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Surprising symptoms of an Unhealthy Heart

We’ve all read the signs of a heart attack listed on posters in the hospital waiting room. But what if there were other, earlier signs that could alert you ahead of time that your heart was in trouble?

It turns out there are. Researchers have done a lot of work in recent years looking at the signs and symptoms patients experienced in the months or even years leading up to a heart attack. “The heart, together with the arteries that feed it, is one big muscle, and when it starts to fail the symptoms can show up in many parts of the body,” says cardiologist Jonathan Goldstein of Saint Michael’s Medical Center in Newark, New Jersey. Here are seven surprising clues that your heart needs a check. Any of these signs — and particularly two or more together — should send you to the doctor for tests.

Sexual problems

Something cardiologists know but the average guy doesn’t: Erectile dysfunction (ED) is one of the best early tip-offs to progressive heart disease. “Today, any patient who comes in with ED should be considered a cardiovascular patient until proven otherwise,” says Goldstein. In women, reduced blood flow to the genital area can impede arousal, make it harder to reach orgasm, or make orgasms less satisfying.

Scary stat: Researchers at the Mayo clinic followed men ages 40-49 with erectile dysfunction and found they were twice as likely to develop heart disease as those with no sexual health problems. Another study looked backward and found that two out of three men being treated for cardiovascular disease had suffered from erectile dysfunction, often for years, before they were diagnosed with heart trouble.

Why it happens: Narrowing and hardening of the arteries restricts blood flow to the penis, which can give men trouble when it comes to getting or keeping an erection. And because those arteries are smaller than the ones leading to the heart, erectile dysfunction can occur before any other sign of artery stiffness. Lack of oxygen can also lead to ongoing fatigue and weakness, which can sabotage libido, so lack of desire may accompany lack of success.

What to do: If you or your partner has difficulty getting or maintaining an erection or has problems with sexual satisfaction, that’s reason enough to visit your doctor to investigate cardiovascular disease as an underlying cause. Get a full workup to assess possible causes of erectile dysfunction or difficulty with orgasm. (Guys, see your GP, not just a urologist; gals, don’t just see an ob/gyn.) If your doctor doesn’t mention heart tests, request them.

Read about Cardiac Arrest VS Heart Attack
Snoring, Sleep Apnea

If you snore loudly enough to keep your sleeping partner awake or to force him or her to resort to earplugs, your heart may be at risk as well. Restricted breathing during sleep — the underlying cause of snoring — is linked with all types of cardiovascular disease. Sleep apnea, in which breathing briefly stops during sleep, is linked with a higher risk of both cardiovascular disease and heart attack.

Scary stat: Those with sleep apnea were found to have three times the normal risk of having a heart attack within five years.

Why it happens: Sleep-disordered breathing, which includes sleep apnea and a lesser condition known as UARS, lowers the blood oxygen that feeds the heart. Obstructive sleep apnea is thought to damage the right side of the heart, which has to pump harder to support the lungs, which are strained by trying to overcome the airway obstruction.

What to do: Any sleep-related breathing problem is a clue that something’s wrong, so call the doctor. She may recommend a sleep study, but get your heart checked out too.

Sore, swollen, or bleeding gums

Sore, swollen, or bleeding gums are symptoms not only of periodontal disease — in which exposure to bacteria causes the gums to become inflamed and pull away from the teeth — but also a possible early sign of underlying cardiovascular disease.

Scary stat: A 2010 study by the American Academy of Periodontology (AAP) estimated that the prevalence of periodontal disease may be underestimated by as much as 50 percent.

Why it happens: Experts believe that poor circulation due to heart disease could be an underlying cause of periodontal disease. Researchers are also studying whether a common bacteria is involved in both gum disease and plaque buildup inside coronary arteries.
What to do: See a dentist to treat gum disease and prevent the presence of bacteria. Because gum disease can be a red flag for inflammation and circulatory problems, ask your doctor if ongoing gum symptoms warrant a checkup.

Puffy or Swollen Legs

If you notice that your feet swell enough to make your shoes tight; your ankles, wrists, or fingers are noticeably puffy; or there are deep pressure marks or indents when you take off socks or hose, you may have a problem with fluid retention. Also called edema, fluid retention can be a sign of coronary artery disease (CAD), heart failure, and other forms of cardiovascular disease.

Scary stat: More than 80 million people have one or more forms of cardiovascular disease, and approximately 900,000 people die from it each year.

Why it happens: Fluid retention occurs when the heart doesn’t pump strongly enough and blood doesn’t carry waste products away from tissues. Edema usually starts in the feet, ankles, fingers, hands, and legs because they’re furthest from the heart, where circulation is poorer.

What to do: Report problems with edema to your doctor, who can run tests that may indicate CAD and can determine if your heart function is normal.

Shortness of Breath (SOB)

An early sign that something is wrong with a major bodily system is shortness of breath, typically with exercise, exertion, and stress. (Typically, shortness of breath indicates either early-stage heart disease or early-stage lung disease, and it’s not possible to know which it is without seeing a doctor.) It may feel like you can’t catch your breath, or you may notice a feeling of compression in the chest and lungs, making it difficult to take a deep breath. Another breathing symptom of poor circulation may be labored breathing, which occurs when fluid accumulates in the lungs. If you notice that your breathing problems are worse at night or anytime you lie down, that can also indicate a heart problem.

Scary stat: In a landmark study by the National Institutes of Health (NIH) published in Circulation: Journal of the American Heart Institute, 95 percent of women who’d had heart attacks reported experiencing unusual symptoms in the weeks and months before the attack, and 40 percent reported shortness of breath.

Why it happens: When your heart isn’t pumping strongly enough, less oxygen circulates in your blood. The result is shortness of breath; you might feel like you do at high altitude or when you’ve run for the bus, unable to draw enough oxygen into your lungs.

What to do: Shortness of breath, either with exercise and stress or all the time, is always a reason to see the doctor for a checkup, since it can be a symptom of a number of serious conditions.

Constriction or aching in the chest or shoulder

The most common symptom of coronary artery disease (CAD) is angina, a type of chest pain. Angina (officially called angina pectoris) is different from the sharp clutching pain of a heart attack; it’s likely to feel like a deep ache or a constriction or weight on the chest, and it may worsen when you draw in a breath. One of the reasons angina is often missed is that it feels different to different people; to some it’s more of a heaviness, fullness, or pressure rather than pain. It can also be mistaken for indigestion or heartburn when the pain occurs lower down in the abdominal area. The tightness, constriction, or pain may also occur in the shoulder, neck, jaw, arm, or upper back, where it may be mistaken for a pulled muscle.

A tip-off to angina versus a pulled muscle or gastrointestinal problem is that you’re likely to experience the problem repeatedly rather than to have one isolated or prolonged episode.

Scary stat: According to the National Heart, Lung, and Blood Institute, 17 million people are living with angina. Cases of angina are divided almost equally between men and women, with men being slightly more at risk.

Why it happens: When plaque builds up in the coronary arteries, it deprives the heart muscle of blood, making it feel squeezed. Most people with stable angina find that episodes are most often triggered by anything that puts an additional strain on the heart, such as exercise or stress.

What to do: If you’re diagnosed with angina, your doctor will recommend resting when episodes occur; or she may prescribe nitroglycerin, which relaxes the coronary arteries and other blood vessels, increasing blood supply to the heart and easing its workload.

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Assessment and diagnosis for successful pain management

To provide optimal patient care, nurses require appropriate knowledge, skills and attitudes towards pain, pain assessment and its management. This must be based on the best available evidence to prevent patients from suffering harm (NMC, 2008 ). It is unacceptable for patients to experience unmanaged pain or for nurses to have inadequate knowledge about pain and a poor understanding of their professional accountability in this aspect of care (Dimond, 2002).
Pain - The fifth vital sign

Pain has been identified as the fifth vital signs by Australian and New Zealand College of Anaesthetists and the Chronic pain Coalition in an attempt to facilitate accountability for pain assessment and management (Chronic Pain Policy Coalition, 2007; ANZCA, 2005).
Education

Pre-registration nursing programmes should incorporate pain as a compulsory component, to equip future nurses with the knowledge, skills and attitude to carry out appropriate pain assessment and management from the start of their professional careers. This could result in all patients receiving a higher standard of pain assessment and management in the future and reduce the incidence of unnecessary suffering (Wilson, 2007).
Why is assessment important?

Assessment of a patient’s experience of pain is a crucial component in providing effective pain management. A systematic process of pain assessment, measurement and re-assessment (re-evaluation), enhances the health care teams’ ability to achieve:
a reduced experience of pain;
increased comfort;
improved physiological, psychological and physical function;
increased satisfaction with pain management.

Pain is not a simple sensation that can be easily assessed and measured. Nurses should be aware of the many factors that can influence the patients overall experience and expression of pain, and these should be considered during the assessment process. Fig 1 illustrates the factors involved in the experience of pain.
Pain assessment and measurement

The pain assessment involves:
an overall appraisal of the factors that may influence a patients experience and expression of pain (McCaffery and Pasero 1999)
acomprehensive process of describing pain and its effect on function;
an awareness of the barriers that may affect nurses assessment andmanagement of pain. These include:
- inadequate skills, knowledge, attitudes and beliefs about pain, its assessment and management and the nurses experience (Hall-Lord and Larsson, 2006);
- poor documentation of pain, its assessment, management and re-evaluation;
- patients’ age, type and stage of illness (Hall-Lloyd and Larson, 2006) - older people are less likely to report pain despite evidence showing that they are more likely to experience at least one concurrent problem with pain, for example, musculoskeletal pain or pain associated with peripheral vascular disease (British Pain Society and British Geriatric Society, 2007);
- Myths and misconceptions about pain and its management, for example, fear that patients with acute pain can easily become addicted to their pain medication (McCaffery et al, 2005).
Watch video on Pain Assessment in Older Adults
Measuring pain

Pain should be measured using an assessment tool that identifies the quantity and/or quality of one or more of the dimensions of the patients’ experience of pain. This includes the:
intensity of pain;

Pain Assessment in older Adults

Also read Assessment of Pain and its Scales click here

Fall Risk Assessment in seniors

Aso Read MORSEY FALL RISK ASSESSMENT SCALE

Morse Fall Scale

Item	Item Score	Patient Score
1. History of falling (immediate or previous)	No   0 Yes   25	______________
2. Secondary diagnosis (≥ 2 medical diagnoses in chart)	No   0 Yes   15	______________
3. Ambulatory aid None/bedrest/nurse assist Crutches/cane/walker Furniture	0 15 30	______________
4. Intravenous therapy/heparin lock	No   0 Yes   20	______________
5. Gait Normal/bedrest/wheelchair Weak* Impaired†	0 10 20	______________
6. Mental status Oriented to own ability Overestimates/forgets limitations	0 15	______________
Total Score‡: Tally the patient score and record. <25: br="" low="" risk="">25-45: Moderate risk >45: High risk		______________

* Weak gait: Short steps (may shuffle), stooped but able to lift head while walking, may seek support from furniture while walking, but with light touch (for reassurance).
† Impaired gait: Short steps with shuffle; may have difficulty arising from chair; head down; significantly impaired balance, requiring furniture, support person, or walking aid to walk.

Also watch Video on Fall Assessment in Seniors

‡ Suggested scoring based on Morse JM, Black C, Oberle K, et al. A prospective study to identify the fall-prone patient. Soc Sci Med 1989; 28(1):81-6. However, note that Morse herself said that the appropriate cut-points to distinguish risk should be determined by each institution based on the risk profile of its patients. For details, see Morse JM, Morse RM, Tylko SJ. Development of a scale to identify the fall-prone patient. Can J Aging 1989;8;366-7.

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Table of Contents:

Abdominal Aortic Aneurysm through Burns…
Abdominal Aortic Aneurysm
Abdominal Trauma
Abortion, Spontaneous
Abruptio Placentae
Acid-Base Imbalances: Metabolic Acidosis and Alkalosis
Acquired Immunodeficiency Syndrome
Acromegaly
Acute Adrenal Crisis
Acute Alcohol Intoxication
Acute Respiratory Distress Syndrome
Adrenal Insufficiency (Addison's Disease)
Air Embolism
Alcohol Withdrawal
Allergic Purpura
Alzheimer's Disease
Amputation
Amyloidosis
Amyotrophic Lateral Sclerosis
Anaphylaxis
Angina Pectoris
Anorectal Abscess and Fistula
Anorexia Nervosa
Aortic Insufficiency
Aortic Stenosis
Aplastic Anemia
Appendicitis
Arterial Occlusive Disease
Asthma
Atelectasis
Atrial Dysrhythmias
Basal Cell Epithelioma

Vit D and Smoking

Life of Love

Health Indicators of Pakistan (Mortality Rates)

Life expectancy at birth, female (years)                              67

Life expectancy at birth, male (years)                                 65

Life expectancy at birth indicates the number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life.

Mortality rate, under-5 (per 1,000 live births)                    86

Under-five mortality rate is the probability per 1,000 that a newborn baby will die before reaching age five, if subject to current age-specific mortality rates.

Mortality rate, infant (per 1,000 live births)                       69.3

Mortality rate, adult, male (per 1,000 male adults)            190.1

Mortality rate, adult, female (per 1,000 female adults)      157.0

Death rate, crude (per 1,000 people)                                    7.0

Reference:

http://search.worldbank.org/data?qterm=maternal+mortality+rate&language=EN&format=