Symptoms We Treat
Mitral Valve Stenosis
Mitral valve stenosis, also known as mitral stenosis, occurs when the mitral valve, the opening that separates the upper and lower left chambers of the heart, becomes narrowed. This prevents the valve from opening fully and blocks the blood from flowing between the upper and lower chambers. This condition can lead to:
- Blood clots
- Lung congestion
- Heart failure
Diagnosis of Mitral Valve Stenosis
Mitral valve stenosis may be determined during a physical examination when a heart murmur, irregular heart beat or other abnormality is heard. There may also be evidence of congestion of the lung. To confirm diagnosis, the following tests may be conducted:
- Chest X-ray
- CT of the heart
- Cardiac catheterization
Treatment for Mitral Valve Stenosis
Treatment for mitral valve stenosis is necessary even if the patient is not experiencing symptoms. Medication may be prescribed to minimize mild symptoms, although medication cannot correct the defect. If narrowing becomes more severe and symptoms arise, surgery to repair or replace the valve may be recommended. While mitral valve stenosis does not cause serious symptoms, it can worsen and lead to severe complications, making treatment and monitoring of the condition necessary for all patients.
Pediatric Heart Murmur
A heart murmur is defined as an extra or unusual sound that is heard during a heartbeat, which is the sound made when blood flows into and out of the heart. It is not unusual for a child to have a heart murmur; in most cases, it is not an indicator of an underlying heart problem. Referred to as “innocent” or “functional,” this type of murmur is heard only periodically, often goes away as a child gets older, and does not affect quality of life in any way. However, a problematic murmur, which is classified as abnormal, can be the result of a congenital heart defect (a structural defect present at birth). A heart murmur is graded, based on its intensity (loudness), on a scale of one to six.
Treatment of a Pediatric Heart Murmur
An innocent heart murmur does not require treatment because it is not caused by a heart condition; it also tends to go away on its own. An abnormal murmur is addressed by treating the underlying heart condition. Although some types of structural defects require surgery, others, such as small holes in the heart’s lower chambers, may resolve on their own.
Palpitations are the sensation that your heart is racing while you are at rest. They are caused by an irregular heart rhythm (arrhythmia) that is making your heart beat faster than normal. Some arrhythmias can be benign (SVT), and others requiring either blood thinners (AF or AFL) or even a defibrillator. Treatment is customized to the actual arrhythmia causing your palpitations. The exact arrhythmia is diagnosed using an EKG or an event monitor.
Pericardial effusion involves an accumulation of fluid in the pericardium, the protective sac surrounding the heart. This may occur as a result of inflammation, infection, hypothyroidism, cancer, trauma or other conditions that may block the flow of pericardial fluids, although the specific cause is sometimes unknown.
Most patients with pericardial effusion do not experience symptoms, especially during the early stages of this condition, although there may be pain or pressure in the chest, shortness of breath, nausea or difficulty swallowing as the pericardium begins to stretch and compress surrounding structures.
To diagnose pericardial effusion, your doctor will likely perform a series of tests, including a chest x-ray, CT scan and echocardiogram. A procedure called pericardiocentesis, which removes fluid from the pericardium, can also determine the cause of the effusion.
Treatment for pericardial effusion depends on the underlying cause of the condition, but may include anti-inflammatory medication, diuretics, antibiotics, pericardiocentesis or other surgical procedures to drain excess fluid. There are several more invasive surgical procedures that may be performed, including open heart surgery or pericardiectomy to remove part or all of the pericardium. Your doctor will determine which type of treatment is best for your individual condition.
Pericarditis is an inflammation of the pericardium, the membrane or sac around the heart that keeps the heart in place and helps it work properly. The pericardium normally has two layers and contains lubricating fluid to prevent friction between the two layers. When the sac becomes inflamed, the friction between the layers can cause sharp chest pain and may eventually lead to permanent damage to the pericardium.
Treatment for Pericarditis
Mild cases of pericarditis may not need treatment, while others may require anti-inflammatory or antibiotic medication. If complications occur, a procedure called periocardiocentesis may be performed to remove excess fluid within the pericardium. Acute cases may last up to three weeks while chronic cases can last for several months.
Peripheral Artery Disease
Peripheral artery disease, also known as PAD, is a common vascular condition involving a buildup of plaque within the peripheral arteries of the limbs, usually the legs and feet. Plaque is an accumulation of fat, cholesterol, calcium and other substances in the blood. The buildup of plaque can severely narrow or block the arteries and limit the flow of oxygen-rich blood to the body. PAD may be a symptom of atherosclerosis, a specific form of arteriosclerosis, which leads to a more widespread occurrence of plaque buildup in arteries.
Diagnosis of PAD
Peripheral artery disease may be effectively diagnosed using the following:
- Physical examination
- Ankle-brachial index (ABI)
- Doppler ultrasound
- Blood tests
Treatment of PAD
Treatment for peripheral artery disease is a two-pronged effort, designed not only to relieve symptoms, but to stop the progression of vascular disease. It is important to get atherosclerosis under control since this disease puts the patient at risk for heart attack or stroke. Treatments for PAD may include any and all of the following:
Before any additional medical treatment is undertaken, patients are advised to make changes in their habits which may be lifesaving. The most important of these is for patients who smoke to stop smoking. Other beneficial changes include losing weight, eating a healthier diet, making sure to get regular exercise and alleviating stress wherever possible. Particular exercise programs to assist in treating PAD are sometimes recommended.
Several types of medications may be helpful in treating PAD. These may include:
- Cholesterol-lowering drugs known as statins
- Medications to lower blood pressure
- Medications to control glucose levels in patients with diabetes
- Anticoagulants to increase blood flow
- Medications to relieve symptoms such as claudication
- Drugs injected into the artery to dissolve clots, or thrombolytics
In some cases, surgical interventions may be necessary to treat PAD, including angioplasty to reopen the blocked artery and increase blood flow or bypass surgery to circumvent the blocked artery. The latter may be accomplished using either synthetic materials or a blood vessel from another part of the body.
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