Structure & Function of the Heart:
Risk factors for Coronary Artery disease:
Coronary Artery Disease:
Emergency Complications of Heart Attack:
Coronary Artery Bypass Grafting (CABG):
Rheumatic Fever and Heart Valve Diseases:
Heart Transplantation and Assisted devices
Diabetes is a disease that occurs when you have too much sugar in your blood. Everyone’s blood has some sugar in it because the body uses sugar as its main source of energy. After you eat, your body breaks the food down into sugar and other nutrients. Your blood carries the sugar to the cells in your body, which then use that sugar for energy. The sugar can only get into the cells when insulin is there to let it in. Insulin is a hormone made in the pancreas, a gland behind your stomach. The pancreas releases insulin into the blood. If your body doesn’t make enough insulin or the insulin doesn’t work properly, the sugar cannot get into the cells, and instead stays in the blood. This makes your blood sugar level high, causing you to have diabetes.
Some people who have diabetes think it's not a very serious disease. They may believe that their diabetes is not serious because they got it late in life or because they don't take insulin. There are people who believe that they only have a "touch" of sugar or "borderline" diabetes. These ideas are not correct – diabetes is always a serious disease. Whether you take insulin or not, your diabetes puts you at risk for the following serious complications:
Symptoms of diabetes:
Types Of Diabetes
There are three common types of diabetes: type 1, type 2, and gestational. Gestational diabetes occurs during pregnancy. It usually goes away after the baby is born, but diabetes may return later.
Type 1 Diabetes
Occurs most often in children and young adults. In type 1 diabetes the immune system attacks and destroys insulin producing cells in the pancreas, which results in high blood glucose levels. Insulin injections are required to treat type 1 diabetes.
Type 2 Diabetes
Accounts for 90% of all diagnosed cases of diabetes. In type 2 diabetes “insulin resistance” occurs. This happens when the pancreas produces insulin but the body’s cells cannot read the signal to let glucose into the cells. Being overweight or obese is a leading risk factor for developing type 2 diabetes. Other risk factors include: physical inactivity, aging (type 2 diabetes is more prevalent in middle age and older adults), family history of diabetes, prior history of gestational diabetes, and certain racial groups.
There are two other conditions that pose risk for developing diabetes, including prediabetes and the metabolic syndrome.
Prediabetes: Blood glucose levels are higher than normal but not high enough to have a diagnosis of diabetes. Prediabetes raises the risk of developing type 2 diabetes and increases the risk of heart disease by 50 percent. Most people with prediabetes develop type 2 diabetes within ten years. Lifestyle modification involving weight loss and physical exercise helps to prevent or delay the onset of diabetes.
The metabolic syndrome: Is another commonly used term in discussing diabetes. Metabolic syndrome, which is sometimes referred to as “insulin resistance syndrome” or “syndrome X” is a cluster of conditions including obesity, high blood pressure, high cholesterol, and high triglycerides, that may indicate a tendency to develop diabetes, hypertension and heart disease.
Diabetes and your heart:
Longterm (chronic) health problems don’t happen overnight. They develop over months and years. Often, these problems are not reversible. In most cases, you don’t even know that diabetes complications are occurring until they cause a serious problem. Cardiovascular disease (CVD) includes those conditions that affect the proper functioning of the heart and blood vessels. It is the most common complication of diabetes, and can lead to heart attacks, strokes, and other serious problems. Examples of cardiovascular disease include heart attack, angina, heart failure, and peripheral vascular diseases, which can cause gangrene or ulceration of the feet and leg, requiring amputation. People with diabetes are two to four times more likely to suffer from heart disease. Risk factors for cardiovascular disease include high blood pressure, high blood fat (lipid) levels, high blood sugar, obesity, inactivity, heredity, sex (males), and advancing age. By controlling your lipids (total “good” and “bad” cholesterol and triglycerides) and blood pressure and diabetes you can help reduce the risk of cardiovascular complications.
Blood pressure and lipids goals for people with diabetes:
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Management of diabetes:
Goal of treatment: The goal of treatment for diabetes is to keep blood sugar levels close to normal to prevent complications. The American Diabetes Association’s guidelines for blood glucose levels for people with diabetes are 80 - 120mg/dL before meals and 100 – 140 mg/dL before bedtime.
Having diabetes does not mean you need special foods, or that you will never be able to eat sweets again. You can eat the same healthy foods that everyone else can! Your meal plan should include foods that are low in saturated fat, salt, and sugar, and high in fiber (such as beans, fruits, vegetables, and whole grains). Eating properly will help you:
Your key to success is a meal plan. A meal plan is a daily eating plan. There are many different types of meal plans. Some focus on controlling calories or portion size, while others count fat or carbohydrates. Still others combine both of these methods. The exchange meal plan is an example. With this meal plan, you can choose a specific number of servings each day from these six food groups: starch/bread, meat (or fish, poultry, or meat alternative such as soy products) vegetable, fruit, milk, and fat. The number of servings is based on how many calories you can have each day. Using Exchange Lists for Meal Planning, developed by the American Diabetes Association and American Dietetic Association, you can choose the foods you would like to eat for each meal. A defined serving or “exchange” of each food item in one of these categories has the same calories, grams of fat, protein and carbohydrate in it as every other food item in that category. So, under the “fruit choices” in the exchange system, for example, 1/ 2 cup of apple sauce and a small banana each equals one “fruit exchange” that has 60 calories, 15 grams of carbohydrate, and no protein or fat. In the exchange meal planning system, your healthcare team works with you to develop a meal plan that distributes a number of exchanges from each of the six food categories through each of three meals and two or three snacks each day. The meal plan is developed based on the patient's diabetes treatment plan and goals. If weight loss is a goal, for example, the patient will have fewer exchanges to spend at each meal, so that total calories are kept at a level to enable the patient to lose weight. Patients then use food lists to figure out how to “spend” those exchanges at each meal. The following are some tips for a meal plan:
Exercise and Fitness
There is no safe way to smoke, and diabetes and smoking are a bad combination. Smoking puts you at greater risk for heart and blood vessel problems, like heart attack and stroke. It also increases your risk for lung cancer and other cancers, chronic lung disease (e.g., emphysema, chronic bronchitis) diabetic eye disease and kidney problems.
If you have type 2 diabetes, you may have tried to control your blood sugar through exercise and diet. If diet and exercise alone have not worked, you may need to take diabetes pills. Diabetes pills, also called oral diabetes medicine or oral hypoglycemic agents, only work in people whose bodies make some insulin of their own. There are many different kinds of diabetes pills. Each works differently in the body, and you may need to take more than one type of pill. Some pills, like glyburide and glipizide, increase your insulin output. Others, like metformin, Actos ® , help enhance the work of insulin. Diabetes pills are safe and easy to take. Keep in mind that diabetes pills may not lower blood sugar enough by themselves. You will still have to follow an eating and exercise plan to help lower your blood sugar. Losing even a little bit of weight can sometimes help lower your blood sugar, and you may be able to stop taking diabetes pills if you lose weight. Sometimes people who take diabetes pills need insulin shots for a short period of time.
is a hormone made in the pancreas, and everyone needs it to stay alive. Insulin works like a gatekeeper, allowing the sugar in your bloodstream to enter the cells, which is where the sugar is used as fuel for your body. People with type 1 diabetes do not make any or enough insulin. People with type 2 diabetes cannot use insulin properly, so they need more of it. In both types of diabetes there is not enough insulin to let the sugar into your cells. As a result, sugar builds up in your bloodstream. This leads to high blood sugar. Insulin cannot be taken as a pill. You need to inject it into your body. There are three ways to do this:
Monitoring Blood Sugar Control
Self Testing: To test your blood sugar, you need a small needle called a lancet (used with a fingerstick device), special blood testing strips, and a blood sugar testing machine called a glucometer.
Ketone Testing: While urine testing is not very accurate for checking your blood sugar, but it can show if you have ketones in your urine. Ketones are a chemical your body makes when it burns fat, instead of sugar, for energy. Your body makes ketones when there is not enough insulin in your blood. This occurs more often in type 1 diabetes. You probably will only have to do a urine test when you are sick or if your blood sugar is unusually high (over 240–300 mg) before eating a meal.
Hemoglobin A1c (three Month Sugar Test): Blood sugar levels vary a lot from day to day, especially if you have diabetes. Any time you check your blood sugar you get important information, but you are only getting the level for that one time. The glycosylated hemoglobin test (often called the hemoglobin A1c test or HbA1c test) shows your average blood sugar levels over a three month period.
Symptoms and signs of heart disease:
NonInvasive diagnostic tests For heart disease:
Invasive Diagnostic Tests for heart disease:
Cardiac Arrythmias and Pacemakers:
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