Dr Haroon Child Specialist

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18/06/2018
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25/08/2017

From:
The Desk of
Dr.Sohail Haroon
MD, D.Peds,, MICP, (Eng) FACIP, (USA)
DDCT, (Geneva) EMBRO/EPI. (Alexandria)
Haroon’s Children Clinic & Family Physician.

Date :- Subject :-

What is atheromatous disease of the aorta?

Atherosclerosis is a major cause of abdominal aortic aneurysm and is the most common kind of arteriosclerosis, or hardening of the arteries. This disease process can be seen in any blood vessel in the body and is the cause of coronary artery disease, stroke, and peripheral arterial disease (PAD).

Atherosclerosis is a process in which blood, fats such as cholesterol, and other substances build up on your artery walls. Eventually, deposits called plaques may form. The deposits may narrow — or block — your arteries. These plaques can also rupture, causing a blood clot.

The main cause is atherosclerosis, when deposits known as atheromatous plaques are formed, mainly of cholesterol, in the walls of arteries and cause narrowing of the lumen, e.g. in the coronary arteries (leading to angina or thrombosis), in the cerebral arteries (leading to stroke or senile dementia) or in arteries in …

Atherosclerosis, a progressive process responsible for most heart disease, is a type of arteriosclerosis or hardening of the arteries. An artery is made up of several layers: an inner lining called the endothelium, an elastic membrane that allows the artery to expand and contract, a layer of smooth muscle, and a layer of connective tissue. Arteriosclerosis is a broad term that includes a hardening of the inner and middle layers of the artery. It can be caused by normal aging, by high blood pressure, and by diseases such as diabetes. Atherosclerosis is a type of arteriosclerosis that affects only the inner lining of an artery. It is characterized by plaque deposits that block the flow of blood.
Plaque is made of fatty substances, cholesterol, waste products from the cells, calcium, and fibrin, a stringy material that helps clot blood. The plaque formation process stimulates the cells of the artery wall to produce substances that accumulate in the inner layer. Fat builds up within these cells and around them, and they form connective tissue and calcium. The inner layer of the artery wall thickens, the artery's diameter is reduced, and blood flow and oxygen delivery are decreased. Plaques can rupture or crack open, causing the sudden formation of a blood clot (thrombosis). Atherosclerosis can cause a heart attack if it completely blocks the blood flow in the heart (coronary) arteries. It can cause a stroke if it completely blocks the brain (carotid) arteries. Atherosclerosis can also occur in the arteries of the neck, kidneys, thighs, and arms, causing kidney failure or gangrene and amputation.

Causes and symptoms

Atherosclerosis can begin in the late teens, but it usually takes decades to cause symptoms. Some people experience rapidly progressing atherosclerosis during their thirties, others during their fifties or sixties. Atherosclerosis is complex. Its exact cause is still unknown. It is thought that atherosclerosis is caused by a response to damage to the endothelium from high cholesterol, high blood pressure, and cigarette smoking. A person who has all three of these risk factors is eight times more likely to develop atherosclerosis than is a person who has none. Physical inactivity, diabetes, and obesity are also risk factors for atherosclerosis. High levels of the amino acid homocysteine and abnormal levels of protein-coated fats called lipoproteins also raise the risk of coronary artery disease. These substances are the targets of much current research. The role of triglycerides, another fat that circulates in the blood, in forming atherosclerotic plaques is unclear. High levels of triglycerides are often associated with diabetes, obesity, and low levels of high-density lipoproteins (HDL cholesterol). The more HDL ("good") cholesterol, in the blood, the less likely is coronary artery disease. These risk factors are all modifiable. Non-modifiable risk factors are heredity, s*x, and age.
Risk factors that can be changed:
• Cigarette/tobacco smoke-Smoking increases both the chance of developing atherosclerosis and the chance of dying from coronary heart disease. Second hand smoke may also increase risk.
• High blood cholesterol-Cholesterol, a soft, waxy substance, comes from foods such as meat, eggs, and other animal products and is produced in the liver. Age, s*x, heredity, and diet affect cholesterol. Total blood cholesterol is considered high at levels above 240 mg/dL and borderline at 200-239 mg/dL. High-risk levels of low-density lipoprotein (LDL cholesterol) begin at 130-159 mg/dL.
• High triglycerides-Most fat in food and in the body takes the form of triglycerides. Blood triglyceride levels above 400 mg/dL have been linked to coronary artery disease in some people. Triglycerides, however, are not nearly as harmful as LDL cholesterol.
• High blood pressure-Blood pressure of 140 over 90 or higher makes the heart work harder, and over time, both weakens the heart and harms the arteries.
• Physical inactivity-Lack of exercise increases the risk of atherosclerosis.
• Diabetes mellitus-The risk of developing atherosclerosis is seriously increased for diabetics and can be lowered by keeping diabetes under control. Most diabetics die from heart attacks caused by atherosclerosis.
• Obesity-Excess weight increases the strain on the heart and increases the risk of developing atherosclerosis even if no other risk factors are present.

Risk factors that cannot be changed:
• Heredity-People whose parents have coronary artery disease, atherosclerosis, or stroke at an early The progression of atherosclerosis. (Illustration by Hans & Cassady.)�����age are at increased risk. The high rate of severe hypertension among African-Americans puts them at increased risk.
• Sex-Before age 60, men are more likely to have heart attacks than women are. After age 60, the risk is equal among men and women.
• Age-Risk is higher in men who are 45 years of age and older and women who are 55 years of age and older.
Symptoms differ depending upon the location of the atherosclerosis.
• In the coronary (heart) arteries: Chest pain, heart attack, or sudden death.
• In the carotid (brain) arteries: Sudden dizziness, weakness, loss of speech, or blindness.
• In the femoral (leg) arteries: Disease of the blood vessels in the outer parts of the body (peripheral vascular disease) causes cramping and fatigue in the calves when walking.
• In the renal (kidney) arteries: High blood pressure that is difficult to treat.

Diagnosis

Physicians may be able to make a diagnosis of atherosclerosis during a physical exam by means of a stethoscope and gentle probing of the arteries with the hand (palpation). More definite tests are electrocardiography, echocardiography or ultrasonography of the arteries (for example, the carotids), radionuclide scans, and angiography.
An electrocardiogram shows the heart's activity. Electrodes covered with conducting jelly are placed on the patient's body. They send impulses of the heart to a recorder. The test takes about 10 minutes and is performed in a physician's office. Exercise electrocardiography (stress test) is conducted while the patient exercises on a treadmill or a stationary bike. It is performed in a physician's office or an exercise laboratory and takes 15-30 minutes.
Echocardiography, cardiac ultrasound, uses sound waves to create an image of the heart's chambers and valves. A technician applies gel to a hand-held transducer, presses it against the patient's chest, and images are displayed on a monitor. This technique cannot evaluate the coronary arteries directly. They are too small and are in motion with the heart. Severe coronary artery disease, however, may cause abnormal heart motion that is detected by echocardiography. Performed in a cardiology outpatient diagnostic laboratory, the test takes 30-60 minutes. Ultrasonography is also used to assess arteries of the neck and thighs.
Radionuclide angiography and thallium (or sestamibi) scanning enable physicians to see the blood flow through the coronary arteries and the heart chambers. Radioactive material is injected into the bloodstream. A device that uses gamma rays to produce an image of the radioactive material (gamma camera) records pictures of the heart. Radionuclide angiography is usually performed in a hospital's nuclear medicine department and takes 30-60 minutes. Thallium scanning is usually done after an exercise stress test or after injection of a vasodilator, a drug to enlarge the blood vessels, like dipyridamole (Persantine). Thallium is injected, and the scan is done then and again four hours (and possibly 24 hours) later. Thallium scanning is usually performed in a hospital's nuclear medicine department. Each scan takes 30-60 minutes.
Coronary angiography is the most accurate diagnostic method and the only one that requires entering the body (invasive procedure). A cardiologist inserts a catheter equipped with a viewing device into a blood vessel in the leg or arm and guides it into the heart. The patient has been given a contrast dye that makes the heart visible to x rays. Motion pictures are taken of the contrast dye flowing though the arteries. Plaques and blockages, if present, are well defined. The patient is awake but has been given a sedative. Coronary angiography is performed in a cardiac catheterization laboratory and takes from 30 minutes to two hours.

Treatment

Treatment includes lifestyle changes, lipid-lowering drugs, percutaneous transluminal coronary angioplasty, and coronary artery bypass surgery. Atherosclerosis requires lifelong care.
Patients who have less severe atherosclerosis may achieve adequate control through lifestyle changes and drug therapy. Many of the lifestyle changes that prevent disease progression-a low-fat, low-cholesterol diet, losing weight (if necessary), exercise, controlling blood pressure, and not smoking-also help prevent the disease.

Alternative treatment

Alternative therapies that focus on diet and lifestyle can help prevent, re**rd, or reverse atherosclerosis. Herbal therapies that may be helpful include: hawthorn (Crataegus laevigata), notoginseng root (Panax notoginseng), garlic (Allium sativum), ginger (Zingiber officinale), hot red or chili peppers, yarrow (Achillea millefolium), and alfalfa (Medicago sativum). Relaxation techniques including yoga, meditation, guided imagery, biofeedback, and counseling and other "talking" therapies may also be useful to prevent or slow the progress of the disease. Dietary modifications focus on eating foods that are low in fats (especially saturated fats), cholesterol, sugar, and animal proteins and high in fiber and antioxidants (found in fresh fruits and vegetables). Liberal use of onions and garlic is recommended, as is eating raw and cooked fish, especially cold-water fish like salmon. Smoking, alcohol, and stimulants like coffee should be avoided. Chelation therapy, which uses anticoagulant drugs and nutrients to dissolve plaque and flush it through the kidneys, is controversial. Long-term remedies can be prescribed by specialists in ayurvedic medicine, which combines diet, herbal remedies, relaxation and exercise, and homeopathy, which treats a disease with small doses of a drug that causes the symptoms of the disease.

Prognosis

Atherosclerosis can be successfully treated but not cured. Recent clinical studies have shown that atherosclerosis can be delayed, stopped, and even reversed by aggressively lowering LDL cholesterol. New diagnostic techniques enable physicians to identify and treat atherosclerosis in its earliest stages. New technologies and surgical procedures have extended the lives of many patients who would otherwise have died. Research continues.

Prevention

A healthy lifestyle-eating right, regular exercise, maintaining a healthy weight, not smoking, and controlling hypertension-can reduce the risk of developing atherosclerosis, help keep the disease from progressing, and sometimes cause it to regress.
• Eat right-A healthy diet reduces excess levels of LDL cholesterol and triglycerides. It includes a variety of foods that are low in fat and cholesterol and high in fiber; plenty of fruits and vegetables; and limited sodium. Fat should comprise no more than 30%, and saturated fat no more than 8-10%, of total daily calories according to the American Heart Association. Cholesterol should be limited to about 300 milligrams per day and sodium to about 2,400 milligrams. The "Food Guide" Pyramid developed by the U.S. Departments of Agriculture and Health and Human Services provides daily guidelines: 6-11 servings of bread, cereal, rice, and pasta; 3-5 servings of vegetables; 2-4 servings of fruit; 2-3 servings of milk, yogurt, and cheese; and 2-3 servings of meat, poultry, fish, dry beans, eggs, and nuts. Fats, oils, and sweets should be used sparingly. Mono-unsaturated oils, like olive and rapeseed (Canola) are good alternatives to use for cooking.
• Exercise regularly-Aerobic exercise can lower blood pressure, help control weight, and increase HDL ("good") cholesterol. It may keep the blood vessels more flexible. Moderate to intense aerobic exercise lasting about 30 minutes (or three 10-minute exercise periods) four or more times per week is recommended, according to the Centers for Disease Control and Prevention and the American College of Sports Medicine. Aerobic exercise includes walking, jogging, and cycling, active gardening, climbing stairs, or brisk housework. A physician should be consulted before exercise if a person has atherosclerosis or is at increased risk for it.
• Maintain a desirable body weight-Losing weight can help reduce total and LDL cholesterol, reduce triglycerides, and boost HDL cholesterol. It may also reduce blood pressure. Eating right and exercising are two key components in maintaining a desirable body weight.
• Do not smoke or use tobacco-Smoking has many adverse effects on the heart but quitting can repair damage. Ex-smokers face the same risk of heart disease as non-smokers within five to 10 years of quitting. Smoking is the worst thing a person can do to their heart and lungs.
• Seek treatment for hypertension-High blood pressure can be controlled through lifestyle changesreducing sodium and fat, exercising, managing stress, quitting smoking, and drinking alcohol in moderation-and medication. Drugs that provide effective treatment are: diuretics, beta-blockers, sympathetic nerve inhibitors, vasodilators, angiotensin converting enzyme inhibitors, and calcium antagonists. Hypertension usually has no symptoms so it must be checked to be known. Like cholesterol, hypertension is called a "silent killer."

17/06/2017

Stay Clean !!!!! Is your body clean? Were talking clean blood and overall colon (gut) health. The good book (Bible) says that life is in the blood. Clean blood is imperative to great health and longevity and so is the colon. When you have sickness of any kind including constipation and or diarrhea, you have problems, not good! All drugs do this to the body and so does eating wrong foods for many years. Cleaning up the body does not mean a good shower. it means cleaning up the blood and the entire internal system. Drink plenty of water and get rid of the all the other drinks. Eat plenty of vegetables, include some fruit and nuts. Do a colon cleanse twice yearly with a good liver//gallbladder flush and clean yourself up. Skin brush twice daily with the Bernard Jensen brush and you will see and feel the difference in 1-2 weeks, Get clean, not mean ! Be healthy, not sickly. Be the best you can be and prosper ! Let's go, time to clean up.

06/06/2017

Dr Sohail Haroon is the only doctor in Pakistan who is available 24 hours a day 7 days a week for a personalised conversation concerning your child health.

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17 Ferozepur Road
Lahore
54000

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+923226677780

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mujhy ek help chaiya plz reply karni I'm worried plz help me
Salam Dr my son involve in marsmus age 2 years i m very poor and i can't treatment