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<s>[INST] What are the symptoms of aortic stenosis? [/INST] You may have no symptoms at all until late in the course of the disease. The diagnosis may have been made when your healthcare provider heard a heart murmur and then performed additional tests. Breathlessness with activity. Chest pain, which resembles what is known as angina -type pain. The pain is crushing, squeezing, pressure or tightness in nature. The pain increases with exercise, relieved with rest. The patient feels pain under the chest bone, it may move to other areas. Fainting, weakness, or dizziness with activity. Sensation of feeling the heart beat (palpitations). Becoming tired or fatigued with exertion more easily than others (in mild cases) Serious breathing problems that develop within days or weeks of birth (in severe cases) Extremely tired Sweaty Pale skin Fast breathing They may also be smaller than other children their age Children with mild or moderate aortic stenosis may get worse as the get older. They also run the risk of developing an infection of the heart valves (bacterial endocarditis). </s>

<s>[INST] What causes aortic stenosis? [/INST] In the United States, aortic stenosis often results from calcium deposits on the aortic valve. These deposits occur naturally with age and have no relationship with the amount of calcium in the diet. Approximately 2% of all people have a bicuspid aortic valve, which increases the risk of these calcifications and makes them more likely to develop aortic stenosis. Worldwide, aortic stenosis occurs most commonly in those who've had rheumatic fever, a condition that may develop after strep throat or scarlet fever. Valve problems do not develop for 5 - 10 years or longer after rheumatic fever occurs. Rheumatic fever is increasingly rare in the United States. Aortic stenosis may be present from birth (congenital), or it may develop later in life (acquired). Children with aortic stenosis may have other congenital conditions. Radiation treatment to the chest, and some medications may cause aortic stenosis. Aortic stenosis is not common. It occurs more often in men than in women. As the aortic valve becomes more narrow, the pressure increases inside the lower chamber of the heart (the left ventricle). This causes the left ventricle to become thicker, decreasing blood flow and can lead to chest pain. As the pressure continues to rise, blood may back up into the lungs, and you may feel short of breath. Severe forms of aortic stenosis prevent enough blood from reaching the brain and rest of the body. This can cause lightheadedness and fainting. </s>

<s>[INST] Who is at highest risk for Aortic stenosis ? [/INST] Aortic stenosis occurs more often in men than in women. The calcifications that cause most cases of aortic stenosis are more likely to occur in patients above the age of 50, who are overweight, who smoke, and who have diabetes, high blood pressure, and high cholesterol. These are the same risk factors for atherosclerosis of the coronary blood vessels. People who had rheumatic fever as a child also have a somewhat higher risk of developing aortic stenosis, but rheumatic fever is very rare in the United States. Radiation therapy for treatment of cancer, such as breast cancer or lymphoma, may also increase the risk of aortic stenosis. </s>

<s>[INST] When to seek urgent medical care when I have Aortic stenosis ? [/INST] Call your health care provider if you or your child have symptoms of aortic stenosis. For example, call if you or your child have increasing shortness of breath, chest pain or fainting. Also contact your doctor if you have been diagnosed with this condition and your symptoms get worse or new symptoms develop. </s>

<s>[INST] What to expect if I have Aortic stenosis (Outlook/Prognosis)? [/INST] People with mild aortic stenosis may do very well using a watchful waiting approach with their health care provider. They may be treated medically for some conditions associated with aortic stenosis, such as high blood pressure, and may have a normal life expectancy. Those with more severe symptoms, such as chest pain or signs of heart failure like shortness of breath and leg swelling, generally do poorly without surgery. However, surgery does have the potential to cure a person's aortic stenosis. The success of surgery depends on a number of factors, including patient age, overall activity level, and presence of other medical conditions. As with any operation, aortic valve surgery has some risks, most of which occur during the first 1-2 days after surgery. These include an irregular heart rhythm and blood clots in the legs. There is also a chance that the new or repaired valve may stop working which might require another surgery. </s>

<s>[INST] What Causes An Aortic Valve To Malfunction? [/INST] The aortic valve to malfunction for several reasons. For example, the aortic valve may be abnormal from birth (congenital aortic valve disease), or it could become diseased with age (acquired aortic valve disease). The most common congenital abnormality is a bicuspid aortic valve. As shown below, the aortic valve normally has three leaflets, but a bicuspid aortic valve has only two. It may, therefore, not open or close completely. A bicuspid aortic valve is a common abnormality and occurs in 1-2% of people. This is the second most common cause of aortic valve disease requiring surgery. Such valves may function normally for years before becoming stenotic, regurgitant, or both. People with a bicuspid aortic valve require antibiotic prophylaxis before dental procedures but generally no other special precautions are required other than regular follow up with a qualified cardiologist. The most common cause of aortic valve disease requiring surgery is called "senile aortic calcification," meaning that the valve has worn out with age. When a valve becomes worn, the body deposits calcium on it for reasons that are unknown. The calcium restricts or limits the motion of the valve leaflets. This may prevent the valve from opening (causing stenosis) or closing (causing leakage or regurgitation). Less common causes of aortic valve disease include diseases of the aorta, the main blood vessel coming out of the heart and carrying blood to the rest of the body, including ascending aortic aneurysms, aortic dissection, and Marfan's syndrome. </s>

<s>[INST] Are There Any Warning Signs For A Failing Aortic Valve? [/INST] A failing aortic valve may cause a variety of symptoms including shortness of breath, chest pain (angina pectoris), and dizziness or loss of consciousness (passing out). A narrow valve makes the heart work harder just to pump the blood through the valve to the body. A leaky valve lets blood back into the heart after it has been pumped out. The heart must therefore pump more blood forward to make up for the blood that is leaking backwards. Either way the extra work may cause symptoms of heart failure, such as shortness of breath. Early on the shortness of breath may be noticeable only with exercise. Later, with the progression of valve disease, a patient could experience shortness of breath with even light activity or at rest. Some patients will be unable to sleep flat in bed or may awaken from sleep short of breath. Another sign of heart failure that may occasionally occur is swelling of your feet, particularly prominent later in the afternoon or evening although other conditions, such as varicose veins, can also cause this to occur. The extra work the heart has to perform may also cause chest pain or angina pectoris similar to the symptoms of a heart attack. It may be difficult to tell the difference between heart valve disease and narrowing of the blood vessels to the heart itself (coronary arteries). Aortic valve disease may also cause dizziness, light headedness or even fainting spells. </s>

<s>[INST] How Does Someone Know If They Should Have Surgery To Repair An Aortic Valve? [/INST] The decision to proceed with surgery should be made with your medical care team which usually consists of a thoracic or cardiothoracic surgeon and a cardiologist. Your medical team will likely base their recommendations on your symptoms and on the results of several tests including an echocardiogram and sometimes cardiac catheterization. An echocardiogram may show enlargement of the heart, and can help to measure the degree of stenosis or regurgitation. A cardiac catheterization provides similar information, but can also identify any narrowings of the coronary arteries. </s>

<s>[INST] What Options Exist For The Replacement Of Artificial Valves? [/INST] Unlike the mitral valve which can often be repaired, the aortic valve usually requires replacement. Once the decision is made to proceed with surgery, choices regarding the type of artificial valve (prosthesis) used should be considered. In broad terms there are two types of artificial valves or prostheses: mechanical valves and biological valves. Examples of the valves that your cardiothoracic surgeon might use are pictured below. </s>

<s>[INST] Are There Differences Between Mechanical And Biological Replacement Valves? [/INST] A number of excellent mechanical replacement valves or prostheses are available today. Most surgeons have a particular preference for one valve over another related to technical factors (how they are sewn into place), however from the patient's point of view there is little if any difference between valves. The principle advantage of mechanical valves is their excellent durability. From a practical standpoint, they do not wear out. The principle disadvantage is that there is a tendency for blood to clot on all mechanical valves. Therefore patients with artificial valves must take anticoagulants or "blood thinners" for the rest of their life. There is also a small but definite risk of blood clots causing stroke. There are a variety of natural or biological valves that can be used to replace an abnormal valve. They all share a reduced risk of blood clots forming but all are less durable than mechanical valves. Given enough time, they will probably all wear out. The options in this category include "xenograft" valves made from animal tissues (most often pig aortic valves), "homograft" or "allograft" valves retrieved from human cadavers, and "pulmonary autograft" valves moved from the patient's pulmonary artery on the right side of the heart to the aortic position on the left. The decision on the type of valve used should be made in conjunction with your cardiothoracic surgeon and your cardiologist. Ultimately the choice will depend on a patient's preferences, lifestyle, and individual risks as determined by age and other medical conditions. </s>

<s>[INST] Why Is Surgery Necessary? [/INST] The aortic valve is the outflow valve of the left side of the heart, meaning that it opens during systole (when the ventricle contracts or squeezes blood out into the aorta and the rest of the body). When the aortic valve is too narrow or stenotic, the ventricle has to work harder to pump the blood out to the body. This extra work consumes significant energy and ultimately requires extra blood flow to the heart itself. If there is not enough blood flow, the heart becomes ischemic causing anginal chest pain. Aortic stenosis is often progressive, growing worse with time. As the valve gets tighter, the heart has to continue to work harder and harder to keep pumping blood out of the heart. At some point the heart can no longer compensate, resulting in episodes of low blood pressure or hypotension or even syncope. As the heart fails to compensate, fluid will build up in the lungs creating congestion. When the aortic valve leaks, the heart has to work harder and similar problem occur. The ventricle must pump more blood with each contraction to produce the same forward output, creating a condition called volume overload. The heart can compensate for this volume overload for many months or years provided the leakage develops slowly. Eventually, the heart begins to fail producing shortness of breath and fatigue. </s>

<s>[INST] What Are The Risks Of Surgery? [/INST] Individual risks of surgery can be best estimated by your cardiothoracic surgeon and cardiologist. Risks generally depend on age, general health, specific medical conditions, and heart function. </s>

<s>[INST] What Will My Condition Be Like After Aortic Valve Replacement? [/INST] After successful aortic valve replacement, patients can expect to return to their preoperative condition or better. Anticoagulation ("blood thinners") with a drug like Coumadin may be prescribed for 6 weeks to 3 months after surgery for those with biological valves, and for life for those with mechanical valves. Once the wounds have healed, most patients should experience few if any restrictions to activity. A patient will require preventative or prophylactic antibiotics whenever having dental work, and should always tell a doctor about their valve surgery before any surgical procedure. Template:WH Template:WS CME Category::Cardiology </s>

<s>[INST] How is Aortic valve surgery (minimally invasive) done? [/INST] Before your surgery you will receive general anesthesia. This will make you fall into a pain-free sleep. There are several different ways to do minimally invasive aortic valve surgery. Techniques include laparoscopy or endoscopy, robot-assisted surgery, and percutaneous surgery. Your surgeon may make a 2-inch to 3-inch cut in the right part of your chest near the sternum (breastbone). Muscles in the area will be divided. This allows the surgeon to reach your heart and aortic valve. For the endoscopic, or keyhole, approach, your surgeon makes one to four small holes in your chest. Then your surgeon uses special instruments and a camera to do the surgery. For robotically-assisted valve surgery, the surgeon makes two to four tiny cuts (about 1/2 to 3/4 inches) in your chest. The surgeon uses a special computer to control robotic arms during the surgery. The surgeon sees a three-dimensional view of the heart and aortic valve on the computer. This method is very precise. You will need to be on a heart-lung machine for all of these surgeries. If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves: Mechanical: Made of man-made materials, such as titanium or ceramic. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life. Biological: made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life. In some cases, you will have coronary artery bypass surgery, or surgery to replace the first part of the aorta (large blood vessel leaving the heart) at the same time. Once the new valve is working, your surgeon will: Close the small cut to your heart or aorta Place catheters (flexible tubes) around your heart to drain fluids that build up Close the surgical cut in your muscles and skin The surgery may take 3 to 6 hours. Aortic valve surgery can also be done through a groin artery. No cuts are made on your chest. The doctor sends a catheter (tube) with a balloon attached on the end to the valve. The balloon stretches the opening of the valve. This procedure is called percutaneous valvuloplasty. </s>

<s>[INST] Who needs Aortic valve surgery (minimally invasive)? [/INST] Aortic valve surgery is done when the valve does not work properly. Surgery may be done for these reasons: Changes in your aortic valve are causing major heart symptoms, such as chest pain (angina), shortness of breath, fainting spells (syncope), or heart failure. Tests show that changes in your aortic valve are beginning to seriously harm how well your heart works. Your heart valve has been damaged by endocarditis (infection of the heart valve). A minimally invasive procedure has many benefits. There is less pain, blood loss, and risk of infection. You will also recover faster than you would from open heart surgery. Percutaneous valvuloplasty is only done in patients who are too sick for major heart surgery. The results of percutaneous valvuloplasty are not long-lasting. </s>

<s>[INST] Where to find centers that perform Aortic valve surgery (minimally invasive)? [/INST] Directions to Hospitals Performing Aortic valve surgery - minimally invasive </s>

<s>[INST] What are the risks of Aortic valve surgery (minimally invasive)? [/INST] Risks for any surgery are: Blood clots in the legs that may travel to the lungs. Blood loss. Breathing problems. Infection, including in the lungs, kidneys, bladder, chest, or heart valves. Reactions to medicines. Minimally invasive surgery techniques have far fewer risks than open surgery. Possible risks from minimally invasive valve surgery are: Damage to other organs, nerves, or bones. Heart attack, stroke, or death. Infection of the new valve. Irregular heartbeat that must be treated with medicines or a pacemaker. Kidney failure. Poor healing of the wounds. </s>

<s>[INST] What to expect before Aortic valve surgery (minimally invasive)? [/INST] Always tell your doctor or nurse: If you are or could be pregnant What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon about how you and your family members can donate blood. For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. Some of them are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). If you are taking warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs. Prepare your house for when you get home from the hospital. The day before your surgery. Shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest two or three times with this soap. You also may be asked to take an antibiotic to guard against infection. During the days before your surgery: Ask your doctor which drugs you should still take on the day of your surgery. If you smoke, you must stop. Ask your doctor for help. Always let your doctor know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery. On the day of the surgery: You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the drugs your doctor told you to take with a small sip of water. Your doctor or nurse will tell you when to arrive at the hospital. </s>

<s>[INST] What to expect after Aortic valve surgery (minimally invasive)? [/INST] After your operation, you will spend 3 to 7 days in the hospital. You will spend the first night in an intensive care unit (ICU). Nurses will monitor your condition constantly. Usually within 24 hours, you will be moved to a regular room or a transitional care unit in the hospital. You will slowly resume some activity. You may begin a program to make your heart and body stronger. You may have two to three tubes in your chest to drain fluid from around your heart. These are usually removed 1 to 3 days after surgery. You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV, in the vein) lines for fluids. Nurses will closely watch monitors that display information about your vital signs (pulse, temperature, and breathing). You will have daily blood tests and EKGs to test your heart function until you are well enough to go home. A temporary pacemaker may be placed in your heart if your heart rhythm becomes too slow after surgery. Once you are home, recovery takes time. Take it easy, and be patient with yourself. </s>

<s>[INST] How is Aortic valve surgery (open) done? [/INST] Before your surgery you will receive general anesthesia. This will make you unconscious and unable to feel pain. Your surgeon will make a 10-inch-long cut in the middle of your chest. Next, your surgeon will separate your breastbone to be able to see your heart and aorta (the main blood vessel leading from your heart to the rest of your body). Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped. If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves: Mechanical: Made of man-made materials, such as titanium or ceramic. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life. Biological: Made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life. Once the new valve is working, your surgeon will: Close your heart and take you off the heart-lung machine. Place catheters (tubes) around your heart to drain fluids that build up. Close your breastbone with stainless steel wires. It will take about 6 weeks for the bone to heal. The wires will stay inside your body. This surgery may take 2 to 5 hours. Sometimes other procedures are done during open aortic surgery. These include: Coronary bypass surgery Graft of the first part of the aorta (large blood vessel leaving the heart) Ross (or switch) procedure </s>

<s>[INST] Who needs Aortic valve surgery (open)? [/INST] You may need surgery if your aortic valve does not work properly. You may need open-heart valve surgery for these reasons: Changes in your aortic valve are causing major heart symptoms, such as chest pain (angina), shortness of breath, fainting spells (syncope), or heart failure. Tests show that changes in your aortic valve are beginning to seriously harm how well your heart works. Your heart valve has been damaged by infection of the heart valve (endocarditis). You have received a new heart valve in the past and it is not working well, or you have other problems such as blood clots, infection, or bleeding. </s>

<s>[INST] Where to find centers that perform Aortic valve surgery (open)? [/INST] Directions to Hospitals Performing Aortic valve surgery - open </s>

<s>[INST] What are the risks of Aortic valve surgery (open)? [/INST] Risks for any anesthesia are: Blood clots in the legs that may travel to the lungs Blood loss Breathing problems Infection, including in the lungs, kidneys, bladder, chest, or heart valves Reactions to medicines Possible risks from having open heart surgery are: Heart attack or stroke Heart rhythm problems Incision infection, which is more likely to occur in people who are obese, have diabetes, or have already had this surgery Infection of the new valve Kidney failure Memory loss and loss of mental clarity, or "fuzzy thinking" Poor healing of the incision Post-pericardiotomy syndrome (low-grade fever and chest pain) that could last up to 6 months </s>

<s>[INST] What to expect before Aortic valve surgery (open)? [/INST] Always tell your doctor or nurse: If you are or could be pregnant What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon how you and your family members can donate blood. For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). If you are taking warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs. During the days before your surgery: Ask your doctor which drugs you should still take on the day of your surgery. If you smoke, you must stop. Ask your doctor for help. Always let your doctor know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery. Prepare your house for when you get home from the hospital. The day before your surgery, shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest two or three times with this soap. You also may be asked to take an antibiotic to prevent infection. On the day of your surgery: You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the drugs your doctor told you to take with a small sip of water. Your doctor or nurse will tell you when to arrive at the hospital. </s>

<s>[INST] What to expect after Aortic valve surgery (open)? [/INST] Expect to spend 5 to 7 days in the hospital after surgery. You will spend the first night in the ICU and may stay there for 1 or 2 days. Two to three tubes will be in your chest to drain fluid from around your heart. These are usually removed 1 to 3 days after surgery. You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV, in a vein) lines to deliver fluids. Nurses will closely watch monitors that show information about your vital signs (your pulse, temperature, and breathing). You will be moved to a regular hospital room from the ICU. Your nurses and doctors will continue to monitor your heart and vital signs until you are stable enough to go home. You will receive pain medicine to control pain around your surgical cut. Your nurse will help you slowly resume some activity. You may begin a program to make your heart and body stronger. A temporary pacemaker may be placed in your heart if your heart rate becomes too slow after surgery. </s>

<s>[INST] What are the symptoms of Atherosclerosis? [/INST] Hardening of the arteries does not cause symptoms until blood flow to part of the body becomes slowed or blocked. If the arteries to the heart become narrow, blood flow to the heart can slow down or stop. This can cause chest pain (stable angina), shortness of breath, and other symptoms. Narrowed or blocked arteries may also cause problems and symptoms in your intestines, kidneys, legs, and brain. </s>

<s>[INST] What causes Atherosclerosis? [/INST] Hardening of the arteries is a process that often occurs with aging. As you grow older, plaque buildup narrows your arteries and makes them stiffer. These changes make it harder for blood to flow through them. Clots may form in these narrowed arteries and block blood flow. Pieces of plaque can also break off and move to smaller blood vessels, blocking them. Either way, the blockage starves tissues of blood and oxygen, which can result in damage or tissue death.This is a common cause of heart attack and stroke. High blood cholesterol levels can cause hardening of the arteries at a younger age. </s>

<s>[INST] Who is at highest risk for Atherosclerosis ? [/INST] For many people, high cholesterol levels are the result of an unhealthy lifestyle -- most commonly, eating a diet that is high in fat. Other risk factors are heavy alcohol use, lack of exercise, and being overweight. Other risk factors for hardening of the arteries are: Diabetes Family history of hardening of the arteries High blood pressure Smoking </s>

<s>[INST] What to expect if I have Atherosclerosis (Outlook/Prognosis)? [/INST] Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse. </s>

<s>[INST] What are the Symptoms of Atrial Fibrillation? [/INST] You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time. Symptoms may include: Pulse that feels rapid, racing, pounding, fluttering, or too slow Irregularly irregular pulse Sensation of feeling the heart beat (palpitations) Shortness of breath while lying down (orthopnea) Confusion Dizziness, light-headedness Fainting (syncope) Fatigue Note: Symptoms may begin or stop suddenly. </s>

<s>[INST] What Causes Atrial Fibrillation? [/INST] Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart. Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated way. The electrial impulse that signals your heart to contract in a synchronized way begins in the sinoatrial node (SA node). This node is your heart's natural pacemaker. The signal leaves the SA node and travels through the two upper chambers (atria). Then the signal passes through another node (the AV node), and finally, through the lower chambers (ventricles). This path enables the chambers to contract in a coordinated fashion. In atrial fibrillation, the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse. In atrial flutter, the ventricles may beat very fast, but in a regular pattern. If the atrial fibrillation / flutter is part of a condition called sick sinus syndrome, the sinus node may not work properly and the heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body. Atrial fibrillation can affect both men and women. It becomes more common with increasing age. Causes of atrial fibrillation include: Alcohol abuse (especially binge drinking) Congestive heart failure Coronary artery disease (especially after a heart attack or coronary artery bypass surgery) Heart surgery Hypertension Hypertrophic cardiomyopathy Medications e.g. porfimer sodium Hyperthyroidism Pericarditis Valvular heart disease (especially mitral stenosis and mitral regurgitation) </s>

<s>[INST] Where to Find Medical Care for Atrial Fibrillation? [/INST] Directions to Hospitals Treating Atrial fibrillation </s>

<s>[INST] What to expect if I have Atrial fibrillation (Outlook/Prognosis)? [/INST] The disorder is usually controllable with treatment. Many people with atrial fibrillation do very well. Atrial fibrillation tends to become a chronic condition, however, it may relapse even with treatment. </s>

<s>[INST] When could I drive after i underwent Atrial fibrillation ablation discharge instructions ? [/INST] You should not drive for 48 hours after the procedure. </s>

<s>[INST] What medications should I take after Atrial fibrillation ablation discharge instructions ? [/INST] Have all of your prescriptions filled before you go home. You should take your drugs the way your doctor and nurse have told you to. Go back to taking any medicine you were on before, unless your doctor has told you otherwise. Be sure your doctor knows about everything you are taking, including prescription medicines, non-prescription medicines, vitamins, herbs, and supplements. You may have been given medicines to change your heartbeat or to slow it down. Some are: Beta blockers, such as metoprolol (Lopressor, Toprol-XL) or atenolol (Senormin, Tenormin). Digoxin. Antiarrhythmics, such as amiodarone (Cordarone, Pacerone) or sotalol (Betapace). Medicines that help prevent or treat heart rhythms. You may be taking aspirin or clopidogrel (Plavix), warfarin (Coumadin), heparin, or another blood thinner to help keep your blood from clotting. See also: Aspirin and heart disease. Clopidogrel (Plavix). Taking warfarin (Coumadin). If you are taking warfarin: You will need to have extra blood tests to make sure your dose is correct. You need to watch for any bleeding or bruising, and let your doctor or nurse know if it happens. Your dentist, doctors, and pharmacist should all know you take this medicine. </s>

<s>[INST] Should I take any OTC pain medications? [/INST] You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. If pain is not relieved with acetaminophen, contact your doctor. Please be sure you are not taking more than one product containing acetaminophen, and don’t take more Tylenol than what is recommended on the label. </s>

<s>[INST] When may I resume my regular activities? [/INST] One week after the procedure, you may resume your regular activities, including sexual activity. For at least one week, you should not lift, push, or pull anything heavier than 10 pounds or do any exercise that causes you to hold your breath and bear down with your abdominal muscles. </s>

<s>[INST] When should I bathe or swim? [/INST] You may remove the Band-aid over your puncture site and shower the day after the procedure. </s>

<s>[INST] When can I go back to work after Atrial fibrillation ablation discharge instructions ? [/INST] Ask your doctor when you may go back to work. This will depend on the type of work you do. </s>

<s>[INST] When to seek urgent medical care when I have Atrial fibrillation ablation discharge instructions ? [/INST] Call your 911 if you feel: Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw. Shortness of breath. Gas pains or indigestion. Sweaty, or if you lose color. Lightheaded. Fast heartbeat, irregular heartbeat, or your heart is pounding uncomfortably. Numbness or weakness in your face, arm, or leg. Blurry or decreased vision. Problems speaking or understanding speech. Dizziness, loss of balance, or falling. Severe headache. Bleeding. </s>

<s>[INST] What are the symptoms of Atrial flutter? [/INST] You may not be aware that your heart is not beating in a normal pattern. Symptoms may start or stop suddenly. This is because atrial fibrillation may stop or start on its own. Symptoms may include: Pulse that feels rapid, racing, pounding, fluttering, irregular, or too slow Sensation of feeling the heart beat (palpitations) Confusion Dizziness, light-headedness Fainting Fatigue Loss of ability to exercise Shortness of breath </s>

<s>[INST] What causes Atrial flutter? [/INST] Normally, the four chambers of the heart contract (squeeze) in a very organized way. The electrical impulse that signals your heart to contract begins in an area called the sinoatrial node (also called the sinus node or SA node). This helps the heart pump all the blood the body needs. In atrial fibrillation, the electrical impulse of the heart is not regular. Parts of the heart cannot contract in a coordinated pattern. As a result, the heart cannot pump enough blood to meet the body's needs. In atrial flutter, the ventricles may beat very rapidly, but in a regular pattern.These problems can affect both men and women and become more common as you get older. Common causes of atrial fibrillation include: Alcohol use (especially binge drinking) Coronary artery disease Heart attack or heart bypass surgery Heart failure or an enlarged heart Heart valve disease (most often the mitral valve) Medications Overactive thyroid gland (hyperthyroidism) Pericarditis Sick sinus syndrome </s>

<s>[INST] Who is at highest risk for Atrial flutter ? [/INST] Risk factors for the development of atrial flutter are: Presence of heart disease Past history of cardiac surgery Hyperactive thyroid gland Abnormal heart valves Elderly age Chronic alcoholism Caffeine addiction Chronic use of diet pills and cold medications History of chronic pulmonary disease Stress and anxiety </s>

<s>[INST] When to seek urgent medical care when I have Atrial flutter ? [/INST] Call your health care provider if you have symptoms of atrial fibrillation or flutter. </s>

<s>[INST] What to expect if I have Atrial flutter (Outlook/Prognosis)? [/INST] Treatment can often control this disorder. Many people with atrial fibrillation do very well. However, atrial fibrillation tends to return and get worse. It may come back even with treatment. Clots that break off and travel to the brain can cause a stroke. </s>

<s>[INST] What are the symptoms of Atrial myxoma? [/INST] Symptoms may occur at any time, but most often they accompany a change of body position. Symptoms may include: Breathing difficulty that is relieved when lying flat (platypnea) Breathing difficulty when asleep Chest pain or tightness Dizziness Fainting Sensation of feeling your heart beat (palpitations) Shortness of breath with activity The symptoms and signs of left atrial myxomas often mimic mitral stenosis. General symptoms may also be present, such as: Blueness of skin, especially the fingers (Raynaud's phenomenon) Cough Curvature of nails accompanied with soft tissue enlargement (clubbing) of the fingers Fever Fingers that change color upon pressure or with cold or stress General discomfort (malaise) Involuntary weight loss Joint pain Swelling - any part of the body These general symptoms may also mimic those of infective endocarditis. </s>

<s>[INST] What causes Atrial myxoma? [/INST] A myxoma is a primary heart (cardiac) tumor. This means that the tumor started within the heart. Most heart tumors start somewhere else. A tumor that originates elsewhere is called a metastatic tumor to the heart. Primary cardiac tumors are rare. Myxomas are the most common type of these rare tumors. About 75% of myxomas occur in the left atrium of the heart, usually growing out of the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas sometimes cause mechanical blockage of the heart valve a condition called tricuspid stenosis and an regular heartbeat, atrial fibrillation. </s>

<s>[INST] Who is at highest risk for Atrial myxoma ? [/INST] Myxomas are more common in women. About 10% of myxomas are passed down through families (inherited). Such tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age than other myxomas. </s>

<s>[INST] When to seek urgent medical care when I have Atrial myxoma ? [/INST] Tell your health care provider if there is any family history of myxomas or if you have symptoms of atrial myxoma. </s>

<s>[INST] What to expect if I have Atrial myxoma (Outlook/Prognosis)? [/INST] Although a myxoma is not cancer, complications are common. Untreated, a myxoma can lead to an embolism (tumor cells breaking off and traveling with the bloodstream), which can block blood flow or cause the myxoma to grow in another part of the body. Myxoma fragments can move to the brain, eye, or limbs. If the tumor grows inside the heart, it can block blood flow through the mitral valve and cause symptoms of mitral stenosis. This may require emergency surgery to prevent sudden death. </s>

<s>[INST] What are the Symptoms of Atrial Septal Defect? [/INST] When a person has no other congenital defect, symptoms may be absent, especially in children. Symptoms may begin any time after birth through childhood and even into adulthood. Symptoms may include: Difficulty breathing Heart palpitations in adults Frequent respiratory infections in children Shortness of breath with activity Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible. </s>

<s>[INST] What Causes Atrial Septal Defect? [/INST] A heart normally develops with a small opening between the two upper chambers of the heart (called atria) to allow blood to bypass the lungs. As the lungs become more developed, the heart no longer needs to bypass the blood and the opening between atria will close. An atrial septal defect occurs when the opening between the two chambers does not close completely In rare cases, the hole may spontaneously close after birth. Shunting refers to when the blood flows from the left chamber to the right chamber. If too much blood moves from the right side of the heart, pressures in the lungs build up. The shunt can be reversed so that blood flows from right to left. {{#ev:youtube|e46jtin-H50}} </s>

<s>[INST] Who is at highest risk for Atrial septal defect ? [/INST] Worldwide, atrial septal defects occur in 1 in 1500 live births. The Centers for Disease Control (CDC) estimated that, every year, 1,966 babies in the United States are born with an atrial septal defect. As with most congenital heart diseases, it is unclear exactly why certain babies are born with atrial septal defects. More commonly found in women than men, the female-to-male ratio of 2:1. More common in families with a history of genetic problems and other congenital heart diseases. Certain types of atrial septal defects are associated to down syndrome. Genetic counseling may be performed to estimate the likelihood that any future children may be born with an atrial septal defect. Expectant mothers exposed to rubella may have an increased risk in having a baby with a heart defect. Drug and alcohol use during pregnancy can harm fetal development. Alcohol use during pregnancy nearly doubles the likelihood of an atrial septal defect. </s>

<s>[INST] When to seek urgent medical care when I have Atrial septal defect ? [/INST] Call your health care provider if your baby has the following symptoms as soon as possible: Heart failure Shortness of breath (Dyspnea) Bluish coloring to the skin Failure to thrive Call your health care provider if you are an adult experiencing the following symptoms: Heart failure Shortness of breath (Dyspnea) Bluish coloring to the skin Pounding or racing of the heart </s>

<s>[INST] Where to Find Medical Care for an Atrial Septal Defect? [/INST] Directions to hospitals treating atrial septal defects </s>

<s>[INST] What to expect if I have Atrial septal defect (Outlook/Prognosis)? [/INST] Small atrial septal defects often cause very few problems and may be found much later in life. Many problems can occur if the shunt is large, however. In advanced and severe cases with large shunts the increased pressure on the right side of the heart would result in reversal of blood flow (now from right to left). This usually results in significant shortness of breath. With a small to moderate atrial septal defect, a person may live a normal life span without symptoms. Larger defects may cause disability by middle age because of increased blood flow and shunting of blood back into the pulmonary circulation. Some patients with ASD may have other congenital heart conditions, such as a leaky valve. </s>

<s>[INST] What are the symptoms of Atrioventricular canal defect? [/INST] Symptoms associated with an atrioventricular canal defect depend largely on the type of defect: partial or complete. A partial atrioventricular canal defect involves a malformation of the upper two chambers of the heart only. A complete atrioventricular canal defect is a malformation that allows blood to freely circulate amongst all four of the heart's chambers. In both partial and complete defects there is an increased, extra amount of blood that circulates to the lungs. Complete atrioventricular canal defect: Signs/symptoms of a complete defect usually present within the first few weeks of life. Common symptoms include: Poor appetite Difficulty gaining weight Blue discoloring of the skin (cyanosis) Difficulty breathing/respiratory distress Heart failure (signs include: wheezing, swelling of the legs, ankles, and feet, excessive sweating, sudden gaining of eight, irregular/fast heartbeat) Partial atrioventricular canal defect: Signs/symptoms of a partial defect usually are asymptomatic (meaning without symptoms) until much later in life into adulthood. Common symptoms include: An abnormal heart rhythm/heartbeat (arrhythmia) Heart failure High blood pressure, specifically within the lungs (pulmonary hypertension) </s>

<s>[INST] What causes atrioventricular canal defect? [/INST] The exact cause of an atrioventricular canal defect is unknown. There is some evidence to suggest a genetic component, especially in relation to Down syndrome as many Down syndrome patients have heart defects at birth. </s>

<s>[INST] Who is at highest risk for Atrioventricular canal defect ? [/INST] Like most congenital heart defects, it is unclear exactly why certain babies are born with atrioventricular canal defects. There is evidence, however, to suggest that certain factors may increase the risk for a congenital heart defect. Risk factors include: A family history of Down syndrome/chromosomal disorders A family history of congenital heart defect Expectant mothers who: Contract German measles or other viral illnesses in the first trimester Drink too much alcohol during pregnancy Poorly manage diabetes during pregnancy Take certain prescriptions during pregnancy, such as Accutane (a popular acne medicine noted for causing birth defects). </s>

<s>[INST] When to seek urgent medical care when I have Atrioventricular canal defect ? [/INST] Contact your health care provider immediately if your child develops signs of heart failure, such as: Decreased/poor appetite Shortness of breath Extreme fatigue/easy tiring Swelling in the legs, ankles, or feet A blue discoloration to the skin Failure to thrive/gain weight </s>

<s>[INST] What to expect if I have Atrioventricular canal defect (Outlook/Prognosis)? [/INST] After a successful surgery, the prognosis is good. Children are likely to lead a normal, healthy life without activity restrictions. Care, however, is lifelong and requires yearly follow-ups to track progress and monitor potential complications, such as a leaky heart valve. Children will also have to take preventative antibiotics prior to any procedures, dental or surgical. These preventative antibiotics help minimize the potential risk of complications such as endocarditis, a bacterial infection occurring within the lining of the heart that can be very severe and life-threatening. Endocarditis is more common: When the child may have lingering defects post-surgery. After surgery with an artificial valve repair. After surgical patching utilizing artificial materials. Often, adults may not need any additional surgery. Women anticipating childbearing must have an atrioventricular canal defect evaluated by a cardiologist prior to pregnancy. </s>

<s>[INST] What are the symptoms of Beriberi ? [/INST] Symptoms of dry beriberi include: Difficulty walking Loss of feeling (sensation) in hands and feet Loss of muscle function or paralysis of the lower legs Mental confusion/speech difficulties Pain Strange eye movements (nystagmus) Tingling Vomiting Symptoms of wet beriberi include: Awakening at night short of breath Increased heart rate Shortness of breath with activity Swelling of the lower legs </s>

<s>[INST] What are the causes of Beriberi ? [/INST] There are two major types of beriberi: Wet beriberi affects the cardiovascular system. Dry beriberi and Wernicke-Korsakoff syndrome affect the nervous system. Beriberi is rare in the United States because most foods are now vitamin enriched. If you eat a normal, healthy diet, you should get enough thiamine. Today, beriberi occurs mostly in patients who abuse alcohol. Drinking heavily can lead to poor nutrition, and excess alcohol makes it harder for the body to absorb and store thiamine. A rare condition known as genetic beriberi is inherited (passed down through families). People with genetic beriberi lose the ability to absorb thiamine from foods. This can happen slowly over time and symptoms occur when the person is an adult. However, because doctors may not consider beriberi in nonalcoholics, this diagnosis is often missed. Beriberi can occur in breast-fed infants when the mother's body is lacking in thiamine. The condition can also affect infants who are fed unusual formulas that don't have enough thiamine. Getting dialysis and taking high doses of diuretics raise your risk of beriberi. </s>

<s>[INST] When to Contact a Medical Professional? [/INST] Beriberi is extremely rare in the United States. However, if you feel your family's diet is inadequate or poorly balanced, and you or your children have any symptoms of beriberi, call your health care provider. </s>

<s>[INST] What to expect if I have Beriberi (Outlook/Prognosis)? [/INST] Untreated, beriberi is often deadly. With treatment, symptoms usually improve quickly. Heart damage is usually reversible, and a full recovery is expected. However, if acute heart failure has already occurred, the outlook is poor. Nervous system damage is also reversible, if caught early. If it is not caught early, some symptoms (such as memory loss) may remain even with treatment. If a patient with Wernicke's encephalopathy receives thiamine replacement, language problems, unusual eye movements, and walking difficulties may go away. However, Korsakoff syndrome (or Korsakoff psychosis) tends to develop as Wernicke's symptoms go away. </s>

<s>[INST] What are the symptoms of Bicuspid aortic stenosis? [/INST] Most of the time, bicuspid aortic valve is not diagnosed in infants or children because it causes no symptoms. However, the abnormal valve can leak or become narrow. Symptoms of such complications may include: Baby or child tires easily Chest pain Difficulty breathing Rapid and irregular heartbeat (palpitations) Loss of consciousness (fainting) Pale skin If a baby has other congenital heart problems, they may cause symptoms that will lead to the discovery of a bicuspid aortic valve. </s>

<s>[INST] What causes Bicuspid aortic stenosis? [/INST] The aortic valve allows oxygen-rich blood to flow from the heart to the aorta. It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes. Bicuspid aortic valve is present at birth (congenital). An abnormal aortic valve develops during the early weeks of pregnancy, when the baby's heart develops. The cause of this problem is unclear, but it is the most common congenital heart disease. It often runs in families. The bicuspid aortic valve may not be completely effective at stopping blood from leaking back into the heart. This is called aortic regurgitation. The aortic valve may also become stiff and not open up as well, causing the heart to have to pump harder than usual to get blood past the valve (aortic stenosis). The aorta may become enlarged with this condition. This condition is more common among males than females. A bicuspid aortic valve often exists in babies with coarctation of the aorta and other diseases in which there is a blockage to blood flow on the left side of the heart. </s>

<s>[INST] When to seek urgent medical care when I have Bicuspid aortic stenosis ? [/INST] Call your health care provider if your baby: Has no appetite Has unusually pale or bluish skin Seems to tire easily </s>

<s>[INST] What to expect if I have Bicuspid aortic stenosis (Outlook/Prognosis)? [/INST] How well the baby does depends on whether complications of bicuspid aortic valve are present, and how severe they are. The presence of other physical problems at birth also can affect how well a baby does. Most babies with this condition have no symptoms, and the problem is not diagnosed until they are adults. Some people never find out that they have this problem. </s>

<s>[INST] What are the symptoms of Brugada syndrome? [/INST] Brugada syndrome usually becomes apparent in adulthood, although signs and symptoms, including sudden death, can occur any time from early infancy to old age. The mean age of sudden death is approximately 40 years. This condition may explain some cases of sudden infant death syndrome (SIDS), which is a major cause of death in babies younger than one year. It is characterized by sudden and unexplained death, usually during sleep. Sudden unexplained nocturnal death syndrome (SUNDS) is a condition characterized by unexpected cardiac arrest in young adults, usually at night during sleep. This condition was originally described in Southeast Asian populations, where it is a major cause of death. Researchers have determined that SUNDS and Brugada syndrome are the same disorder. </s>

<s>[INST] What causes Brugada syndrome? [/INST] Mutations in the SCN5A gene cause Brugada syndrome. Mutations in the SCN5A gene have been identified in fewer than one-third of people with Brugada syndrome. This gene provides instructions for making a sodium channel, which normally transports positively charged sodium atoms (ions) into heart muscle cells. This type of ion channel plays a critical role in maintaining the heart's normal rhythm. Mutations in the SCN5A gene alter the structure or function of the channel, which reduces the flow of sodium ions into cells. A disruption in ion transport alters the way the heart beats, leading to the abnormal heart rhythm characteristic of Brugada syndrome. In affected people without an identified SCN5A mutation, the cause of Brugada syndrome is often unknown. In some cases, certain drugs may cause a nongenetic (acquired) form of the disorder. Drugs that can induce an altered heart rhythm include medications used to treat some forms of arrhythmia, a condition called angina (which causes chest pain), high blood pressure, depression, and other mental illnesses. Abnormally high blood levels of calcium (hypercalcemia) or potassium (hyperkalemia), as well as unusually low potassium levels (hypokalemia), also have been associated with acquired Brugada syndrome. In addition to causing a nongenetic form of this disorder, these factors may trigger symptoms in people with an underlying SCN5A mutation. </s>

<s>[INST] Who is at highest risk for Brugada syndrome ? [/INST] This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In most cases, an affected person has one parent with the condition. Other cases may result from new mutations in the gene. These cases occur in people with no history of the disorder in their family. </s>

<s>[INST] When to seek urgent medical care when I have Brugada syndrome ? [/INST] Patients with Brugada syndrome should immediately be transported to the hospital if they suffer from cardiac arrest. Patients should seek medical care when there are symptoms such as syncope, seizures, or shortness of breath. </s>

<s>[INST] What to expect if I have Brugada syndrome (Outlook/Prognosis)? [/INST] Brugada syndrome usually becomes apparent in adulthood, although it may present in infants and children as sudden cardiac death. The mean age of sudden death in patients with Brugada syndrome is 40 years old. The Brugada patient may develop atrial arrhythmia. </s>

<s>[INST] What are the symptoms of Buerger's disease? [/INST] Patients with Buerger's disease may experience symptoms as the following: Pain and weakness in the legs and feet or arms and hands Swelling in your feet and hands Fingers and toes that turn pale when exposed to cold (Raynaud's phenomenon) Skin ulcers Diseases with similar symptoms: Atherosclerosis Raynaud phenomenon Frostbite Scleroderma Systemic lupus erythematosus </s>

<s>[INST] What causes Buerger's disease? [/INST] Thromboangiitis obliterans (Buerger's disease) is caused by vasculitis (inflammation of the blood vessels). The blood vessels of the hands and feet are especially affected. They tighten or become totally blocked. The average age when symptoms begin is around 35 years. Woman and older adults are affected less often. Thromboangiitis obliterans mostly affects men ages 20 to 40 who have a history of heavy smoking or chewing tobacco. Only 1 out of 10 patients are women. The condition may also be related to a history of Raynaud's disease. This disorder is very uncommon in children, but it may occur in children with autoimmune diseases. </s>

<s>[INST] Who is at highest risk for Buerger%27s disease ? [/INST] Smoking Patients with medical history of Raynaud's disease or autoimmune diseases Race: Buerger disease is relatively more common in people of natives of India, Korea, and Japan, and Israeli Jews of Ashkenazi descent. Gender: Buerger disease is as 3 times as common in males than in female. Age between 20~45 years </s>

<s>[INST] When to seek urgent medical care when I have Buerger%27s disease ? [/INST] Call your health care provider if symptoms of Buerger's disease develop. </s>

<s>[INST] What to expect if I have Buerger%27s disease (Outlook/Prognosis)? [/INST] Prognosis of Buerger's disease varies from person to person, depending on: The patient's life-style The severity of the damaged vessles </s>

<s>[INST] What are the Symptoms of Cardiac Amyloidosis? [/INST] Most patients with cardiac amyloidosis may experience symptoms of restrictive cardiomyopathy, while others may show no symptoms. Common symptoms include: Skipped heart beats or extra heart beats also known as Palpitations Shortness of breath, or difficulty breathing while lying flat also known as orthopnea Fatigue Increased urination at night also known as nocturia Swelling of the ankles, the legs, or other part of the body Diseases with similar symptoms: Coronary artery disease Constrictive pericarditis Dilated cardiomyopathy Hypertrophic cardiomyopathy Restrictive cardiomyopathy Sarcoidosis cordis </s>

<s>[INST] What Causes Cardiac Amyloidosis? [/INST] Amyloidosis refers to a family of diseases in which there is a buildup of clumps of proteins called amyloids in body tissues and organs. These proteins slowly replace normal tissue, leading to failure of the involved organ. There are many forms of amyloidosis that may involve specific organs like the heart (cardiac amlyoidosis), the neurologic system with a peripheral neuropathy or the kidney. Cardiac amyloidosis usually occurs as part of primary amyloidosis (AL type amyloidosis). Primary amyloidosis is often seen in people with multiple myeloma and cancer. Cardiac amyloidosis (" stiff heart syndrome ") occurs when amyloid deposits take the place of normal heart muscle. It is the most typical form of restrictive cardiomyopathy. Cardiac amyloidosis may affect the way electrical impulses move through the heart (electrical conduction system). This can lead to irregular heart beating also known as arrhythmias and failure of the electrical impulses to conduct through the heart (heart block). Secondary amyloidosis (AA type amyloidosis) rarely affects the heart. However, one form of secondary amyloidosis called senile amyloidosis may involve the heart and blood vessels. Senile amyloidosis is caused by overproduction of a different protein. The condition is becoming more common as the average age of the population increases. There is no difference in the incidence of cardiac amyloidosis between men and women as it affects both genders equally. The disease is rare in people under age 40. </s>

<s>[INST] Who Is at the Highest Risk? [/INST] Amyloidosis refers to abnormal deposition of amyloid protein in the body tissues and organs. These proteins gradually replace the normal tissue resulting in organ dysfunction. Amyloidosis often occurs in patients with the following diseases or characteristics: Multiple myeloma: Cardiac amyloidosis usually occurs in patients with multiple myeloma. Age over 40: The disease is rare in people under age 40. </s>

<s>[INST] When to seek urgent medical care when I have Cardiac amyloidosis ? [/INST] Call your health care provider if symptoms of cardiac amyloidosis develop. If you experience any of the following symptoms, seek urgent medical care as soon as possible: Skipped heart beats or extra heart beats also known as palpitations Severe shortness of breath, or difficulty breathing while lying flat also known as orthopnea </s>

<s>[INST] Where to Find Medical Care for Cardiac Amyloidosis? [/INST] Directions to Hospitals Treating cardiac amyloidosis </s>

<s>[INST] What to expect if I have Cardiac amyloidosis (Outlook/Prognosis)? [/INST] Cardiac amyloidosis is a long-term (chronic) condition that slowly worsens. On average, persons with cardiac amyloidosis live less than 1 year. </s>

<s>[INST] What are the symptoms of cardiac arrhythmia? [/INST] When you have an arrhythmia, your heartbeat may be: Too slow (bradycardia) Too quick (tachycardia) Irregular, uneven or skipping beats An arrhythmia may be present all of the time or it may come and go. You may or may not feel symptoms when the arrhythmia is present. Or, you may only notice symptoms when you are more active. Symptoms can be very mild, or they may be severe or even life-threatening. Common symptoms that may occur when the arrhythmia is present include: Chest pain Fainting Light-headedness, dizziness Paleness Shortness of breath Sweating </s>

<s>[INST] What causes cardiac arrhythmia? [/INST] Normally, your heart works as a pump that brings blood to the lungs and the rest of the body.To help this happen, your heart has an electrical system that makes sure it contracts (squeezes) in an orderly way. The electrical impulse that signals your heart to contract begins in the sinoatrial node (also called the sinus node or SA node). This is your heart's natural pacemaker. The signal leaves the SA node and travels though the heart along a set electrical pathway. Different nerve messages signal your heart to beat slower or faster. Arrhythmias are caused by problems with the heart's electrical conduction system. Abnormal extra signals may occur Electrical signals may be blocked or slowed Electrical signals travel in new or different pathways through the heart Some common causes of abnormal heartbeats are: Abnormal levels of potassium or other substances Heart attack, or a damaged heart muscle from a past heart attack Heart disease that is present at birth (congenital) Heart failure or an enlarged heart Overactive thyroid gland Arrhythmias may also be caused by some substances or drugs, including: Alcohol, caffiene, or stimulants such as amphetamines Beta-blockers Cigarette smoking Drugs that mimic the activity of the nervous system Medications used for depression or psychosis Sometimes anti-arrhythmic medications prescribed to treat one type of arrhythmia will cause another type of arrhythmia. Some of the more common abnormal heart rhythms are: Atrial fibrillation or atrial flutter Atrioventricular nodal reentry tachycardia (AVNRT) Multifocal atrial tachycardia Paroxysmal supraventricular tachycardia Heart block or atrioventricular block Sick sinus syndrome Ventricular fibrillation or ventricular tachycardia Wolff-Parkinson-White syndrome </s>

<s>[INST] Who is at highest risk for Cardiac arrhythmia ? [/INST] Risk factors for cardiac arrhythmia include: Hypertension or high blood pressure Previous heart surgery Congenital heart disease Thyroid problems Drugs and certain supplements Obesity Diabetes Obstructive sleep apnea Drinking too much alcohol Caffeine and nicotine use Electrolyte imbalances </s>

<s>[INST] When to seek urgent medical care when I have Cardiac arrhythmia ? [/INST] Call your health care provider if: You develop any of the symptoms of a possible arrhythmia You have been diagnosed with an arrhythmia and your symptoms worsen or do not improve with treatment </s>

<s>[INST] What to expect if I have Cardiac arrhythmia (Outlook/Prognosis)? [/INST] The outcome depends on several factors: The kind of arrhythmia -- some arrhythmias may be life threatening if not treated right away, or do not respond well to treatment Whether you have coronary artery disease, heart failure, or valvular heart disease </s>

<s>[INST] When could I drive after i underwent Cardiac catheterization discharge instructions ? [/INST] You should not drive for 48 hours after the procedure. </s>

<s>[INST] What medications should I take after Cardiac catheterization discharge instructions ? [/INST] 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. </s>

<s>[INST] Should I take any OTC pain medications? [/INST] 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. </s>

<s>[INST] When may I resume my regular activities? [/INST] 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. </s>

<s>[INST] When could I bathe or swim? [/INST] 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. </s>

<s>[INST] When can I go back to work after Cardiac catheterization discharge instructions ? [/INST] It depends on the type of your work. You can ask your doctor when you can go back to work. </s>

<s>[INST] When to seek urgent medical care when I have Cardiac catheterization discharge instructions ? [/INST] Call your doctor if: There is bleeding at the catheter insertion site that does not stop when you apply pressure. Your arm or leg below where the catheter was inserted changes color, is cool to the 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 -- it is very slow (fewer than 60 beats a minute) 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. </s>

<s>[INST] What to eat at the restaurant? [/INST] Ask about low-fat or fat-free choices. Ask the server to make substitutions like steamed vegetables instead of French fries. Use the basic guidelines of your healthy eating plan when choosing a main dish. Pick lean meat, fish or skinless chicken. Make sure your entrée is broiled, baked, grilled, steamed or poached instead of fried. Order vegetable side dishes and ask that any sauces or butter be left off. Ask for low-calorie salad dressing or a lemon to squeeze on your salad instead of dressing. Ask for baked, boiled or roasted potatoes instead of fried. And ask for them without the butter and sour cream. Order fresh fruit or fruit sorbet in place of cake, pie or ice cream. When it seems that everything on the menu is “off limits,” ask if the chef will make you a fruit or vegetable platter. Most chefs are happy to do so. </s>

<s>[INST] What to avoid at the restaurant? [/INST] Push the butter out of your way or ask that it be removed. Ask for soft margarine instead. Order your dressings and sauces on the side so you can control how much you use. Stay away from fried appetizers and creamy soups. Begin your meal with broth-based soup like minestrone or gazpacho. At salad bars, stay away from high-fat items like cheese, cream dressings, chopped eggs, croutons, olives and bacon bits. Ask that your food be made without butter or cream sauces. You’ll be surprised at how delicious meat, fish and chicken can be when broiled “dry.” Take the skin off poultry when it arrives, and remove visible fat from meat. </s>

<s>[INST] What are the symptoms of cardiac tamponade? [/INST] Anxiety, restlessness Chest pain - Sharp and stabbing pain which worsens with deep breathing or coughing. Difficulty breathing Discomfort, sometimes relieved by sitting upright or leaning forward Fainting, light-headedness Pale, gray, or blue skin Palpitations Rapid breathing Swelling of the abdomen or other areas Low blood pressure Weak or absent pulse </s>