The problem with this disease is that nearly one third of the folks who have hypertension do not know it because they never feel any direct pain. But overtime the force of that pressure damages the inside surface of your blood vessels.

However, according to experts, hypertension is not predestined. Reducing salt intake, adopting a desirable dietary pattern losing weight and exercising can all help prevent hypertension.

Obviously, quitting bad habits and eating a low fat diet will help, but the most significant part that you can do is to exercise. And just as exercise strengthens and improves limb muscles, it also enhances the health of the heart muscles.

Heart and Exercise

The exercise stimulates the development of new connections between the impaired and the nearly normal blood vessels, so people who exercise had a better blood supply to all the muscle tissue of the heart.

The human heart basically, supply blood to an area of the heart damaged in a “myocardial infarction.” A heart attack is a condition, in which, the myocardium or the heart muscle does not get enough oxygen and other nutrients and so it begins to die.

For this reason and after a series of careful considerations, some researchers have observed that exercise can stimulate the development of these life saving detours in the heart. One study further showed that moderate exercise several times a week is more effective in building up these auxiliary pathways than extremely vigorous exercise done twice as often.

Such information has led some people to think of exercise as a panacea for heart disorders, a fail-safe protection against hypertension or death. That is not so. Even marathon runners that have suffered hypertension, and exercise cannot overcome combination of other risk factor.

What Causes Hypertension?

Sometimes abnormalities of the kidney are responsible. There is also a study wherein the researchers identified more common contributing factors such as heredity, obesity, and lack of physical activity. And so, what can be done to lower blood pressure and avoid the risk of developing hypertension? Again, exercise seems to be just what the doctor might order.

If you think that is what he will do, then, try to contemplate on this list and find some ways how you can incorporate these things into your lifestyle and start to live a life free from the possibilities of developing hypertension. But before you start following the systematic instructions, it would be better to review them first before getting into action.

1. See your doctor
Check with your doctor before beginning an exercise program. If you make any significant changes in your level of physical activity — particularly if those changes could make large and sudden demands on your circulatory system — check with your doctors again.

2. Take it slow

Start at a low, comfortable level of exertion and progress gradually. The program is designed in two stages to allow for a progressive increase in activity.

3. Know your limit

Determine your safety limit for exertion. Use some clues such as sleep problems or fatigue the day after a workout to check on whether you are overdoing it. Once identified, stay within it. Over-exercising is both dangerous and unnecessary.

4. Exercise regularly

You need to work out a minimum of three times a week and a maximum of five times a week to get the most benefit. Once you are in peak condition, a single workout a week can maintain the muscular benefits. However, cardiovascular fitness requires more frequent activity.

5. Exercise at a rate within your capacity

The optimum benefits for older exercisers are produced by exercise at 40% to 60% of capacity.

Indeed, weight loss through exercise is an excellent starting point if you wan tot prevent hypertension. Experts say that being overweight is linked to an increased risk of developing hypertension, and losing weight decreases the risk.

What is a Heart Monitor
Also known as a cardiac monitor, a heart monitor is a piece of electronic equipment that can be used to track or observe heart functions continuously. It allows people to place a numerical value on their healthiness based on their heart rate and have a target heart rate to work for. The more complex versions of the heart monitor allow physicians to see any signs of deterioration or improvement and make the necessary adjustments immediately.

Types of Heart Monitors
Today, heart monitors are produced by the millions and designed to cater specific types of individuals. Some heart monitors are primarily designed for weight loss programs while others are meant for the use of athletes or fitness programs. Some are wireless or come as a built-in feature of exercise equipment like a treadmill or an exercise bike. It can be strapped to your wrist or of considerable size. It may or may not emit any electromagnetic waves, depending on its purpose. A fetal heart monitor, for instance, must not produce any waves at all as this may affect the health of the baby.

Factors on Selecting the Best Heart Monitor for You

ECG-Accurate Monitors with Chest Straps – Heart monitors that come with chest straps are more often not the most accurate of heart monitors. The chest strap is strapped around your chest, a few centimeters below your breast. It contains a device that’s able to detect electrical activity of your heart and transmit it to the brain of the machine – just like an ECG. The results are shown on the display monitor, which most of the times is attached to your wrist like a watch. Others however prefer results to be transmitted through audio messages via earphones.

Upon choosing heart monitors with chest straps, you need to remember to keep the strap constantly connected to your body lest you want the heart monitor to produce inaccurate readings.

Lastly, the only alternative against buying heart monitors with chest straps are the ones that rely on pulses on your fingertips. These however do not provide readings as accurate as those with chest straps.

Heart Monitor Features – Basic and lower end models tend to display only your heart rate and maybe the elapsed exercise time as well. This of course does not provide sufficient information if you want to know exactly how much you need to improve before you can be qualified as a completely healthy individual. Higher end models will naturally offer a wider range of features – for a price. Examples of such features are – but not limited to – heart rate zone alarms, timers and number of calories burned. It may also allow users to set pre-programmed workouts along with a targeted heart rate.

Ease of Use – Lastly, you must purchase a heart rate monitor that you will have no problems of using. What good would a high end heart monitor do if it takes you an hour to operate it? Are the numbers and words appearing in the heart rate monitor readable? Can it be used in no-light situations? Are buttons well-labeled and ergonomically positioned?

To Buy or Not to Buy a Heart Monitor
Heart monitors can be especially costly, more so if you are intent on purchasing higher-end models. If you have a limited budget, you should ask yourself whether or not you truly need to buy a heart monitor. You can of course purchase one of the lower-end models but low quality heart monitors can lead to inaccurate results and that sort of defeats the purpose of buying one.

If you are intent on purchasing a heart monitor, you need to ask yourself another question: do you need to make a solo purchase or is it alright with you to use the heart monitor that comes as a built-in feature of a treadmill? Lastly, you should remember as well that you can always pay your doctor regular visits and have him monitor your heart rate for you.

Why does aging contort so many bodies in this way? The reason is that many people, throughout their lives, never extend the neck to its full range, and so the muscles shorten. Long hours of reading, sewing, typing, or standing at a workbench take their toll. Eventually deposits of calcium salts in the joints complete the process of immobilization. Once this calcification takes place, nothing can be done to reverse it.

Fortunately, older persons can take action before it is too late. The best action is regular exercise that stretches the muscles and improves flexibility, with special considerations on the core muscles. This kind of response is relatively important for a number of factors that when taken for granted will only lead to serious health problems.

What Are Core Muscles?

Core muscles pertain to the muscles found at the obliques, abdominals, lower back, and the glutes. These four areas of the body are the ones that usually frame the posture of a person. Hence, a good posture reflects the good condition of these muscle areas.

What people do not know is that core muscles are actually the “core” or the central part for all the strength that is needed to boost carry out different physical activities. This only means that if an individual’s core muscle is physically powerful, it will maintain equilibrium on the body and will stabilize the system every time the person is working out and moving.

Strengthening Core Muscles

The main responsibility of the core muscles is to provide enough power to the body in order to enable it to cope up with the dynamic challenges of every physical activity that a person encounters.

For this reason, many health and fitness experts have realized that it is relatively important to strengthen the core muscles than with the other muscles in the body. Through some series of experiments and research, they have found out that having a stronger core can lessen a lot of health problems concerning posture.

For instance, a well-conditioned core muscle can project good posture. It can also improve the endurance of the back all the way through the day.

Why? Because muscles that are included in the group of core muscles are actually the ones that initiate the proper stabilization of the whole upper and lower torso.

So, for those who wish to know and understand why it is important strengthen the core muscles, here is a list of some of the benefits that you can use as references:

1. Strengthening core muscles will improve posture and prevent low back pain of the muscular origin.

This means that as you incorporate stretching exercises in your routine, taking a particular focus on the muscles of the upper and front part of the trunk, including the abdominal and trunk muscles, the activity has the tendency to strengthen the muscles of the back that extend to the spine.

2. It will help tone the muscles, thereby, avoiding further back injury

Exercising your core muscles will strengthen and tones your lower back muscles and buttocks while stretching the hip flexors and the muscles on the front of the thighs.

Achieving this state will deter you from any serious lower back injury.

3. Improves physical performance

Exercising the core muscles with slow, static stretching is just as effective in relieving stiffness and enhances flexibility. Once the flexibility of a person has improved, it follows that he will be able to perform his physical activities at a better state.

4. They do not cause sore aching muscles

Static stretching for core muscles is best for the muscles and connective tissues. And because it employs slow stretches only, it will not cause any soreness, as do the quick, bouncing exercises that rely on jerky muscle contraction.

5. Lengthen muscles and avoid unbalanced footing as you get old

Core muscle exercises lengthen the muscles that have contracted as a result of pain. It also prevents pain from vigorous exercise if they are included at the end of each workout.

Health and fitness experts highly recommend starting core work out immediately and repeating the routine at least 2 times a week. The process can be done after the workout or even during the activity, for about 10 to 20 minutes only.

Indeed, core muscles are absolutely important in determining the good posture of the body. Strengthening them can absolutely eliminate those nuisances of back pains.

Wherever bones meet, there is also cartilage, a rubbery, protective layer that ensures your joints bend smoothly and painlessly. But even cartilage cannot do this tremendous job alone. A thin membrane called the “synovium” provides fluid that lubricates the moving parts of the joint. When the cartilage wears out of the synovium becomes inflamed, the result is generally a case of “osteoarthritis” or “rheumatoid arthritis.”

In osteoarthritis, the cartilage can be eroded so much that bone does rub on bone. Thos type of arthritis develops gradually over a lifetime as a simple result of the wear and tear placed on your joints over the years. Very few people escape some degree of osteoarthritis, though the severity varies a great deal.

As a matter of fact, if you are over the age of 50, you are likely to have at least one joint affected by osteoarthritis. Osteoarthritis affects men and women equally and is by far the most common type of arthritis, with almost 16 million Americans in the list.

In rheumatoid arthritis, damage to the synovium is at the source of trouble. Doctors and researchers are not absolutely sure what causes it, but most think that rheumatoid arthritis is a disease in which the immune system actually attacks certain tissues in the body, including those that connect the joints and the synovium.

Rheumatoid arthritis begins with swollen, red, stiff, and painful joints, but it may progress until scar tissue forms in the joint or, in extreme cases, until the bones actually fuse together. Almost 75% of the 2 million people with rheumatoid arthritis in the United States are women. The disease can hit as early as teen years.

Exercising Your Prevention Options

Investing a little time in developing a good weight-bearing low-impact exercise and stretching plan can add up to great results when it comes to staving off arthritis pain. Strong muscles help protect the joints from wear and tear, and the movement keeps joints flexible.

That is why the quest for fitness is at hand, even if you are 50 years and over. However, most Americans over 50 are still right where they always were sitting back and watching others jog by. Most of them contend that that is just for people who have been athletic all their life, or some say exercise is for young people and engaging into exercise will do them more harm than good.

There are still some that insist on excusing their selves in exercise routines because they do not just have time or they have less energy than ever before. These are all lame excuses. Hence, it is time to start to get rid of those pains. Start exercising.

Consequently, preventing arthritis is not an exact science, but physicians have discovered a few ways to lower your risk. Here is how:

1. Do not weight around

The single most important measure anyone can take to prevent osteoarthritis of the knee is to lose weight if they are overweight. Extra weight puts extra stress on your knees. If you are 10 pounds overweight, for example, you put 60 pounds per square inch of extra pressure on your knees every time you take a step. That extra pressure can slowly but surely erode the cartilage in your knees, leading to arthritis.

A study has clearly supported the theory that weight loss weighs in on the side of prevention. In the study, overweight women who lost 11 pounds or more over a 10-year period decreased their risk of developing osteoarthritis of the knee by 50%.

2. Stretch those muscles

Any kind of stretching is good as long as you do not bounce, which can lead to a muscle pull. This is according to some of the professors of clinical medicine in New York City.

Try to hold a slow, steady stretch for 15 to 20 seconds, then relax and repeat. It is best to flex up by stretching before any exercise, especially running and walking. But it is also a good idea to stretch each day. Ask your doctor to teach you stretches that focus on potential arthritis trouble spots, such as the knees or the lower back.

3. Walking is always the best exercise

Take a good long walk at least three times a week or participate in a step-aerobics or low-impact exercise routine maximum results. There is no proof that running is bad for the joints, but remember, it may aggravate an injury if you already have one. Just remember to check with your doctor before starting a new exercise program.

The bottom line is that of all the healthful habits, exercise is the most important. This is because people are designed to be active. Hence, it is really important for people to exercise in order to stay healthy and keep those joints free from wear and tear.

Just keep in mind that the unexercised body, even if free from the symptoms of illness or problems like arthritis, is not at its full potential. Hence, start exercising right now!

When it comes to ensuring and maintaining the health, the best option is to do cardio training.

What Is Cardio Training?

Cardio training involves any activity that requires the use of the large muscle groups of the body in a regular and uninterrupted manner. It elevates the heart rate between 60 to 85 percent of the fastest heart rate you could get.

Some of the usual cardio training activities are walking, jogging, running, aerobics, cycling, tae bo, swimming and rowing. Cardio training is considered an aerobic exercise as one is required to move from one exercise to another.

What Are the Benefits of Training?

1. Gives Energy to the Body
You can expect more energy and higher endurance after some time of regular cardio training.

2. Prevents Diseases
One could prevent heart diseases with regular cardio training. It is also helpful in preventing other variety of diseases like diabetes, obesity and even high cholesterol. The cardiovascular training strengthens the heart and the lungs. The low to moderated type of cardio exercises are required for people seeking to prevent diseases. Examples of these are walking, brisk walking or jogging.

3. Control Your Weight
With cardio training, you are able to burn more calories. This will help one who needs to lose weight. While those who already achieved their ideal body mass, the training will make it easier to control the weight.

Cardio training helps burn calories. However this generally depends on your current weight and the kind of cardio training you are undergoing. Better consult this matter with your physician or trainer, to know the proper type of training for your needs.

4. Lose Body Fats
Some people do not have problem with their weights. However, there may be some excess fats that keep bothering. Cardio training will help in getting rid of those. The activities involve the movements of large muscle groups. Regularly doing the training will make you leaner.

5. Get Rid of Boredom
Cardio training is fun. It pumps up your system. You will definitely feel more energized and on the go.

Recommendations to Better Enjoy the Benefits of Cardio Training

Cardio training is essential when you need to make health improvements. For starters, it is best to do the 30 to 45 minutes of exercises, 3 to 5 days a week. If you are aiming for weight loss, the training must be done 5 days a week. The more frequent you do it; the more likely it is that you will lose weight. However, avoid exhausting yourself too much in exercise. Avoid going beyond 45 minutes. Remember, it has to be done in a regular basis.

Start now. Walk or ride the bike around the neighborhood now. Follow that aerobics video you purchased. Set a goal and follow that goal. At the same time, modify your diet too. Eat healthy food.

As you increase in the fitness level, the intensity of the training must also increase. This is to have an area of variation and there should always be room for improvement. Implement this by intensifying some parts of the training. If you are into jogging or running, increase speed every 5 minutes for at least a minute or two. It is important that you challenge yourself, so as not to be stuck in a stump.

Avoid doing the cardio exercises before bedtime. You will have a difficult time sleeping if you do so as the energy level of the body will stay high for sometime.

If you are undergoing weight training too, do the cardio exercises right after, not before.

It is best to take a snack 30 minutes before doing the cardio exercises. Do not start with training in an empty stomach. This will not help in achieving the proper momentum when you train. At the same time, avoid indulging in large meals too before exercise. Just give your body the proper supply it will need to sustain exhausting movements.

It is good to do the cardio exercises outdoors. This way you can easily interact with nature and breathe fresh air. You can also simply enjoy going around the neighborhood as you get your system healthier by the minute. It is possible to make some friends among the people who also do their exercises.

Be consistent and stick with the training once you have started it. This is the only way that cardio training will benefit your body and your health in the long run.

Among the highest risk factors are male sex, age over 35, cigarette smoking, high blood pressure, high levels of certain blood fats, and a family history of cardiovascular disorders.

Other researchers have added to this list another risk factor: the compulsive, hard-driving, highly anxious personality. The greater the number of severity, the greater the person’s overall risk.

These threats to the heart can be divided into two main categories: those beyond individual control, such as age, sex, and heredity, and those that can be controlled, avoided, or even eliminated. Among those in the second category are what cardiologists call “the triple threat.” These are the high blood pressure, cigarette smoking, and high cholesterol levels in the blood.

If you smoke a pack of cigarettes a day, your risk of having a heart attack is twice that of a nonsmoker. If you smoke, have hypertension, and eat a diet high in fats without any exercise at all, your risk is five times greater than normal.

The Healthy Heart

If these risk factors endanger the heart’s health, what enhances its well-being and improves its odds of working long and well?

Obviously, quitting cigarettes and eating a low-fat diet will help. The next best thing you can do for your heart’s sake is to give it what it needs: regular exercise or a complete cardio interval training.

The heart is a muscle, or, more accurately, a group or “package” of muscles, similar in many ways to the muscles of the arms and legs. And just as exercise strengthens and improves limb muscles, it enhances the health of the heart muscles as well.

Since World War II, several large-scale statistical studies have evaluated the relationship between physical activity and cardiovascular disease. One well-known survey compared 31,000 drivers and conductors of some bus companies. The more sedentary drivers had a significantly higher rate of heart disease than the conductors, who walked around the buses and climbed stairs to the upper level.

The why and how behind these statistics were bet explained by classic experiments with dogs whose coronary arteries were surgically narrowed to resemble those of humans with arteriosclerosis. Dogs who were exercised were had much better blood flow than those kept inactive.

The exercise seemed to stimulate the development of new connections between the impaired and the nearly normal blood vessels, so exercised dogs had a better blood supply to all the muscle tissue of the heart. The human heart reacts in the same way to provide blood to the portion that was damaged by the heart attack.

To enable the damaged heart muscle to heal, the heart relies on new small blood vessels for what is called collateral circulation. These new branches on the arterial tress can develop long before a heart attack — and can prevent a heart attack if the new network takes on enough of the function of the narrowed vessels.

With all these facts, it is now boiled down to a single question: What should be done in order to prevent such dilemmas?

Some studies showed that moderate exercise several times a week is more effective in building up these auxiliary pathways than extremely vigorous exercise done twice often.

The general rule is that exercise helps reduce the risk of harm to the heart. Some researches further attested the link between exercise and healthy heart based from the findings that the non-exercisers had a 49% greater risk of heart attack than the other people included in the study. The study attributed a third of that risk to sedentary lifestyle alone.

Hence, with employing the cardio interval training, you can absolutely expect positive results not only on areas that concerns your cardiovascular system but on the overall status of your health as well.

This particular activity that is definitely good for the heart is a cycle of “repeated segments” that is of intense nature. In this process, there is an interchange periods of recuperation. It can both be comprehensive activity and moderate motion.

Consequently, the benefits of merely engaging into this kind of activity can bring you more results that you have ever expected. These are:

1. The threats of heart attack are lessened, if not eliminated

2. Enhanced heart task

3. Increase metabolism, increase the chance of burning calories, therefore, assist you in losing weight

4. Improves lung capacity

5. Helps lessen or eliminate the cases of stress

Indeed, cardio interval training is the modern way of creating a healthy, happy heart and body.

Any irregularity in your heart’s natural rhythm is called an arrhythmia. Almost everyone’s heart skips or flutters at one time or another, and these mild, one-time palpitations are harmless. But there are about 4 million Americans who have recurrent arrhythmias, and these people should be under the care of a doctor.

Categories of Arrhythmia

Arrhythmias can be divided into two categories: ventricular and supraventricular. Ventricular arrhythmias happen in the heart’s two lower chambers, called the ventricles. Supraventricular arrhythmias happen in the structures above the ventricles, mainly the atria, which are the heart’s two upper chambers.

Arrhythmias are further defined by the speed of the heartbeats. A very slow heart rate, called bradycardia, means the heart rate is less than 60 beats per minute. Tachycardia is a very fast heart rate, meaning the heart beats faster than 100 beats per minute. Fibrillation, the most serious form of arrhythmia, is fast, uncoordinated beats, which are contractions of individual heart-muscle fibers.

What is heart block?

Heart block happens when the SA node’s electrical signal cannot travel to the heart’s lower chambers (the ventricles).

See also on this site: Categories of Arrhythmia

What causes an arrhythmia?

Many factors can cause your heart to beat irregularly. Some people are born with arrhythmias, meaning the condition is congenital. Some medical conditions, including many types of heart disease and high blood pressure, may be factors. Also, stress, caffeine, smoking, alcohol, and some over-the-counter cough and cold medicines can affect the pattern of your heartbeat.

What are the symptoms?

Whether you have symptoms and what those symptoms feel like depend on the health of your heart and the type of arrhythmia you have. Symptoms also depend on how severe the arrhythmia is, how often it happens, and how long it lasts. Some arrhythmias do not produce any warning signs. Contrary to popular belief, heart palpitations do not always mean that you have an arrhythmia.

Symptoms of bradycardia

You may feel tired, short of breath, dizzy, or faint.
Symptoms of tachycardia

Your heartbeat may feel like a strong pulse in your neck, or a fluttering, racing beat in your chest.
 
You may feel chest discomfort, weak, short of breath, faint, sweaty, or dizzy.
How is an arrhythmia diagnosed?

The following techniques are used to diagnose arrhythmias.

A standard electrocardiogram (ECG or EKG) is the best test for diagnosing arrhythmia. This test helps doctors analyze the electrical currents of your heart and determine the type of arrhythmia you have.
 
Holter monitoring gets a non-stop reading of your heart rate and rhythm over a 24-hour period (or longer). You wear a recording device (the Holter monitor), which is connected to small metal disks called electrodes that are placed on your chest. With certain types of monitors, you can push a “record” button to capture a rhythm when you feel symptoms. Doctors can then look at a printout of the recording to find out what causes your arrhythmia.
 
Event monitoring records problems that may not be found within a 24-hour period. The devices used for this type of test are smaller than a Holter monitor. One such device is the size of a beeper, and another is worn like a wristwatch. As with Holter monitoring, you wear the recording device. When you feel the symptoms of an arrhythmia, you can telephone a monitoring station, where a record can be made. If you cannot get to a telephone during your symptoms, you can turn on the device’s memory function. Later, you can send the recorded information to a monitoring station by using a telephone. These devices also work during episodes of fainting.
 
Electrophysiology studies (EPS) are usually done in a cardiac catheterization laboratory. A long, thin tube called a catheter is inserted into an artery in your leg and guided to your heart. A map of electrical impulses from your heart is sent through the catheter. This map helps doctors find out what kind of arrhythmia you have and where it starts. During the study, doctors can give you controlled electrical impulses to show how your heart reacts. Medicines may also be tested at this time to see which will stop the arrhythmia. Once the electrical pathways causing the arrhythmia are found, radio waves can be sent through the catheter to destroy them. (See radiofrequency ablation in treatment section below.)
 
A tilt-table exam is a way to evaluate your heart’s rhythm in cases of fainting. The test is noninvasive, which means that doctors will not use needles or catheters. Your heart rate and blood pressure are monitored as you lie flat on a table. The table is then tilted to 65 degrees. The angle puts stress on the area of the nervous system that maintains your heart rate and blood pressure. Doctors can see how your heart responds under carefully controlled times of stress.
How is arrhythmia treated?

Anti-arrhythmic medicines, including digitalis, beta-blockers, and calcium channel blockers, are often the first approach taken for treating arrhythmia. Other treatments include percutaneous (catheter) interventions, implantable devices, and surgery (for severe cases).

Ventricular tachycardia and ventricular fibrillation can be treated by an implantable cardioverter defibrillator (ICD). This is a device that applies electric impulses or, if needed, a shock to restore a normal heartbeat. The device’s power source is implanted in a pouch beneath the skin of your chest or the area above your stomach and connected to patches placed on your heart. Newer implantable devices are inserted through blood vessels, which means that you do not need open-chest surgery.
 
An electronic pacemaker is used in some cases of slow heart rate. Smaller than a matchbox, the pacemaker is surgically implanted near the bone below your neck (the collarbone). The pacemaker’s batteries supply the electrical energy that acts like your heart’s natural pacemaker.
 
Radiofrequency ablation is a procedure that uses a catheter and a device for mapping the electrical pathways of the heart. After you are given medicine to relax you, a catheter is inserted into a vein and guided to your heart, where doctors use high-frequency radio waves to destroy (ablate) the pathways causing the arrhythmia.
In some cases, these treatments may not work or they may not be right for you, and surgery may be needed to destroy the source of the irregular heartbeat.

Surgical ablation is like radiofrequency ablation. Using computerized mapping techniques, surgeons can find out which cells are “misfiring.” A technique called cryoablation can then be used to eliminate tissue with a cold probe and destroy the “misfiring” cells.
 
Maze surgery may be recommended if you have atrial fibrillation that has not responded to medicines or electrical shock (cardioversion therapy) or to pulmonary vein ablation (a procedure similar to radiofrequency ablation). Surgeons create a number of incisions in the atrium to block the erratic electrical impulses that cause atrial fibrillation.
 
Ventricular resection involves a surgeon removing the area in the heart’s muscle where the arrhythmia starts.
In other cases, no treatment is needed. Most people with an arrhythmia lead normal, active lifestyles. Often, certain lifestyle changes, such as avoiding caffeine (found in coffee, tea, soft drinks, chocolate, and some over-the-counter pain medicines) or avoiding alcohol, are enough to stop the arrhythmia.

What causes angina?

Angina is the pain you feel when a diseased vessel in your heart (called a coronary artery) can no longer deliver enough blood to a part of the heart muscle to meet its need for oxygen. The heart’s lack of oxygen-rich blood is called ischemia. Angina usually happens when your heart has an extra need for oxygen-rich blood, such as during exercise. Other triggers of angina can be emotional stress, extreme cold or hot temperatures, heavy meals, alcohol, and smoking.

Angina attacks in men usually happen after the age of 30 and are nearly always caused by coronary artery disease (CAD). For women, angina tends to happen later in life and can be caused by many different factors. Causes other than CAD include narrowing of the aortic valve in the heart (aortic stenosis), a low number of red blood cells in the bloodstream (anemia), or an overactive thyroid gland (hyperthyroidism).

What are the symptoms?

Angina is usually a symptom of CAD. People with angina have a greater chance of having a heart attack than those who do not have symptoms of CAD.

Angina tends to start in the center of the chest, but the pain may spread to your left arm, neck, back, throat, or jaw. You may have numbness or a loss of feeling in your arms, shoulders, or wrists. An episode usually lasts no more than a few minutes. But if the pain lasts longer than a few minutes, it may mean that you have a sudden total blockage of a coronary artery or that you may be having a heart attack.

Patients may have one of several types of angina. Those with stable angina usually know the level of activity or stress that brings on an attack. Patients should also keep track of how long their attacks last, if the attacks feel different from other attacks they have had, and whether medicine helps ease the symptoms. Sometimes the pattern changes—attacks happen more often, last longer, or happen without exercise. A change in the pattern of attacks may mean that patients have what is called unstable angina, and they should see a doctor as soon as they can. Patients who have new, worsening, or constant chest pain have a greater risk of heart attack, an irregular heartbeat (arrhythmia), and even sudden death.

Other Types of Angina

Variant angina pectoris, or Prinzmetal’s angina, is a rare form of angina caused by something called coronary spasm (vasospasm). The spasm temporarily narrows the coronary artery, so the heart does not get enough blood. It may happen in patients who also have a severe buildup of fatty plaque (atherosclerosis) in at least one major vessel. Unlike typical angina, variant angina usually happens during times of rest. These attacks, which may be very painful, tend to happen regularly at certain times of the day.

Microvascular angina is a type of angina where patients have chest pain but do not seem to have a blockage in a coronary artery. The pain in the chest is because the tiny blood vessels that feed the heart, arms, and legs are not working properly. Generally, patients cope well with this type of angina and have very few long-term side effects.

How is angina diagnosed?

Doctors can usually find out if you have angina by listening to you talk about your symptoms and their patterns. Some tests may include x-rays, exercise electrocardiography (ECG or EKG), a nuclear stress test, and coronary angiography.

Variant angina can be diagnosed using a Holter monitor. Holter monitoring gets a non-stop reading of your heart rate and rhythm over a 24-hour period (or longer). You wear a recording device (the Holter monitor), which is connected to small metal disks called electrodes that are placed on your chest. With certain types of monitors, you can push a “record” button to capture a rhythm when you feel the symptoms of angina.

How is angina treated?

Lifestyle changes and medicine are the most common ways to control angina. In more severe cases, a procedure called revascularization may be necessary.

Lifestyle Changes

Although angina may be brought on by exercise, this does not mean that you should stop exercising. In fact, you should keep doing an exercise program that has been approved by your doctor. Risk factors for CAD (usually atherosclerosis) should be controlled, including high blood pressure, cigarette smoking, high cholesterol, and excess weight. By eating healthfully, not smoking, limiting how much alcohol you drink, and avoiding stress, you may live more comfortably and with fewer angina attacks.

Medicines

Certain medicines may help prevent or relieve the symptoms of angina. The most well-known medicine for angina is called nitroglycerin. It works by widening (dilating) the blood vessels, which improves blood flow and allows more oxygen-rich blood to reach the heart muscle. “Nitro” works in seconds. The moment an attack happens, patients are usually told to sit or lie down and then take their nitroglycerin. If an activity such as climbing the stairs brings on angina, you can take nitroglycerin beforehand to prevent an attack.

Other medicines used to control typical angina and microvascular angina are beta-blockers and calcium channel blockers. These medicines reduce the oxygen needs of the heart by slowing the heart rate or lowering blood pressure. They also reduce the likelihood of an irregular heartbeat, called an arrhythmia. Calcium channel blockers and nitrates may also be used to prevent the spasms that cause variant angina.

For patients with unstable angina, doctors normally prescribe bed rest and some type of blood-thinning medicine such as heparin.

Percutaneous Coronary Interventions and Surgery

If typical angina or variant angina is caused by severe CAD, then a revascularization procedure may be needed to improve the blood supply to your heart. Procedures may include either a percutaneous coronary intervention (such as balloon angioplasty or stenting) or coronary artery bypass surgery.

This test can show doctors the detailed size, shape, and movement of your heart muscle, and the condition of your aorta, which is the main blood vessel supplying blood to your body. It can also show how the heart valves are working and how blood is flowing through your heart. TEE also gives doctors information about your arteries. Doctors use this test when they cannot get a clear picture of your heart using standard echocardiography.

How does it work?

TEE uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your heart. The test is like standard echocardiography except that the pictures of the heart come from inside the esophagus rather than through the chest wall. The sound waves are sent through the body with a device called a transducer, which is attached to a tube and put down your esophagus. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce a picture of your heart and aorta.

What should I expect?

You will need to stop eating for at least 4 hours before the test. Your doctor will tell you exactly how long. Talk to your doctor about any medicines that you are taking because he or she may want you to stop taking them before the test.

The test will begin with the technician spraying your throat with an anesthetic, which will make it feel numb. Then, you will lie down on the examination table. A needle with a tube connected to it will be put in your arm. This is called an intravenous line or IV. The IV will give you a mild sedative to relax you throughout the test. Small metal disks called electrodes will be placed on your chest. These electrodes have wires called leads, which hook up to an electrocardiogram machine. This machine will monitor your heart rhythm during the test.

Then, a small flexible tube called a probe will be put down your throat. The technician will ask you to swallow, and the probe will be gently moved down your throat. This is often the most uncomfortable part of the test. If you feel the need to gag, do not worry, this is quite common. Once the probe is in place, you should not feel any pain.

On the end of the probe is the transducer, which takes pictures of your heart. The technician can also move the probe to get pictures of your heart from different angles.

After the technician has enough pictures, the probe and IV line will be removed. You will also be disconnected from the electrocardiogram machine. You may feel a little sleepy until the sedative has worn off, and you will be watched to see that your heart rate and blood pressure are normal.

You may find that you have a sore throat or trouble swallowing after the procedure. These side effects usually go away after a day or so.

If your doctor wants you to have a stress echocardiogram, you will have the same test as exercise stress testing, except that when your heart rate reaches a certain number you will be asked to step off of the treadmill or stationary bike and lie down.

For patients who are too sick to exercise, doctors can give them a drug that has the same effect on the body that exercise does. Some examples of the drugs that may be given are dobutamine or adenosine. You may hear this type of test called a dobutamine stress echo.

How does it work?

Echocardiography uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your heart. The sound waves are delivered through the body with a device called a transducer. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce a one-, two-, or three-dimensional picture of your heart.
What should I expect?

After your heart has reached a certain rate during exercise on a treadmill or stationary bike, you will be asked to lie down on an examination table. Next, the technician will put a thick gel on your chest. The gel may feel cold, but it does not harm your skin. Then the technician will use the transducer to send and receive the sound waves.

The transducer will be placed directly on your chest, above your heart. The technician will press firmly as he or she moves the transducer across your chest. You may be asked to breathe in or out or to hold your breath briefly during the test. For most of the test, you will lie still.

Most stress echo tests take about 45 minutes, but a dobutamine stress echo takes longer.