Some say a particular person is quarrelsome, angry and argumentative etc. But how those modes of expression came to existence? If those were not needed how come they have a place in our day to day life! Silent sufferers are more prone to heart attack as the bad feeling remains within and smokes inside. That creates stress followed by stress related hormone secretion. So, it is better ventilate the grievances or the bad feeling. One may quarrel even with the boss; of course, in a healthier way to express his stand on a particular issue. One may cry to relieve the tension. I support it.
Some years back, one of my friends asked me that a person known to him is having pain in the left arm while walking, compelling him to take a break; and gets back the pain sometimes after resuming his walk. I suggested an electrocardiogram (ECG), and as expected by me a coronary artery disease was diagnosed. This symptom is somewhat a tale tell story of angina pain of heart. In my childhood, I have seen dancing of some superficial arteries of old aged persons and surprised over it; now, I am clear about its cause i.e. it is due to thickening of wall of peripheral arteries from atherosclerosis. In atherosclerosis; there occurs deposit of cholesterol, calcium, some blood cells and some other components in the inner layer of blood vessels called intima. This is equally seen larger as well as smaller blood vessels in the body. Smoking is an important cause of atherosclerosis.
Recently, researchers have found out the role of immune cells in the formation of atheroma after triggering an inflammation in the intima of blood vessels. Drugs targeting these cells also cause harm to useful effects of these cells. So, now they are targeting research, how to destroy the bad effect of cells leaving ahead the good effects. They also found out one molecule that switches on the harmful effect of these immune cells. The new research will be focusing more on blocking the action of the molecule.
Pot bellied persons due excess abdominal fat; the apples are prone to develop atherosclerosis than the pears; persons having fat deposit around hip, researchers say. Smoking, alcohol, sedentary life style and more saturated fat consumption are some of the contributing factors for atherosclerosis. Measurements of waist circumference (WC), waist to hip ratio (WHR) and Body mass index (BMI) are some of predictors of risk of heart attack. Waist circumference >32 inches in female and >37 inches in male have the risk of heart attack. Persons having WHR > 0.7 and BMI >30 are at the risk of developing atherosclerosis.
Aspirin appeared and used fro treatment of headache alone or in combination with paracetamol and caffeine long time back .It was very much an effective remedy.But is notorious to cause stomach problem in form of gastritis, ulcers and bleeding.Then it was not used for many years till its beneficial effect in myocardial ischaemia and infarction was rediscovered.In low doses, as low as 75 mgs per day is prescribed to myocardial infarction patients to keep their blood more fluid i.e. to prevent thrombosis.It is also prescribed in combination with other thrombolytic agents.The advantage it has is low cost and easy availability. It is said that if heart attack is suspected and nothing is found a tablet of aspirin will prevent much damage to heart muscle.The potential side effect ,gastrointestinal bleeding can be prevented by other anti-ulcerogenic drugs. Researchers also say that aspirin helps in early diagnosis of colon cancer.The hall mark of colon cancer is painless bleeding per anus besides other symptoms.the bleeding tendency is probably facilitated by aspirin. It is still the drug of choice for a very important disease called Rheumatic arthritis having much dreaded sequelae of rheumatic heart disease. So in right doses and judicious combination it is a panacea for health.
Some eleven years back one known to me asked about his relative who was getting pain in his left shoulder and becoming breathless while walking.The presumptive diagnosis was somewhat straight forward.And an ECG revealed that he is suffering from Myocardial Ischaemia.The typical description of angina pectoris pain is a feeling of severe compression of chest ,a squeezing or a sharp pain in the left lower chest lasting for minutes and radiating to neck,shoulder tip,axilla,Lt. arm,back,right side of chest and upper abdomen.Unfortunately this typical description is lacking in many.
Other symptoms of Myocardial Ichaemia include sweating,breathlessness,stupor,fainting , vomiting and many other atypical ones. But in a physically active person with regular brisk walk having some burning symptom of upper abdomen and normal ECG in two different occassions ,it is hard to digest that he is suffering from myocardial ischaemia.But later his description of this burning sensation and discomfort of upper abdomen while walking, compelling him to take breaks two to three times in about two kilometers distance should have given rise to suspicion of ischaemia. Eventually an ECG on that day revealed a change in ECG prompting an urgent treatment.Further an angiography revealed narrowing in one of the branches of a main coronary artery and he was treated according.Also it was noticed that the artery in question was little less in caliber than usual.During review of literature in the Wiley Interscience database it was seen that narrow coronay may go for spasm.And I think this must be happening during an exercise while there is demand for more oxygen in the myocardium i.e. heart muscle.
But the lesson is that highest degree of suspicion till ischaemic heart disease is excluded confidently.
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Headache ???
