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Although many indications are the same for performing either PCI or CABG, these two procedures have inherently different mechanisms. While PCI mitigates an obstruction, it can not prevent plaque progression or rupture in other involved segments of the artery. On the contrary, CABG is able to prevent future ischemic insults caused by plaque progression or rupture in other involved segments of the artery. Most studies report the same outcome with PCI and CABG, but there are some reports that favor CABG over PCI: The SYNTAX trial with 705 patients demonstrated a significantly higher rate of major adverse cardiovascular events and mortality rate among those who received PCI than the CABG cohort. Two Studies reported that CABG is more effective in prevention of late spontaneous MI when compared to PCI. ACA 2021 revascularization guideline recommends to consider the following factors to decide whether to chose PCI or CABG: SYNTAX Score SYNTAX score derived from a clinical trial with the same name which predicts the grade of the anatomic complexity and can be used as a decision-making tool. This score is a guide for selection of a revascularization procedure in patients with multivessel coronary artery disease. All cause mortality rate among patients with a coronary artery disease -associated SYNTAX score equal or greater than 33 were significantly lower when undergone CABG than PCI For patients with SYNTAX score lower than 33, no differences have been report in mortality rate of CABG and PCI Compliance to medications Preferences of patient Individual factors, such as anatomic complexity, which is discussed in the following table: PCI would help patients with STEMI and ischemic symptoms for less than 12 hours. Rescue PCI is recommended for STEMI patients who failed re-perfusion after fibrinolytic therapy to improve the survival. PCI has been related to improved survival rate when done in STEMI patients who are stable and presented 12 to 24 hours after symptom onset. Regardless of time from MI, PCI can increase survival in STEMI patients who developed complications such as ongoing ischemia, acute sever heart failure, or life-threatening cardiac arrhythmia. Performing the PCI is not beneficial in stable and asymptomatic STEMI patients who have a totally occluded infarct artery >24 hours after symptom onset with no evidence for sever ischemia. The role of PCI in asymptomatic STEMI patients who are presenting after 12 to 24 hours after symptom onset is not well studied. However, based on a small trial named BRAVE-2 a reduction in left ventricular infarct size has been reported among asymptomatic STEMI patients who were treated with an invasive strategy of coronary stent within 12 to 48 hours after symptom onset, compared to conservative therapies. Both PCI and CABG are indicated in patients with STEMI, cardiogenic shock, and hemodynamic instability. CABG is recommended for patients with STEMI who have mechanical complications such as ventricular septal rupture, mitral regurgitation because of papillary muscle infarction or rupture, or free wall rupture. Emergent or urgent CABG is recommended in STEMI patients whose PCI is not feasible with a large area of myocardial involvement. On the other hand, emergent or urgent CABG should be avoided in these patients in the absence of ischemia or large myocardial involvement. Furthermore, CABG is usually avoided if patients' distal targets are poor. The following algorithm demonstrates the proper revascularization in STEMI patients. The sole condition that fibrinolytic therapies are superior to PCI is when the duration from hospital presentation to PCI is anticipated to be more than 120 minutes. An early revascularization strategy could increase the survival rate in patients with STEMI complicated by cardiogenic shock. Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are commonly used to assess the lesion significant. Fractional flow reserve (FFR) compares the maximal blood flow distal to the lesion to the normal maximal blood flow. On the other hand iFR compares the instantaneous wave-free ratio of the coronary pressure distal to the lesion during the diastole with the aortic pressure. Reported in numbers of trials which used FFR, FFR -guided PCI was successful in lowering the revascularization rate, procedure-related chest pain in patients with stable coronary artery disease and functionally significant stenosis. In one of these trials patients with abnormal FFR significantly benefited from PCI over medical therapy with lower rate of ischemia -driven revascularization and shorter procedural time. FFR -guided revascularization with CABG was more off-pump with fewer anastomosis and simpler procedure compared to CABG with angiogram -guided revascularization in one of the clinical trials. Although other studies reported similar outcomes in both. iFR measure does not require the administration of adenosine has been also studied in clinical trials. Results supported that this measure is not inferior to FFR and also showed less adverse outcome related to the procedure. Lower rate of long-term major adverse cardiac events has been reported when PCI was deferred with FFR greater than 0.80 or iFR that is >0.89. One of the trials named DEFER (Deferral of Percutaneous Intervention) reported that the rate of adverse outcome cardiac outcomes is similar in both group of patients whose PCI has been deferred either with a FFR greater than 0.75 or intermediate angiographic measures.	Answer this question truthfully	What Procedure to Choose?	Although many indications are the same for performing either {{ORGANIZATION}} or CABG, these two procedures have inherently different mechanisms. While {{ORGANIZATION}} mitigates an obstruction, it can not prevent plaque progression or rupture in other involved segments of the artery. On the contrary, {{ORGANIZATION}} is able to prevent future ischemic insults caused by plaque progression or rupture in other involved segments of the artery. Most studies report the same outcome with {{ORGANIZATION}} and {{ORGANIZATION}}, but there are some reports that favor CABG over {{ORGANIZATION}}: The {{ORGANIZATION}} trial with 705 patients demonstrated a significantly higher rate of major adverse cardiovascular events and mortality rate among those who received PCI than the CABG cohort. Two Studies reported that CABG is more effective in prevention of late spontaneous MI when compared to {{ORGANIZATION}}. ACA 2021 revascularization guideline recommends to consider the following factors to decide whether to chose {{ORGANIZATION}} or CABG: {{ORGANIZATION}} {{ORGANIZATION}} score derived from a clinical trial with the same name which predicts the grade of the anatomic complexity and can be used as a decision-making tool. This score is a guide for selection of a revascularization procedure in patients with multivessel coronary artery disease. All cause mortality rate among patients with a coronary artery disease -associated {{ORGANIZATION}} score equal or greater than 33 were significantly lower when undergone CABG than PCI For patients with {{ORGANIZATION}} score lower than 33, no differences have been report in mortality rate of CABG and PCI Compliance to medications Preferences of patient {{ORGANIZATION}} factors, such as anatomic complexity, which is discussed in the following table: {{ORGANIZATION}} would help patients with STEMI and ischemic symptoms for less than 12 hours. Rescue PCI is recommended for STEMI patients who failed re-perfusion after fibrinolytic therapy to improve the survival. {{ORGANIZATION}} has been related to improved survival rate when done in STEMI patients who are stable and presented 12 to 24 hours after symptom onset. Regardless of time from MI, PCI can increase survival in STEMI patients who developed complications such as ongoing ischemia, acute sever heart failure, or life-threatening cardiac arrhythmia. Performing the {{ORGANIZATION}} is not beneficial in stable and asymptomatic STEMI patients who have a totally occluded infarct artery >24 hours after symptom onset with no evidence for sever ischemia. The role of {{ORGANIZATION}} in asymptomatic STEMI patients who are presenting after 12 to 24 hours after symptom onset is not well studied. However, based on a small trial named BRAVE-2 a reduction in left ventricular infarct size has been reported among asymptomatic STEMI patients who were treated with an invasive strategy of coronary stent within 12 to 48 hours after symptom onset, compared to conservative therapies. Both {{ORGANIZATION}} and {{ORGANIZATION}} are indicated in patients with STEMI, cardiogenic shock, and hemodynamic instability. CABG is recommended for patients with STEMI who have mechanical complications such as ventricular septal rupture, mitral regurgitation because of papillary muscle infarction or rupture, or free wall rupture. Emergent or urgent {{ORGANIZATION}} is recommended in STEMI patients whose {{ORGANIZATION}} is not feasible with a large area of myocardial involvement. On the other hand, emergent or urgent {{ORGANIZATION}} should be avoided in these patients in the absence of ischemia or large myocardial involvement. Furthermore, {{ORGANIZATION}} is usually avoided if patients' distal targets are poor. The following algorithm demonstrates the proper revascularization in STEMI patients. The sole condition that fibrinolytic therapies are superior to {{ORGANIZATION}} is when the duration from hospital presentation to {{ORGANIZATION}} is anticipated to be more than 120 minutes. An early revascularization strategy could increase the survival rate in patients with STEMI complicated by cardiogenic shock. Fractional flow reserve ({{ORGANIZATION}}) and instantaneous wave-free ratio (iFR) are commonly used to assess the lesion significant. Fractional flow reserve ({{ORGANIZATION}}) compares the maximal blood flow distal to the lesion to the normal maximal blood flow. On the other hand iFR compares the instantaneous wave-free ratio of the coronary pressure distal to the lesion during the diastole with the aortic pressure. Reported in numbers of trials which used {{ORGANIZATION}}, {{ORGANIZATION}} -guided {{ORGANIZATION}} was successful in lowering the revascularization rate, procedure-related chest pain in patients with stable coronary artery disease and functionally significant stenosis. In one of these trials patients with abnormal {{ORGANIZATION}} significantly benefited from {{ORGANIZATION}} over medical therapy with lower rate of ischemia -driven revascularization and shorter procedural time. FFR -guided revascularization with CABG was more off-pump with fewer anastomosis and simpler procedure compared to CABG with angiogram -guided revascularization in one of the clinical trials. Although other studies reported similar outcomes in both. iFR measure does not require the administration of adenosine has been also studied in clinical trials. Results supported that this measure is not inferior to {{ORGANIZATION}} and also showed less adverse outcome related to the procedure. Lower rate of long-term major adverse cardiac events has been reported when PCI was deferred with FFR greater than 0.80 or iFR that is >0.89. One of the trials named {{NAME}} (Deferral of Percutaneous Intervention) reported that the rate of adverse outcome cardiac outcomes is similar in both group of patients whose {{ORGANIZATION}} has been deferred either with a {{ORGANIZATION}} greater than 0.75 or intermediate angiographic measures.
Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood. Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding. The blood is sent to a laboratory, where the following are measured: Low density lipoprotein (LDL or "bad" cholesterol) High density lipoprotein (HDL or "good" cholesterol) Total cholesterol Triglycerides Very low density lipoprotein (VLDL cholesterol, though this is often calculated from the triglyceride level) Other blood tests, such as C-reactive protein (CRP), may be added to the profile in some laboratories.	Answer this question truthfully	How a coronary risk profile performed?	Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood. Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding. In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding. The blood is sent to a laboratory, where the following are measured: Low density lipoprotein (LDL or "bad" cholesterol) High density lipoprotein ({{NAME}} or "good" cholesterol) Total cholesterol Triglycerides Very low density lipoprotein (VLDL cholesterol, though this is often calculated from the triglyceride level) Other blood tests, such as C-reactive protein ({{ORGANIZATION}}), may be added to the profile in some laboratories.
You should not eat or drink anything except water for 9 - 12 hours before having your blood drawn.	Answer this question truthfully	How to prepare for a coronary risk profile?	You should not eat or drink anything except water for 9 - 12 hours before having your blood drawn.
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.	Answer this question truthfully	How will a coronary risk profile feel?	When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
A coronary risk profile may be done: To screen adults and children for high blood cholesterol and triglycerides To follow people who have had high cholesterol levels and are being treated Screening for adults: The first screening test is performed between ages 20 - 35 in men, and ages 20 - 45 in women. (Note: Different national medical organizations recommend different starting ages.) Follow-up screening should be done every 5 years Screening is done for anyone who develops diabetes, high blood pressure, heart disease, or another illness caused by atherosclerosis. Follow-up testing is done to determine how well diet and medications are controlling high cholesterol. Screening for children is less agreed upon: Some experts recommend only screening children with risk factors, such as a family history of high cholesterol or early heart disease (a history of heart attacks before age 55 in men, and before age 65 in women). Some experts recommend screening all children, but according to the U.S. Preventive Services Task Force, there is not enough evidence to recommend for or against cholesterol screening in children.	Answer this question truthfully	Why is a coronary risk profile performed?	A coronary risk profile may be done: To screen adults and children for high blood cholesterol and triglycerides To follow people who have had high cholesterol levels and are being treated Screening for adults: The first screening test is performed between ages 20 - 35 in men, and ages 20 - 45 in women. (Note: Different national medical organizations recommend different starting ages.) Follow-up screening should be done every 5 years Screening is done for anyone who develops diabetes, high blood pressure, heart disease, or another illness caused by atherosclerosis. Follow-up testing is done to determine how well diet and medications are controlling high cholesterol. Screening for children is less agreed upon: Some experts recommend only screening children with risk factors, such as a family history of high cholesterol or early heart disease (a history of heart attacks before age 55 in men, and before age 65 in women). Some experts recommend screening all children, but according to {{ORGANIZATION}}, there is not enough evidence to recommend for or against cholesterol screening in children.
The ideal values are different for people without coronary artery disease or other risk factors than for those with known coronary artery disease, diabetes, or high blood pressure. The desired values in adults are: LDL: 70 - 130 mg/dL (lower numbers are desired) HDL: greater than 40 - 60 mg/dL (higher numbers are desired) Total cholesterol: less than 200 mg/dL (lower numbers are desired) Triglycerides: 10 - 150 mg/dL (lower numbers are desired) VLDL: 2 - 38 mg/dL Talk to your health care provider about the ideal levels in children. (Note: mg/dL = milligrams per deciliter) (Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.)	Answer this question truthfully	What are normal results?	The ideal values are different for people without coronary artery disease or other risk factors than for those with known coronary artery disease, diabetes, or high blood pressure. The desired values in adults are: LDL: 70 - 130 mg/dL (lower numbers are desired) HDL: greater than 40 - 60 mg/dL (higher numbers are desired) Total cholesterol: less than 200 mg/dL (lower numbers are desired) Triglycerides: 10 - 150 mg/dL (lower numbers are desired) VLDL: 2 - 38 mg/dL Talk to your health care provider about the ideal levels in children. (Note: mg/dL = milligrams per deciliter) (Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.)
Abnormal values may be a sign that you are at increased risk for atherosclerosis and related disorders, including: Heart disease Kidney disease Poor blood supply to the legs Stroke	Answer this question truthfully	What do abnormal results mean?	Abnormal values may be a sign that you are at increased risk for atherosclerosis and related disorders, including: Heart disease {{NAME}} disease Poor blood supply to the legs Stroke
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others. Other risks associated with having blood drawn are slight but may include: Excessive bleeding Fainting or feeling light-headed Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)	Answer this question truthfully	What are the risks?	Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others. Other risks associated with having blood drawn are slight but may include: Excessive bleeding Fainting or feeling light-headed {{NAME}} (blood accumulating under the skin) Infection (a slight risk any time the skin is broken)
You should not drive for 48 hours after the procedure.	Answer this question truthfully	When could I drive after i underwent Coronary stent discharge instructions ?	You should not drive for 48 hours after the procedure.
Aspirin every day - usually for the rest of your life. Ask your doctor about the dose you should take. Plavix (clopidogrel) and Effient (prasugrel) may be used in addition to Aspirin to decrease the risk of a blood clot forming in the heart artery. You will be given a list of all medicines you should take once you are at home. Ask your doctor whether you should go back to taking the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.	Answer this question truthfully	What medications should I take after Coronary stent discharge instructions ?	Aspirin every day - usually for the rest of your life. Ask your doctor about the dose you should take. Plavix (clopidogrel) and Effient (prasugrel) may be used in addition to {{NAME}} to decrease the risk of a blood clot forming in the heart artery. You will be given a list of all medicines you should take once you {{EMAIL}}. Ask your doctor whether you should go back to taking the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.
You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.	Answer this question truthfully	Should I take any OTC pain medications?	You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.
You may resume your regular activities one week after the procedure. Avoid lifting, pushing, or pulling anything heavier than 10 pounds in the first week after the procedure. Also avoid any exercise that causes you to hold your breath and bear down with your abdominal muscles. Begin your exercise program one week after the procedure at half your usual routine, then gradually work back to your full routine. Please ask your doctor about your exercise instructions.	Answer this question truthfully	When may I resume my regular activities?	You may resume your regular activities one week after the procedure. Avoid lifting, pushing, or pulling anything heavier than 10 pounds in the first week after the procedure. Also avoid any exercise that causes you to hold your breath and bear down with your abdominal muscles. Begin your exercise program one week after the procedure at half your usual routine, then gradually work back to your full routine. Please ask your doctor about your exercise instructions.
Usually after one week, when the puncture site is healed. This usually takes about a week. You may shower on the day after the procedure after removing the Band-Aid over your puncture site.	Answer this question truthfully	When could I bathe or swim?	Usually after one week, when the puncture site is healed. This usually takes about a week. You may shower on the day after the procedure after removing the Band-Aid over your puncture site.
It depends on the type of your work. You can ask your doctor when you can go back to work.	Answer this question truthfully	When can I go back to work after Coronary stent discharge instructions ?	It depends on the type of your work. You can ask your doctor when you can go back to work.
Call your doctor if: There is bleeding at the catheter insertion site that does not stop when you apply pressure. There is swelling at the catheter site. Your leg or arm below where the catheter was inserted changes color, becomes cool to touch, or is numb. The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it. You have chest pain or shortness of breath that does not go away with rest. Your pulse feels irregular -- very slow (fewer than 60 beats), or very fast (over 100 to 120 beats) a minute. You have dizziness, fainting, or you are very tired. You are coughing up blood or yellow or green mucus. You have problems taking any of your heart medicines. You have chills or a fever over 101 °F.	Answer this question truthfully	When to seek urgent medical care when I have Coronary stent discharge instructions ?	Call your doctor if: There is bleeding at the catheter insertion site that does not stop when you apply pressure. There is swelling at the catheter site. Your leg or arm below where the catheter was inserted changes color, becomes cool to touch, or is numb. The small incision for your catheter becomes red or painful, or yellow or green discharge is draining from it. You have chest pain or shortness of breath that does not go away with rest. Your pulse feels irregular -- very slow (fewer than 60 beats), or very fast (over 100 to 120 beats) a minute. You have dizziness, fainting, or you are very tired. You are coughing up blood or yellow or green mucus. You have problems taking any of your heart medicines. You have chills or a fever over 101 °F.
Coronary vasospasm may be silent (without symptoms) or it may result in chest pain or angina. If the spasm lasts long enough, it may even cause a heart attack. The main symptom is a type of chest pain called angina, which can be felt under the chest bone and is described as: Constricting Crushing Pressure Squeezing Tightness The pain: Often occurs at rest May occur at the same time each day, usually between midnight and 8:00 AM Lasts from 5 to 30 minutes It is usually severe. The pain may spread to the neck, jaw, shoulder, or arm. The person may lose consciousness. Unlike angina that is caused by hardening of the coronary arteries, chest pain and shortness of breath are often not present when you walk or exercise.	Answer this question truthfully	What are the symptoms of Coronary vasospasm?	Coronary vasospasm may be silent (without symptoms) or it may result in chest pain or angina. If the spasm lasts long enough, it may even cause a heart attack. The main symptom is a type of chest pain called angina, which can be felt under the chest bone and is described as: Constricting Crushing Pressure Squeezing Tightness The pain: Often occurs at rest May occur at the same time each day, usually between midnight and 8:00 AM Lasts from 5 to 30 minutes It is usually severe. The pain may spread to the neck, jaw, shoulder, or arm. The person may lose consciousness. Unlike angina that is caused by hardening of the coronary arteries, chest pain and shortness of breath are often not present when you walk or exercise.
The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis). However, it also can occur in arteries with plaque buildup. A contraction (squeezing) of muscles in the artery wall causes these spasms in the arteries. The contraction occurs in just one area of the artery. The coronary artery may appear normal during angiography, but it does not function normally.	Answer this question truthfully	What causes Coronary vasospasm?	The spasm often occurs in coronary arteries that have not become hardened due to plaque buildup (atherosclerosis). However, it also can occur in arteries with plaque buildup. A contraction (squeezing) of muscles in the artery wall causes these spasms in the arteries. The contraction occurs in just one area of the artery. The coronary artery may appear normal during angiography, but it does not function normally.
Coronary vasospasm affects approximately 4 out of 100,000 people. About 2% of patients with angina have coronary vasospasm. Coronary vasospasm occurs most commonly in people who smoke or who have high cholesterol or high blood pressure. In many people, coronary vasospasm may occur without any other heart risk factors and it may be triggered by: Alcohol withdrawal, Emotional stress, Exposure to cold, Medications that cause narrowing of the blood vessels (vasoconstriction), Stimulant drugs such as amphetamines and cocaine.	Answer this question truthfully	Who is at highest risk for Coronary vasospasm ?	Coronary vasospasm affects approximately 4 out of 100,000 people. About 2% of patients with angina have coronary vasospasm. Coronary vasospasm occurs most commonly in people who smoke or who have high cholesterol or high blood pressure. In many people, coronary vasospasm may occur without any other heart risk factors and it may be triggered by: Alcohol withdrawal, Emotional stress, Exposure to cold, Medications that cause narrowing of the blood vessels (vasoconstriction), {{ORGANIZATION}} drugs such as amphetamines and cocaine.
Immediately call- 911 or go to the hospital emergency room if you have a history of angina and the crushing or squeezing chest pain is not relieved by nitroglycerin. The pain may be due to a heart attack. Rest and nitroglycerin do not completely relieve the pain of a heart attack. A heart attack is a medical emergency. If you have symptoms of a heart attack, seek immediate medical help.	Answer this question truthfully	When to seek urgent medical care when I have Coronary vasospasm ?	Immediately call- 911 or go to the hospital emergency room if you have a history of angina and the crushing or squeezing chest pain is not relieved by nitroglycerin. The pain may be due to a heart attack. Rest and nitroglycerin do not completely relieve the pain of a heart attack. A heart attack is a medical emergency. If you have symptoms of a heart attack, seek immediate medical help.
Changes in skin color (redness) in one leg Increased warmth in one leg Leg pain in one leg Leg tenderness in one leg Skin that feels warm to the touch Swelling (edema) of one leg	Answer this question truthfully	What are the symptoms of Deep vein thrombosis?	Changes in skin color (redness) in one leg Increased warmth in one leg Leg pain in one leg Leg tenderness in one leg Skin that feels warm to the touch Swelling (edema) of one leg
Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart or another other area that can lead to severe damage. Blood clots may form when something causes the flow of blood in the veins to slow or change. {{#ev:youtube\|CETfozL0cQg}}	Answer this question truthfully	What causes Deep vein thrombosis?	Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart or another other area that can lead to severe damage. Blood clots may form when something causes the flow of blood in the veins to slow or change. {{#ev:youtube\|CETfozL0cQg}}
DVTs are most common in adults over age 60, but can occur at any age. Sitting for long periods when traveling can increase the risk of DVTs. This is most likely when one or more of the risk factors listed below are also present. Risk factors include: After a pacemaker catheter has been passed through the vein in the groin Bedrest Cigarette smoking Family history of blood clots Fractures in the pelvis or legs Giving birth within the last 6 months Heart failure Obesity Recent surgery (especially hip, knee, or female pelvic surgery) Too many blood cells being made by the bone marrow (polycythemia vera), causing the blood to be thicker and slower than normal You're also more likely to develop DVT if you have any of the following conditions: Blood that is more likely to clot (hypercoagulability) Cancer Taking estrogens or birth control pills. This risk is even higher if you smoke.	Answer this question truthfully	Who is at highest risk for Deep vein thrombosis ?	DVTs are most common in adults over age 60, but can occur at any age. Sitting for long periods when traveling can increase the risk of DVTs. This is most likely when one or more of the risk factors listed below are also present. Risk factors include: After a pacemaker catheter has been passed through the vein in the groin {{NAME}} smoking Family history of blood clots Fractures in the pelvis or legs Giving birth within the last 6 months Heart failure {{ORGANIZATION}} surgery (especially hip, knee, or female pelvic surgery) Too many blood cells being made by the bone marrow (polycythemia vera), causing the blood to be thicker and slower than normal You're also more likely to develop DVT if you have any of the following conditions: Blood that is more likely to clot (hypercoagulability) Cancer Taking estrogens or birth control pills. This risk is even higher if you smoke.
Call your health care provider if you have symptoms of DVT. Go to the emergency room or call the local emergency number (such as 911) if you have DVT and you develop chest pain, difficulty breathing, coughing blood, fainting, loss of consciousness, or other severe symptoms.	Answer this question truthfully	When to seek urgent medical care when I have Deep vein thrombosis ?	Call your health care provider if you have symptoms of DVT. Go to the emergency room or call the local emergency number (such as 911) if you have DVT and you develop chest pain, difficulty breathing, coughing blood, fainting, loss of consciousness, or other severe symptoms.
Many DVTs disappear without a problem, but they can return. Some people may have long-term pain and swelling in the leg known as post-phlebitic syndrome. Wearing tight (compression) stockings during and after the DVT may help prevent this problem. Blood clots in the thigh are more likely to break off and cause pulmonary embolism (PE) than blood clots in the lower leg or other parts of the body.	Answer this question truthfully	What to expect if I have Deep vein thrombosis (Outlook/Prognosis)?	Many DVTs disappear without a problem, but they can return. Some people may have long-term pain and swelling in the leg known as post-phlebitic syndrome. Wearing tight (compression) stockings during and after the {{ORGANIZATION}} may help prevent this problem. Blood clots in the thigh are more likely to break off and cause pulmonary embolism (PE) than blood clots in the lower leg or other parts of the body.
Dengue fever begins with a sudden high fever, often as high as 104–105 degrees Fahrenheit. A flat, red rash may appear over most of the body 2–5 days after the fever starts. A second rash, which looks like the measles, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable. Other symptoms include: Headache (especially behind the eyes) Fatigue Joint aches Muscle aches Nausea Swollen lymph nodes Vomiting	Answer this question truthfully	What are the symptoms of Dengue fever?	Dengue fever begins with a sudden high fever, often as high as 104–105 degrees Fahrenheit. A flat, red rash may appear over most of the body 2–5 days after the fever starts. A second rash, which looks like the measles, appears later in the disease. Infected people may have increased skin sensitivity and are very uncomfortable. Other symptoms include: Headache (especially behind the eyes) Fatigue Joint aches Muscle aches {{NAME}} lymph nodes {{ORGANIZATION}}
Dengue fever is caused by one of four different but related viruses. It is spread by the bite of mosquitoes, most commonly the mosquito Aedes aegypti, which is found in tropic and subtropic regions. This includes parts of: Indonesian archipelago into northeastern Australia South and Central America Southeast Asia Sub-Saharan Africa Dengue fever is being seen more in world travelers. Dengue fever should not be confused with dengue hemorrhagic fever, which is a separate disease that is caused by the same type of virus but has much more severe symptoms.	Answer this question truthfully	What causes Dengue fever?	Dengue fever is caused by one of four different but related viruses. It is spread by the bite of mosquitoes, most commonly the mosquito Aedes aegypti, which is found in tropic and subtropic regions. This includes parts of: Indonesian archipelago into northeastern Australia South and Central America Southeast Asia Sub-Saharan Africa Dengue fever is being seen more in world travelers. Dengue fever should not be confused with dengue hemorrhagic fever, which is a separate disease that is caused by the same type of virus but has much more severe symptoms.
Living or traveling to a region of the world where the infection is endemic is a risk factor for the disease. These regions include: Indonesian archipelago into northeastern Australia South and Central America Southeast Asia Sub-Saharan Africa The presence of water-holding containers in and around the home needed for the mosquito's to complete their development sustains the reservoir for disease and is a risk factor. Risk factors for severe disease include being a neonate or young child, female sex, high body mass index, a high viral load, genetic polymorphisms and previous infection with DENV-1 if the patient contracts the DENV-2 or DENV-3 strain. Diabetes and asthma are risk factors for fatal disease.	Answer this question truthfully	Who is at highest risk for Dengue fever ?	Living or traveling to a region of the world where the infection is endemic is a risk factor for the disease. These regions include: Indonesian archipelago into northeastern Australia South and Central America Southeast Asia Sub-Saharan Africa The presence of water-holding containers in and around the home needed for the mosquito's to complete their development sustains the reservoir for disease and is a risk factor. Risk factors for severe disease include being a neonate or young child, female sex, high body mass index, a high viral load, genetic polymorphisms and previous infection with DENV-1 if the patient contracts the DENV-2 or DENV-3 strain. Diabetes and asthma are risk factors for fatal disease.
Call your health care provider if you have traveled in an area where dengue fever is known to occur and have developed symptoms of the disease.	Answer this question truthfully	When to seek urgent medical care when I have Dengue fever ?	Call your health care provider if you have traveled in an area where dengue fever is known to occur and have developed symptoms of the disease.
The condition generally lasts a week or more. Although uncomfortable, dengue fever in most cases is not deadly. People with the condition should fully recover. Some people develop a more severe form of the disease which requires hospitalization.	Answer this question truthfully	What to expect if I have Dengue fever (Outlook/Prognosis)?	The condition generally lasts a week or more. Although uncomfortable, dengue fever in most cases is not deadly. People with the condition should fully recover. Some people develop a more severe form of the disease which requires hospitalization.
There are no symptoms of dextrocardia if the heart is normal. Conditions that may include dextrocardia may cause the following symptoms: Bluish skin Difficulty breathing Failure to grow and gain weight Fatigue Jaundice (yellow skin and eyes) Pale skin (pallor) Repeated sinus or lung infections	Answer this question truthfully	What are the symptoms of Dextrocardia?	There are no symptoms of dextrocardia if the heart is normal. Conditions that may include dextrocardia may cause the following symptoms: Bluish skin Difficulty breathing Failure to grow and gain weight Fatigue Jaundice (yellow skin and eyes) Pale skin (pallor) Repeated sinus or lung infections
During the early weeks of pregnancy, the baby's heart develops. Sometimes, for reasons that are unclear, the heart develops and turns so that it points to the right side of the chest instead of the left side. There are several types of dextrocardia. Most involve other defects of the heart and abdomen area. The simplest type of dextrocardia is one in which the heart is a mirror image of the normal heart, and no other problems exist. This condition is rare. Usually in this case, the organs of the abdomen and the lungs will also be arranged in a mirror image of their normal position. For example, the liver will be on the left side instead of the right. Some people with mirror-image dextrocardia have a problem with the fine hairs (cilia) that filter the air going into their nose and air passages. This condition is called Kartagener syndrome. In the more common types of dextrocardia, heart defects are present in addition to the abnormal location of the heart. The most common heart defects seen with dextrocardia include: Double outlet right ventricle Endocardial cushion defect Pulmonary stenosis or atresia Single ventricle Transposition of the great vessels Ventricular septal defect The abdominal and chest organs in babies with dextrocardia may be abnormal and may not work correctly. A very serious syndrome that appears with dextrocardia is called heterotaxy. Heterotaxy means the organs (atria of the heart and abdominal organs) are not in their usual places. In heterotaxy, the spleen may be completely missing. Because the spleen is an extremely important part of the immune system, babies born without a spleen are in danger of severe bacterial infections and death. In another form of heterotaxy several small spleens exist, but may not work correctly. Heterotaxy may also include: Abnormal gallbladder system Problems with the lungs Problems with the structure of the intestines Severe heart defects Possible risk factors for dextrocardia include: Family history of the condition Mother with diabetes (may play a role in some forms of dextrocardia)	Answer this question truthfully	What causes Dextrocardia?	During the early weeks of pregnancy, the baby's heart develops. Sometimes, for reasons that are unclear, the heart develops and turns so that it points to the right side of the chest instead of the left side. There are several types of dextrocardia. Most involve other defects of the heart and abdomen area. The simplest type of dextrocardia is one in which the heart is a mirror image of the normal heart, and no other problems exist. This condition is rare. Usually in this case, the organs of the abdomen and the lungs will also be arranged in a mirror image of their normal position. For example, the liver will be on the left side instead of the right. Some people with mirror-image dextrocardia have a problem with the fine hairs (cilia) that filter the air going into their nose and air passages. This condition is called {{ORGANIZATION}} syndrome. In the more common types of dextrocardia, heart defects are present in addition to the abnormal location of the heart. The most common heart defects seen with dextrocardia include: Double outlet right ventricle Endocardial cushion defect {{NAME}} stenosis or atresia Single ventricle {{NAME}} of the great vessels Ventricular septal defect The abdominal and chest organs in babies with dextrocardia may be abnormal and may not work correctly. A very serious syndrome that appears with dextrocardia is called heterotaxy. Heterotaxy means the organs (atria of the heart and abdominal organs) are not in their usual places. In heterotaxy, the spleen may be completely missing. Because the spleen is an extremely important part of the immune system, babies born without a spleen are in danger of severe bacterial infections and death. In another form of heterotaxy several small spleens exist, but may not work correctly. Heterotaxy may also include: Abnormal gallbladder system Problems with the lungs {{ORGANIZATION}} with the structure of the intestines Severe heart defects Possible risk factors for dextrocardia include: Family history of the condition Mother with diabetes (may play a role in some forms of dextrocardia)
Like most congenital heart defects, it is unclear exactly why certain babies are born with dextocardia. There is evidence to suggest that families with a history of genetic problems and other congenital heart disease may be at an increased risk for carrying and expressing the trait. Genetic testing may be performed to assist you in estimating the likelihood that any future children may be born with dextrocardia. Expectant mothers who consume alcohol and illicit drugs during pregnancy are putting their fetus at an increased risk for a congenital heart disease, such as dextrocardia.	Answer this question truthfully	Who is at highest risk for Dextrocardia ?	Like most congenital heart defects, it is unclear exactly why certain babies are born with dextocardia. There is evidence to suggest that families with a history of genetic problems and other congenital heart disease may be at an increased risk for carrying and expressing the trait. Genetic testing may be performed to assist you in estimating the likelihood that any future children may be born with dextrocardia. Expectant mothers who consume alcohol and illicit drugs during pregnancy are putting their fetus at an increased risk for a congenital heart disease, such as dextrocardia.
Babies with simple dextrocardia have a normal life expectancy and should have no problems related to the location of the heart. When dextrocardia appears with other defects in the heart and elsewhere in the body, how well the baby does depends on the severity of the problems. The death rate in babies and children without a spleen may be high due to infections. This is at least partially preventable with daily antibiotics.	Answer this question truthfully	What to expect if I have Dextrocardia (Outlook/Prognosis)?	Babies with simple dextrocardia have a normal life expectancy and should have no problems related to the location of the heart. When dextrocardia appears with other defects in the heart and elsewhere in the body, how well the baby does depends on the severity of the problems. The death rate in babies and children without a spleen may be high due to infections. This is at least partially preventable with daily antibiotics.
Difficulty swallowing or pain with swallowing Pain in the chest or upper abdomen It can be hard to tell a spasm from angina pectoris, a symptom of heart disease. The pain may spread to the neck, jaw, arms, or back	Answer this question truthfully	What are the symptoms of Diffuse esophageal spasm?	Difficulty swallowing or pain with swallowing Pain in the chest or upper abdomen It can be hard to tell a spasm from {{NAME}}, a symptom of heart disease. The pain may spread to the neck, jaw, arms, or back
The cause of diffuse esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people.	Answer this question truthfully	What causes Diffuse esophageal spasm?	The cause of diffuse esophageal spasm is unknown. Very hot or very cold foods may trigger an episode in some people.
Call for an appointment with your health care provider if you have symptoms of diffuse esophageal spasm that don't go away.	Answer this question truthfully	When to seek urgent medical care when I have Diffuse esophageal spasm ?	Call for an appointment with your health care provider if you have symptoms of diffuse esophageal spasm that don't go away.
A diffuse esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms.	Answer this question truthfully	What to expect if I have Diffuse esophageal spasm (Outlook/Prognosis)?	A diffuse esophageal spasm may come and go (intermittent) or last for a long time (chronic). Medicine can help relieve symptoms.
Symptoms of heart failure are most common. Usually, they develop slowly over time. However, sometimes symptoms start very suddenly and are severe. Common symptoms are: Chest pain or pressure (more likely when you exercise) Cough Fatigue, weakness, faintness Irregular or rapid pulse Loss of appetite Shortness of breath with activity or after lying down (or being asleep) for a while Swelling of feet and ankles (in adults)	Answer this question truthfully	What are the symptoms of Dilated Cardiomyopathy?	Symptoms of heart failure are most common. Usually, they develop slowly over time. However, sometimes symptoms start very suddenly and are severe. Common symptoms are: Chest pain or pressure (more likely when you exercise) {{ORGANIZATION}}, weakness, faintness {{NAME}} or rapid pulse {{NAME}} of appetite Shortness of breath with activity or after lying down (or being asleep) for a while Swelling of feet and ankles (in adults)
Heart disease (which is caused by a narrowing of the arteries) and poorly controlled high blood pressure are the most common causes of dilated cardiomyopathy. These problems lead to a weakened and enlarged heart muscle. There are many other causes of dilated cardiomyopathy, including: Alcohol or cocaine abuse, or medicines that can be toxic to the heart (such as drugs used to treat cancer) Abnormal heart rhythms in which the heart beats very fast for a long period of time Autoimmune illnesses, when the immune system attacks and destroys healthy body tissue by mistake Conditions that run in families Infections that involve the heart muscle Heart valves that are either too narrow or too leaky (regurgitant) Trace elements, such as lead, arsenic, or mercury This condition can affect anyone at any age. However, it is most common in adult men.	Answer this question truthfully	What causes Dilated Cardiomyopathy?	Heart disease (which is caused by a narrowing of the arteries) and poorly controlled high blood pressure are the most common causes of dilated cardiomyopathy. These problems lead to a weakened and enlarged heart muscle. There are many other causes of dilated cardiomyopathy, including: Alcohol or cocaine abuse, or medicines that can be toxic to the heart (such as drugs used to treat cancer) Abnormal heart rhythms in which the heart beats very fast for a long period of time Autoimmune illnesses, when the immune system attacks and destroys healthy body tissue by mistake Conditions that run in families {{ORGANIZATION}} that involve the heart muscle Heart valves that are either too narrow or too leaky (regurgitant) Trace elements, such as lead, arsenic, or mercury This condition can affect anyone at any age. However, it is most common in adult men.
Call your health care provider if you have symptoms of cardiomyopathy. If chest pain, palpitations, or faintness develop seek emergency medical treatment immediately.	Answer this question truthfully	When to seek urgent medical care when I have Dilated cardiomyopathy ?	Call your health care provider if you have symptoms of cardiomyopathy. If chest pain, palpitations, or faintness develop seek emergency medical treatment immediately.