• Dr. Safoin Kadi

Echocardiography:

This is an ultrasound machine which has no radiation ( no irradiation injury) which is equipped by Probes for the examination of the arteries and the veins of whole the body including inside the brain.

W e have a specialized option to examine the blood flow in the capillaries of the heart whose diameters are some Microns ( USING SPECIAL CONTRAST MATERIALS) knowing that coronarography can see only the arteries whose diameters are in millimeters. And the tow examinations may be complementary to understand the origin of the chest pain and the presence of ischemia.

Holter Monitoring:

Our up-to-date (LX analysis) from Northeast Monitoring, INC. is a small unit which can be attached to the patient to take it home for diagnosis of palpitation and arrhythmias , a developed option was added to the basic function for monitoring of oxygen saturation during night so we can assess the possibility of sleep apnea during snoring.

Electrocardiogram:

Our ECG is an up-to date e.c.g. machine (from G.E., VERSION 6.6) with a sophisticated program to do electrocardiogram, vectorcardiogram, exercise ecg, with interpretation and detailed analysis.

How does the normal heart work?

The normal heart is composed of four chambers. The two upper chambers (called atriums or atria) are reservoirs which collect blood as it flows back to the heart. From the atriums, blood flows into the lower two chambers (called ventricles) which pump blood, with each heart beat, into the main arteries. From the right side of the heart one of these arteries (the pulmonary artery) carries blood to the lungs for re-oxygenation. The left side of the heart pumps blood into the other main artery (the aorta), which takes blood to the rest of the body.

The two ventricles and the two atriums are separated by partitions called 'septums'. The partition between the atriums is called the 'atrial septum' and the one separating the two ventricles is the 'ventricular septum'. Dark red deoxygenated blood (shown blue in diagram) returns to the right atrium from the body through the two main veins called the 'superior vena cava' and 'inferior vena cava'. It is pumped by the right ventricle to the lungs for replenishment with oxygen. The dark blood becomes bright red (shown red in diagram) in the lungs when oxygen is taken up. This red blood returns through two veins from each lung, to the left atrium and is pumped by the left ventricle to the body again. (Illustration)

The heart has its own internal pacemaker which controls its rhythmical beating. It creates an electrical impulse which causes firstly the atriums, and secondly the ventricles, to contract in turn. With each contraction the blood is pumped, then the heart muscle relaxes and the chambers refill with blood, ready for the next contraction.

What are the heart valves?

There are four valves which control the blood flow through the heart. They all consist of two or three flaps which swing open to allow blood through with each heart beat, and swing closed to prevent blood going back in the wrong direction.

Deoxygenated (blue) blood returning from the body collects in the right atrium. It flows to the right ventricle through the 'tricuspid valve'. It is then pumped through the 'pulmonary valve' into the pulmonary artery on its way to the lungs. Oxygenated (red) blood returning from the lungs collects in the left atrium and flows through the 'mitral valve' into the left ventricle. It is then pumped through the 'aortic valve' into the aorta and to the body. (Illustration)

What is an echocardiogram of the heart?

Also known as transthoracic (across the chest) echo, it is a painless test used to observe the heart chambers and valves. Not an x-ray, it uses ultrasound high frequency waves to get a picture of all four heart chambers and valves. The sound waves bounce back and produce images and sounds that can be used by the cardiologist to detect damage and disease. An echocardiogram is a safe, noninvasive test, and in fact, is the same technology used to image a fetus before it is born. To perform the test, a special gel is placed on the chest wall and a transducer is then moved over the gelled areas to produce images for interpretation.

What is coronary artery disease?


Coronary artery disease is a chronic condition that leads to the narrowing and hardening of the arteries that supply blood to the heart muscle. This narrowing leaves less room for blood flow, depriving the heart muscle. Many risk factors, smoking, diabetes, high cholesterol, high blood pressure, lifestyle, and family history, can contribute to the development of coronary artery disease. Aside from inherited factors, any of the risks can be modified and the chance of developing heart disease reduced.

How can I improve my HDL, or “good cholesterol," without taking medications?

Consuming monounsaturated fats can improve your HDL as well as reduce triglycerides and bad cholesterol (LDL). These include olive oils and other vegetable oils, nuts and avocados. Some foods such as peanuts, green peas, sunflower seeds and corn can also raise HDL. Other important strategies to raise HDL include a regular exercise program,and the cessation of smoking. Calcium supplements have also been shown to increase HDL levels.

I have hypertension should I stop drinking coffee?

A daily coffee habit may counteract aortic stiffness in older adults with hypertension, researchers reported. One to two cups a day correlated with greater aortic distensibility compared with rarely consuming coffee. But a higher dose -- three to five cups a day -- had no effect on flexibility of the aorta, according to Christina Chrysohoou, MD, PhD, of the University of Athens, and colleagues.

- Note that this study used a surrogate marker, aortic distensibility measured by echocardiography, rather than a clinical endpoint.

"We cannot give the recommendation for every hypertensive to start drinking coffee, but we can strongly recommend if they do drink coffee to continue in moderation in order to improve their vascular age even if they are elderly.

At higher intake levels, she explained, caffeine's effects may overpower the benefits for vessel distensibility that the researchers attributed to polyphenol compounds in coffee.

Hypertension makes vessels less responsive to signals to expand. But even in those in whom hypertension disrupts this function, lower elasticity of the aorta remains a significant predictor of cardiovascular events, the investigators noted.

Some prior studieshave suggested that coffee intake doesn't increase risk of developing hypertension, but evidence on cardiovascular effects has been conflicting overall.

So the researchers analyzed coffee consumption results for the 435 hypertensive individuals among those ages 65 to 100 in a larger study of permanent inhabitants of Island. Inhabitants of the island have a long life expectancy and unusually high proportion of residents who reach 90.

Chrysohoou and colleagues found that, compared with rarely drinking coffee, moderate consumption of one or two cups a day was associated with:

- Lower prevalence of diabetes (22% versus 34%, P=0.02)

- Lower prevalence of high cholesterol (41% versus 55%, P=0.001)

- Lower body mass index (28 versus 29 kg/m2, P=0.04)

- Higher creatinine clearance levels (70.2 versus 65 mL/min, P=0.01)

- Lower prevalence of cardiovascular disease (19% versus 26%, P=0.04)

- Higher values of aortic distensibility (P<0.05)

Moderate coffee drinkers didn't differ in other dietary habits or in systolic and diastolic blood pressure levels compared with nondrinkers, though.

Multivariate analysis with regard to echocardiographically-measured aortic distensibility accounted for potential confounders including age, sex, physical activity status, creatinine levels, BMI, and diabetes status.

What is the relation between Chocolate and blood pressure ?


A small Australian study looking at whether it would be practical to give people dark chocolate as a treatment to lower blood pressure long term surprisingly found that half of those who were assigned to the chocolate found it difficult to eat every day.

Although many people may find these results difficult to digest, there is a difference between "consuming a food item voluntarily or having to eat it on a daily basis for 12 weeks." The participants in the study, who had to eat half a bar of dark chocolate a day, "reported strong taste and concerns about fat/sugar content as reasons for unacceptability of chocolate as a long-term treatment option,

"Fifty percent of the people said they were happy to eat the chocolate and liked it. And 73% said they would consume that amount of chocolate if it were known to have health benefits."

"If we have an intervention that's beneficial and that half the people would accept, that's pretty good, because clearly half of the people don't want to exercise vigorously and half certainly don't want to change their diet.

But too soon yet to advocate chocolate as a treatment for high BP.

Ried and her colleagues have also recently published a meta-analysis of 15 trials looking at this subject [4], and she says they too concluded that the studies "are too diverse to give confident answers on optimal dosage or duration of treatment." Their main finding, she says, "was that chocolate may help people with high blood pressure but not with normal blood pressure"—they found BP reductions of around 5 mm Hg systolic, which, "albeit modest, is comparable to the effects of 30 daily minutes of moderate exercise," she says.

"There is some reasonable science suggesting that there might be a modest effect of chocolate on Brands may vary in their BP lowering effects.

Egan says the recent literature review he and his colleagues performed did show that one brand of dark chocolate, consisting of 50% cocoa (Ritter Sport dark chocolate), has consistently lowered blood pressure in four studies, "while another manufacturer's chocolate (Mars Dove chocolate) has never lowered BP," he notes, so "we think it makes a difference which dark chocolate is selected and how the cocoa beans are processed.

Primary source: European Society of Cardiology