bowang0911/MedQuAD huggingface dataset:
Doctors often diagnose varicose veins based on a physical exam alone. Sometimes tests or procedures are used to find out the extent of the problem or to rule out other conditions.
                
Specialists Involved
                
If you have varicose veins, you may see a vascular medicine specialist or vascular surgeon. These doctors specialize in blood vessel conditions. You also may see a dermatologist. This type of doctor specializes in skin conditions.
                
Physical Exam
                
To check for varicose veins in your legs, your doctor will look at your legs while you're standing or sitting with your legs dangling. He or she may ask you about your signs and symptoms, including any pain you're having.
                
Diagnostic Tests and Procedures
                
Duplex Ultrasound
                
Your doctor may recommend duplex ultrasound to check blood flow in your veins and to look for blood clots. Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create apicture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through theveins. The two types of ultrasound together paint a picture that helps your doctor diagnose your condition.
                
During this test, a handheld device will be placed on your body and passed back and forth over the affected area. The device sends and receives sound waves. A computer will convert the sound waves into a picture of the blood flow in your arteries and veins.
                
Angiogram
                
Although it is not very common, your doctor may recommend an angiogram to get a more detailed look at the blood flow through your veins.
                
For this procedure, dye is injected into your veins. The dye outlines your veins on x-ray images.
                
An angiogram can help your doctor confirm whether you have varicose veins or another condition.
You can't prevent varicose veins from forming. However, you can prevent the ones you have from getting worse. You also can take steps to delay other varicose veins from forming.
                
Avoid standing or sitting for long periods without taking a break. When sitting, avoid crossing your legs. Keep your legs raised when sitting, resting, or sleeping. When you can, raise your legs above the level of your heart.
                
Do physical activities to get your legs moving and improve muscle tone. This helps blood move through your veins.
                
If you're overweight or obese, try to lose weight. This will improve blood flow and ease the pressure on your veins.
                
Avoid wearing tight clothes, especially those that are tight around your waist, groin (upper thighs), and legs. Tight clothes can make varicose veins worse.
                
Avoid wearing high heels for long periods. Lower heeled shoes can help tone your calf muscles. Toned muscles help blood move through the veins.
                
Wear compression stockings if your doctor recommends them. These stockings create gentle pressure up the leg. This pressure keeps blood from pooling in the veins and decreases swelling in the legs.
A lack of activity in the ADAMTS13 enzyme (a type of protein in the blood) causes thrombotic thrombocytopenic purpura (TTP). The ADAMTS13 gene controls the enzyme, which is involved in blood clotting.
                
Not having enough enzyme activity causes overactive blood clotting. In TTP, blood clots form in small blood vessels throughout the body. These clots can limit or block the flow of oxygen-rich blood to the body's organs, such as the brain, kidneys, and heart. As a result, serious health problems can develop.
                
The increased clotting that occurs in TTP also uses up many of the blood's platelets. With fewer platelets available in the blood, bleeding problems can occur.
                
People who have TTP may bleed inside their bodies, underneath the skin, or from the surface of the skin. When cut or injured, they also may bleed longer than normal.
                
TTP also can cause red blood cells to break apart faster than the body can replace them. This leads to hemolytic anemia.
                
Inherited Thrombotic Thrombocytopenic Purpura
                
In inherited TTP, the ADAMTS13 gene is faulty. It doesn't prompt the body to make a normal ADAMTS13 enzyme. As a result, enzyme activity is lacking or changed.
                
"Inherited" means that the condition is passed from parents to children through genes. A person who inherits TTP is born with two copies of the faulty geneone from each parent.
                
Most often, the parents each have one copy of the faulty gene, but have no signs or symptoms TTP.
                
Acquired Thrombotic Thrombocytopenic Purpura
                
In acquired TTP, the ADAMTS13 gene isn't faulty. Instead, the body makes antibodies (proteins) that block the activity of the ADAMTS13 enzyme.
                
"Acquired" means you aren't born with the condition, but you develop it sometime after birth.
                
Triggers for Thrombotic Thrombocytopenic Purpura
                
It's unclear what triggers inherited and acquired TTP, but some factors may play a role. These factors may include:
                
Some diseases and conditions, such as pregnancy, cancer, HIV, lupus, and infections
                
Some medical procedures, such as surgery and blood and marrow stem cell transplant
                
Some medicines, such as chemotherapy, ticlopidine, clopidogrel, cyclosporine A, and hormone therapy and estrogens
                
Quinine, which is a substance often found in tonic water and nutritional health products
Thrombotic thrombocytopenic purpura (TTP) is a rare disorder. Most cases of TTP are acquired. Acquired TTP mostly occurs in adults, but it can affect children. The condition occurs more often in women and in Black people than in other groups.
                
Inherited TTP mainly affects newborns and children. Most people who have inherited TTP begin to have symptoms soon after birth. Some, however, don't have symptoms until they're adults.
                
It isn't clear what triggers inherited and acquired TTP, but some factors may play a role. These factors may include:
                
Some diseases and conditions, such as pregnancy, cancer, HIV, lupus, and infections
                
Some medical procedures, such as surgery and blood and marrow stem cell transplant
                
Some medicines, such as chemotherapy, ticlopidine, clopidogrel, cyclosporine A, and hormone therapy and estrogens
                
Quinine, which is a substance often found in tonic water and nutritional health products
Blood clots, a low platelet count, and damaged red blood cells cause the signs and symptoms of thrombotic thrombocytopenic purpura (TTP).
                
The signs and symptoms include:
                
Purplish bruises on the skin or mucous membranes (such as in the mouth). These bruises, called purpura, are caused by bleeding under the skin.
                
Pinpoint-sized red or purple dots on the skin. These dots, called petechiae, often are found in groups and may look like a rash. Bleeding under the skin causes petechiae.
                
Paleness or jaundice (a yellowish color of the skin or whites of the eyes).
                
Fatigue (feeling very tired and weak).
                
Fever.
                
A fast heart rate or shortness of breath.
                
Headache, speech changes, confusion, coma, stroke, or seizure.
                
A low amount of urine, or protein or blood in the urine.
                
If you've had TTP and have any of these signs or symptoms, you may be having a relapse (flareup). Ask your doctor when to call him or her or seek emergency care.
Thrombotic thrombocytopenic purpura (TTP) can be fatal or cause lasting damage, such as brain damage or a stroke, if it's not treated right away.
                
In most cases, TTP occurs suddenly and lasts for days or weeks, but it can go on for months. Relapses (flareups) can occur in up to 60 percent of people who have acquired TTP. Flareups also occur in most people who have inherited TTP.
                
Plasma treatments are the most common way to treat TTP. Other treatments include medicines and surgery. Treatments are done in a hospital.
                
Plasma Therapy
                
Plasma is the liquid part of your blood. It carries blood cells, hormones, enzymes, and nutrients to your body.
                
TTP is treated with plasma therapy. This includes:
                
Fresh frozen plasma for people who have inherited TTP
                
Plasma exchange for people who have acquired TTP
                
Plasma therapy is started in the hospital as soon as TTP is diagnosed or suspected.
                
For inherited TTP, fresh frozen plasma is given through an intravenous (IV) line inserted into a vein. This is done to replace the missing or changed ADAMTS13 enzyme.
                
Plasma exchange (also called plasmapheresis) is used to treat acquired TTP. This is a lifesaving procedure. It removes antibodies (proteins) from the blood that damage your ADAMTS13 enzyme. Plasma exchange also replaces the ADAMTS13 enzyme.
                
If plasma exchange isn't available, you may be given fresh frozen plasma until it is available.
                
During plasma exchange, an IV needle or tube is placed in a vein in your arm to remove blood. The blood goes through a cell separator, which removes plasma from the blood. The nonplasma part of the blood is saved, and donated plasma is added to it.
                
Then, the blood is put back into you through an IV line inserted into one of your blood vessels. The time required to complete the procedure varies, but it often takes about 2hours.
                
Treatments of fresh frozen plasma or plasma exchange usually continue until your blood tests results and signs and symptoms improve. This can take days or weeks, depending on your condition. You'll stay in the hospital while you recover.
                
Some people who recover from TTP have flareups. This can happen in the hospital or after you go home. If you have a flareup, your doctor will restart plasma therapy.
                
Other Treatments
                
Other treatments are used if plasma therapy doesn't work well or if flareups occur often.
                
For acquired TTP, medicines can slow or stop antibodies to the ADAMTS13 enzyme from forming. Medicines used to treat TTP include glucocorticoids, vincristine, rituximab, and cyclosporine A.
                
Sometimes surgery to remove the spleen (an organ in the abdomen) is needed. This is because cells in the spleen make the antibodies that block ADAMTS13 enzyme activity.
Both inherited and acquired thrombotic thrombocytopenic purpura (TTP) occur suddenly with no clear cause. You can't prevent either type.
                
If you've had TTP, watch for signs and symptoms of a relapse (flareup). (For more information, go to "Living With Thrombotic Thrombocytopenic Purpura.")
                
Ask your doctor about factors that may trigger TTP or a flareup, including:
                
Some diseases or conditions, such as pregnancy, cancer, HIV, lupus, or infections.
                
Some medical procedures, such as surgery and blood and marrow stem cell transplant.
                
Some medicines, such as ticlopidine, clopidogrel, cyclosporine A, chemotherapy, and hormone therapy and estrogens. If you take any of these medicines, your doctor may prescribe a different medicine.
                
Quinine, which is a substance often found in tonic water and nutritional health products.
Mitral valve prolapse (MVP) is a condition in which the hearts mitral valve doesnt work well. The flaps of the valve are floppy and may not close tightly. These flaps normally help seal or open the valve.
                
Much of the time, MVP doesnt cause any problems. Rarely, blood can leak the wrong way through the floppy valve. This can lead topalpitations, shortness of breath, chest pain, and other symptoms. (Palpitations are feelings that your heart is skipping a beat, fluttering, or beating too hard or too fast.)
                
Normal Mitral Valve
                
The mitral valve controls blood flow between the upper and lower chambers of the left side of the heart. The upper chamber is called the left atrium. The lower chamber is called the left ventricle.
                
The mitral valve allows blood to flow from the left atrium into the left ventricle, but not back the other way. The heart also has a right atrium and ventricle, separated by the tricuspid valve.
                
With each heartbeat, the atria contract and push blood into the ventricles. The flaps of the mitral and tricuspid valves open to let blood through. Then, the ventricles contract to pump the blood out of the heart.
                
When the ventricles contract, the flaps of the mitral and tricuspid valves close. They form a tight seal that prevents blood from flowing back into the atria.
                
For more information, go to the Health TopicsHow the Heart Worksarticle. This article contains animations that show how your heart pumps blood and how your hearts electrical system works.
                
Mitral Valve Prolapse
                
In MVP, when the left ventricle contracts, one or both flaps of the mitral valve flop or bulge back (prolapse) into the left atrium. This can prevent the valve from forming a tight seal. As a result, blood may leak from the ventricle back into the atrium. The backflow of blood is called regurgitation.
                
MVP doesnt always cause backflow. In fact, most people who have MVP dont have backflow and never have any related symptoms or problems. When backflow occurs, it can get worse over time and itcan change the hearts size and raise pressure in the left atrium and lungs. Backflow also raises the risk of heart valve infections.
                
Medicines can treat troublesome MVP symptoms and help prevent complications. Some people will need surgery to repair or replace their mitral valves.
                
Mitral Valve Prolapse
The exact cause of mitral valve prolapse (MVP) isn't known. Most people who have the condition are born with it. MVP tends to run in families. Also, it's more common in people who are born with connective tissue disorders, such as Marfan syndrome.
                
In people who have MVP, the mitral valve may be abnormal in the following ways:
                
The valve flaps may be too large and thick.
                
The valve flaps may be "floppy." The tissue of the flaps and their supporting "strings" are too stretchy, and parts of the valve flop or bulge back into the atrium.
                
The opening of the valve may stretch.
                
These problems can keep the valve from making a tight seal. Some people's valves are abnormal in more than one way.
Mitral valve prolapse (MVP) affects people of all ages and both sexes; however, aging raises the risk of developing the disease.
                
Certain conditions have been associated with MVP, including:
                
A history of rheumatic fever
                
Connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome
                
Graves disease
                
Scoliosis and other skeletal problems
                
Some types of muscular dystrophy
Mitral valve prolapse (MVP) most often is detected during a routine physical exam. During the exam, your doctor will listen to your heart with a stethoscope.
                
Stretched valve flaps can make a clicking sound as they shut. If the mitral valve is leaking blood back into the left atrium, your doctor may heart a heart murmur or whooshing sound.
                
However, these abnormal heart sounds may come and go. Your doctor may not hear them at the time of an exam, even if you have MVP. Thus, you also may have tests and procedures to diagnose MVP.
                
Diagnostic Tests and Procedures
                
Echocardiography
                
Echocardiography (echo) is the most useful test for diagnosing MVP. This painless test uses sound waves to create a moving picture of your heart.
                
Echo shows the size and shape of your heart and how well your heart chambers and valves are working. The test also can show areas of heart muscle that aren't contracting normally because of poor blood flow or injury to the heart muscle.
                
Echo can show prolapse of the mitral valve flaps and backflow of blood through the leaky valve.
                
There are several types of echo, including stress echo. Stress echo is done before and after a stress test. During a stress test, you exercise or take medicine (given by your doctor) to make your heart work hard and beat fast.
                
You may have stress echo to find out whether you have decreased blood flow to your heart (a sign of coronary heart disease).
                
Echo also can be done by placing a tiny probe in your esophagus to get a closer look at the mitral valve. The esophagus is the passage leading from your mouth to your stomach.
                
The probe uses sound waves to create pictures of your heart. This form of echo is called transesophageal (tranz-ih-sof-uh-JEE-ul) echocardiography, or TEE.
                
Doppler Ultrasound
                
A Doppler ultrasound is part of an echo test. A Doppler ultrasound shows the speed and direction of blood flow through the mitral valve.
                
Other Tests
                
Other tests that can help diagnose MVP include:
                
A chest x ray. This test is used to look for fluid in your lungs or to show whether your heart is enlarged.
                
An EKG (electrocardiogram). An EKG is a simple test that records your heart's electrical activity. An EKG can show how fast your heart is beating and whether its rhythm is steady or irregular. This test also records the strength and timing of electrical signals as they pass through your heart.
You can't prevent mitral valve prolapse (MVP). Most people who have the condition are born with it.
                
Complications from MVP, such as arrhythmias (irregular heartbeats) and infective endocarditis (IE), are rare. IE is an infection of the inner lining of your heart chambers and valves.
                
People at high risk for IE may be given antibiotics before some types of surgery and dental work. Antibiotics can help prevent IE. Your doctor will tell you whether you need this type of treatment.
                
People at high risk for IE may include those who've had valve repair or replacement or who have some types of underlying heart disease.
Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. In some cases, the heart can't fill with enough blood. In other cases, the heart can't pump blood to the rest of the body with enough force. Some people have both problems.
                
The term "heart failure" doesn't mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.
                
Overview
                
Heart failure develops over time as the heart's pumping action grows weaker. The condition can affect the right side of the heart only, or it can affect both sides of the heart. Most cases involve both sides of the heart.
                
Right-side heart failure occurs if the heart can't pump enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if the heart can't pump enough oxygen-rich blood to the rest of the body.
                
Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen, and the veins in the neck. Right-side and left-side heart failure also may cause shortness of breath and fatigue (tiredness).
                
The leading causes of heart failure are diseases that damage the heart. Examples include coronary heart disease (CHD), high blood pressure, and diabetes.
                
Outlook
                
Heart failure is a very common condition. About 5.7 million people in the United States have heart failure.Both children and adults can have the condition, although the symptoms and treatments differ. The Health Topicfocuses on heart failure in adults.
                
Currently, heart failure has no cure. However, treatmentssuch as medicines and lifestyle changescan help people who have the condition live longer and more active lives. Researchers continue to study new ways to treat heart failure and its complications.
About 5.7 million people in the United States have heart failure. The number of people who have this condition is growing.
                
Heart failure is more common in:
                
People who are age 65 or older. Aging can weaken the heart muscle. Older people also may have had diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays among people on Medicare.
                
Blacks are more likely to have heart failure than people of other races. Theyre also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure.
                
People who areoverweight. Excess weight puts strain on the heart. Being overweight also increases your risk of heart disease and type 2diabetes. These diseases can lead to heart failure.
                
People who have had a heart attack. Damage to the heart muscle from a heart attack and can weaken the heart muscle.
                
Children who havecongenital heart defectsalso can develop heart failure. These defects occur if the heart, heart valves, or blood vessels near the heart dont form correctly while a baby is in the womb. Congenital heart defects can make the heart work harder. This weakens the heart muscle, which can lead to heart failure. Children dont have the same symptoms of heart failure or get the same treatments as adults. This Health Topic focuses on heart failure in adults.
The most common signs and symptoms of heart failure are:
                
Shortness of breath or trouble breathing
                
Fatigue (tiredness)
                
Swelling in the ankles, feet, legs, abdomen, and veins in the neck
                
All of these symptoms are the result of fluid buildup in your body. When symptoms start, you may feel tired and short of breath after routine physical effort, like climbing stairs.
                
As your heart grows weaker, symptoms get worse. You may begin to feel tired and short of breath after getting dressed or walking across the room. Some people have shortness of breath while lying flat.
                
Fluid buildup from heart failure also causes weight gain, frequent urination, and a cough that's worse at night and when you're lying down. This cough may be a sign of acute pulmonary edema (e-DE-ma). This is a condition in which too much fluid builds up in your lungs. The condition requires emergency treatment.
                
Heart Failure Signs and Symptoms