Heart Disease Risk – What? Me Worry???

NurseBob

Bob

I’ve been talking about heart attacks, what the symptoms are, how the symptoms may differ between men and women, what they actually are, what causes them, and what may happen as a result.  Now it’s time to talk about risk factors for developing heart disease. Continue reading

Heart Attack! What is it? What causes it? What’s going to happen to me?

NurseBob

Bob

What is a Heart Attack? My very short description would be: A reduction, or complete loss of blood flow to some or all of the heart, which causes the heart tissue to begin to die. The longer the loss of flow lasts, the more tissue that dies.
Pretty general, don’t you think? Doesn’t tell you much, such as what caused it, or more importantly, what’s going to happen to you.  The flippant answer to that one is: It Depends…  As always, the devil is in the details.  What does it depend on? Well, what caused the loss of flow? How  complete is the is the loss of flow?  How much of your heart is affected?   How healthy is your heart?  How healthy are you? Continue reading

Food and Water at the End-of-Life – What’s “Normal”?


NurseBob

NurseBob

Before I can talk about possible problems with TPN at the End-of-Life, I need to lay a quick foundation describing what the “normal” components are in the blood when we’re healthy, and how those components function to help maintain the balance of fluids in the blood and in the tissues. The scientific term for this is “osmolarity” – which in the most general sense, refers to the concentration of the various components dissolved in water. But in addition to their concentration, it also is related to how big the molecules are that make up these components. The reason that “osmolarity” is so important is that it plays a very significant role in determining whether the blood is loosing water to the surrounding tissues, or pulling it in. If the blood is loosing water to the tissues it can result in dehydration, edema, or in severe cases, anasarca.
In this blog entry, I’ll give you both some definitions of the terms I just introduced, as well as some examples.  In my video blog, I will be showing how these processes work using both some animation, and a short time-lapse video.
So, what are the major players among the blood components? Well, of course there are inorganic salts (primarily table salt)  and sugar (glucose), as well as a number of other organic components and proteins.  When it comes to managing the amount of water in the circulatory system, all of the components just mentioned play a role, but one of the more important components is a protein called albumin (which is manufactured by the liver).  When the level of albumin in the blood serum drops, the water normally contained in the blood and blood vessels begins to leak out of the blood and into the tissue.  The “why” for this leakage is due, in part, to the change in the balance of osmolarity between the blood and the fluids in the tissue surrounding the blood vessels.

Osmolarity is one of those “scientific” terms, which as I mentioned earlier, generally refers to the concentration of various substances in water.  The Wikipedia entry for Osmolarity is too complex for the purposes of my blog.  The very high-level explanation I’ll offer is that it’s a way of determining the total concentration of multiple substances in a sample of water.  If there are two samples with different osmolarity, the one that has a higher value will tend to draw water from the lower value.
This flow is called osmosis – and the direction is determined by the osmolarity.  In short, water moves from the lower to the higher concentration in an attempt to make the two samples equal. (Remember the old adage:  Nature abhors a vaccuum?  Well, Nature “hates” any imbalance!).  Another way to think of osmosis is that if there are two samples with water, each with different substances dissolved, the water will tend to flow from the sample with more water to the one with less water.  Think of it as water flowing “downhill.”
Well then, when we have blood in the circulatory system with fewer dissolved substances in it than the fluid surrounding the cells in the tissue – the water will migrate from the blood, through the walls of the blood vessels, and into the fluid in the tissue.  The net result is that you end up “dehydrated” from the perspective of the circulatory system, but swollen from the resulting increase in water in the tissue – this is edema.


Stay Well -NurseBob

visit my video blog for other health information


References Researched
References

Famous Last Words: “I Think It’s Just Heartburn” – Heart Attack Symptoms for Men

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NurseBob

NurseBob

Ok guys, this is not the time to be macho, “play with pain,” or otherwise tough-it-out. Better safe than sorry may well be a life-saver. While it may be mildly embarrassing to visit the emergency department only to find out it was the “7 jalapeno taco special,” there is no practical way for you to self-diagnose and determine that the pain is not from your heart crying-out that it’s dying.  Not unless you have an EKG machine out in the home workshop, and know how to read the results…

So, what’s the deal?  Time is muscle – that is, the longer you play with pain, pain which can indicate the muscle cells are dying, the more of your heart muscle is permanently lost, to be replaced by useless scar tissue, a bulging weak spot in your heart.

What causes the pain, you ask?  The heart muscle, similar to other muscles in your body, likes to “burn” glucose to stoke its fires.  To effectively do so, it needs BOTH glucose and oxygen.  That particular metabolic pathway makes very efficient use of all the energy stored in that simple sugar.  Where does it get both the fuel and the oxidizer from?  The blood!  What happens when there’s no blood? Maybe there’s a small clot in one of the little arteries supplying a small section of the heart (if you’re lucky).  Just like kinking a hose, nothing flows past, no blood, no glucose, no oxygen.  What’s a lonely, starving little heart cell to do? It tries to use it’s emergency supplies!  It uses glycogen (a stored form of glucose), and breaks it down for the contained energy without using oxygen.

While the large skeletal muscle cells have a relatively large supply of glycogen, the heart muscle cells don’t.  So they burn through their stores very quickly.  By the way, when your other muscles switch over to this alternative pathway (anaerobic – no oxygen) and burn glycogen, one of the byproducts is lactic acid – which is responsible for the “burn” when you exercise heavily.  That “burn” is a component of chest pain.  The difference between heart and skeletal muscle?  In the heart, the burn is almost instant – as opposed to the large muscles where it takes some time to develop.  This burn is your early warning, because shortly after, the cells begin to die, and for all intents and purposes, they are not replaced with new muscle cells, just scar tissue.

So, what are the classic heart attack symptoms for men?
Shortness of Breath
Chest discomfort – “uncomfortable pressure, squeezing, fullness or pain.
(Which may include the jaw, or arm)
Cold sweat
Nausea
Lightheadedness


Want to know more?
WebMD – Heart Attack Symptoms In Men
American Heart Association – 911 Warning Signs of a Heart Attack
Cardiovascular Physiology Concepts – Myocardial Metabolism
SportsMedicine – Lactic acid does more than cause fatigue


Stay Well -NurseBob

Visit my Video Blog for more health information.


References Reviewed

Women are Atypical… Heart Attack Symptoms


NurseBob

NurseBob

If you’re feeling unusually tired, or short of breath, experiencing a nagging back-ache between the shoulder blades, is your first thought  – “Gee, I wonder if I’m having a heart attack?”  For the average woman, probably not.  Due to the research focus on men over the last several decades, based on a now identified erroneous assumption that men and women were the same, at least as far as heart attack symptoms were concerned, there was an unintentional bias in both the reporting and descriptions of  “typical” heart attack symptoms.
Heart disease is the leading cause of death for women, and while heart attacks are not the only thing “heart disease” relates to, they are certainly a significant item on the list.
First, what should you do if you think, just maybe, you might be having a heart attack?  Don’t hesitate, and don’t be embarrassed to seek emergency medical attention – in short, don’t wait it out.  While it may be indigestion, stress, anxiety, etc., the adage is: “Time is Muscle.”  If the heart is starving for blood, the longer you wait the greater the damage.  And one truism when it comes to heart tissue, once it’s gone, it won’t grow back.  A second fact: if caught early, before heart muscle has died, the damage can be reversible.


Want to learn more?
American Heart Association
Heart Attack Symptoms in Women
Do You Know Which Symptoms Signal a Heart Attack in Women?
Are you having a heart attack?


Stay Well -NurseBob

Visit my Video Blog for more health information.