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<s>[INST] What causes cardiac tamponade? [/INST] Cardiac tamponade can occur when fluid or blood rapidly accumulates in pericardial cavity and thereby cause elevated intrapericardial pressure. Below are few of the causes for fluid in pericardium leading to cardiac tamponade. Chest trauma Rupture of aortic aneurysm (thoracic) End-stage lung cancer Heart attack (acute MI) Heart surgery Pericarditis caused by bacterial or viral infections Wounds to the heart Heart tumors Hypothyroidism Kidney failure Placement of central lines Radiation therapy to the chest Recent invasive heart procedures Recent open heart surgery Systemic lupus erythematosus </s>

<s>[INST] When to seek urgent medical care when I have Cardiac tamponade ? [/INST] Go to the emergency room or call the local emergency number (such as 911) if symptoms develop. Cardiac tamponade is an emergency condition requiring immediate attention. </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 Cardiac tumors ? [/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 Cardiac tumors ? [/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 Cardiac tumors (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 Cardiogenic shock? [/INST] Chest pain or pressure Coma Decreased urination Fast breathing Fast pulse Heavy sweating, moist skin Lightheadedness Loss of alertness and ability to concentrate Restlessness, agitation, confusion Shortness of breath Skin that feels cool to the touch Pale skin color or blotchy skin Weak (thready) pulse </s>

<s>[INST] What causes Cardiogenic shock? [/INST] Cardiogenic shock occurs whenever the heart is unable to pump as much blood as the body needs. The most common causes are serious heart complications. Many of these occur during or after a heart attack (myocardial infarction). These complications include: A large section of heart muscle that no longer moves well or does not move at all Breaking open (rupture) of the heart muscle due to damage from the heart attack Dangerous heart rhythms, such as ventricular tachycardia, ventricular fibrillation, or supraventricular tachycardia Pressure on the heart due to a build up of fluid around it (pericardial tamponade) Tear or rupture of the muscles or tendons that support the heart valves, especially the mitral valve Tear or rupture of the wall (septum) between the left and right ventricles (lower heart chambers) Very slow heart rhythm (bradycardia) or problem with the electrical system of the heart (heart block) </s>

<s>[INST] When to seek urgent medical care when I have Cardiogenic shock ? [/INST] Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of cardiogenic shock. Cardiogenic shock is a medical emergency. </s>

<s>[INST] What to expect if I have Cardiogenic shock (Outlook/Prognosis)? [/INST] In the past, the death rate from cardiogenic shock ranged from 80 - 90%. In more recent studies, this rate has decreased to 50 - 75%. When cardiogenic shock is not treated, the outlook is poor. </s>

<s>[INST] What are the symptoms of cardiomegaly? [/INST] It can present with the following symptoms: Shortness of breath Dizziness Swelling (edema) Abnormal rhythm (arrhythmia) Cough It can also be asymptomatic in some people. </s>

<s>[INST] What causes Cardiomegaly? [/INST] Cardiomegaly can occur in various disease conditions like congenital heart defects, heart valve disease, hemochromatosis, HIV, pulmonary hypertension and high blood pressure etc. It can also occur in some storage diseases like Fabry disease, amyloidosis, sarcoidosis etc. It can also occur in other conditions like alcoholism, cocaine and crack abuse, pregnancy. </s>

<s>[INST] Who is at highest risk for Cardiomegaly ? [/INST] Cardiomegaly as mentioned above is a physical sign so the patient is at risk if present with the following conditions like: High blood pressure Positive family history of cardiomyopathy Coronary artery disease Congenital heart disease </s>

<s>[INST] When to seek urgent medical care when I have Cardiomegaly ? [/INST] One should seek medical care when suffering from symptoms of cardiomegaly or a positive family history. </s>

<s>[INST] What are the symptoms of Cardiomyopathy? [/INST] In early stages of the disease, some patient might be asymptomatic. During the course of the disease it can present with the following symptoms Breathlessness which can be exertional or at rest. Swelling of lower limbs. Fatigue and fainting. Irregular heart beat. </s>

<s>[INST] What causes Cardiomyopathy? [/INST] Heart attacks, high blood pressure, nutritional deficiencies, pregnancy, alcohol / cocaine abuse or infections can all cause cardiomyopathy. Some types of cardiomyopathy run in families. In many people, however, the cause is unknown </s>

<s>[INST] Who is at highest risk for Cardiomyopathy ? [/INST] People of all ages and races can have cardiomyopathy. However, certain types of the disease are more common in certain groups. Dilated cardiomyopathy is more common in african americans than caucasians. This type of the disease also is more common in men than women. Teens and young adults are more likely than older people to have arrhythmogenic right ventricular dysplasia, although it's rare in both groups. Certain diseases, conditions, or factors can raise your risk for cardiomyopathy. Major risk factors include: A family history of cardiomyopathy, heart failure, or sudden cardiac arrest (SCA) A disease or condition that can lead to cardiomyopathy, such as coronary heart disease, heart attack, or a viral infection that inflames the heart muscle Diabetes or other metabolic diseases, or severe obesity Diseases that can damage the heart, such as hemochromatosis, sarcoidosis, or amyloidosis Long-term alcoholism Long-term high blood pressure Some people who have cardiomyopathy never have signs or symptoms. Thus, it's important to identify people who may be at high risk for the disease. This can help prevent future problems, such as serious arrhythmias (irregular heartbeats) or SCA. </s>

<s>[INST] When to seek urgent medical care when I have Cardiomyopathy ? [/INST] One should seek medical care when suffering from symptoms of cardiomyopathy or a positive family history. </s>

<s>[INST] What to expect if I have Cardiomyopathy (Outlook/Prognosis)? [/INST] Some people live long, healthy lives with cardiomyopathy. Some people don't even realize they have it. In others, however, it can make the heart less able to pump blood through the body Some people who have cardiomyopathy—especially those who have hypertrophic cardiomyopathy (HCM)—may live a healthy life with few problems or symptoms. Others may have serious symptoms and complications. </s>

<s>[INST] What are the symptoms of Carotid artery stenosis? [/INST] You may not have any symptoms or you may have symptoms of a stroke or a transient ischemic attack (TIA). Some of these symptoms include: Weakness in one part of your body Blurred vision Confusion Loss of memory Problems with speech and language Loss of sensation </s>

<s>[INST] What causes Carotid artery stenosis? [/INST] Carotid artery disease occurs when sticky, fatty substances called plaque build up in the inner lining of the arteries. The plaque may slowly block or narrow the carotid artery or cause a clot (thrombus) to form. Clots can lead to stroke. </s>

<s>[INST] Who is at highest risk for Carotid artery stenosis ? [/INST] Risk factors for blockage or narrowing of the arteries include: High blood pressure Diabetes Heart disease High cholesterol Heavy alcohol use Kidney disease, especially when dialysis is needed Cocaine abuse Family history of stroke Increasing age Smoking is also a risk factor. Smoking increases the risk of most types of stroke. People who smoke one pack a day have over two times the risk of stroke compared to nonsmokers. Two uncommon conditions called Marfan syndrome and fibromuscular dysplasia (abnormal growth or development of the cells in the walls of carotid arteries) may also cause narrowing of the carotid arteries. </s>

<s>[INST] When to seek urgent medical care when I have Carotid artery stenosis ? [/INST] Go to the emergency room or call the local emergency number (such as 911) as soon as symptoms occur. When having a stroke, every second of delay can result in more brain injury. </s>

<s>[INST] What to expect if I have Carotid artery stenosis (Outlook/Prognosis)? [/INST] Stroke is a leading cause of death in the United States. Some people who have a stroke recover most or all of their functions. Others die from the stroke itself or from complications. About half of those who have a stroke have long-term problems. </s>

<s>[INST] What are the symptoms of Catecholaminergic polymorphic ventricular tachycardia? [/INST] The symptoms typically start with ventricular tachycardia (VT) during physical activity or emotional stress: Fainting is commonly the first sign of the disease Light-headedness or dizziness Palpitations or unpleasant awareness of the heartbeat Sometimes the ventricular tachycardia goes away, and symptoms stop. At times, ventricular tachycardia can turn into ventricular fibrillation (VF) in which the ventricles quiver and are unable to pump blood. This sudden loss of heart function leads to sudden cardiac arrest. A person stops breathing and becomes unresponsive. Unfortunately, sudden cardiac arrest is sometimes the first sign of CPVT. Sudden cardiac arrest can lead to sudden cardiac death. </s>

<s>[INST] What causes Catecholaminergic polymorphic ventricular tachycardia? [/INST] CPVT is caused by a gene defect (abnormal gene). Genes are part of your DNA, the material passed down from parents to children, which can be passed down through families and inherited in different ways (from either one or both parents). In some cases, CPVT is autosomal dominant which means you need an abnormal gene from only one of your parents to have it. In other cases, CPVT is autosomal recessive which means you need an abnormal gene from both of your parents to get the disease. CPVT can result from mutations in genes such as RYR2 and CASQ2. RYR2 gene mutations cause about half of all cases, while mutations in the CASQ2 gene account for 1 percent to 2 percent of cases. The RYR2 and CASQ2 genes provide instructions for making proteins that help maintain a regular heartbeat. For the heart to beat normally, heart muscle cells called myocytes must tense (contract) and relax in a coordinated way. Both the RYR2 and CASQ2 proteins are involved in handling calcium within myocytes, which is critical for the regular contraction of these cells. Mutations in either the RYR2 and CASQ2 gene disrupt the handling of calcium within myocytes. During exercise or emotional stress, impaired calcium regulation in the heart can lead to ventricular tachycardia in people with CPVT. Stress and exercise can trigger episodes. Certain medicines, such as catecholamines, can also make it worse. </s>

<s>[INST] Who is at highest risk for Catecholaminergic polymorphic ventricular tachycardia? [/INST] Children and young adults Having a relative with CPVT Family history of fainting (syncope) or sudden death. Thus, if you or someone in your family has CPVT, you and all other family members should see a healthcare provider to get checked. You may need a genetic test. </s>

<s>[INST] When to seek urgent medical care when I have Catecholaminergic polymorphic ventricular tachycardia? [/INST] Go to the emergency room or call the local emergency number (such as 911) if you have a rapid, irregular pulse, faint, or have chest pain. All of these may be signs of ventricular tachycardia. </s>

<s>[INST] What to expect if I have Catecholaminergic polymorphic ventricular tachycardia (Outlook/Prognosis)? [/INST] Prognosis is generally poor. But CPVT can be managed with medication compliance, ICD, regular monitoring with exercise testing and follow-ups. </s>

<s>[INST] What are the symptoms of Cerebral aneurysm? [/INST] A person may have an aneurysm without having any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason. A cerebral aneurysm may begin to "leak" a small amount of blood. This may cause a severe headache that a patient may describe as "the worst headache of my life." Another phrase used to describe this is a sentinel headache. This means the headache could be a warning sign of a rupture days or weeks after the headache first happens. Symptoms may also occur if the aneurysm pushes on nearby structures in the brain or breaks open (ruptures) and causes bleeding into the brain. Symptoms depend on the location of the aneurysm, whether it breaks open, and what part of the brain it is pushing on, but may include: Double vision Loss of vision Headaches Eye pain Neck pain Stiff neck A sudden, severe headache is one symptom of an aneurysm that has ruptured. Other symptoms of an aneurysm rupture may include: Confusion, lethargy, sleepiness, or stupor Eyelid drooping Headaches with nausea or vomiting Muscle weakness or difficulty moving any part of the body Numbness or decreased sensation in any part of the body Seizures Speech impairment Stiff neck (occasionally) Vision changes (double vision, loss of vision) NOTE: A ruptured aneurysm is a medical emergency. Seek immediate medical help. </s>

<s>[INST] What causes Cerebral aneurysm? [/INST] Aneurysms in the brain occur when there is a weakened area in the wall of a blood vessel. An aneurysm may be present from birth (congenital) or it may develop later in life, such as after a blood vessel is injured. There are many different types of aneurysms. A berry aneurysm can vary in size from a few millimeters to over a centimeter. Giant berry aneurysms can reach well over 2 centimeters. These are more common in adults. Multiple berry aneurysms are inherited more often than other types of aneurysms. Other types of cerebral aneurysm involve widening of an entire blood vessel, or they may appear as a "ballooning out" of part of a blood vessel. Such aneurysms can occur in any blood vessel that supplies the brain. Atherosclerosis, trauma, and infection, which can injure the blood vessel wall, can cause cerebral aneurysms. </s>

<s>[INST] Who is at highest risk for Cerebral aneurysm ? [/INST] About 5% of the population has some type of aneurysm in the brain, but only a small number of these aneurysms cause symptoms or rupture. Risk factors include a family history of cerebral aneurysms, and certain medical problems such as polycystic kidney disease, coarctation of the aorta, and high blood pressure. </s>

<s>[INST] When to seek urgent medical care when I have Cerebral aneurysm ? [/INST] Go to the emergency room or call the local emergency number (such as 911) if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other neurological symptoms. Also call if you have a headache that is unusual for you, especially if it is severe or your worst headache ever. </s>

<s>[INST] What to expect if I have Cerebral aneurysm (Outlook/Prognosis)? [/INST] The outcome varies. Patients who are in deep comas after an aneurysm rupture generally do not do as well as those with less severe symptoms. Ruptured cerebral aneurysms are often deadly. About 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, about 25% will have some sort of permanent disability. </s>

<s>[INST] What are the symptoms of Chagas disease? [/INST] Chagas disease has two phases -- acute and chronic. The acute phase may have no symptoms or very mild symptoms. Symptoms include: Fever General ill feeling (malaise) Swelling of one eye Swollen red area at site of insect bite After the acute phase the disease goes into remission. No other symptoms may appear for many years. When symptoms finally develop, they may include: Constipation Digestive problems Pain in the abdomen Swallowing difficulties </s>

<s>[INST] What causes Chagas disease? [/INST] Chagas disease is caused by Trypanosoma cruzi, a parasite related to the African trypanosome that causes sleeping sickness. It is spread by reduvid bugs and is one of the major health problems in South America. Due to immigration, the disease also affects people in the United States. </s>

<s>[INST] Who is at highest risk for Chagas disease ? [/INST] Risk factors for Chagas disease include: Living in a hut where reduvid bugs live in the walls Living in Central or South America Poverty Receiving a blood transfusion from a person who carries the parasite but does not have active Chagas disease </s>

<s>[INST] When to seek urgent medical care when I have Chagas disease ? [/INST] Call for an appointment with your health care provider if you may be infected with Chagas disease. </s>

<s>[INST] What to expect if I have Chagas disease (Outlook/Prognosis)? [/INST] About 30% of infected people who are not treated will develop chronic or symptomatic Chagas disease. It may take more than 20 years from the time of the original infection to develop heart or digestive problems. Abnormal heart rhythms (arrhythmias, ventricular tachycardia) may cause sudden death. Once heart failure develops, death usually occurs within several years. </s>

<s>[INST] What causes Chest pain? [/INST] Many people with chest pain fear a heart attack. However, there are many possible causes of chest pain. Some causes are mildly inconvenient, while other causes are serious, even life-threatening. Any organ or tissue in your chest can be the source of pain, including your heart, lungs, esophagus, muscles, ribs, tendons, or nerves. Heart problems that can cause chest pain: Angina is a type of heart-related chest pain. This pain occurs because your heart is not getting enough blood and oxygen. The most common symptom is chest pain that occurs behind the breast bone or slightly to the left of it. It may feel like tightness, heavy pressure, squeezing, or crushing pain. The pain may spread to the arm, shoulder, jaw, or back. Heart attack pain can be similar to the pain of unstable angina, but more severe. Aortic dissection causes sudden, severe pain in the chest and upper back. Inflammation or infection in the tissue around the heart (pericarditis) causes pain in the center part of the chest. Lung problems that can cause chest pain: Pneumonia, which causes chest pain that usually feels sharp, and often gets worse when you take a deep breath or cough A blood clot in the lung (pulmonary embolism), collapse of a small area of the lung (pneumothorax), or inflammation of the lining around the lung (pleurisy) can cause chest pain that usually feels sharp, and often gets worse when you take a deep breath or cough Asthma, which generally also causes shortness of breath, wheezing, or coughing Other causes of chest pain: Strain or inflammation of the muscles and tendons between the ribs Inflammation where the ribs join the breast bone or sternum (costochondritis) Shingles (sharp, tingling pain on one side that stretches from the chest to the back) Anxiety and rapid breathing Chest pain can also be related to the following digestive system problems: Heartburn or gastroesophageal reflux (GERD) Stomach ulcer (burning pain occurs if your stomach is empty and feels better when you eat food) Gallbladder (pain often gets worse after a meal, especially a fatty meal) In children, most chest pain is not caused by the heart. </s>

<s>[INST] When to seek urgent medical care when I have Chest pain ? [/INST] Call 911 if: You have sudden crushing, squeezing, tightening, or pressure in your chest. Pain radiates to your jaw, left arm, or between your shoulder blades. You have nausea, dizziness, sweating, a racing heart, or shortness of breath. You know you have angina and your chest discomfort is suddenly more intense, brought on by lighter activity, or lasts longer than usual. Your angina symptoms occur at rest. You have sudden sharp chest pain with shortness of breath, especially after a long trip, a stretch of bedrest (for example, following an operation), or other lack of movement that can lead to a blood clot in your leg. Know that your risk of heart attack is greater if you have a family history of heart disease, you smoke, use cocaine, are overweight, or you have high cholesterol, high blood pressure, or diabetes. Call your doctor if: You have a fever or a cough that produces yellow-green phlegm. You have chest pain that is severe and does not go away. You are having problems swallowing. Chest wall pain persists for longer than 3 to 5 days. </s>

<s>[INST] What are the symptoms of angina? [/INST] It's important to know the symptoms of angina and to seek medical help if you think you are experiencing angina. Symptoms of angina can include one or more of the following: Chest discomfort: A common precipitating factor is exertion. Other precipitating factors include emotional stress, large meals, and cold weather. The discomfort is often described as a sense of heaviness, squeezing, pressure, or band like tightness. Most anginal discomfort is located in the center of the chest behind the breast bone and lasts between 1-15 minutes. Pain is relieved with rest or by a medicine called nitroglycerin. Spreading pain that extends to left arm, shoulder, back, neck or jaw. Shortness of breath: You may feel tired and be short of breath Sweaty Feeling Lightheaded Unexplained tiredness after activity You may also have indigestion or be sick to your stomach A sensation in which you can feel your heart beating irregularly or too fast: palpitations </s>

<s>[INST] What should you ask your doctor? [/INST] {{#ev:youtube|p47QFhkKKfI}} </s>

<s>[INST] What causes angina? [/INST] Angina is a symptom of underlying coronary artery disease that is characterized by a fatty material called plaque that builds up over many years on the inner walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). This build up limits the blood supply to the heart (as shown in the video below). Blood supply is specifically limited when the muscles of the heart have to work harder during exercise or when a person is under stress. {{#ev:youtube|GIWb4-a7A6A}} </s>

<s>[INST] Who is at highest risk for Chronic stable angina ? [/INST] Certain risk factors make it more likely that you will develop coronary artery disease (CAD) and subsequently present with anginal pain. Major risk factors for stable angina that you can control include: Smoking High blood pressure High blood cholesterol Overweight and obesity Physical inactivity Diabetes (high blood sugar) Poor diet Risk factors that you can't change include: Age Family history of early coronary artery disease. Previous heart attack Having other diseases that affect the heart Certain CAD risk factors tend to occur together. When they do, it’s called metabolic syndrome. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome. </s>

<s>[INST] When to seek urgent medical care when I have Chronic stable angina ? [/INST] You should seek medical care if you are experiencing: New, unexplained chest pain, upper body discomfort in one or both arms, the back, neck, jaw, or stomach Shortness of breath Nausea, vomiting Lightheadedness or fainting Breaking out in a cold sweat If the symptoms mentioned above persists for more than 15 minutes even after resting or three doses of nitroglycerin or is worsening, call 911 immediately as these symptoms could be the signs of a heart attack (also called myocardial infarction or MI) because immediate treatment is essential. {{#ev:youtube|U2DkFeBKkM8}} </s>

<s>[INST] What to expect if I have Chronic stable angina (Outlook/Prognosis)? [/INST] Stable angina usually improves with lifestyle modifications and proper medication. {{#ev:youtube|O3jJ-s23G5M}} </s>

<s>[INST] What are the symptoms of Claudication? [/INST] Symptoms of claudication may include: Pain while engaging in rigorous activity. Pain may occur in: Buttocks Hips Thighs Calves Feet Arms Pain that is stop-and-go during moderately rigorous activity Weakness Aching or burning sensations Some men may experience impotence For more severe cases of claudication, you may also experience: Pain while sitting or lying down Extremities that are bluish in color, and may feel cold when you touch them Ulcerations or sores on your extremities or lower legs. </s>

<s>[INST] What causes Claudication? [/INST] Claudication is typically caused by peripheral artery disease, a disease in which a person’s arteries in his limbs are damaged. The artery damage is usually caused by atherosclerosis. Atheroschlerosis occurs when arteries become blocked by atherosclerotic plaque, which is usually made up of fat and cholesterol. This plaque causes arteries to become rigid and constricted, which can restrict the blood flow through them. Since arteries carry oxygen to your muscles, this can be a serious problem. The pain from claudication occurs because not enough oxygen is reaching your muscles. </s>

<s>[INST] Who is at highest risk for Claudication ? [/INST] People with the following characteristics are at higher risk for developing both claudication and atherosclerosis: Smokers High blood pressure Body mass index over 30 (obesity) Total blood cholesterol over 240 mg/dL (6.2 mmol/L) Diabetes Age over 70 years Age over 50 years if you have diabetes or you smoke A family history of: Claudication Atherosclerosis Peripheral artery disease </s>

<s>[INST] When to seek urgent medical care when I have Claudication ? [/INST] If you have pain in your limbs when you exercise, see your doctor. Claudication and peripheral artery disease can be serious, and may affect your quality of life if they are not treated. </s>

<s>[INST] What to expect if I have Claudication (Outlook/Prognosis)? [/INST] With proper treatment, many people are able to stay active without experiencing pain. However, it is important to maintain a healthy lifestyle to prevent your condition from worsening. </s>

<s>[INST] Who is at highest risk for Commotio cordis ? [/INST] Young athletes who are involved in sports such as baseball, soccer, ice hockey, polo, rugby, cricket, softball, pelota, fencing, lacrosse, boxing, karate, kung fu and other martial arts where there is a likelihood of sustaining blow to the chest. </s>

<s>[INST] When to seek urgent medical care when I have Commotio cordis ? [/INST] 9-1-1 should be contacted immediately when the athlete is found to be unresponsive, apneic, pulseless, and without an audible heartbeat. Emergent resuscitation is mandated by any person who is trained in CPR and AED (automated external defibrillator). </s>

<s>[INST] What to expect if I have Commotio cordis (Outlook/Prognosis)? [/INST] Commotio cordis has a poor prognosis with only about a quarter of these victims surviving after immediate resuscitation. </s>

<s>[INST] What are the symptoms of Congenital heart block? [/INST] Signs and symptoms depend on the type of heart block you have. First-degree heart block rarely causes symptoms. Symptoms of second- and third-degree heart block include: Fainting Dizziness or light-headedness Fatigue (tiredness) Shortness of breath Chest pain </s>

<s>[INST] What causes Congenital heart block? [/INST] In pregnant women, antibodies can cross the placenta. (The placenta is the organ that attaches the umbilical cord to the mother's womb.) These proteins can damage the baby's heart and lead to congenital heart block. These defects are problems with the heart's structure that are present at birth. Often, doctors don't know what causes these defects. </s>

<s>[INST] Who is at highest risk for Congenital heart block ? [/INST] One form of congenital heart block occurs in babies whose mothers have autoimmune diseases, such as lupus. People who have these diseases make proteins called antibodies that attack and damage the body's tissues or cells. </s>

<s>[INST] When to seek urgent medical care when I have Congenital heart block ? [/INST] The symptoms may suggest other health problems as well. If the symptoms mentioned above are new or severe,the patient need to visit hospital emergency room. For milder symptoms, talk with your doctor right away to find out whether the patient need prompt treatment. </s>

<s>[INST] What to expect if I have Congenital heart block (Outlook/Prognosis)? [/INST] Patients presenting as fetuses or at birth have significantly higher morbidity and mortality rates than do patients presenting later in childhood. </s>

<s>[INST] What are the symptoms of Congenital heart disease? [/INST] Symptoms depend on the specific condition. While congenital heart disease is present at birth, the symptoms may not be immediately obvious for e.g. coarctation of the aorta may not cause problems for many years. Also, a small ventricular septal defect (VSD), may never cause any problems, and some people with a VSD have normal physical activity and a normal life span. </s>

<s>[INST] What causes Congenital heart disease? [/INST] Congenital heart disease is often divided into two types: cyanotic (blue discoloration caused by a relative lack of oxygen) and non-cyanotic. The common causes of congenital heart diseases are: Cyanotic: Tetralogy of Fallot Transposition of the great vessels Tricuspid atresia Total anomalous pulmonary venous return Truncus arteriosus Hypoplastic left heart Pulmonary atresia Some forms of total anomalous pulmonary venous return Ebstein's anomaly Non-cyanotic: Ventricular septal defect (VSD) Atrial septal defect (ASD) Patent ductus arteriosus (PDA) Aortic stenosis Pulmonic stenosis Coarctation of the aorta Atrioventricular canal (endocardial cushion defect) These problems may occur alone or together. The majority of congenital heart diseases occurs as an isolated defect and is not associated with other diseases. However, they can also be a part of various genetic and chromosomal syndromes such as Down syndrome, trisomy 13, Turner syndrome, Marfan syndrome, Noonan syndrome, and DiGeorge syndrome. Drugs such as retinoic acid for acne, chemicals, alcohol, and infections (such as rubella) during pregnancy can contribute to some congenital heart problems. </s>

<s>[INST] Who is at highest risk for Congenital heart disease ? [/INST] Individuals at an increased risk for congenital heart disease include: People with a family history of congenital heart disease Babies born to mothers who: Drink during pregnancy Use recreational drugs Use certain prescriptions and over-the-counter medications dangerous to fetal development Fail to get proper prenatal care </s>

<s>[INST] When to seek urgent medical care when I have Congenital heart disease ? [/INST] Call your health care provider if you suspect that your child has a heart problem. </s>

<s>[INST] What to expect if I have Congenital heart disease (Outlook/Prognosis)? [/INST] How well a patient does depends on the specific defect. </s>

<s>[INST] What are the symptoms of Congestive heart failure? [/INST] Early cases of heart failure do not have any symptoms. As the disease develops, people may notice one or more of the following symptoms: Ankle edema or swelling of the feet and legs Claudication or pain with walking Confusion and altered mentation Cool extremities or cold and clammy hands Cyanosis or bluish color to the skin Dizziness Dyspnea on ordinary exertion or greater shortness of breath with usual activities Fainting Fatigue Hemoptysis or frothy sputum Nocturia or urination during the night Nocturnal cough Orthopnea or sleeping on pillows Palpitations or extra heart beats Paroxysmal nocturnal dyspnea or awakening at night with shortness of breath Shortness of breath Syncope or passing out Weakness Wheezing or cardiac asthma 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 Congestive heart failure? [/INST] Heart failure is a long-term (chronic) condition, but it can sometimes develop suddenly. The condition may affect only the right side or only the left side of the heart. These are called right-sided heart failure or left-sided heart failure. More often, both sides of the heart are involved. Heart failure is present when: Your heart muscle cannot pump (eject) the blood out of the heart very well. This is called systolic heart failure. Your heart muscles are stiff and do not fill up with blood easily. This is called diastolic heart failure. Both of these problems mean the heart is no longer able to pump enough oxygen-rich blood out to the rest of your body, especially when you exercise or are active. As the heart's pumping action is lost, blood may back up in other areas of the body. Fluid builds up in the lungs, liver, gastrointestinal tract, and the arms and legs. This is called congestive heart failure. The most common cause of heart failure is coronary artery disease (CAD), a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an infection weakens the heart muscle. This condition is called cardiomyopathy. Other heart problems that may cause heart failure are: Congenital heart disease Heart attack Heart valve disease Some types of abnormal heart rhythms (arrhythmias) Other diseases that can cause or contribute to heart failure: Emphysema Overactive thyroid Severe anemia Underactive thyroid </s>

<s>[INST] Who is at highest risk for Congestive heart failure ? [/INST] Certain factors increase your risk of getting heart disease, then increase your risk of getting heart failure. You are at a higher risk if you are: A woman aged 55 or older A man aged 45 or older Obesity or overweight Smoking High cholesterol High blood pressure Heavy drinking Diabetes Lack of exercise </s>

<s>[INST] When to seek urgent medical care when I have Congestive heart failure ? [/INST] Patients with early heart failure can compensate. With the disease developing, the heart function decompensate and patients demonstrate a series of signs and symptoms. Call your health care provider if symptoms of heart failure develops. If you experience either of the following symptoms, seeking urgent medical care as soon as possible: Serious shortness of breath Patients can not lie in flat at night, even orthopnea. Hemoptysis or congh pink frothy sputum </s>

<s>[INST] What to expect if I have Congestive heart failure (Outlook/Prognosis)? [/INST] The prognosis of people with heart failure can vary dramatically. The following factors may help the doctor estimate the prognosis. The severity of the symptoms: It is well established that patients who have more severe symptoms of heart failure do not survive as long as those who have mild symptoms. For example, patients with class IV heart failure have the poorest prognosis, while patients with class I have the best. Heart function: The ejection fraction of left ventricle (LVEF) is an important indicator of the prognosis. The more severely damaged your heart muscle is, the worse your ejection fraction and worse prognosis will be, regardless of your symptoms. The causes of heart failure: Heart failure associated with alcohol use or pregnancy may spontaneously recover itself over time. Heart failure can be caused by treatable conditions such as hyperthyroidism or hypothyroidism, anemia, or vitamin deficiency. The prognosis of these conditions are generally excellent. Heart failure as a result of a valve condition may also be reversible if the valve problem is recognized early and fixed before permanent damage happens. People with heart failure caused by severe hypertension may see considerable improvement of their symptoms when they control their hypertension. But the majority of patients have heart failure as a result of coronary artery disease (CAD) have a worse prognosis and a higher death rate than people who have heart failure that is not a result of CAD. How long you've had heart failure: There is no specific length of time after which your heart function is unlikely to improve. General speaking, the longer you have had heart failure, the poorer prognosis may be even with appropriate treatment. Compensatory factors: "compensatory factors" are various adjustments to correct the effects of heart failure on other organs. When heart failure occurs, various hormone levels including renin, aldosterone, norepinephrine, atrial natriuretic peptide, and prostaglandin, may increase. Increases in these hormonal factors and other compensatory factors often make heart failure worse over time. </s>

<s>[INST] What are the symptoms of constrictive pericarditis? [/INST] Symptoms of constrictive pericarditis include: Dyspnea - difficulty breathing that slowly develops and worsens Fatigue Edema - long term swelling of the legs and ankles due to exertion Swollen abdomen Weakness </s>

<s>[INST] What causes constrictive pericarditis? [/INST] Constrictive pericarditis can occur after any major pericardial disease that cause inflammation around the heart, such as: Heart surgery (post-cardiac surgery) Radiation therapy to the chest area (post-radiation therapy, specifically after Hodgkin disease or breast cancer) Tuberculosis (postinfectious) Constrictive pericarditis can also develop with no apparent cause. </s>

<s>[INST] Who is at highest risk for Constrictive pericarditis ? [/INST] Patients who have had heart surgery or any pericardial disease are at risk. This condition is most common among adults and is exceedingly rare in children. </s>

<s>[INST] When to seek urgent medical care when I have Constrictive pericarditis ? [/INST] Call your health care provider if you have symptoms of constrictive pericarditis. </s>

<s>[INST] What to expect if I have Constrictive pericarditis (Outlook/Prognosis)? [/INST] If left untreated, constrictive pericarditis may become life threatening. Surgery is reserved for patients who have severe symptoms due to the high complication rate. </s>

<s>[INST] What are the symptoms of Cor pulmonale? [/INST] Chest discomfort, usually in the front of the chest. Exercise intolerance. Shortness of breath. Swelling of the feet or ankles. Symptoms of underlying disorders (wheezing, coughing). </s>

<s>[INST] What causes Cor pulmonale? [/INST] Normally, the left side of the heart produces a higher blood pressure in order to pump blood to the body. The right side of the heart pumps blood through the lungs under much lower pressure. Any condition that leads to prolonged high blood pressure in the arteries of the lungs (called pulmonary hypertension) puts a strain on the right side of the heart. When the right ventricle is unable to properly pump against these abnormally high pressures, it is called cor pulmonale. Almost any chronic lung disease or condition causing prolonged low blood oxygen levels can lead to cor pulmonale. A few of these causes include: Central sleep apnea Chronic obstructive pulmonary disease (COPD) Chronic thromboembolic pulmonary disease Cystic fibrosis Interstitial lung disease Kyphoscoliosis Obstructive sleep apnea Pneumoconiosis Primary pulmonary hypertension Pulmonary vascular disease Secondary pulmonary hypertension </s>

<s>[INST] When to seek urgent medical care when I have Cor pulmonale ? [/INST] Call your health care provider if you experience shortness of breath or chest pain. </s>

<s>[INST] What to expect if I have Cor pulmonale (Outlook/Prognosis)? [/INST] The outcome depends on the cause of the condition. Giving oxygen often improves symptoms, stamina, and survival. Treating primary pulmonary hypertension often leads to greater stamina and a longer life. In some cases, a lung transplant or heart-lung transplant can extend survival. </s>

<s>[INST] What are the symptoms of cor triatriatum? [/INST] Signs and symptoms depend upon the size of the opening in the septum and the manifestations of associated congenital cardiac defects. In most patients, the opening is severely restrictive and produces symptoms similar to those of severe mitral stenosis. Usual symptoms are the following: Exertional dyspnea Cough Effort intolerance and easy fatigability Hemoptysis Orthopnea Palpitation Signs of systemic embolism 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] Who is at highest risk for Cor triatriatum ? [/INST] Like many congenital heart disease, the cause of cor triatriatum is not clear. Clinical studies suggest that both genetic and environmental factors may play a role during the pregnancy. Viral infection Poor nutrition Genetic disorder </s>

<s>[INST] When to seek urgent medical care when I have Cor triatriatum ? [/INST] Call your health care provider if symptoms of cor triatriatum develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible: Dyspnea Hemoptysis Palpitation </s>

<s>[INST] What to expect if I have Cor triatriatum (Outlook/Prognosis)? [/INST] The prognosis of cor triatriatum depends on whether the surgery has been done. The outcomes of infants or children, who are untreated with symptomatic cor triatriatum sinistrum associated with complex congenital cardiac defects, are very poor. On the contrary, adults with isolated cor triatriatum after surgery have good outcomes. </s>

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

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

<s>[INST] Who needs coronary artery bypass grafting? [/INST] Coronary artery bypass grafting (CABG) is used to treat people who have severe coronary heart disease (CHD) that could lead to a heart attack. CABG also may be used to treat people who have heart damage following a heart attack but still have blocked arteries. Your doctor may recommend CABG if other treatments, such as lifestyle changes or medicines, haven't worked. He or she also may recommend CABG if you have severe blockages in the large coronary (heart) arteries that supply a major part of the heart muscle with blood—especially if your heart's pumping action has already been weakened. CABG also may be a treatment option if you have blockages in the heart that can't be treated with angioplasty. Your doctor will decide whether you're a candidate for CABG based on a number of factors, including: The presence and severity of CHD symptoms. The severity and location of blockages in your coronary arteries. Your response to other treatments. Your quality of life. Any other medical problems you have. CABG may be done on an emergency basis, such as during a heart attack. </s>

<s>[INST] What to expect before coronary artery bypass grafting? [/INST] Tests may be done to prepare you for coronary artery bypass grafting (CABG). For example, you may have blood tests, an EKG (electrocardiogram), echocardiography, a chest x ray, cardiac catheterization, and coronary angiography. Your doctor will give you specific instructions about how to prepare for surgery. He or she will advise you about what to eat or drink, what medicines to take, and what activities to stop (such as smoking). You'll likely be admitted to the hospital on the same day as the surgery. If tests for coronary heart disease show that you have severe blockages in your coronary (heart) arteries, your doctor may admit you to the hospital right away. You may have CABG that day or the day after. </s>

<s>[INST] What to expect during coronary artery bypass grafting? [/INST] Coronary artery bypass grafting (CABG) requires a team of experts. A cardiothoracic surgeon does the surgery with support from an anesthesiologist, perfusionist (heart-lung bypass machine specialist), other surgeons, and nurses. There are several types of CABG. They range from traditional surgery in which the chest is opened to reach the heart, to nontraditional surgery in which small incisions (cuts) are made to bypass the blocked or narrowed artery. This type of surgery usually lasts 3 to 5 hours, depending on the number of arteries being bypassed. Numerous steps take place during traditional CABG. You'll be under general anesthesia for the surgery. The term "anesthesia" refers to a loss of feeling and awareness. General anesthesia temporarily puts you to sleep. During the surgery, the anesthesiologist checks your heartbeat, blood pressure, oxygen levels, and breathing. A breathing tube is placed in your lungs through your throat. The tube is connected to a ventilator (a machine that helps you breathe). An incision is made down the center of your chest. The chest bone is then cut and your ribcage is opened so that the surgeon can get to your heart. Medicines are used to stop your heart, which allows the surgeon to operate on it while it's not beating. You're also given medicines to protect your heart function during the time that it's not beating. A heart-lung bypass machine keeps oxygen-rich blood moving throughout your body during the surgery. An artery or vein is taken from your body—for example, from your chest or leg—and prepared to be used as a graft for the bypass. In surgery with several bypasses, both artery and vein grafts are commonly used. Artery grafts. These grafts are much less likely than vein grafts to become blocked over time. The left internal mammary artery most often is used for an artery graft. It's located inside the chest, close to the heart. Arteries from the arm or other places in the body are sometimes used as well. Vein grafts. Although veins are commonly used as grafts, they're more likely than artery grafts to develop plaque and become blocked over time. The saphenous vein—a long vein running along the inner side of the leg—is typically used. After the grafting is done, blood flow to your heart is restored. Usually, the heart starts beating again on its own. In some cases, mild electric shocks are used to restart the heart. You're then disconnected from the heart-lung bypass machine. Tubes are inserted into your chest to drain fluid. The surgeon uses wires to close your chest bone (much like how a broken bone is repaired). The wires stay in your body permanently. After your chest bone heals, it will be as strong as it was before the surgery. Stitches or staples are used to close the skin incision. The breathing tube is removed when you're able to breathe without it. Nontraditional CABG includes off-pump CABG and minimally invasive CABG. Off-pump coronary artery bypass grafting: This type of surgery can be used to bypass any of the coronary (heart) arteries. Off-pump CABG also is called beating heart bypass grafting because the heart isn't stopped and a heart-lung bypass machine isn't used. Instead, the part of the heart where grafting is being done is steadied with a mechanical device. Minimally invasive direct coronary artery bypass grafting: There are several types of minimally invasive direct coronary artery bypass (MIDCAB) grafting. These types of surgery differ from traditional bypass surgery. They only require small incisions rather than opening the chest bone to get to the heart. These procedures sometimes use a heart-lung bypass machine. This procedure is done through small incisions (ports) made in your chest. Artery or vein grafts are used. A heart-lung bypass machine is used during this procedure. This type of procedure allows for even smaller, keyhole-sized incisions. A small video camera is inserted in one incision to show the heart, while the surgeon uses remote-controlled surgical instruments to do the surgery. A heart-lung bypass machine is sometimes used during this procedure. </s>

<s>[INST] What are the risks of coronary artery bypass grafting? [/INST] Although complications from coronary artery bypass grafting (CABG) are uncommon, the risks include: Wound infection and bleeding. Reactions to anesthesia. Fever. Pain. Stroke, heart attack, or even death. Some patients develop a fever associated with chest pain, irritability, and decreased appetite. This is due to inflammation involving the lung and heart sac. This complication sometimes is seen 1 to 6 weeks after surgeries that involve cutting through the pericardium (the outer covering of the heart). This reaction usually is mild. However, some patients may develop fluid buildup around the heart that requires treatment. Memory loss and other changes, such as problems concentrating or thinking clearly, may occur in some people. These changes are more likely to occur in people who are older, who have high blood pressure or lung disease, or who drink excessive amounts of alcohol. These side effects often improve several months after surgery. Use of a heart-lung bypass machine increases the risk of blood clots forming in your blood vessels. Clots can travel to the brain or other parts of the body and block the flow of blood, which may cause a stroke or other problems. Recent technical improvements in heart-lung bypass machines are helping reduce the risk of blood clots forming. In general, the risk of complications is higher if CABG is done in an emergency situation (for example, during a heart attack), if you're older than 70, or if you have a history of smoking. Your risk also is higher if you have other diseases or conditions, such as diabetes, kidney disease, lung disease, or peripheral arterial disease. </s>

<s>[INST] What to expect after coronary artery bypass grafting? [/INST] After surgery, you'll typically spend 1 or 2 days in an Intensive care unit (ICU). Your heart rate, blood pressure, and oxygen levels will be checked regularly during this time. An intravenous line (IV) will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood circulation and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube to drain fluid from your chest. You may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms. Your doctor may recommend that you wear compression stockings on your legs as well. These stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting. While in the ICU, you'll also have bandages on your chest incision (cut) and on the areas where an artery or vein was removed for grafting. After you leave the ICU, you'll be moved to a less intensive care area of the hospital for 3 to 5 days before going home. Your doctor will give you specific instructions for recovering at home, especially concerning: How to care for your healing incisions. How to recognize signs of infection or other complications. When to call the doctor right away. When to make followup appointments. You also may get instructions on how to deal with common side effects from surgery. Side effects often go away within 4 to 6 weeks after surgery, but may include: Discomfort or itching from healing incisions. Swelling of the area where an artery or vein was removed for grafting. Muscle pain or tightness in the shoulders and upper back. Fatigue (tiredness), mood swings, or depression. Problems sleeping or loss of appetite. Constipation. Chest pain around the site of the chest bone incision (more frequent with traditional CABG). Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for nontraditional CABG. Your doctor will tell you when you can start physical activity again. It varies from person to person, but there are some typical timeframes. Most people can resume sexual activity within about 4 weeks and driving after 3 to 8 weeks. Returning to work after 6 weeks is common unless your job involves specific and demanding physical activity. Some people may need to find less physically demanding types of work or work a reduced schedule at first. Care after surgery may include periodic checkups with doctors. During these visits, tests may be done to see how your heart is working. Tests may include EKG (electrocardiogram), stress testing, echocardiography, and cardiac CT. CABG is not a cure for coronary heart disease (CHD). You and your doctor may develop a treatment plan that includes lifestyle changes to help you stay healthy and reduce the chance of CHD getting worse. Lifestyle changes may include making changes to your diet, quitting smoking, doing physical activity regularly, and lowering and managing stress. Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems. Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Doctors supervise these programs, which may be offered in hospitals and other community facilities. Talk to your doctor about whether cardiac rehab might benefit you. Taking medicines as prescribed also is an important part of care after surgery. Your doctor may prescribe medicines to manage pain during recovery; lower cholesterol and blood pressure; reduce the risk of blood clots forming; manage diabetes; or treat depression. </s>

<s>[INST] What are the symptoms of Coronary heart disease? [/INST] Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person. It may feel heavy or like someone is squeezing your heart. You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back. The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin. Other symptoms include: Shortness of breath Fatigue with activity (exertion). Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as: Fatigue Shortness of breath Weakness </s>

<s>[INST] What causes Coronary heart disease? [/INST] Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and other substances form a plaque build-up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop. This can cause chest pain (stable angina), shortness of breath, heart attack, and other symptoms, usually when you are active. Coronary heart disease (CHD) is the leading cause of death in the United States for men and women. </s>

<s>[INST] Who is at risk for Coronary heart disease? [/INST] Many things increase your risk for heart disease: Men in their 40s have a higher risk of CHD than women. But as women get older (especially after they reach menopause), their risk increases to almost equal that of a man's risk. Bad genes (heredity) can increase your risk. You are more likely to develop the condition if someone in your family has a history of heart disease -- especially if they had it before age 50. Your risk for CHD goes up the older you get. Diabetes is a strong risk factor for heart disease. High blood pressure increases your risks of coronary artery disease and heart failure. Abnormal cholesterol levels: your LDL ("bad") cholesterol should be as low as possible, and your HDL ("good") cholesterol should be as high as possible to reduce your risk of CHD. Metabolic syndrome refers to high triglyceride levels, high blood pressure, excess body fat around the waist, and increased insulin levels. People with this group of problems have an increased chance of getting heart disease. Smokers have a much higher risk of heart disease than nonsmokers. Chronic kidney disease can increase your risk. Already having atherosclerosis or hardening of the arteries in another part of your body (examples are stroke and abdominal aortic aneurysm) increases your risk of having coronary heart disease. Other risk factors include alcohol abuse, not getting enough exercise, and having excessive amounts of stress. Higher-than-normal levels of inflammation-related substances, such as C-reactive protein and fibrinogen are being studied as possible indicators of an increased risk for heart disease. Increased levels of a chemical called homocysteine, an amino acid, are also linked to an increased risk of a heart attack. </s>

<s>[INST] How to know you have a Coronary heart disease? [/INST] Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis. Tests may include: Electrocardiogram (ECG) Exercise stress test Echocardiogram Magnetic resonance angiography Nuclear scan Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries: the more calcium, the higher your chance for CHD CT angiography -- a noninvasive way to perform coronary angiography Coronary angiography /arteriography -- an invasive procedure designed to evaluate the heart arteries under x-ray </s>