issue: heart
NOVEMBER, 2018 | THE HEALTH
13
MEDICAL NEWS TODAY
Diagram of the human heart
cardiomegaly.
Cardiomegaly an
enlargement of
the heart
The illustration shows the difference between a normal heart, a systolic and a diastolic dysfunction.
Hypertensive heart disease
H
YPERTENSIVE heart disease is a type
of cardiomyopathy which results from
the response of the biomechanical
stress by the left ventrical basically because
of the uncontrolled or poorly controlled
hypertension.
Sri Kota Specialist Medical Centre Con-
sultant Cardiologist Dr G.S. Sridhar reasoned
that when there is a very poorly controlled
hypertension, the heart is under tremendous
stress, and the heart muscle tend to grow a
bit thick which changes the pressure inside
the heart.
“This can cause systolic or a diastolic
dysfunction which in turn causes various
clinical symptoms.”
Who are more susceptible?
Anybody who have hypertension and it is not
under control are susceptible to hypertensive
heart disease. However, it is quite common
in both males and in females.
“In males, they would present in the
Insomnia
associated with
ischemic heart
disease
middle age group (40 – 50) while females
would present at a much later age especially
after menopause basically due to the hor-
monal changes.”
Symptoms
The most common symptoms patient’s
would present is lower limb swelling where
both the legs will be swollen and sometimes
with difficulty breathing and exertion, angina
and a chest pain.
Diagnosis
“It is both by clinical examination and by
imaging. Clinical examination – when we
listen to the heart sounds, it would be of a
different anatomy where it is not supposed
to be. In addition to these, they would also
have leg swellings and crepitation of the
lungs (water retention in the lungs).”
“If we take an ECG, we can see evidence
of the left ventricular hypertrophy. The same
goes when an echocardiography is done.”
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The journal revealed that
“If we take an
ECG, we can
see evidence
of the left
ventricular
hypertrophy.
The same
goes when
an echocar-
diography is
done.”
insomnia has a significant impact
on individual health particularly
those with co-morbid conditions,
whereby it has been reported to be
associated with chronic diseases
such as ischemic heart disease and
hypertension, morning headaches
and depression.
CARDIOMEGALY is not a disease but
the enlargement of the heart.
Sri Kota Specialist Medical Centre
Consultant Cardiologist Dr G.S. Sridhar
explained that there could be various
reasons as to why the heart is enlarged.
“It can be due to a dilated cardiomyop-
athy or a hypertrophic cardiomyopathy.”
“Dilated cardiomyopathy means that
the heart is enlarged due to an ischemic
heart disease or the patient would have a
heart attack in the past. It could also be
an underlying valvular heart disease. In
these kinds of situation, the heart would
be enlarged.”
“Hypertrophic cardiomyopathy can
occur due to hypertensive heart disease.
High pressure causes the heart muscle to
be thicker and enlarged.”
Symptoms
In patients with dilated cardiomyopathy,
they tend to have heart failure symptoms,
difficulty in breathing, leg swelling, can’t
lay flat and would require two to three
pillows to sleep which are all symptoms
of water retention.
“For hypertrophic cardiomyopathy,
they would present with uncontrolled
hypertension and the most common sign
is the lower leg swelling.”
Treatment
“For dilated cardiomyopathy, we need to
treat the underlying cause. If the patient
had an ischemic heart disease, the patient
would most probably require an angio-
gram to clear up the blocks.”
“If it is a hypertensive cardiomyopathy,
then we would need to optimise the pres-
sure to control the medication to control
the pressure appropriately,” he said.