Dos and Don'ts for cardiac patients during winter

With the cold conditions continue to grip the northern states, peaople with heart diseases are more prone to complications of precautions are not taken by them says a cardiologist.

The Dr. said, definitely the winter and low-temperature are not good for the patients who are having underlying coronary artery diseases. They've  a high incidence of an acute coronary syndrome, that means heart attack and unstable angina, which are common in the winter season.

A higher dise of medication during winter is suggested by the Dr. for the patients who are hypertensive and who are taking BP-lowering medications.

patients having arrhythmia problems like rhythm disorder, atrial fibrillation also have a higher incidence of the problems, feels the Dr.

The caring measures suggested by the doctor for the patients with slow heart-pumping include avoid smoking and consumption of alcohol, control the intake of fat-rick food items, which is more of a tendency during winter. Keeping a count on your blood pressure is a must.

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Lonely cardiac pateints are at higher risk of death

Cardiac patients who tend to feel lonely are more likely to die in a year of getting discharged from the hospital, a new study highlighted.

While lonely men were twice more likely to die compared to those who aren't women were at nearly 3 times higher risk of dying than other women who aren't lonely.

Loneliness should be priotitised in public health initiatives and regarded as a legitimate health risk in people who have a serious illness, researchers stated in the study.

Previous research suggests that loneliness and poor social support are associated with a heightened risk of developing and dying from coronary artery disease. But it's not clear if other types of heart disease might also be influenced by feelings of loneliness, and if living alone might be as influential as feeling lonely.

To explore this further, researchers looked at the one-year health outcomes of patients admitted to a specialist heart centre with either ischemic ( coronary ) heart disease, abnormal heart rhythm, heart failure or valve disease, over the course of a year in 2013-2014.

Most of them were ( 70 %) were men with an average age of 66.

On discharge from the centre, 13, 443 ( 53 % of the total) completed validated questionnaires on their physical health, psychological well0being and quality of life and their levels of anxiety and depression.

Moreover, the patients were also quizzed about health behaviours, including smoking, drinking and how often they took their prescribed medicines.

National data were used to find out if they lived alone or with other people.

Those who said they felt lonely were nearly 3 times as likely to be anxious and depressed and to report a significantly lower quality of life as those who said they didn't feel lonely.

One year later, researchers checked national registry data to see what had happened to the patients' cardiac health as well as how many of them had died.

They found that irrespective of the diagnosis, loneliness was associated with significantly poorer physical health after a year.

After taking account of potentially influential factors, including health behaviours, lonely women were nearly 3 times as likely to have died from any cause after a year as women who didn't feel lonely.

Similarly, lonely men were more than twice as likely to have died from any cause.

The significant differences in risk between those who felt lonely and those who didn't, suggest that health-related behaviours and underlying conditions can't fully explain the associations found, said researchers.

Although living alone wasn't associated with feeling lonely, it was associated with a lower risk of anxiety / depression than in those who loved with other people.

And it was associated with a higher ( 39%) risk of poor cardiac health among men.

Previous studies indicate that women have larger social networks than men, so separation, divorce or the death of a partner, may disadvantage men more, suggests the researchers, by way of an explanation for this particular finding.

This is an observational study, and as such, can't establish a cause.

However, the finding are in line with previous research, suggesting that loneliness is associated with changes in cardiovascular, neuroendocrine and immune function as well as unhealthy lifestyle choices which impact negative health outcomes, the researchers stated.

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Gut bacteria may help prevent stroke, says study

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The bacteria could be especially useful to high-risk patients, like those undergoing cardiac surgery or those who have multiple obstructed blood vessels. 

Certain types of bacteria in the gut can leverage the immune system to decrease the severity of stroke, according to a new study that suggests modifying the gut's microbiotic makeup may help prevent the deadly condition. The finding can help mitigate stroke, the second leading cause of death worldwide, researchers said.

For the study, researchers from Weill Cornell Medicine and Memorial Sloan Kettering Cancer Centre in US, gave mice a combination of antibiotics. Two weeks later, they induced the most common type of stroke, called ischemic stroke, in which an obstructed blood vessel prevents blood from reaching the brain. 

Mice treated with antibiotics experienced a stroke that was about 60 per cent smaller than rodents that did not receive the medication.

The microbial environment in the gut directed the immune cells there to protect the brain, the researchers said, shielding it from the stroke's full force. "Our experiment shows a new relationship between the brain and the intestine," said Josef Anrather, an associate professor at Weill Cornell Medicine. "The intestinal microbiota shape stroke outcome, which will impact how the medical community views stroke and defines stroke risk," Anrather said. The findings suggest that modifying the microbiotic makeup of the gut can become an innovative method to prevent stroke, researchers said.

This could be especially useful to high-risk patients, like those undergoing cardiac surgery or those who have multiple obstructed blood vessels in the brain. Further investigation is needed to understand exactly which bacterial components elicited their protective message. However, the researchers do know that the bacteria did not interact with the brain chemically, but rather influenced neural survival by modifying the behaviour of immune cells. Immune cells from the gut made their way to the outer coverings of the brain, called the meninges, where they organised and directed a response to the stroke. "One of the most surprising findings was that the immune system made strokes smaller by orchestrating the response from outside the brain, like a conductor who does not play an instrument himself but instructs the others, which ultimately creates music," said Costantino Iadecola, from Weill Cornell Medicine. 

The newfound connection between the gut and the brain holds promising implications for preventing stroke in the future, which the researchers said might be achieved by changing dietary habits in patients or "at risk" individuals. "Dietary intervention is much easier to accomplish than drug use, and it could reach a broad base," Anrather said. 

The study was published in the journal Nature Medicine.

Capsule-size pacemaker may hit markets by June

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 Slightly bigger than a matchstick, lighter than a two-rupee coin and wireless. Patients may get this pacemaker by the middle of this year. It will have the same efficiency as that of a conventional device, but is priced substantially higher than the existing ones.
But the world's smallest pacemaker will use an improved technology that will benefit cardiac patients in the long run and is bound to edge out the existing pacemakers that have a clumsy wiring, feel experts.
Recommended for people whose hearts are beating too slowly or irregularly , a pacemaker stimulates the heart muscle with precisely-timed discharges of electricity that cause the heart to beat in a manner similar to the natural heart rhythm.
The Micra Transcatheter Pacing System (TPS) -which could hit the market in June -is a miniaturized, self-contained device that is one-tenth the size of conventional pacemakers, yet delivers the most advanced pacing technology available to patients. "Besides being small, the implant has no wires and is one-tenth the size of a conventional pacemaker. The wires or `leads' in existing devices often turn cumbersome since they can't be taken out with the pacemaker and forms a clump near the heart. But with TPS, successive implants will become easier," said Atul Mathur, director of interventional Cardiology , Fortis Escorts Heart Institute, New Delhi.

The new device will be the size of a vitamin capsule and can be implanted through a minimally invasive procedure. It will be delivered straight to the heart through a catheter via the femoral vein. This cuts out the need for incision and the pocket near the heart where a conventional pacemaker is lodged.
"Since there is no incision, the chances of complications arising from it are also eliminated. More importantly , patients can undergo full-body MRI scans with the implant, which are not permitted in case of the conventional devices," Mathur said.
But the cost may be a deterring factor. While existing pacemakers cost up to Rs 1.5 lakh, the TPS could be priced at Rs 2.5 lakh. But the price could come down over the next two years, felt experts.
"The size is an advantage, apart from the fact that since the technology will be advanced, it will pack in more features. In terms of efficiency, the existing pacemakers are good enough. But with time, smaller implants should have all the features of a multi-chambered pacemaker," said Debashish Saha, consult at AMRI Hospital, Salt Lake.