following MI allowing easy diagnosis if patient presents late with an old MI as other CE’s will not be raised unless reinfarction occurs.

Elevation of Cardiac Enzymes in Myocardial Infarction

Enzyme Rises in Peaks in Normalizes in Normal Value CKMB ratio

CK 12 hrs 16-30hrs 3-5 days 35-232IU/L

CKMB 4-8 hrs 24 hrs 72 hrs < 51IU/L <6% Troponin I 3-6 hrs 20 hrs 14 days 0.0-0.4 ng/ml Troponin T 2-4 hrs 8-12 hrs 14 days 0.0-0.1 ng/ml LDH 12 hrs 12-24 hrs 10 days 100-190 IU/L PATHOPHYSIOLOGY The most common sites of MI are in the left ventricle, the chamber of heart which has the greatest work load. Tissue changes that occur in the myocardium are related to the extent to which the cells have been deprived of oxygen. Total deprivation results in an area of infarction in which the cells die and the tissue become necrotic. Necrosis in this area is evident with in 5 to 6 hours after the occlusion. In response to this necrosis the body increases its products of leukocytes, which aid in the removal of dead cells. As collateral circulation enlarges, it brings fibroblasts, which form a connective tissue scar with in the area of infarction. Usually, the formation of fibrous scar tissue is complete with in 2 to 3 months. Immediately surrounding the area of infarction is a less seriously damaged area of injury. It may deteriorate and thus extend the area of infarction or with adequate collateral circulation; it may regain its function with in 2 weeks. The outer most area of damage is the zone of ischemia which borders the area of injury. The cells in this area are weakened by decreased oxygen supply, but function can return usually with in 2 to 3 weeks after the onset of occlusion. RISK FACTORS There are two types of risk factors for heart attack, including 1. Inherited factors 2. Acquired factors Inherited factors These are risk factors you are born with that cannot be changed, but can be improved with medical management and life style changes. Following are most at risk- * persons with inherited hypertension * persons with inherited low levels of HDL or high levels of LDL * persons with a family history of heart disease aging men and women * persons with diabetes mellitus [ type 1 diabetes ] * women, after the onset of menopause- generally, men are at risk, at an earlier age than women, but after the onset women are equally at risk Acquired factors These are risk factors that are caused by activities that we choose to include in our lives that can be managed through life style changes and clinical care. Following are most at risk- * Persons with acquired hypertension * persons with acquired low level of HDL or high level of LDL * cigarette smokers * people who are under a lot of stress * individual who lives a sedentary life * persons overweight by 30 % or more TYPE OF MYOCARDIAL INFARCTION 1. Different degrees of damage occurs to the heart muscle- Zone of necrosis: death to the heart muscle caused by extensive and complete oxygen deprivation that is, irreversible damage Zone of injury: region of heart muscle surrounding the area of necrosis; inflamed and injured, but still viable if adequate oxygen can be restored. Zone of ischemia: region of the heart muscle surrounding the area of injury, which is ischemic and viable; not endangered unless extension of the infarction occurs. 2. According to the layers of the heart muscle involved, MI can be classified as- Transmural or Q wave infarction; area of necrosis occurs throughout the thickness of the heart muscle. Subendocardial or non transmural infarction; area of necrosis is confined to the innermost layer of the heart muscle. 3. Location of the MI is identified as location of the damaged heart muscle within the left ventricle inferior, anterior, lateral and posterior- Left ventricle is the most common and dangerous location for MI, as it is the main pumping chamber of the heart Right ventricular infarction commonly occurs I junction with damage to the inferior and or posterior wall of the left ventricle 4. Region of the heart muscle that becomes damaged determine by the coronary artery that becomes obstructed Left main coronary artery Circumflex branch Anterior ascending branch Great cardiac vein Middle cardiac vein Right cardiac vein CLINICAL MANIFESTATIONS 1) Chest pain * not relieved by the rest over sublingual vasodilator therapy * severe steady sub sternal chest pain of a crushing and squeezing nature * may radiate to the arms, neck, jaw and shoulders * continuous more than 15 minutes * may produce anxiety and fear 2) Diaphoresis 3) Hypertension or hypotension 4) Bradycardia or tachycardia 5) Palpitation, severe anxiety, dyspnea 6) Disorientation, confusion and restlessness 7) Fainting, marked weakness 8) Nausea, vomiting, hiccoughs 9) Atypical symptoms such as epigastric pain abdominal distress, dull aching or tingling sensation, shortness of breath, extensive fatigue DIGNOSTIC EVALUATION 1. ECG changes Generally occur within 2 – 12 hours, but may take 72 – 96 hours. Necrotic, injured and ischemic tissue alter ventricular depolarization and repolarization ST segment depression and T wave inversion indicate a pattern of ischemia ST elevation indicates an injury pattern * Anterior small V3 – V4 leads * Anterior extensive V2 – V5 leads * Anteroseptal V1- V3 leads * Posterior V1 – V2 leads, progressive R wave and ST depression * Anterolateral V4 – V6, I, Avl leads * Apical V5 – V6 leads * Inferior lead ii, iii and avf [ reciprocal ] 2. Elevation of serum enzymes and isoenzymes: Enzymes are drawn in a serial pattern usually on admission and every 6 – 24 hours until 3 samples are obtained. Enzyme activity then is correlated to the extent of heart muscle damage Enzymes commonly evaluated include are CK, LDH, CK-MB, AST, Troponin I, Troponin T. [Fig.4 ] LDH 2 is normally greater than LDH 1 except when the heart muscle is damaged a reversal occurs 3. Other findings: White blood cell count and sedimentation rate elevates due to inflammatory process associated with damaged heart muscle. Radionuclide imaging allows recognition of areas of decreased perfusion Position emission tomography determines the presence of reversible heart muscle injury and irreversible or necrotic tissue, extends to which the injured heart muscle has responded to treatment also can be determined MANAGEMENT Therapy is aimed at the protection of ischemic and injured heart tissue to preserve muscle function, reduce the infarct size, and prevent death. Innovative modalities provide early restoration of coronary blood flow , and the use of pharmacologic agents improve oxygen supply and demand, reduce and/or prevent disarrhythmias, and inhibit the progression of coronary artery disease. 1. Opiate analgesic therapy: Morphine is used to relieve pain, improve cardiac hemodynamics by reducing preload and after load and to relieve anxiety. Meperidine [Demerol] is useful for pain management in those patients contraindicated to morphine or sensitivity to respiratory depression. 2. Anxiolytic agents: Benzodiazepines are used with analgesics when anxiety complicates chest pain and its relief 3. Antiplatelet agents: Aspirin interfere with the function of the enzyme cyclooxygenase and inhibits the formation of thromboxane A2. Within minutes aspirin prevents additional platelet activation and interferes with platelet adhesion and cohesion Other antiplatelet agents are, Clopidogrel, Ticlopidine, Dipyridamole, these agents, specifically Clopidogrel may be useful for patients who have a true allergy to aspirin and some times can be used with combination with Aspirin. 4. Supplemental oxygen: Supplemental oxygen should be administered. The rationale for use is the assurance that erythrocytes will be saturated to maximum carrying capacity. Because MI impairs the circulatory function of the heart, oxygen extraction by the heart and by other tissue may be diminished. 5. Nitrates: Intravenous Nitrates should be administered in MI, persistent ischemia, hypertension or large anterior wall MI. Nitrates are metabolized to nitric oxide in the vascular endothelium. Nitric oxide relaxes vascular smooth muscle and dilates the blood vessel lumen. Vasodilatation reduces both cardiac preload and after load, and decreases the myocardial oxygen requirements. Vasodilatation of the coronary arteries improves the blood flow through the partially obstructed vessels as well as through collateral vessels. When administered sublingually or intravenously, Nitroglycerin has a rapid onset of action. 6. Beta adrenergic blocking agents: Beta blockers are recommended within 12 hours of MI symptoms and are continued indefinitely. Beta blockers decrease the rate and force of myocardial contraction and decreases overall myocardial oxygen demand. During the acute phase of MI beta blockers may be initiated intravenously 7. Heparin: Unfractionated Heparin: intravenous unfractionated Heparin is recommended who undergo percutaneous revascularization. It is also recommended in patients who receive fibrinolytic therapy and non selective fibrinolytic agents such as urokinase, streptokinase and anistreplace. Heparin inhibits the additional formation and propagation of thrombi, effective when administered intravenous or subcutaneously. Low-molecular-weight-Heparin: can be administered to MI clients not treated with fibrinolytic therapy 8. Fibrinolytic or Thrombolytic agents: Fibrinolytic therapy is indicated with ST segment elevation. Plasminogen activators restore coronary vessels by dissolving obstructing thrombus. The plasminogen activators have been shown to restore coronary blood flow in 50% to 80% of MI patients. The successful use of fibrinolytic agents provides a definite survival benefit that is maintained for years. Reteplase has been shown to produce slightly higher 60- and 90-minute angiographic patency rates than accelerated alteplase, while adverse-event rates were equal. However, the better early patency rate did not translate into any survival advantage at 30 days follow-up. The most critical variable in achieving successful fibrinolysis is time from symptom onset to drug administration. A fibrinolytic is most effective when the "door-to-needle" time is 30 minutes or less. 9. Angiotensin converting enzyme inhibitors: Oral ACEI are recommended within the first 24 hours of the onset of the MI symptoms, decreases myocardial after load through vasodilatation. 10. Anti dysarrhythmic agents: Lidocaine decreases ventricular irritability, which commonly occurs post MI. 11. Calcium channel blockers: Improves the balance between the oxygen supply and demand by decreasing heart rate, blood pressure and dilating coronary vessels. Diltiazem has been shown to decrease the incidence of reinfarction in patients with non-Q-Wave MIs. 12. Percutaneous Coronary Intervention [Fig-15]: Mechanical opening of the coronary vessel can be performed during an evolving infarction. A balloon tipped catheter is introduced through a guide wire into a coronary vessel with a non calcified atheromatous lesion. The balloon of the catheter is the inflated, causing disruption of the intima and changes in the atheroma. The result is an increase in the diameter of the lumen of the coronary vessel and improvement of blood flow below the lesion. Percutaneous coronary intervention is an alternative therapy to fibrinolysis Restoration of coronary blood flow in a MI can be accomplished mechanically by percutaneous coronary intervention (PCI). Mechanical revascularization by PCI is used as a primary therapy as an alternative to fibrinolysis when fibrinolysis is not clearly indicated or contraindicated. PCI can successfully restore coronary blood flow in 90% to 95% of MI patients. 13. Surgical Revascularization: Emergent or urgent coronary artery bypass graft surgery is warranted in the setting of failed percutaneous intervention in patients with hemodynamic instability and coronary anatomy amenable to surgical grafting. Surgical revascularization is also indicated in the setting of mechanical complications of MI such as ventricular septal defect, free wall rupture, or acute mitral regurgitation. Restoration of coronary blood flow with emergency Coronary Artery Bypass Grafting (CABG) can limit myocardial injury and cell death if it is performed within 2 or 3 hours of symptom onset. Emergency CABG carries a higher risk of perioperative morbidity (bleeding and MI extension) and mortality than elective CABG. The risk of operative mortality during emergency CABG is increased in patients, who are in cardiogenic shock, those with previous CABG surgery, and with multi-vessel disease. On the other hand, urgent CABG confers a survival benefit in patients with recurrent ischemia post-MI whose coronary anatomy is unsuitable for complete revascularization with PCI. Elective CABG improves survival in post-MI patients who have left main artery disease, three-vessel disease, or two-vessel disease that is not amenable to PCI. The timing of elective CABG post-MI is controversial, but retrospective studies indicate that when CABG is performed as early as 3 to 7 days post-MI, operative mortality is equivalent to CABG performed on non-MI patients. 14. Cardiac Stress Testing: Cardiac stress testing post-MI has established value in risk stratification and assessment of functional capacity. Stress testing is not recommended within several days post-MI. Only sub-maximal stress tests should be performed in stable patients 4 to 7 days after MI. Exercise testing identifies patients with residual ischemia for additional efforts at revascularization. Exercise testing also provides prognostic information and acts as a guide for post-MI exercise prescription and cardiac rehabilitation. 15. Lipid Management: All post-MI patients should be on an American Heart Association Step II diet (< 200 mg cholesterol/day, < 7% of total calories from saturated fats). Post-MI patients with LDL-cholesterol levels > 100 mg/dL on a Step II diet are recommended to be on drug therapy to lower LDL-cholesterol levels < 100 mg/dL. Post-MI patients with HDL-cholesterol levels < 35 mg/dL on a Step II diet are recommended to participate in a regular exercise program and on drug therapy designed to increase HDL-cholesterol levels.4 Recent data indicate the all MI patients should be on statin therapy, regardless of lipid levels or diet 16. Long-term Medications: Most oral medications instituted in the hospital at the time of MI will be continued long-term. Therapy with aspirin and beta-blockade is continued indefinitely in all patients. ACEI is continued indefinitely in patients with congestive heart failure, left ventricular dysfunction (ejection fraction < 0.40), hypertension, or diabetes. A lipid-lowering agent, specifically a statin, in addition to dietary modification is continued indefinitely 17. Cardiac Rehabilitation: Cardiac rehabilitation provides a venue for continued education, re-enforcement of lifestyle modification, and adherence to a comprehensive prescription of therapies for recovery from MI, which includes exercise training. Participation in cardiac rehabilitation programs post-MI is associated with a decrease in subsequent cardiac morbidity and mortality. Other benefits include improvement in quality of life, functional capacity and social support. A minority of post-MI patients actually participate in formal cardiac rehabilitation programs due to either lack of structured programs, physician referrals, low patient motivation, non-compliance, or financial constraints. NEED FOR THE STUDY Reperfusion therapy, within which we include thrombolytic therapy and percutaneous coronary intervention (PCI), which includes angioplasty and stent placement, is the greatest advance in the treatment of acute myocardial infarction Studies have shown that many patients with AMI who are eligible for reperfusion therapy do not receive it. Moreover, of those who do receive it, the time to administration of thrombolytic therapy, or "door-to-needle time" is often delayed, jeopardizing myocardium and leading to greater morbidity and mortality. Clinical criteria and simple ECG parameters have limited value for the non-invasive diagnosis of myocardial reperfusion. Other methods, such as ST segment monitoring and kinetic analysis of biochemical markers, may also be value of in early identification of IRA {Infarct Related Artery}, total CK activity, CK-MB isoenzymes appear to be the most promising biochemical markers. In addition, the thresholds suggested for the diagnosis of reperfusion were generally derived from “time-to-peak” values. This rules out early diagnosis because peak CK plasma values are reached, on averages 9 -+ 6 hours after thrombolysis. Determination of plasma total and MB CK concentration provides accuracy superior to any other currently available method for the diagnosis of acute MI. In addition to providing precise diagnosis of acute MI, quantitative MB CK assays can also be used to obtain an accurate estimate of infarct size. In recent years, accuracy in the diagnosis of acute MI has assumed even greater importance, since the choice and timing of a variety of diagnostic and therapeutic options following coronary care unit admission hinge on whether infarction has occurred. Furthermore, the advent of thrombolytic therapy of acute MI has emphasized the need for more sensitive biochemical markers of necrosis in the first hours. The eventual realization that the reestablishment of blood flow was the dominant mechanism for the diminution of infarct size led to a therapeutic approach dominated by thrombolysis and more literally by the use of interventions to open vessels and maintain them open. The key observation is that benefit by the use of a drug could be demonstrated if the drug was given prior to the period of ischemia. Nevertheless, the greatest benefit in the management of patients with myocardial infarction ha unquestionably been the reestablishment of blood flow as early as possible after occlusion The aim of this study is to determine the reperfusion of injury exacerbated by thrombolytic drugs in Myocardial Infarction through the process of elevation of cardiac enzymes which peaks and comes to normal levels within 24 hours, preventing prolonged injury and ischemia of myocardial tissue. However, the aim was to evaluate prospectively biochemical markers for the diagnosis of coronary patency early after IV thrombolysis for Acute Myocardial Infarction. STATEMENT OF THE PROBLEM “The effect of thrombolytric drugs on cardiac enzymes, Creatine Phospho kinase and Creatine Kinase -MB, in myocardial Infarction”. OBJECTIVES * To evaluate the effect of thrombolytic drugs on cardiac enzymes. * To compare the effect of thrombolytic drugs and non thrombolytic drugs on cardiac enzymes * To determine the importance of thrombolytics for a patient with myocardial infarction * To suggest teaching guidelines to public regarding early seeking of medical help at the onset of chest pain. OPERATIONAL DEFIITIONS Effect: Result or produce a result Thrombolytic drugs: medications used to dissolve blood clots CPK: A cardiac isoenzyme which releases into the blood in high levels when an injury occurs to the heart. It is also known as Creatine Kinase or Creatine Phophokinase. CK-MB: It is also a cardiac isoenzyme releases into the blood from the heart muscle during an injury of the heart Myocardial infarction: Necrosis of a region of the myocardium caused by an interruption in the supply of blood to the heart, usually as a result of occlusion of a coronary artery. HYPOTHESIS "Thrombolytic agents has effect on fall in peak levels on cardiac enzymes, CK and CK-MB" LIMITATIONS Coronary care unit: The data of this research is applicable in the settings of coronary care unit. Age: Clients are selected only between 35 to 65 yrs of age. Myocardial infarction: This is also applicable to the clients who were admitted in the hospital within 6 hours of the onset of the chest pain with myocardial infarction who received Inj. Metalyse. Acute coronary syndrome: The clients who are admitted after 6 hours of the onset of the chest pain with acute coronary syndrome are included in the control group. METHODOLOGY: This study was done by an experimental method of research design in the settings of Coronary Care Unit in Dubai Hospital, U.A.E. A consecutive series of patients receiving IV Metalyse [ Tenecteplase ] for MI from May 2006 to November 2006 were included in this study. RESEARCH DESIGN: This study uses the comparative design. THE SETTINGS: This study was conducted in patients irrespective of age, sex and nationality, who were admitted in Coronary Care Unit through Emergency Department in Dubai Hospital, U.A.E. SAMPLE SIZE: This study included 60 clients, men and women, irrespective of nationalities, between 35 years to 65 years of age. Among 60 clients 30 were taken as experimental group and another 30 considered as control group. SAMPLING TECHNIQUE: The samples are selected as convenient sample, into two groups, the experimental and control groups. The clients who received thrombolytic agents within 6 hours of the onset of the chest pain are selected as an experimental group, and the clients who were presented late after 6 hours of the onset of the chest pain and not received thrombolytics, are selected as control group. All patients treated had the diagnosis of myocardial infarction confirmed by subsequent elevation of both Creatine Kinase [CK] and CK-MB isoenzymes levels. IV Metalyse is administered at a dose of 6000 units to 9000 units according to the weight of the patients. Patients with acute MI who were admitted to CCU more than 6 hours of onset of pain were also included. DATA COLLECTION PROCEDURE: Data for the study is collected by an instrument, which consists of 22 items including sample number, age, and sex. Religion, nationality, occupation, food habits, life style onset of chest pain, date and time of admission, signs and symptoms, vital signs, type of MI, protocol of thrombolytic therapy, levels of cardiac enzymes, post thrombolytic treatment, drugs received and date of discharge. Study reveals that, majority of the clients who had MI was from the Indian subcontinents, constituting 63.3 % and the minority constituting just 1.6 %, from Great Briton and Turkey. 3.3 % of the clients were Egyptians and Syrians. Bangladeshis comprised, 6.6 % and Pakistanis were about 21.6 %. Only 9.9 % of the clients who had MI were Dubai Nationals. Among them 46.6% of the clients were aged between 46 – 55 years and 41.6 % of the clients were between 36 – 45 years and the remaining 11.6 % of the clients are between 56 – 65 years of age. 36.2 % of the clients had acute coronary syndrome and were not given thrombolytics. Remaining of the clients was with true MI and most of them were thrombolysed. However, all clients have undergone coronary angioplasty. Out of these clients only one client had normal coronary vessels, two were with mild coronary stenosis for conservative medical treatment and 4 clients with major triple vessel block were posted for CABG. Rest of the clients was treated with Percutaneous Coronary Angioplasty to LAD [50%], RCA [21.6%] and Circumflex [13.5%]. It is also evident from the study that most of the Indians are affected with MI and the major contributing factors are smoking, stress and lack of knowledge about the disease condition. Based on Chi-Square deviation the association between normalization of cardiac enzymes levels in the study groups are as follows- In Experimental group, 30 clients have received Inj. Metalyse . among them except 4 clients, remaining 26 clients reports seen that cardiac enzymes are normalized within 24 hours after the admission and administration of thrombolytic agent. In control group, 30 clients blood reports for normalization of cardiac enzymes were anlysed, where we found 27 clients reports shown the higher levels of cardiac enzymes after 24 hours of the admission. 1. Critical Value 14.56, P value < 0.05 and Null hypothesis rejected Inj. Metalyse has a good effect on the cardiac muscle provided with Critical Value- 14.56, Probability Value- < 0.05, as evidenced by fall in peak levels of cardiac enzymes CK and CK-MB within 24 hours after received thrombolytic agent. DISCUSSION Tenecteplase [ Metalyse] is a recombinant fibrin-specific plasminogen activator. It binds to the fibrin component of the thrombus and selectively converts thrombus-bound plasminogen to plasmin, which degrades the fibrin matrix of the thrombus. Tenecteplase is cleared from the circulation by binding to specific receptors in the liver followed by catabolism to small peptides. After single intravenous bolus injection of tenecteplase in patients with acute myocardial infarction, tenecteplase antigen exhibits biphasic elimination from plasma. There is no dose dependence of tenecteplase clearance in the therapeutic dose range. The initial dominant half-life is 24+_5.5 [mean=/-SD] min. the terminal half-life is 129+_87 minutes, and plasma clearance is 119+_49 ml/min The main finding of this study is the early peaking of the total CPK level and CK-MB isoenzymes have identified with successful reperfusion after Metalyse therapy. The peak CPK levels reached in 12 hours and CK-MB levels were shifted in 6 hours. The study reveals that the cardiac enzymes levels peaked and normalized within 24 hours time in the experimental group who received Thrombolytic agents within 6 hours of the onset of the chest pain. Where as it took 3- 5 days for the enzyme levels to peak for clients in the control group, who did not receive thrombolytic agents due to late arrival to the hospital, resulting in more damage to the myocardium. Thus, it is evident that the extent of injury to the myocardium as well as the oxygen demand is less in the experimental group of the clients. Finally, it may be used as a surrogate end point for angiographic demonstration of patency in future clinical studies of reperfusion therapy. Diagnostic performance improved when the analysis was restricted to patients treated >6 hours after the onset of symptoms.

CONCLUSION

Clinical studies of fibrinolytic therapy in myocardial infarction show, that early thrombolytic treatment starting within 6 hours of the onset of the chest pain, significantly decreases the risk of further damage of the myocardium and oxygen demand, by the process of fall in peak levels of cardiac enzyme levels within 24 hours.

Inj. Metalyse has early peaking of cardiac enzymes in experimental group reflect the Infarction Related Artery opened, the clot has dissolved by Inj. Metalyse which means we have good thrombolytic effect, that is why we have early peaking levels.

Early identification of patients with persistent occlusion after thrombolyis during

Acute Myocardial Infarction also is important because it can pave the way for rescue interventions such as rescue Percutaneous Transluminal Coronary Angioplasty or repeated thrombolysis.

NURSING IMPLICATIONS:

SERVICE

Determine intensity of client’s angina

Observe for signs and symptoms

Place patient in a comfortable position

Administer oxygen if required

Obtain vital signs every 15 minutes for 2 hours, every half an hour for one hour and

every hour for two hours then as required

Obtain a 12 lead ECG

Monitor for relief of pain

Monitor patient’s response to drug therapy

Institute continuous cardiac monitoring and observe for- reperfusion, arrhythmias, rhythm changes, bradycardia and tachycardia

Interpret rhythm strips

Watch for complaints of headache with use of nitrates

Watch for recurrences of pain. Reinforce the importance of notifying nursing staff whenever pain is experienced.

Administer medications to relieve patient’s anxiety as directed such as sedatives and tranquilizers

Provide complete bed rest for 24 hours

Determine level of activity that precipitated anginal pain occurs.

Identify specific activities patient may engage in that are below the level at which anginal pain occurs

Prepare for the diagnostic and treatment procedures such as coronary angiogram and PTCA [ Percutaneous Transluminal Coronary Angioplasty]

EDUCATION

Counsel on risk factors and life style changes such as-

Methods of stress reduction such as biofeedback and relaxation techniques

Low fat and low cholesterol diet

Avoid excessive caffeine intake

Do not use diet pills, nasal decongestants

Follow up visits to control diabetes and hypertension

Educate patient and family members regarding-

Prevention of recurrence of pain

Regular use of medications

Hazards of smoking

Prevention of other contributing factors

Regular follow up

Importance of dietary modifications

Avoiding activities which cause anginal pain such as sudden exertion, walking against the wind, extremes of temperature, emotionally stressful situations, refraining from engaging in physical activity for 2 hours after meals, reduce weight etc.

Appropriate use of medications

Side effects of medications

ADMINISTARTION

Lead interdisciplinary intervention programs

Education of nursing students and staff

Provide in-service nursing education

Maintenance of records and reports

Maintenance of statistics

Making of policies and procedures

Supervision and evaluation of staff performance

Recommendations for further study

A majority of post MI patients actually not participating in formal cardiac rehabilitation programs due to either lack of structured programs, physician

referrals, low patient motivation, non compliance and financial constraints.

Cardiac rehabilitation provides a venue for continued education, reinforcement

of life style modification and adherence to comprehensive prescriptions of

therapies for recovery for MI, which includes exercise training.

Participation in cardiac rehabilitation programs, post MI with a decrease in

subsequent cardiac morbidity and mortality.

Adequate education in the hospitals and work places on causative and contributing factors, preventive measures of heart attacks and re heart attacks, is necessary.

All forms of reperfusion, depending on local facilities, need to be available to patients. Protocols must be written and agreed for the strategy of reperfusion to be applied within a network. Early diagnosis of ST Elevation Myocardial Infarction is essential and is best achieved by rapid ECG recording and interpretation at first medical contact, wherever this contact takes place.

Read more: http://www.articlesbase.com/diseases-and-conditions-articles/the-effect-of-thrombolytric-drugs-on-cardiac-enzymes-creatine-phospho-kinase-and-creatine-kinase-mb-in-myocardial-infarction-1014246.html#ixzz1BSNrR6ta
Under Creative Commons License: Attribution

Cardiac Rehabilitation – An Overview

2011-01-18T21:36:00.000-08:00

Definition

Cardiac rehabilitation — also called cardiac rehab — is a customized program of exercise and education, designed to help you recover after a heart attack, from other forms of heart disease or after surgery to treat heart disease. Cardiac rehabilitation is often divided into phases that involve monitored exercise, nutritional counseling, emotional support, and support and education about lifestyle changes to reduce your risks of heart problems. The goals of cardiac rehabilitation are to help you regain strength, to prevent your condition from worsening and to reduce your risk of future heart problems. Cardiac rehabilitation programs increase your chances of survival.

Why it's done

Cardiac rehabilitation is an option for people of all ages and with many forms of heart disease. In particular, you may benefit from cardiac rehabilitation if your medical history includes -

* Heart attack
* Coronary artery disease
* Heart failure
* Peripheral arterial disease
* Chest pain (angina)
* Cardiomyopathy
* Certain congenital heart diseases
* Coronary artery bypass surgery
* Angioplasty and stents
* Heart transplant
* Heart valve replacements

Don't let older age hold you back from joining a cardiac rehabilitation program. Even if you're older than 65, you're likely to benefit from cardiac rehabilitation.

Risks

Cardiac rehabilitation isn't appropriate for everyone who's had heart disease. Your health care team will evaluate your health to make sure you're ready to start a cardiac rehabilitation program.

Rarely, some people suffer injuries, such as strained muscles, sprains or broken bones, while exercising as a part of cardiac rehabilitation. Your health care team will carefully monitor you while you exercise to lower this risk and will teach you how to avoid injuries when you exercise on your own.

How you prepare

If you've had a heart attack or heart surgery or if you have another heart condition, ask your doctor about joining a cardiac rehabilitation program. Insurance and Medicare often cover the costs of cardiac rehabilitation.

What you can expect

During cardiac rehabilitation

Cardiac rehabilitation often begins while you're still in the hospital and continues with monitored programs in an outpatient setting until home-based maintenance programs can be safely followed.

The first stages of most cardiac rehabilitation programs last about three to six months. During that time, you may work with cardiologists, nurse educators, dietitians, exercise rehabilitation specialists, occupational therapists, physical therapists, psychologists and psychiatrists.

Cardiac rehabilitation has four main parts -

* Medical evaluation - Initial and ongoing evaluation helps your health care team check your physical abilities, medical limitations and other conditions you may have, and keep track of your progress over time. Your health care team looks at your risk factors for heart disease, stroke or high blood pressure. This helps your team tailor a cardiac rehabilitation program to your individual situation, making sure it's safe and effective.

* Physical activity - Cardiac rehabilitation improves your cardiovascular fitness through walking, cycling, rowing, or even jogging and other endurance activities. You may also do strength training (lifting weights, for example) to increase your muscular fitness. Don't worry if you've never exercised before. Your cardiac rehabilitation team will make sure the program moves at a comfortable pace and one that's safe for you, but in general you should exercise three to five times a week. You'll be taught proper exercise techniques, such as warming up and stretching.

* Lifestyle education - Guidance about diet and nutrition helps you shed excess weight and learn to make healthier food choices aimed at reducing fat, sodium and cholesterol intake. You receive support and education on making lifestyle changes and breaking unhealthy habits, such as smoking. You also learn how to manage pain or fatigue you may have. Cardiac rehabilitation also gives you ample opportunity to ask questions about such issues as sexual activity. Finally, it's critical you closely follow your doctor's advice on medications.

* Support - Adjusting to a serious health problem often takes time. You may feel depressed or anxious, lose touch with your social support system, or have to stop working for several weeks. If you get depressed, don't ignore it because depression can make your cardiac rehab program more difficult, as well as impact your relationships and other areas of your life and health. Counseling will help you learn healthy ways to cope with depression and other feelings, and your doctor may also suggest medications such as antidepressants. Vocational or occupational therapy will teach you new skills to help you return to work.

Although it may be difficult to start a cardiac rehabilitation program when you're not feeling well, you'll benefit in the long run. Cardiac rehabilitation can guide you through fear and anxiety as you return to an active lifestyle, with more motivation and energy to do the things you enjoy. Cardiac rehabilitation helps you rebuild your life, both physically and emotionally. As you get stronger and learn how to manage your condition, you'll likely return to a normal routine, along with your new diet and exercise habits. It's important to know that your chances of having a successful cardiac rehab program rest largely with you; the more dedicated you are to following your program's recommendations, the better you'll do.

After cardiac rehabilitation

After your initial cardiac rehabilitation program ends, you'll need to continue the diet and exercise habits you learn during cardiac rehabilitation for the rest of your life to maintain its heart health benefits.

Results

Cardiac rehabilitation is a long-term maintenance program — something to follow for the rest of your life. After about 12 weeks, you probably will have developed your own exercise routine at home or at a local gym. You may also continue to exercise at a cardiac rehab center. You may remain under medical supervision during this time, particularly if you have special health concerns. Education about nutrition, lifestyle and weight loss may continue, as well as counseling. For best success, make sure your exercise and lifestyle practices become lifelong habits.

Over the long term, you gain strength, learn heart-healthy behaviors, improve your diet, cut bad habits, such as smoking, and learn how to cope with heart disease. You'll also decrease your risk of coronary artery disease and other heart conditions. One of the most valuable benefits of cardiac rehabilitation is often an improvement in your overall quality of life. If you stick with your cardiac rehab program, you're likely to come out of your cardiac rehabilitation program feeling better than before.

Why consider India?

Cardiac rehabilitation program in India is available at various hospitals in Mumbai, Bangalore, Hyderabad, Chennai and New Delhi at a reasonable price. With India becoming a hottest destination for medical tourism, healthcare facilities that India offers with great expertise includes heart care and heart surgery. Indian hospitals have good infrastructure and is well equipped with all sophisticated investigative techniques and equipments. Cardiologists in India have made several breakthrough researches on cardiology and have performed complex cardiac surgeries that have never happened anywhere in the world. Cardiologists in India are very innovative who can use their skills with great proficiency with success rate of around 98.50%. Indian Hospitals can handle all stages of cardiac disorder and help diagnose, prevent possible cardiac risk. It can also handle high risk patients that need surgeries that are performed using invasive or non-invasive techniques and robotic surgery.
The cost involved for cardiac care in India comes around $8,000 whereas the same service is delivered in the US at a cost of $30,000. International patients can save more than half the cost if they avail the treatment from India. With medical tourism sector booming effectively in India, patients can couple their heart care trip with visiting some beautiful places across India.

Read more: http://www.articlesbase.com/medical-tourism-articles/cardiac-rehabilitation-an-overview-1477607.html#ixzz1BSN4uddv
Under Creative Commons License: Attribution

The Breathing Exercise To Unblock The Nose

2010-07-19T15:19:00.000-07:00

There is a simple breathing exercise to unblock the nose developed by Russian doctors. About 200 doctors taught it to thousands of their patients. Most patients, according to published studies of these doctors, could unblock their nose in about 2-3 minutes.

Steps to follow

Pinch your nose and start walking quickly with your nose pinched and your mouth closed. You probably will be able to make 20-30 steps. Hold your breath until you get a strong desire to breathe (air hunger). Sit down with your spine absolutely straight and focus on your breathing. After releasing your nose, while sitting, resume your breathing but keep the mouth closed. Instead of taking your usual big inhalation, take a smaller inhalation and then immediately relax all muscles, especially upper chest and all other breathing muscles. Take another (smaller) inhalation and again completely relax. With each breath, take a small or reduced inhalation and then completely relax. The goal is to preserve this level of air hunger for 2-3 minutes with maximum possible relaxation of the body. The breathing is frequent during this reduced or shallow breathing but this is OK.

If later your breathing becomes heavy, your nose will get blocked again. Then you can repeat this exercise. You can download the free PDF manual “How to maintain nasal breathing 24/7” from here: http://www.normalbreathing.com/nb-word/Manual-How-Maintain-Nasal-Breathing-24-7.pdf

Our breathing pattern has profound effects on circulation and blood supply to all tissues. For example, breathing through the mouth affects hundreds of biochemical and physiological processes in the human body. Sleeping on the back can make breathing about 2 times heavier reducing oxygenation and triggering sleep apnea, mouth breathing, headaches, anxiety, panic attacks, and many other problems.

If you retrain your breathing pattern, so that after your exhalation, you can comfortably hold your breath for 25 or more seconds after your usual exhalation, your problem with the blocked nose will disappear. Thus, a permanent solution to the problem of a blocked nose is to have normal breathing parameters 24/7 to sustain good body oxygenation.

This test (stress-free breath holding time after one’s usual exhalation) or body oxygen content (in seconds) is the main health-measuring tool of the Buteyko breathing self-oxygenating therapy developed by leading Russian physiologist Konstantin Buteyko, MD, PhD. He trained about 200 Russian medical professionals to appply this therapy on sick patients. The therapy was approved by Russian Minister of Health for treatment of asthma and heart disease.

7 Secrets of Permanent Fat Loss and Fitness

2010-07-19T15:17:00.001-07:00

Who else would like to lose weight? Well, most people will say that they do, that is why we are looking for a to lose weight.

The big question is how do I lose the weight? Where is the system, the plan or a way I can do this? Most of us have tried many different ways to lose weight and get fit. routines.

What would happen if you are planning to cook a meal, say beef stew, and you leave out the carrots and potatoes? You go ahead and cook it, but what happens. Without the carrots and potatoes, well it is just not beef stew.

Cooking beef stew without all the necessary ingredients just does not work and no matter how many times you try it, it will never work.

Losing weight is the same way. Why, well you need all the ingredients to have your weight loss plan work for you and if you do not it will be just like the beef stew that did not turn out to well.

If you are on a weight loss program that uses only pills, or only restrictive food diets or only an exercise plan then you will not be successful in your weight loss in the long run.

For a Well Balanced and Successful Weight Loss Plan You need:

· Nutritious Food

· Resistance exercise

· Adequate Sleep

1. When you prepare nutritious food you will find that it is colorful, fresh and delicious. Athough a TV dinner is quicker to prepare, a nutritious meal is much tastier and healthier for you.

2. What I like about resistance exercise is that it does not take up a lot of time like other types of exercise do. Exercise 2 to 3 days a week for 20 to 30 minutes a day.

3. Between exercises it is important for you to have an adequate amount of sleep and rest to build lean muscle and have a well conditioned and fit body.

The result of this program is that you will have a more vibrant and energetic life.

Go to 7 Secrets of Permanent Fat Loss and Fitness at URL www.burnfatcaloriesfast.com (Link is at the bottom of this page) for Your FREE eBook on the 7 Secrets of Permanent Fat Loss and Fitness.

This program has been downloaded by tens of thousands of people all over the world; you will learn how you can triple your fat loss results while cutting your workout time in half or more.

You will also discover the most powerful secret in eating for a lean and in shape body.

Plus you will get 5 more secrets of permanent fat loss and get that fit, lean and sexy look in this 40+ page eBook.

How Can I Lose Weight - and Keep it Off Forever!

2010-07-19T15:17:00.000-07:00

Following fad diets is not the answer if you are planning to keep the weight off.

Fad diets have one thing in common, they are all diets.

A pair of bell-bottom pants, in today and out tomorrow. For a few years these diets are popular and then they are out of style. Then, what happens, after a while they come back like a vicious circle when the fitness professionals feel that we are ready to start up with them again. If you really want to burn body fat and lose weight steer clear of the fad diets.

For more information visit http://www.burnfatcaloriesfast.com

In the first days of a fad diet several of you will lose some weight. So you get some weight loss initially, but you might also lose some muscle on these diets too. Your fat burning efforts and overall health could suffer if you lose muscle.

But the most discouraging part of fad diets is that practically all people who use these diets will gain the weight back, and then even more. Has this happened to you?

The most crucial question is, how can I keep the weight off?

One reason is the fad diets frequently advise focusing too much on one type of food, like non-carbohydrate foods (meat and dairy only) or only carbohydrate foods (fruits and vegetables only). If you want unhealthy eating habits, this type of diet will take you there.

You are greatly reducing the number of vitamins and minerals you eat when you just eat foods from one catagory. Limiting yourself of the essential vitamins and minerals that your body requires will lead to poor health and more health problems.

It is said that variety is the spice of life, and to have variety in the nutritious foods that we eat is also needed for good health.

Fad diets are too restrictive to be realistically followed, especially for a lengthy period of time. They are not only unhealthy but these diets are also very difficult to stay on because they take away many of our favorite foods. If you desire to lose weight over a lengthy period of time, then do not go on a strict restrictive diet.

If you want life long weight loss and weight stabilization the solution is behavioral changes in your eating habits.

The very idea of this kind of fad diet just will not work. Why? Diets are based in a temporary mindset. The fact that someone goes on a diet means they will have to come off of the diet. This is temporary…why force yourself to lose 10 pounds when you're just going to gain it back and then even more when you go off of the diet?

A lot of people just don't comprehend this, even though it may sound simple. A lot of individuals turn to dieting in an attempt to resolve their weight and health issues. These fad diets are not the answer as they just lead to more problems. People who are regular dieters don't burn fat over the long haul and many times will gain more weight back than they lost on the diet.

To answer the question how can I keep the weight off, it is important for you to seek life long fat burning, health and fitness in a lean body, you should take some advice from my mom, and probably your mom too.

When I think about it, probably the best base of nutritional knowledge I received was from my mom. For the most part, my mom was right. She didn't know anything about fat burning, but she made sure I got nutritious foods growing up.

She especially made a point to make sure I ate my vegetables, mainly the green ones. She limited sugary stuff and other junk, but didn't totally eliminate it, making it a special treat for me on occasion. During the day she would give me food from different food groups making sure that I got a good healthy balance from each group.

Thank you, Mom! Mom's diet was actually quite sound, and I've found that heeding some of this advice in the pursuit of maximum body fat burning and a lean healthy body for the rest of your life is a smart way to go.

You see your body naturally craves foods rich in nutrients, (antioxidants, phyto nutrients (plant), fiber, vitamins, minerals, etc.) When you eat most of your meals from foods rich in important nutrients, your body will be satisfied and overeating will no longer be much of a concern.

As a result of eating wholesome foods you will go into a fat burning phase as a natural result of giving your body what it thrives on and needs to be healthy. As a result you will be lowering your risk of disease by promoting a natural alkaline environment in your body when you eat these types of foods.

When you find that you are eating and eating and never seem satisfied then recognize that this is your body telling you that you are not getting the nutrients that your body needs. These are fast food, foods high in fat, high sugar foods, etc that are low in nutrition. This means you will be taking in too many calories.

When you eat excess calories you will continue to gain weight, you will become fatter and you will be more likely to contract the diseases that are related to being overweight. Your body will have an acidic environment, which is an additional risk of disease when you gain weight and fat. You can forget about burning fat when this happens.

Nutrition to control your weight, fitness, and health all work together for your benefit. My Fat Burning Furnace students have changed their lives permanently, by simply altering what they put in their bodies…and you can do it to.

establish an eating program of foods high in nutrients. In part two of this article, I'll get more specific in helping you make the transition from your current lifestyle to the one you desire. This plan will have you burning calories 24 hours a day and 7 days a week.

One of the most significant points to remember in healthy eating is to eat from all of the food groups with a lot of variety and eat them regularly.

The Fat Burning Furnace System - How to Burn Fat While You are Resting!

2010-07-19T15:15:00.000-07:00

Do you ever say or hear other people say this!

”I just don’t have the time to get to the gym”, that is what you hear a million times from people who are trying to burn fat. Well that really shouldn’t be a problem once you understand how you can get an appropriate fat burning workout with basic or minimal equipment.

To excite the growth of lean muscle tissue, to speed up your metabolism and burn fat and also to provide cardiovascular conditioning, you need to perform a variety of exercises that work all of your major muscle groups in the same workout.

This workout is to stimulate the growth of lean muscle tissue which will speed up your metabolism. This is the heart of the Fat Burning Furnace System.

With this schedule you will get a great high intensity fat burning workout, like the students of my Fat Burning Furnace System. You have a selection in what equipment you use. If you are considering expensive equipment or a membership in a fitness center nearby, let me say that it is not really necessary.

For your Fat Burning Furnace System workout all that is required is a set of good old-fashioned barbells and/or dumbbells or less. It is as easy as choosing a good pair of adjustable dumbbells and a common weight bench to exercise your whole body completely. This is an essential component of my Fat Burning Furnace System

The adjustable dumbbells and a simple bench take up very little room in your home. They are always easily accessible and ready to use at a moments notice for those fat burning workouts.

It is very convenient to have your workout apparatus at home to use especially if you need to take care of your kids or have other responsibilities this way you do not have to miss a workout by having the need to travel to the fitness center.

The proper workout takes 15 to 20 minutes and when done at home it is very convenient and takes very little time from your busy schedule. Whether you train at the gym or at home the workout time is the same 15 to 20 minutes, but if you train at home, the time it takes to drive to the fitness studio could be spent doing something important at your home.

I highly recommend getting a basic setup at home for ease of use and to help you to keep on your regular routine with your weight loss. Working out at home is my routine and I personally recommend it as it has many advantages.

Working out at home means that there is no tiresome wait for your next machine. Not waiting is the key to receiving the peak cardiovascular benefits and at the same time building muscle and working out to burn fat.

This will keep your time between your exercises down to 60 seconds or less. You will lose the benefits from a sustained workout when you are at the gym and have to wait 5 or 10 minutes or even longer and your muscles have cooled down.

Home workouts are also great for you in that you might be a bit intimidated by working out with weights in public at the gym. If you feel this way, don’t be upset, you’re not alone. This is especially true for some of some women, as weight training is usually thought of as the guy’s territory in the fitness center.

Nothing could be further from the truth, but if you’d rather perform your fat burning workout at home, then that is an excellent option for you.

When people travel they miss their exercises. For busy people, this is a reality. You travel for your company. You go on vacation. You travel out of town to see friends and family.

The Fat Burning Furnace System workout recommends that you try your best to keep up your exercise routine while you are away from home or the fitness studio.

When your working the Fat Burning Furnace System you’re exercising 2 to 3 days a week, the question is what are you going to do if you’re out of town on the day you are scheduled to work out? There may be a gym in the neighborhood that you could go to.

You may wonder if there is a fitness gym, if there is how far away is it, is it expensive for a couple of workouts, etc.

Don’t be too concerned if you do not have any workout equipment because there are several fat burning exercises you can still do. Exercises like push-ups, chin-ups and sit-ups will give your muscles enough of a workout to keep them conditioned until you return home.

You’re using your body-weight as the resistance, rather than the dumbbells, barbells, or machines. If you work out while you are away from home you will be and stay in very good condition. Remember, if you are away from home you can still choose to have an excellent Fat Burning Furnace System workout.

How To Burn Fat Fast - Using Behavioral Change

2010-07-19T15:07:00.000-07:00

To become a fat burning machine and increase your fat loss, most people know, that you need to increase your metabolism by working out and adding lean muscle mass to your body. There will also be many other benefits that will allow you to live your life in a very healthy way. For this Fat Burning Machine guide we are going to look at how you can use intensity, volume and frequency and progression to lose weight and keep it off forever.

Most people that I see exercising at the fitness studio that are doing weight training or resistance training are using too much of their time with the exercise but not working hard enough. Using a low intensity workout you can only expect to burn a small amount of fat.

The key elements to train for lean muscle and strength is the proper application of three vital elements.

The secret I’ve found is that training for lean muscle and strength requires the proper application of three vital elements that are often overlooked by those who try it. These three elements are:

1. Intensity

2. Volume & Frequency

3. Progression

The intensity is how hard it is to perform for you, given your current physical condition.How much weight you use and how often you do the exercise is called volume and frequency. The progression is determined by how much the demands go up from workout to workout. You will turn into a fat burning machine with these 3 key elements. The Fat Burning Machine system will take you from beginning to lose weight to learning how to keep the weight off permanently.

It is essential that you keep the number of your weekly workouts in check and remember not to workout for too long.

Fat burning aerobic exercise and anaerobic exercise are completely different forms of exercise. In fact, they are complete opposites.

The definition of Aerobic exercise is high volume and frequency, low to moderate intensity, and not much progression. Anaerobic exercise, or weight training, must be performed at a high intensity, lower volume and lower frequency, and with progression to be as effective as possible. The one sure way to become a fat burning machine is through an anaerobic exercise.

You will not increase your strength or your muscle building more than a few short weeks if you are only performing weight training at a low or moderate intensity level.

There are a combination of two objectives and that is to use sufficient intensity along with an increase in the number of reps of a weight training exercise or the amount of weight used in each and every workout. These three steps will continue your bodies development into a fat burning machine!

You will want to maximize your workout and minimize the time you spend in the gym when your are creating an effective and efficient exercise routine and remember the other details. Why?The workout is perhaps not as important as the rest period that follows.You’re not going to get stronger or more muscular if you don’t have sufficient rest and adequate sleep.

When you strength train in the proper way you are creating small injuries to your muscles. You then need to let the body repair itself, and then the body will overcompensate and build upon the already existing amount of muscle mass you have.

If you workout again before that process is completed, you’ll experience lackluster results, if any, muscle building or fat burning results. Your muscles will be overworked to the point where they will not respond to your workout.

Typically you need a minimum of one to three full days of rest between well executed resistance workouts, so be sure you get this amount of rest.

Many people, especially women, think by adding muscle to your body to ensure that you will become a maximum fat burning machine that you will become bigger when they really want to just lose weight!”

But this is such a shame, because it’s very unlikely to happen, and countless women are losing out on these fat burning benefits because of it.

You see, most men and almost all women simply lack the necessary genetic traits required to produce such muscle gains that would cause them to look bulky or overly developed to most people. These traits include testosterone levels, muscle fiber makeup, muscle belly length, and others.

The bodybuilders that you see on TV and in the magazines are competing and are the genetic cream of the crop for muscle development and also they are usually on large doses of anabolic steroids, growth hormones and other bodybuilding drugs.

Don’t be fooled by these images, or those that scare you into thinking this way. Did you know that lean muscle takes up less space on your body and is more compact than fat, and because of this you will in actuality be getting smaller.

Whoever you are, if you want to be in the best position to succeed with you fat loss and also your fitness goals you will perform properly conducted intense resistance training.

But make sure you understand and apply the three critical Fat Burning Machine principles I discussed above.

Here they are again: Intensity, Volume and Frequency and Progression.

If you don't apply these three elements your ability to burn fat and get the lean, strong, and healthy body you deserve eventually will leave you unhappy with your results.

Sports Massage Therapy And Fitness In Anonka County, Minneapolis, St Paul And Blaine MN

2010-04-23T11:45:00.000-07:00

Sports massage therapy is the key to maintaining a fitness regimen instead of starting one only to drop it after getting sore all over. Fitness trainers point out that many people go through the cycle of starting and stopping fitness regimens because of this. The missing factor was sports massage therapy from a professional massage therapist. You can find these qualified therapists at a reputable therapeutic massage spa that also offers reflexology massage therapy, deep tissue massage therapy, Swedish massage therapy and pregnancy massage therapy in Anonka County, Minneapolis, St Paul and Blaine MN.

Experts explain that the muscle soreness usually felt after rigorous exercise is caused by the lactic acid and other metabolic wastes that have built up in the muscles. Massage therapists can use sports massage therapy to successfully and safely flush away such unwanted waste matter. The result is reduced inflammation, minimized soreness and the prevention of cramps. At the same time, massage hydrates the muscles properly by bringing more blood flow. When muscle soreness after exercise is minimized, people are more inclined to continue with their fitness plans.

Sports massage therapy not just minimizes soreness but also reduces the risk of exercise-related or sports-related injury. This is because massage improves flexibility and agility and increases range of motion. Tight muscles are stretched, released and relaxed. Blood circulation is increased and oxygenation is improved. Energy levels are, therefore, maximized. Physical problem areas are also exposed, enabling therapists and trainers to address them appropriately. There is a psychological effect, as well, since massage therapy brings about mental clarity and alertness while dissipating anxiety and nervousness. The net effect for the fitness enthusiast is a more effective and efficient workout. For athletes, this results in better performance.

For many athletes, sports massage therapy is a standard component of training. Experts recommend that sports massage therapy be consistently and regularly done, with the minimum frequency being once a week. The regular massage therapy session should also be done three to four days prior to any competition while a short prep massage of about 15 to 20 minutes should be given within four hours before a sports event.

After a competition, another short massage of about 10 to 15 minutes should again be administered once the athlete has finished cooling down and rehydrating. This post event massage should never be skipped nor should it be postponed to a day or more after the event. The immediate post event massage session will enable the athlete to recover faster from fatigue. In case of any injury incurred, this massage session can provide the earliest appropriate treatment to ensure proper healing and quicker recovery.

For the treatment of sports related injuries, sports massage therapy can ensure the prevention of muscle compensation that creates body imbalance. It also encourages proper cell growth while healing.

You need not confine yourself to sports massage therapy for your fitness regimen, too. You may develop some deep tightness and knots in your muscles that need deep tissue massage therapy. At times, you may be between training sessions or workouts and would just want to relax with Swedish massage therapy. If you have other health concerns, reflexology massage therapy may be the best massage modality for them. Or if you happen to be pregnant, you could still have your own pregnancy fitness regimen supported by special pregnancy massage therapy. For as long as you go to a qualified professional massage therapist at a reputable therapeutic massage spa in in Anonka County, Minneapolis, St Paul and Blaine MN, your specific needs can be met through customized massage sessions. You will surely always emerge fit enough to continue with your fitness routines.

Physical Health and Work Performance: A Healthy Employee Enables a Healthy Work Environment

2010-04-23T11:44:00.001-07:00

Physical health is very important in today's work place. In today's high end technology world it is necessary to work smart and possess great skills. There are many important jobs that require good skills and significant amount of strength to be able to perform at the high level. Physical health and work performance go hand in hand. Mental and physical health plays a very important role for an employee's growth and productivity. It helps to improve the efficiency of the employee, leading to better performance.

Good physical health of workers helps in long-term cost benefit saving. Job performance can be predicted through physical health and physiological wellbeing. The productivity can be increased by good physical health of the workers. A company has comparatively higher percentage of educated and skilled workers, and by implementing an up-dated Industrial Safety Program, there can be a noticeable reduction in major accidents in the factory areas too.

Physical health and work performance of the employee are directly related. Healthy work environment will help in improving his productivity. It helps in giving job satisfaction to the employees. It is used to motivate the employees to work better and in safer manner i.e. work hard and play safe. It helps to reduce the expenses on medical aid. It also helps in reducing the labor turnover rate. Safety of the employees is one of the major concerns of the company.

Consequently adequate attention to the aspect of Industrial Safety and Hygiene for improving the production has been given in the last few years. As brought out earlier, it has formulated a well defined healthy environment, has constituted a safety committee and implemented measures for prevention of accidents and fire. All statutory provisions are being followed. A number of non-statutory provisions are also incorporated to improve professional environment.

In the present industrial environment most of the management of industrial organizations has realized the importance of physical health and work performance and is paying much more attention to healthy working environment than ever before. The statutory provisions made by the government, awareness of the workers and the employers about the importance and advantages of good hygiene for good and healthy working condition which has to be improved, developing healthy working conditions for the employees in the industrial organizations.

Unsafe conditions must be removed and unsafe act totally avoided. That would prevent accidents and thus ensure safety of the employees and that of the plant and machinery. There is a need for management to have a sincere and humanitarian interest in their employees. They must implement a good safety program in their factories. When top management supports good safety program on humanitarian grounds, it contributes towards increased production, lower costs and better profits. There is no doubt that companies have realized its motive of physical health and work performance being inter related by providing a safe and labour friendly environment. In fact, companies have used this as a tool or means to keep harmonious industrial relation.

Improvement in physical health aims at the promotion of the workers physical, mental and social well-being. It will also help to improve the physical health and work performance of the employees resulting in increased morale of the employees who are associated with the work environment.

The amazing HCG crash diet - lose 30 lbs in 30 days.

2010-04-23T11:44:00.000-07:00

The days are getting longer and the skies are starting to clear overhead. But it will take more than that to drag me down to the beach and flaunt my over-sized beer-belly. And as hard as I try, I just can’t seem to lose those excess pounds.

For a long time obesity has been treated as a disorder of eating behaviour, or poor self control. It is now understood that obesity is actually caused by an imbalance of your bodies hormones. Losing weight is always a great challenge and people that want to lose weight go through a lot of struggles and difficulties before they can effectively lose weight and maintain healthy weight. For some of us it is almost an impossible task. When your hypothalamus is overwhelmed by excess energy intake it turns off its normal process of storing energy reserves in the form of "normal" fat storage, and begins banking this energy in an "abnormal" form of fat. This is your typical "problem" areas, such as the abdomen, love handles, thighs and buttocks. If you have been trying various fast diets in an effort to lose weight fast, subjecting yourself through rigorous training schedules yet without any results, don’t worry, a new solution is at hand: A new, effective crash diet program called the HCG Diet. HCG is able to safely alter the body’s fat-storing process so you begin to break down this "abnormal" fat storage and sculpt your body while you lose weight. Imagine a diet where you keep your desired lean muscle mass, and only lose the unsightly fat.

The HCG (human chorionic gonadotropin) weight loss program (also known as the Hormone diet) consists of a very low calorie diet accompanied by treatments of HCG. The average HCG dieter experiences rapid weight loss averaging 1 to 3 pounds per day, most aim to lose 30 pounds in 30 days. In addition to loss of unwanted fat, the true benefit of the HCG protocol is its ability to help modify the dieter's relationship with food and eating, resulting in easily maintained, long-term weight loss. The calorie intake on the diet is only 500 calories per day, but despite this fact you feel full of energy and amazingly not feel hungry. This is because your body is breaking down a pound of fat yielding approximately 3500 calories to provide you with plenty of energy. Most patients report an elevated mood while on this diet.

Where I live in South Florida one of the main forces behind the HCG diet is Dr. Dr Bo Rosenblat. Dr. Bo (as he likes to be called) is a nationally recognized physician, and the medical director of a busy Emergency Department. Dr Bo has written articles on numerous medical topics for online medical websites as well as publication for scientific journals. He had this to say about the HCG diet; “After many years of practice it became evident that obesity is a major contributor to many disease processes such as diabetes, hypertension, elevated cholesterol, heart disease and back pain. Many healthcare professionals were unable to give their patients adequate help in achieving their health goals through proper diet and exercise and most doctors would simply tell their patients that they had to lose weight without giving them the proper tools to do so.”

Realizing that many of the patients he encountered would benefit tremendously from weight loss, Dr Bo began investigating the existing diet programs. Many of these diet programs were prohibitively expensive, or required medications that were dangerous and potentially addictive. After extensive research, he came across the HCG diet program developed by Dr Simeon. It was an optimal program for several reasons. It combined rapid results, safe medications, behavioral modification to improve longevity, and the ability to offer a solution to patients that was affordable. After some minor modifications, Dr Bo began to slowly place his patients on the program. The results were truly remarkable and within a short period of time the program grew exponentially, simply by word of mouth referrals from successful patients.

Dr. Bo continues, “One of the problems with many of the fad weight loss programs is that they give you false hope by making you lose your body’s water content giving you the impression of drastic weight loss. It is very easy to gain back your body’s water content and gain your weight once again. So people get disappointed with the results and end up gaining more weight than before. With our HCG diet program you will not face all such problems. You can actually lose weight by following our diet program. Though it is a fast, crash diet, the weight loss here is of lasting nature. You will not have to worry about bouncing back to your earlier weight.”

Not only is the HCG weigh loss programs one of the most effective and the safest weight loss programs available today, it is also surprisingly very cheap when compared to many other weight loss programs and diets. Dr. Bo showed me a price comparison between several diets (which he has posted on his website, www.drbosdiet.com) and I was amazed at how little the HCG diet could be – between half the price or even a tenth of the price of other popular diets and programs.

So, with one hand holding my love handles and another on my wallet, I think I could be paying a visit to Dr. Bo before this summer comes – then I’ll see you on the beach!

What Is Coronary Artery Disease?

2009-11-27T23:03:00.000-08:00

Coronary artery disease (CAD), also called coronary heart disease, is a condition in which plaque (plak) builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood.

Plaque is made up of fat, cholesterol (ko-LES-ter-ol), calcium, and other substances found in the blood. When plaque builds up in the arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis).

Atherosclerosis

Figure A shows a normal artery with normal blood flow. Figure B shows an artery with plaque buildup.

Plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.

Overview

When your coronary arteries are narrowed or blocked, oxygen-rich blood can't reach your heart muscle. This can cause angina (an-JI-nuh or AN-juh-nuh) or a heart attack.

Angina is chest pain or discomfort that occurs when not enough oxygen-rich blood is flowing to an area of your heart muscle. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back.

A heart attack occurs when blood flow to an area of your heart muscle is completely blocked. This prevents oxygen-rich blood from reaching that area of heart muscle and causes it to die. Without quick treatment, a heart attack can lead to serious problems and even death.

Over time, CAD can weaken the heart muscle and lead to heart failure and arrhythmias (ah-RITH-me-ahs). Heart failure is a condition in which your heart can't pump enough blood throughout your body. Arrhythmias are problems with the speed or rhythm of your heartbeat.

Outlook

CAD is the most common type of heart disease. It's the leading cause of death in the United States for both men and women. Lifestyle changes, medicines, and/or medical procedures can effectively prevent or treat CAD in most people.

Bodybuilding Is Not Just For Posers

2009-11-19T13:37:00.000-08:00

When someone says the word bodybuilding, we tend to think of huge muscled phenomenons standing on stage covered in oil wearing only tiny bikini briefs, but it is only a rare few who commit to the dedication and determination it takes to get their bodies into this freakishly huge state. The fact is, just about anyone can benefit from the principles of bodybuilding both from the aspect of how you look as well as your overall health.

Bodybuilding is simply the process of building muscles and losing fat to accentuate the overall musculature of your body. It is extremely unlikely that you will accidentally build a huge and hulking body just from lifting a few weights which is often the fear of those who stay away from them. It takes years of intense dedication and hours of grueling workouts per day to achieve the physiques of those you see standing on stages, not to mention the occasional illegal chemical helper as well. But just going down to your local gym and deciding to begin a bodybuilding routine to help develop and maximize your physique is not only a great idea, it may lead you to an increased sense of satisfaction and a healthier longer life as well.

Bodybuilding exercises are simply any exercise at all that will allow you to build muscle. Push-ups, for instance, are an incredible bodybuilding exercise that will allow you to build the muscles of your chest, triceps, and shoulders. You can perform them anywhere and they help to build a strong and well-defined chest and shoulder region that can be very effective at turning others' heads.

Of all the bodybuilding exercises in existence, none is perhaps more effective than the King of all exercises, the squat. Performed by lifting a barbell on your shoulders and squatting down until your thighs are parallel with the ground and then rising back up, the squat is known as a compound movement. It can work to build the muscles of your entire lower body and many of those in your upper body as well. It takes extreme physical determination to squat with heavy weights but the payoff can be huge. Squats not only allow you to build muscle but they are great way to burn fat considering how much energy is expended performing this exercise. Combining squats with push-ups and perhaps even pull-ups can provide you all the bodybuilding results you need to get into incredible shape and totally transform the look of your entire body.

When choosing to make bodybuilding a part of your exercise regimen, it's important to pay attention to your diet as well. It almost seems senseless to work hard to build big muscles, and then cover them up with thick layers of fat. You want to eat a diet that contains plenty of lean protein and is lower in fat and carbohydrates. These last two nutrients are important for energy, but you want to limit them to avoid excess fat gain.

There you have it. ANYONE can improve the look of their body through bodybuilding and increase their health as well. Don’t worry about the trunks, the oil, or the posing, just pick up some weights, and you’ll be a bodybuilder too!

What To Do If You 'Fall Off The Wagon' On Your Lap Band Journey!

2009-11-19T13:35:00.000-08:00

No matter what the weight loss plan you follow, there will always be a time in which you 'fall off the wagon'. What does 'falling off the wagon' mean to you? Everyone's journey is unique so everyone's answer will be completely different! Is it one meal? Is it a week of bad eating? A missed session of exercise? No matter what it is, we can all handle it by going about it the same way. For me, I think it's all about getting back on the horse straight away!

I have times like I'm sure everyone else does where I haven't eaten as well as I would like or exercised like I had planned, but that doesn't have to mean the sky is falling and I can't recover. What we all need to do at these times is to pick yourself up, dust yourself off and make the very next decision the best it can be for you to continue on your journey in a positive and nurturing way. It's also a good idea to think back to what was happening before you 'fell off the wagon'. You'll probably find there will be a reason that caused you to make the decision to miss that session or eat that block of chocolate!

As I mentioned before, everyone's journey is unique so we can't all measure ourselves in the same way. This is particularly true in the case of what the numbers are on the scale and what our 'ideal' BMI is. I didn't used to weigh myself as much as I do now and sometimes what the numbers on the scale tell me, make me want to head straight for the fridge, so I've stopped weighing myself as much! I have been doing more exercise lately and my clothes are still continuing to get looser so I like to use other methods than just the scales to help keep the madness at bay! However, some people are very motivated by numbers on the scale! Another thing I used to do was 'wait until Monday'...there are so many of us that are overweight that do just that! I'll start exercising next Monday, I'll start eating better next Monday?! Life's too short waiting for all those Monday's to come, so now I tell myself that it doesn't matter what time or day it is, just do it!!! If you have a meal that is not on your plan, make sure that the very next one is. If you didn't end up doing the exercise you planned, commit to doing it tomorrow.

Here are some tips on how to get back on board and make some positive changes:

* The first key to changing any behaviour is to become aware of the negative behaviour that is occurring. You might think your behaviours are uncontrollable, but there are always triggers that sets them off. Be on the lookout for what you see/hear/feel and tell yourself.

* Once you are conscious of the negative behaviour, then you can start to make some changes. You need to think about replacing a negative behaviour with a positive one, otherwise you may go back to your old ways. What positive and nurturing changes will you make?

* Now that you are aware and you have started to change your behaviour, you need to practice, practice, practice! It's quite possible that you've been doing the old behaviour for years so it's important to keep practising so you develop new, positive, nurturing behaviours to replace the old ones.

* One of the key ingredients to be successful in anything you do in life, no matter what, is to have persistence. Do you give up when the going gets a bit tough or do you keep turning up and change what needs to be changed in order to be successful? It doesn't matter whatever the lapse is that you may have had, it's the very next step you take that is important. We can always do better and we can always keep going!

* A big part of your Lap Band journey is taking responsibility. Do you believe that things are happening TO you or that YOU are making them happen? As we all know, the Gastric Band is only a tool to assist us, ultimately every decision we make is our own. Be careful not to confuse taking responsibility and blaming yourself. You don't want to end up being nasty to yourself!

The important thing with anything in life is to keep turning up, keep persisting and keep try to continually improve. If we keep doing that, we'll get there eventually!

Natural Cures for Urinary Tract Infection - 3 Remedies to Try Today

2009-11-17T14:18:00.003-08:00

Did you know that more people are trying natural cures for urinary tract infections than ever before? It is true that natural health has never been so popular.

In this article, you will learn 3 remedies that will help cure your urinary tract infection.

Urinary Tract Infection Remedies

If you are like the average UTI sufferer, you most likely have already tried antibiotics to cure your infection. Did you know that almost 25% of UTIs will be repeat infections if treated with antibiotics?

It is no surprise that antibiotics do not always do the trick for treating this type of infection. But many sufferers are now trying natural health alternative treatments. In fact, many experts and some doctors are now saying that a healthier diet, the right vitamins and simple lifestyle habits are all it takes to cure UTIs.

Here are 3 effective remedies that you may wish to try today.

Natural Cures for Urinary Tract Infection

1. Your diet is extremely important when it comes to your urinary tract and bladder. There are some simple rules that you must follow in order to flush and kill the bacteria. Try to drink as much water as possible. You should also eat plenty of vegetables because of the high fiber content. Try to eat at least 5 servings a day.

2. You should also immediately begin to supplement 2 capsules of acidophilus with bifidus daily if you have taken antibiotics before. The acidophilus and bifidus help restore a normal pH balance in the urinary system by helping regenerate the "good" bacteria that populates and defends your digestive and urinary tracts. You can also get certain types of yogurt with this!

3. Cranberries, cranberry tablets or unsweetened cranberry juice can also be beneficial. Cranberries contain a special compound that actually works to help flush the E coli bacteria from the bladder. And as you know, E coli is the root cause of this infection.

Cure Yourself in 12 Hours

These 3 remedies are a great place to start for curing your infection at home! If you would like a 100% guaranteed way to cure your UTI, please visit our website today. We offer the only researched and step by step Natural Cures for Urinary Tract Infection Remedy Report that is guaranteed to work!

Training Injury Free

2009-11-17T14:18:00.001-08:00

Remaining injury free is of the utmost importance to all people who exercise but especially to those who are over thirty five years old. Can a person lose fat and gain muscle while sitting on the couch recovering from an injury they incurred while training? The answer is no. The reason my clients achieve superior results is because they continue to diet and workout uninterrupted by injury. In this article I will share some techniques I have used to successfully train clients at high intensity without injury. I do take pride in the fact that none of my clients have been seriously injured while training in over twenty years of practicing my art. Stretching is very important for injury prevention. I use basic stretches for both upper body and lower body to get my client's bodies prepared for the stress of intense exercise. Stretching increases muscular circulation and prepares the tendons, ligaments and joints for the work to be done.Warming up is also important for injury prevention. I always have my clients perform their initial sets for a body part with a light weight for high repetitions, this increases circulation in the area we are working and prepares the tendons, ligaments and joints for the more intense work to come.

When it comes to the nitty gritty of the actual high intensity work, one of the secrets of my success in keeping my clients uninjured is that I avoid fixed movements through pre-set ranges of motion. I favor using dumbbells over barbells and machines almost every time. Dumbbells allow a trainee to use more natural range of motion in all pressing movements such as Chest Presses and Shoulder Presses. For example, instead of doing shoulder presses with a fixed barbell or a machine, I prefer using dumbbells; they allow a trainee to make micro-adjustments in exercise form to avoid overly stressing injured tissue. A client with a micro-injury to a shoulder, for example, can most often comfortably do dumbbell press even at high intensity without a problem even when barbell or machine shoulder presses are impossible due to pain. The barbell or machine often forces the trainee to use an unnatural range of motion which can cause injury or aggravate injuries which already exist.

Many of my friends and associates have injured themselves doing heavy barbell bench presses for chest. I myself long ago have just about quit using barbells and machines altogether for upper body work as a strategy to avoid injury. I am forty one years old and am still able to train at a very high level without time off from injury. It is my desire that this article benefits all who read it,in their quest for greater health, vitality, and wellness.

No More Spare Tires!

2009-11-16T05:16:00.001-08:00

This article will discuss strategies I use as a personal trainer to help people get rid of the spare tire around the middle that so many people desire to lose.

The first and most important part of my program is consistent, regular exercise. The primary reason people put on unwanted body fat is inactivity or too little activity, thus, course of action number one is to remedy this problem with vigorous weight training sessions and challenging cardio workouts.

I'll split up the weight training workouts, making sure to work abs and calves every day:

Monday, chest and arms, Tuesday, shoulders and back, Thursday, legs and butt Friday, chest and arms, Saturday, shoulders and back.

As you can see the whole body will be worked over the course of three workouts and this cycle will be continually repeated Cardio must be done for weight reduction programs and will be done every day weight training is done. Many things can be changed with just the addition of regular exercise, but reducing carbs will help you achieve your goals more quickly. Since we're talking about losing your spare tire, let's focus on abdominal specific exercises.

1.) hanging leg raises
2.) abdominal crunches on a machine
3.) seated trunk rotations on a machine

With regard to nutrition, I will create a totally customized plan for the individual and this program will emphasize reduced carbohydrate and fat consumption. This is a typical program I would use for a 200 lb male. The meals will be precisely three hours apart. Meal one, two full servings of oatmeal, I'll even let you add a little honey; Meal two, one grilled or steamed chicken breast accompanied by a dark, leafy salad; Meal three, eight ounces of tilapia and steamed veggies; Meal four, same as meal three; Meal five, one Muscle Milk protein drink.

If this program is diligently followed the body fat will quickly fall off and I will have a happy and successful client.

At times there are issues which must be overcome with regard to the eating plan. Difficulty keeping the client motivated to eat in a clean and healthy way often crops up. I have clients record what they actually eat and report it to me, this helps a great deal in keeping the clients compliant enough with the eating program to see optimum results. In addition, I use a number of creative, motivational techniques which can also be found in my article "Diet Doldrums." I highly advise you to read this article as well as a motivational aid.

Losing Motivation?

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Many times in my over twenty years as a personal trainer, I have seen clients make awesome progress with regard to following the customized eating plan I give them only to become complacent and slip back into the unhealthy dietary habits that brought them to the point of desperation. The question is how do we maintain the mindset that created success with regard to weight loss. The answer is that we must unswervingly focus on the end goal we established when we http://www.blogger.com/post-edit.g?blogID=3143639634367947233&postID=2642638104399527350began on the program. Let's say a client comes to me who weighs two-hundred and fifty pounds and he desires to take his weight down to two hundred pounds. The client, in order to remain motivated, must constantly, reaffirm the commitment he originally made to drop his weight to two hundred pounds.

I firmly believe in using weight loss related mantras in order to stay motivated. The question is what is a mantra? A mantra is a constantly repeated saying which will affirm the client's goals until the mantra becomes a part of the client's belief system. Is this brainwashing? Maybe, but for thousands of years this has been a method which has been used in religion and in education to form belief systems and ingrain powerful and useful truths. In their spare time, I instruct my clients to constantly repeat the success mantra until it becomes such a part of them that nothing could stop them from achieving their weight loss goal.

Another power technique involves obtaining a picture of a body which is representative of what the client's end goal is regarding appearance. Every day that picture should be looked at, and I instruct the client to spend one half hour creating a mental picture of themselves with this goal body. This technique is called visualization and if practiced with regularity will never fail to aid in the quest to remain motivated.

In order achieve success in their fitness program it is necessary for the client to dedicate themselves in totality in achieving their goals. Success only comes when a person dedicates themselves unreservedly in the pursuit of their goal. No negative self talk can be tolerated; examples of this would be "I have never been able to go more than two weeks on a weight loss diet," or "I will always be fat," statements such as these are the exact opposite of the success mantra described previously in this article. Success mantras, if diligently practiced, will drown out negative self talk. Negative self talk is the number one enemy of program success and must be overcome by diligent practice of the techniques mentioned previously in this article.

Success is a certainty if motivation is maintained and I hope the motivational techniques mentioned in this article will enable you to achieve success in your weight loss endeavor.

Nutrition Basics for New Fitness Disciples

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This article is focused on the basics of nutrition for those who embarking on a fitness/weight training program. Today I'll talk about the three primary sources of calories for human beings. Proteins, carbohydrates, and fats. Protein is of the utmost importance for those trying to improve their bodies. The eating plan for a person trying to improve their physique should have a diet whose foundation is protein. This is what I call the skeleton of a proper eating program. The skeleton of a proper eating program is all of the protein foods the eating plan will contain. The most commonly used protein foods will be meat, fish, poultry, protein supplements, eggs and dairy based protein foods such as cottage cheese. Below I will plot out for you a skeleton of a typical eating program for a personal training client.

1.) upon waking, 3 eggs with an additional 3 egg whites 2.) 3 hours later, 8 oz. of grilled tilapia 3.) 3 hours later, 8 oz. of grilled tilapia 4.) 3 hours later, 8 oz of broiled ground sirloin 5.) 3 hours later, Muscle Milk protein supplement 6.) 2 hours later, 1 cup small curd cottage cheese

As of right now the foundation of a proper eating plan, being protein foods, has been completed. All that is needed is to add carbohydrate foods to the eating program. The level of carbohydrate intake should be tailored to the personal training client's goals. For example a skinny high school kid who wants to gain weight for football would eat a plentitude of carbohydrates. Let's take a look at how an eating program for such an individual might look. What we will do is take the skeleton eating program and add to it.

1.) upon waking, 3 eggs with an additional 3 egg whites, 4 slices toast with jam 2.) 3 hours later, 8 oz. of grilled tilapia, 1 cup white rice 3.) 3 hours later, 8 oz. of grilled tilapia, 1 cup white rice 4.) 3 hours later, 8 oz ground sirloin on a bun with ketchup 5.) 3 hours later, Muscle Milk protein supplement 6.) 2 hours later, 1 cup small curd cottage cheese, with 1 cup chopped pineapple.

Now we will look at a more typical scenario for my personal training clients. Nine out of ten people who come to me for training are coming to lose weight and become more toned and fit. I will use the exact same skeleton eating plan as I did in the other example but this eating plan will be vastly different in the carbohydrate department. Healthy carbohydrate foods are grains, rice, potatoes, whole grain bread, and fruit

1.) upon waking, 3 eggs with an additional 3 egg whites, 2 slices dry rye toast 2.) 3 hours later, 8 oz. of grilled tilapia, 1 cup steamed veggies 3.) 3 hours later, 8 oz. of grilled tilapia, 1 cup steamed veggies 4.) 3 hours later, 8 oz of broiled ground sirloin, 1 large green salad, w vinegarette 5.) 3 hours later, Muscle Milk protein supplement. 1 grapefruit 6.) 2 hours later, 1 cup small curd cottage cheese.

When constructing eating plans for weight loss, you can see that the order of the day is drastic reduction in carbohydrate consumption. No matter what kind of eating program I construct, I never purposely add fat calories. Adequate fat consumption is achieved with the fat that is present in the protein sources.

Want to be shredded? The secret is high protein

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Since the 1950's bodybuilders have been using high protein diets in their quest for leanness and greater muscle definition. Steve Reeves followed a high protein/low carb diet before his Mr. America win. In the 1960's Mr. Olympia Sergio Oliva would change his diet from high protein/high carb in the off season to a high protein/low carb precontest, to dial in his definition in his three Mr. Olympia victories. Arnold Schwarzenegger was famous for his very high protein/low carb precontest diet in his seven Mr. Olympia victories. Frank Zane brought to the sport of bodybuilding an anatomy chart level of definition and achieved it using a zero carb/high protein diet. Athletes, actors and actresses have been using high protein/low carb diets for weight control and weight loss for the last fifty years. The question is why this methodology has been effective for so many, for so long. A high protein/low carb diet allows a person to minimize hunger while reducing calories. This is the premise behind the famous Atkins diet. These type diets allow the dieter to eat plenty of satisfying food while still losing weight. Take a look at the eating plan I recently used to lose 35 lbs in two months.

Meal 1, 6 eggs with cheese. Meal 2, 1 chicken breast and a large salad. Meal 3, 8 oz hamburger in a spinach wrap. Meal 4, 10 oz broiled fish and steamed veggies. Meal 5, Muscle Milk protein supplement. Meal 6, 12 oz broiled tilapia and steamed veggies. By anybody's rating I ate plenty of food yet I was not hungry and I lost a good deal of weight. A recent study by the American Journal of Clinical Nutrition demonstrated that people lost weight and did not feel excessive hunger on a high protein. The proponents of this study determined that that a high protein diet created a greater degree of appetite satiation than did either a high carb or high fat diet. Lose weight without feeling hungry, is this the Holy Grail of weight loss? High protein diets even with low carbs gives the body everything it needs to rebuild itself. An individual can lose fat and gain muscle at the same time on a high protein low carb diet.

What does this mean for people trying to improve their bodies? This means with a little discipline and organization an individual can lose weight without starving and without getting weak and feeble. We all know as a nation, we collectively need to lose weight. I call on our leaders to do their part and direct the masses in embracing high protein/low carb lifestyle eating.