Diet - heart and circulation Health Dictionary

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Diet - Heart And Circulation: From 1 Different Sources

It is now widely accepted that changes in diet and lifestyle can dramatically reduce the risk of heart disease. Use DIET – GENERAL as a base.

Unsaturated fatty acids, as in vegetable oils, should replace animal fats (saturated fatty acids) that increase deposits of cholesterol on the inner coat of arteries and encourage hardening. Vegetable oils contain lecithin – a homogeniser which thins and separates the cholesterol, sweeping it along through the bloodstream and preventing deposits to form on walls of the arteries.

A study on the European population has shown a strong link between oily fish consumption and a reduced risk of heart disease. Populations that eat a lot of fish, such as Greenland Eskimos (about 400g a day) and Japanese fishermen (about 200g a day) have low rates of heart disease.

Another study, by the Leiden University of the Netherlands, has found that men who ate more than 30g of fish per day were less than half as likely to die from coronary heart disease as those who ate no fish. A diet high in fish lowers plasma cholesterol, triglyceride and very low density lipoprotein levels and is of value in the treatment of hyperlipidaemia (abnormally high concentration of fats in the blood).

Indicated: Magnesium-containing foods, lecithin, Evening Primrose oil for gamma linoleic acid which is converted into prostaglandin E1 in the body and helps reduce high blood pressure and prevents platelet clumping. Coffee carries a risk factor and should be taken sparingly – alternatives: herbal teas Rutin, Lime flowers and others as available in bulk or tea-bags. Green grapes.

Supplements, daily: Vitamin C 1g; Vitamin E 400iu; Magnesium 300mg – 450mg for pregnant women and nursing mothers. Iodine. Chromium, Selenium. Garlic tablets/capsules – 2-3 at night.

Flora margarine is high in essential polyunsaturated fats – made from sunflower seed oil. Hay diet: good results reported. 

Health Source: Bartrams Encyclopedia of Herbal Medicine
Author: Health Encyclopedia

Heart

A hollow muscular pump with four cavities, each provided at its outlet with a valve, whose function is to maintain the circulation of the blood. The two upper cavities are known as atria; the two lower ones as ventricles. The term auricle is applied to the ear-shaped tip of the atrium on each side.

Shape and size In adults the heart is about the size and shape of a clenched ?st. One end of the heart is pointed (apex); the other is broad (base) and is deeply cleft at the division between the two atria. One groove running down the front and up the back shows the division between the two ventricles; a circular, deeper groove marks o? the atria above from the ventricles below. The capacity of each cavity is somewhere between 90 and 180 millilitres.

Structure The heart lies within a strong ?brous bag, known as the pericardium. Since the inner surface of this bag and the outer surface of the heart are both covered with a smooth, glistening membrane faced with ?at cells and lubricated by a little serous ?uid (around 20 ml), the movements of the heart are accomplished almost without friction. The main thickness of the heart wall consists of bundles of muscle ?bres, some of which run in circles right around the heart, and others in loops, ?rst round one cavity, then round the corresponding cavity of the other side. Within all the cavities is a smooth lining membrane, continuous with that lining the vessels which open into the heart. The investing smooth membrane is known as epicardium; the muscular substance as myocardium; and the smooth lining membrane as endocardium.

Important nerves regulate the heart’s action, especially via the vagus nerve and with the sympathetic system (see NERVOUS SYSTEM). In the near part of the atria lies a collection of nerve cells and connecting ?bres, known as the sinuatrial node or pacemaker, which forms the starting-point for the impulses that initiate the beats of the heart. In the groove between the ventricles and the atria lies another collection of similar nerve tissue, known as the atrioventricular node. Running down from there into the septum between the two ventricles is a band of special muscle ?bres, known as the atrioventricular bundle, or the bundle of His. This splits up into a right and a left branch for the two ventricles, and the ?bres of these distribute themselves throughout the muscular wall of the ventricles and control their contraction.

Openings There is no direct communication between the cavities on the right side and those on the left; but the right atrium opens into the right ventricle by a large circular opening, and similarly the left atrium into the left ventricle. Into the right atrium open two large veins, the superior and inferior venae cavae, with some smaller veins from the wall of the heart itself, and into the left atrium open two pulmonary veins from each lung. One opening leads out of each ventricle – to the aorta in the case of the left ventricle, to the pulmonary artery from the right.

Before birth, the FETUS’s heart has an opening (foramen ovale) from the right into the left atrium through which the blood passes; but when the child ?rst draws air into his or her lungs this opening closes and is represented in the adult only by a depression (fossa ovalis).

Valves The heart contains four valves. The mitral valve consists of two triangular cusps; the tricuspid valve of three smaller cusps. The aortic and pulmonary valves each consist of three semilunar-shaped segments. Two valves are placed at the openings leading from atrium into ventricle, the tricuspid valve on the right side, the mitral valve on the left, so as completely to prevent blood from running back into the atrium when the ventricle contracts. Two more, the pulmonary valve and the aortic valve, are at the entrance to these arteries, and prevent regurgitation into the ventricles of blood which has been driven from them into the arteries. The noises made by these valves in closing constitute the greater part of what are known as the heart sounds, and can be heard by anyone who applies his or her ear to the front of a person’s chest. Murmurs heard accompanying these sounds indicate defects in the valves, and may be a sign of heart disease (although many murmurs, especially in children, are ‘innocent’).

Action At each heartbeat the two atria contract and expel their contents into the ventricles, which at the same time they stimulate to contract together, so that the blood is driven into the arteries, to be returned again to the atria after having completed a circuit in about 15 seconds through the body or lungs as the case may be. The heart beats from 60 to 90 times a minute, the rate in any given healthy person being about four times that of the respirations. The heart is to some extent regulated by a nerve centre in the MEDULLA, closely connected with those centres which govern the lungs and stomach, and nerve ?bres pass to it in the vagus nerve. The heart rate and force can be diminished by some of these ?bres, by others increased, according to the needs of the various organs of the body. If this nerve centre is injured or poisoned – for example, by lack of oxygen – the heart stops beating in human beings; although in some of the lower animals (e.g. frogs, ?shes and reptiles) the heart may under favourable conditions go on beating for hours even after its entire removal from the body.... heart

Diet

The mixture of food and drink consumed by an individual. Variations in morbidity and mortality between population groups are believed to be due, in part, to di?erences in diet. A balanced diet was traditionally viewed as one which provided at least the minimum requirement of energy, protein, vitamins and minerals needed by the body. However, since nutritional de?ciencies are no longer a major problem in developed countries, it seems more appropriate to consider a ‘healthy’ diet as being one which provides all essential nutrients in su?cient quantities to prevent de?ciencies but which also avoids health problems associated with nutrient excesses.

Major diet-related health problems in prosperous communities tend to be the result of dietary excesses, whereas in underdeveloped, poor communities, problems associated with dietary de?ciencies predominate. Excessive intakes of dietary energy, saturated fats, sugar, salt and alcohol, together with an inadequate intake of dietary ?bre, have been linked to the high prevalence of OBESITY, cardiovascular disease, dental caries, HYPERTENSION, gall-stones (see GALL-BLADDER, DISEASES OF), non-insulindependent DIABETES MELLITUS and certain cancers (e.g. of the breast, endometrium, intestine and stomach) seen in developed nations. Health-promotion strategies in these countries generally advocate a reduction in the intake of fat, particularly saturated fat, and salt, the avoidance of excessive intakes of alcohol and simple sugars, an increased consumption of starch and ?bre and the avoidance of obesity by taking appropriate physical exercise. A maximum level of dietary cholesterol is sometimes speci?ed.

Undernutrition, including protein-energy malnutrition and speci?c vitamin and mineral de?ciencies, is an important cause of poor health in underdeveloped countries. Priorities here centre on ensuring that the diet provides enough nutrients to maintain health.

In healthy people, dietary requirements depend on age, sex and level of physical activity. Pregnancy and lactation further alter requirements. The presence of infections, fever, burns, fractures and surgery all increase dietary energy and protein requirements and can precipitate undernutrition in previously well-nourished people.

In addition to disease prevention, diet has a role in the treatment of certain clinical disorders, for example, obesity, diabetes mellitus, HYPERLIPIDAEMIA, inborn errors of metabolism, food intolerances and hepatic and renal diseases. Therapeutic diets increase or restrict the amount and/or change the type of fat, carbohydrate, protein, ?bre, vitamins, minerals and/or water in the diet according to clinical indications. Additionally, the consistency of the food eaten may need to be altered. A commercially available or ‘homemade’ liquid diet can be used to provide all or some of a patient’s nutritional needs if necessary. Although the enteral (by mouth) route is the preferred route for feeding and can be used for most patients, parenteral or intravenous feeding is occasionally required in a minority of patients whose gastrointestinal tract is unavailable or unreliable over a period of time.

A wide variety of weight-reducing diets are well publicised. People should adopt them with caution and, if in doubt, seek expert advice.... diet

Heart Block

A disorder that occurs in the transmission of impulses between the atria (upper chambers) and ventricles (lower chambers) of the heart. A blocking of the normal route of electrical conduction through the ventricles not responding to initiation of the beat by the atria. Beats are missed with possible blackouts.

Causes: myocardial infarction, atherosclerosis, coronary thrombosis or other heart disorder.

Symptoms: slow feeble heart beats down to 36 beats per minute with fainting and collapse, breathlessness, Stoke Adams syndrome.

Treatment. Intensive care. Until the doctor comes: 1-5 drops Oil of Camphor in honey on the tongue or taken in a liquid if patient is able to drink. Freely inhale the oil. On recovery: Motherwort tea, freely. OR, Formula of tinctures: Lily of the Valley 2; Cactus 1; Motherwort 2. Mix. Dose – 30-60 drops in water thrice daily. A fitted pace-maker may be necessary.

Spartiol. 20 drops thrice daily. (Klein) ... heart block

Heart Surgery

Open-heart surgery permits the treatment of many previously inoperable conditions that were potentially fatal, or which made the patient chronically disabled. CORONARY ARTERY VEIN BYPASS GRAFTING (CAVBG), used to remedy obstruction of the arteries supplying the heart muscle, was ?rst carried out in the mid1960s and is now widely practised. Constricted heart valves today are routinely dilated by techniques of MINIMALLY INVASIVE SURGERY (MIS), such as ANGIOPLASTY and laser treatment, and faulty valves can be replaced with mechanical alternatives (see VALVULOPLASTY).

Heart transplant Replacement of a person’s unhealthy heart with a normal heart from a healthy donor. The donor’s heart needs to be removed immediately after death and kept chilled in saline before rapid transport to the recipient. Heart transplants are technically demanding operations used to treat patients with progressive untreatable heart disease but whose other body systems are in good shape. They usually have advanced coronary artery disease and damaged heart muscle (CARDIOMYOPATHY). Apart from the technical diffculties of the operation, preventing rejection of the transplanted heart by the recipient’s immune system requires complex drug treatment. But once the patient has passed the immediate postoperative phase, the chances of ?ve-year survival is as high as 80 per cent in some cardiac centres. A key di?culty in doing heart transplants is a serious shortage of donor organs.... heart surgery

Ketogenic Diet

This contains such an excess of fats that acetone and other KETONE bodies appear in the urine. The diet is sometimes used in the treatment of EPILEPSY and chronic infections of the urinary tract by Escherichia coli; butter, cream, eggs and fat meat are allowed, whilst sugar, bread and other carbohydrates are cut out as far as possible.... ketogenic diet

Heart-lung Machine

A device that temporarily takes over the function of the heart and lungs. It is used in certain operations in the chest, giving the surgeon more time for operations such as open-heart surgery, heart transplants and heart-lung transplants. The machine also ensures an operating area largely free of blood, which helps the surgeon to work more quickly. A pump replaces the heart and an oxygenator replaces the lungs. When connected up, the machine in e?ect bypasses normal cardiopulmonary activity. It also contains a heat exchanger to warm or cool the patient’s blood according to the requirements of the operation. The patient is given an anticoagulant (HEPARIN) to counteract clotting which may occur when blood cells get damaged during the machine’s use. Patients are on the machine for a few hours only, because blood supply to vital organs begins to be reduced.... heart-lung machine

Coronary Heart Disease

The cause of: coronary occlusion, coronary blockage, coronary thrombosis. A heart attack occurs when a coronary artery becomes blocked by swellings composed, among other things, of cholesterol. Such swellings may obstruct the flow of blood leading to a blood clot (thrombus). Cholesterol is a major cause of CHD.

Coronary thrombosis is more common in the West because of its preference for animal fats; whereas in the East fats usually take the form of vegetable oils – corn, sunflower seed, sesame, etc. Fatty deposits (atheroma) form in the wall of the coronary artery, obstructing blood-flow. Vessels narrowed by atheroma and by contact with calcium and other salts become hard and brittle (arterio-sclerosis) and are easily blocked. Robbed of oxygen and nutrients heart muscle dies and is replaced by inelastic fibrous (scar) tissue which robs the heart of its maximum performance.

Severe pain and collapse follow a blockage. Where only a small branch of the coronary arterial tree is affected recovery is possible. Cause of the pain is lack of oxygen (Vitamin E). Incidence is highest among women over 40 who smoke excessively and who take The Pill.

The first warning sign is breathlessness and anginal pain behind the breastbone which radiates to arms and neck. Sensation as if the chest is held in a vice. First-line agent to improve flow of blood – Cactus.

For cholesterol control target the liver. Coffee is a minor risk factor.

Measuring hair calcium levels is said to predict those at risk of coronary heart disease. Low hair concentrations may be linked with poor calcium metabolism, high aortic calcium build-up and the formation of plagues. (Dr Allan MacPherson, nutritionist, Scottish Agricultural College, Ayr, Scotland)

Evidence has been advanced that a diagonal ear lobe crease may be a predictor for coronary heart disease. (American Journal of Cardiology, Dec. 1992)

Tooth decay is linked to an increased risk of coronary heart disease and mortality, particularly in young men. (Dr Frank De Stefano, Marshfield Medical Research Foundation, Wisconsin, USA) Treatment. Urgency. Send for doctor or suitably qualified practitioner. Absolute bedrest for 3 weeks followed by 3 months convalescence. Thereafter: adapt lifestyle to slower tempo and avoid undue exertion. Stop smoking. Adequate exercise. Watch weight.

Cardiotonics: Motherwort, Hawthorn, Mistletoe, Rosemary. Ephedra, Lily of the Valley, Broom.

Cardiac vasodilators relax tension on the vessels by increasing capacity of the arteries to carry more blood. Others contain complex glycosides that stimulate or relax the heart at its work. Garlic is strongly recommended as a preventative of CHD.

Hawthorn, vasodilator and anti-hypertensive, is reputed to dissolve deposits in thickened and sclerotic arteries BHP (1983). It is believed to regulate the balance of lipids (body fats) one of which is cholesterol.

Serenity tea. Equal parts: Motherwort, Lemon Balm, Hawthorn leaves or flowers. 1 heaped teaspoon to each cup boiling water; infuse 5-15 minutes; 1 cup freely.

Decoction. Combine equal parts: Broom, Lily of the Valley, Hawthorn. 1-2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup freely.

Tablets/capsules. Hawthorn, Motherwort, Cactus, Mistletoe, Garlic.

Practitioner. Formula. Hawthorn 20ml; Lily of the Valley 10ml; Pulsatilla 5ml; Stone root 5ml; Barberry 5ml. Tincture Capsicum 1ml. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water or honey.

Prevention: Vitamin E – 400iu daily.

Diet. See: DIET – HEART AND CIRCULATION.

Supplements. Daily. Vitamin C, 2g. Vitamin E possesses anti-clotting properties, 400iu. Broad spectrum multivitamin and mineral including chromium, magnesium selenium, zinc, copper.

Acute condition. Strict bed-rest; regulate bowels; avoid excessive physical and mental exertion. Meditation and relaxation techniques dramatically reduce coronary risk. ... coronary heart disease

Heart Attack

See myocardial infarction.... heart attack

Hole In The Heart

The common name for a septal defect.... hole in the heart

Heart Disease – Congenital

Heart disease arising from abnormal development. Some cases are hereditary, others due to drugs taken during pregnancy. Many owe their origin to illnesses of the mother such as German measles. Structural abnormalities of the heart take different forms but whatever the case, when under abnormal pressure and stress, all may derive some small benefit from the sustaining properties of Hawthorn berry and other phytomedicines.

Alternatives. To sustain.

Teas. Lime flowers, Motherwort, Buckwheat, Hawthorn.

Tablets/capsules. Hawthorn, Mistletoe, Motherwort.

Formula. Hawthorn 2; Lily of the Valley 1; Selenicereus grandiflorus 1. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. In water morning and evening. ... heart disease – congenital

Heart Failure

Inability of the heart to cope with its workload of pumping blood to the lungs and to the rest of the body. Heart failure can primarily affect the right or the left side of the heart, although it most commonly affects both sides, in which case it is known as congestive, or chronic, heart failure.

Left-sided heart failure may be caused by hypertension, anaemia, hyperthyroidism, a heart valve defect (such as aortic stenosis, aortic incompetence, or mitral incompetence), or a congenital heart defect (see heart disease, congenital). Other causes of left-sided heart failure include coronary artery disease, myocardial infarction, cardiac arrhythmias, and cardiomyopathy.

The left side of the heart fails to empty completely with each contraction, or has difficulty in accepting blood that has been returned from the lungs. The retained blood creates a back pressure that causes the lungs to become congested with blood. This condition leads to pulmonary oedema.

Right-sided heart failure most often results from pulmonary hypertension, which is itself caused by left-sided failure or by lung disease (such as chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). Right-sided failure can also be due to a valve defect, such as tricuspid incompetence, or a congenital heart defect.

There is back pressure in the circulation from the heart into the venous system, causing swollen neck veins, enlargement of the liver, and oedema, especially of the legs and ankles. The intestines may become congested, causing discomfort.

Immediate treatment consists of bed rest, with the patient sitting up. Diuretic drugs are given, and digitalis drugs and vasodilators, especially ACE inhibitors, may also be administered. Morphine and oxygen may be given as emergency treatment in acute left-sided failure.... heart failure

Bleeding Heart

Love... bleeding heart

Heart-lung Transplant

An operation in which a patient’s diseased lungs and heart are removed and replaced with donor organs from someone who has been certi?ed as ‘brain dead’ (see BRAIN-STEM DEATH). As well as the technical diffculties of such an operation, rejection by the recipient’s tissues of donated heart and lungs has proved hard to overcome. Since the early 1990s, however, immunosuppressant drug therapy (see CICLOSPORIN; TRANSPLANTATION) has facilitated the regular use of this type of surgery. Even so, patients receiving transplanted hearts and lungs face substantial risks such as lung infection and airway obstruction as well as the long-term problems of transplant rejection.... heart-lung transplant

Heart, Diseases Of

Heart disease can affect any of the structures of the HEART and may affect more than one at a time. Heart attack is an imprecise term and may refer to ANGINA PECTORIS (a symptom of pain originating in the heart) or to coronary artery thrombosis, also called myocardial infarction.

Arrhythmias An abnormal rate or rhythm of the heartbeat. The reason is a disturbance in the electrical impulses within the heart. Sometimes a person may have an occasional irregular heartbeat: this is called an ECTOPIC beat (or an extrasystole) and does not necessarily mean that an abnormality exists. There are two main types of arrhythmia: bradycardias, where the rate is slow – fewer than 60 beats a minute and sometimes so slow and unpredictable (heartblock) as to cause blackouts or heart failure; and tachycardia, where the rate is fast – more than 100 beats a minute. A common cause of arrhythmia is coronary artery disease, when vessels carrying blood to the heart are narrowed by fatty deposits (ATHEROMA), thus reducing the blood supply and damaging the heart tissue. This condition often causes myocardial infarction after which arrhythmias are quite common and may need correcting by DEFIBRILLATION (application of a short electric shock to the heart). Some tachycardias result from a defect in the electrical conduction system of the heart that is commonly congenital. Various drugs can be used to treat arrhythmias (see ANTIARRHYTHMIC DRUGS). If attacks constantly recur, the arrhythmia may be corrected by electrical removal of dead or diseased tissue that is the cause of the disorder. Heartblock is most e?ectively treated with an arti?cial CARDIAC PACEMAKER, a battery-activated control unit implanted in the chest.

Cardiomyopathy Any disease of the heart muscle that results in weakening of its contractions. The consequence is a fall in the e?ciency of the circulation of blood through the lungs and remainder of the body structures. The myopathy may be due to infection, disordered metabolism, nutritional excess or de?ciency, toxic agents, autoimmune processes, degeneration, or inheritance. Often, however, the cause is not identi?ed. Cardiomyopathies are less common than other types of heart diseases, and the incidence of di?erent types of myopathy (see below) is not known because patients or doctors are sometimes unaware of the presence of the condition.

The three recognised groups of cardiomyopathies are hypertrophic, dilated and restrictive.

•Hypertrophic myopathy, a familial condition, is characterised by great enlargement of the muscle of the heart ventricles. This reduces the muscle’s e?ciency, the ventricles fail to relax properly and do not ?ll suf?ciently during DIASTOLE.

In the dilated type of cardiomyopathy, both ventricles overdilate, impairing the e?ciency of contraction and causing congestion of the lungs.

In the restrictive variety, proper ?lling of the ventricles does not occur because the muscle walls are less elastic than normal. The result is raised pressure in the two atria (upper cavities) of the heart: these dilate and develop FIBRILLATION. Diagnosis can be di?cult and treatment is symptomatic, with a poor prognosis. In suitable patients, heart TRANSPLANTATION may be considered. Disorders of the heart muscle may also be

caused by poisoning – for example, heavy consumption of alcohol. Symptoms include tiredness, palpitations (quicker and sometimes irregular heartbeat), chest pain, di?culty in breathing, and swelling of the legs and hands due to accumulation of ?uid (OEDEMA). The heart is enlarged (as shown on chest X-ray) and ECHOCARDIOGRAPHY shows thickening of the heart muscle. A BIOPSY of heart muscle will show abnormalities in the cells of the heart muscle.

Where the cause of cardiomyopathy is unknown, as is the case with most patients, treatment is symptomatic using DIURETICS to control heart failure and drugs such as DIGOXIN to return the heart rhythm to normal. Patients should stop drinking alcohol. If, as often happens, the patient’s condition slowly deteriorates, heart transplantation should be considered.

Congenital heart disease accounts for 1–2 per cent of all cases of organic heart disease. It may be genetically determined and so inherited; present at birth for no obvious reason; or, in rare cases, related to RUBELLA in the mother. The most common forms are holes in the heart (atrial septal defect, ventricular septal defect – see SEPTAL DEFECT), a patent DUCTUS ARTERIOSUS, and COARCTATION OF THE AORTA. Many complex forms also exist and can be diagnosed in the womb by fetal echocardiography which can lead to elective termination of pregnancy. Surgery to correct many of these abnormalities is feasible, even for the most severe abnormalities, but may only be palliative giving rise to major diffculties of management as the children become older. Heart transplantation is now increasingly employed for the uncorrectable lesions.

Coronary artery disease Also known as ischaemic heart disease, this is a common cause of symptoms and death in the adult population. It may present for the ?rst time as sudden death, but more usually causes ANGINA PECTORIS, myocardial infarction (heart attack) or heart failure. It can also lead to a disturbance of heart rhythm. Factors associated with an increased risk of developing coronary artery disease include diabetes, cigarette smoking, high blood pressure, obesity, and a raised concentration of cholesterol in the blood. Older males are most affected.

Coronary thrombosis or acute myocardial infarction is the acute, dramatic manifestation of coronary-artery ischaemic heart disease – one of the major killing diseases of western civilisation. In 1999, ischaemic heart disease was responsible for about 115,000 deaths in England and Wales, compared with 153,000 deaths in 1988. In 1999 more than 55,600 people died of coronary thrombosis. The underlying cause is disease of the coronary arteries which carry the blood supply to the heart muscle (or myocardium). This results in narrowing of the arteries until ?nally they are unable to transport su?cient blood for the myocardium to function e?ciently. One of three things may happen. If the narrowing of the coronary arteries occurs gradually, then the individual concerned will develop either angina pectoris or signs of a failing heart: irregular rhythm, breathlessness, CYANOSIS and oedema.

If the narrowing occurs suddenly or leads to complete blockage (occlusion) of a major branch of one of the coronary arteries, then the victim collapses with acute pain and distress. This is the condition commonly referred to as a coronary thrombosis because it is usually due to the affected artery suddenly becoming completely blocked by THROMBOSIS. More correctly, it should be described as coronary occlusion, because the ?nal occluding factor need not necessarily be thrombosis.

Causes The precise cause is not known, but a wide range of factors play a part in inducing coronary artery disease. Heredity is an important factor. The condition is more common in men than in women; it is also more common in those in sedentary occupations than in those who lead a more physically active life, and more likely to occur in those with high blood pressure than in those with normal blood pressure (see HYPERTENSION). Obesity is a contributory factor. The disease is more common among smokers than non-smokers; it is also often associated with a high level of CHOLESTEROL in the blood, which in turn has been linked with an excessive consumption of animal, as opposed to vegetable, fats. In this connection the important factors seem to be the saturated fatty acids (low-density and very low-density lipoproteins [LDLs and VLDLs] – see CHOLESTEROL) of animal fats which would appear to be more likely to lead to a high level of cholesterol in the blood than the unsaturated fatty acids of vegetable fats. As more research on the subject is carried out, the arguments continue about the relative in?uence of the di?erent factors. (For advice on prevention of the disease, see APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELFHELP.)

Symptoms The presenting symptom is the sudden onset, often at rest, of acute, agonising pain in the front of the chest. This rapidly radiates all over the front of the chest and often down over the abdomen. The pain is frequently accompanied by nausea and vomiting, so that suspicion may be aroused of some acute abdominal condition such as biliary colic (see GALLBLADDER, DISEASES OF) or a perforated PEPTIC ULCER. The victim soon goes into SHOCK, with a pale, cold, sweating skin, rapid pulse and dif?culty in breathing. There is usually some rise in temperature.

Treatment is immediate relief of the pain by injections of diamorphine. Thrombolytic drugs should be given as soon as possible (‘rapid door to needle time’) and ARRHYTHMIA corrected. OXYGEN is essential and oral ASPIRIN is valuable. Treatment within the ?rst hour makes a great di?erence to recovery. Subsequent treatment includes the continued administration of drugs to relieve the pain; the administration of ANTIARRHYTHMIC DRUGS that may be necessary to deal with the heart failure that commonly develops, and the irregular action of the heart that quite often develops; and the continued administration of oxygen. Patients are usually admitted to coronary care units, where they receive constant supervision. Such units maintain an emergency, skilled, round-the-clock sta? of doctors and nurses, as well as all the necessary resuscitation facilities that may be required.

The outcome varies considerably. The ?rst (golden) hour is when the patient is at greatest risk of death: if he or she is treated, then there is a 50 per cent reduction in mortality compared with waiting until hospital admission. As each day passes the prognosis improves with a ?rst coronary thrombosis, provided that the patient does not have a high blood pressure and is not overweight. Following recovery, there should be a gradual return to work, care being taken to avoid any increase in weight, unnecessary stress and strain, and to observe moderation in all things. Smoking must stop. In uncomplicated cases patients get up and about as soon as possible, most being in hospital for a week to ten days and back at work in three months or sooner.

Valvular heart disease primarily affects the mitral and aortic valves which can become narrowed (stenosis) or leaking (incompetence). Pulmonary valve problems are usually congenital (stenosis) and the tricuspid valve is sometimes involved when rheumatic heart disease primarily affects the mitral or aortic valves. RHEUMATIC FEVER, usually in childhood, remains a common cause of chronic valvular heart disease causing stenosis, incompetence or both of the aortic and mitral valves, but each valve has other separate causes for malfunction.

Aortic valve disease is more common with increasing age. When the valve is narrowed, the heart hypertrophies and may later fail. Symptoms of angina or breathlessness are common and dizziness or blackouts (syncope) also occur. Replacing the valve is a very e?ective treatment, even with advancing age. Aortic stenosis may be caused by degeneration (senile calci?c), by the inheritance of two valvular leaflets instead of the usual three (bicuspid valve), or by rheumatic fever. Aortic incompetence again leads to hypertrophy, but dilatation is more common as blood leaks back into the ventricle. Breathlessness is the more common complaint. The causes are the same as stenosis but also include in?ammatory conditions such as SYPHILIS or ANKYLOSING SPONDYLITIS and other disorders of connective tissue. The valve may also leak if the aorta dilates, stretching the valve ring as with HYPERTENSION, aortic ANEURYSM and MARFAN’S SYNDROME – an inherited disorder of connective tissue that causes heart defects. Infection (endocarditis) can worsen acutely or chronically destroy the valve and sometimes lead to abnormal outgrowths on the valve (vegetations) which may break free and cause devastating damage such as a stroke or blocked circulation to the bowel or leg.

Mitral valve disease leading to stenosis is rheumatic in origin. Mitral incompetence may be rheumatic but in the absence of stenosis can be due to ISCHAEMIA, INFARCTION, in?ammation, infection and a congenital weakness (prolapse). The valve may also leak if stretched by a dilating ventricle (functional incompetence). Infection (endocarditis) may affect the valve in a similar way to aortic disease. Mitral symptoms are predominantly breathlessness which may lead to wheezing or waking at night breathless and needing to sit up or stand for relief. They are made worse when the heart rhythm changes (atrial ?brillation) which is frequent as the disease becomes more severe. This leads to a loss of e?ciency of up to 25 per cent and a predisposition to clot formation as blood stagnates rather than leaves the heart e?ciently. Mitral incompetence may remain mild and be of no trouble for many years, but infection must be guarded against (endocarditis prophylaxis).

Endocarditis is an infection of the heart which may acutely destroy a valve or may lead to chronic destruction. Bacteria settle usually on a mild lesion. Antibiotics taken at vulnerable times can prevent this (antibiotic prophylaxis) – for example, before tooth extraction. If established, lengthy intravenous antibiotic therapy is needed and surgery is often necessary. The mortality is 30 per cent but may be higher if the infection settles on a replaced valve (prosthetic endocarditis). Complications include heart failure, shock, embolisation (generation of small clots in the blood), and cerebral (mental) confusion.

PERICARDITIS is an in?ammation of the sac covering the outside of the heart. The sac becomes roughened and pain occurs as the heart and sac rub together. This is heard by stethoscope as a scratching noise (pericardial rub). Fever is often present and a virus the main cause. It may also occur with rheumatic fever, kidney failure, TUBERCULOSIS or from an adjacent lung problem such as PNEUMONIA or cancer. The in?ammation may cause ?uid to accumulate between the sac and the heart (e?usion) which may compress the heart causing a fall in blood pressure, a weak pulse and circulatory failure (tamponade). This can be relieved by aspirating the ?uid. The treatment is then directed at the underlying cause.... heart, diseases of

Ischaemic Heart Disease

See HEART, DISEASES OF.... ischaemic heart disease

Portal Circulation

This is a type of circulatory bypass used when substances in blood or fluid need to be kept out of the general flow. A portal system begins in capillaries and ends in capillaries, and nothing leaves it undocumented. The hypothalamus sends hormones into the portal system between it and the pituitary, and the pituitary responds to it by secreting its own hormones, but dissolving the hypothalamus ones. Blood that leaves the intestinal tract, spleen, and pancreas (partially) goes into the liver’s portal system and does not leave that organ until it has been thoroughly screened and altered.... portal circulation

Heart Palpitations

Abnormally rapid and irregular beating of the heart... heart palpitations

Diet - Low Protein

Reduce intake of foods, taking small helpings: meat, eggs, poultry, fish, milk, cheese, dried peas and beans, pulses, nuts, bread, pasta, wheat flour.

Accept: rice, cornflour, honey, salad vegetables, all fruits, preserves. ... diet - low protein

Diet - Thin People

Often more difficult to ‘put on’ than to ‘take off’ weight. Eat plenty of carbohydrates: bread and wholemeal products. Butter, margarine and other fats, meats, eggs, cream and cheese. In order to metabolise these effectively, without kidney or liver congestion, large quantities of fresh fruits and vegetables and juices should be eaten. Increase daily Vitamin B-complex intake. See: THIN PEOPLE. ... diet - thin people

Diet - Vegan

 A vegan is a strict vegetarian who does not eat meat, fish, eggs, milk and dairy products generally, He, or she, eats no animal products at all. By selecting a number of products from the plant kingdom they claim their diet is adequate.

As the Vegan diet is deficient in Vitamin B12 which may lead to anaemia, supplements are available. Some Vegan products have this vitamin added.

Their rule is to combine legumes with other cereals, seeds or nuts at the same meal. The combination is claimed to be equal to one animal based. ... diet - vegan

Heart, Artificial

A mechanical device in the chest that enhances or takes over the pumping action of the HEART, thus maintaining the necessary level of circulation of blood through the lungs and other body structures. An arti?cial heart was ?rst used in humans in 1985 and the three types in use are: an intra-aortic balloon pump, driven by compressed air, which in?ates a balloon in the AORTA with every heartbeat, increasing the volume of circulating blood; an electrical device that assists the left VENTRICLE by pumping blood into the abdominal aorta; and a mechanical arti?cial heart that replaces a diseased heart that has been removed. As yet there is no arti?cial heart suitable for long-term use. Existing devices are intended to tide over a patient who is extremely ill until a live heart can be transplanted from a donor. The results from arti?cial hearts have been disappointing because of complications and also because the patients have usually been already dangerously ill.... heart, artificial

Tea For Heart Health

Heart conditions may be triggered by many causes, from stomach pains to vascular strokes and depression. However, some people have a congenital predisposition for cardiac problems and all they can do is treat this affection as it is. Having a heart problem could mean that your heart is not pumping enough blood (or too much), that you have an abnormal growth which weakens your circulatory system or that you suffer from arrhythmia (a disease in which your blood flow is never constant, but fluctuates depending on the situation). How a Tea for Heart Health Works A Tea for Heart Health’s main goal is to prevent diseases from developing and treating the already installed ones. If that is the case, you may want to look after teas and tinctures which contain a high level of antioxidants, natural enzymes, volatile oils and minerals (sodium, iron, magnesium and manganese) and are low on acids (in high concentrations, they may cause heartburn). Efficient Tea for Heart Health In order to work properly, a Tea for Heart Health needs to be both efficient and one hundred percent safe. Remember that you must schedule an appointment with your doctor before self medicating! This way, you’ll eliminate the risk of triggering other health problems and you’ll know for sure what’s wrong with your body. If you don’t know which teas could have a positive effect on you, here’s a list for guidance: - Green Tea – according to specialists, this Tea for Heart Health contains all the ingredients necessary to sustain life, so it’s useful for a wide range of ailments, from sore throats, headaches and migraines to infertility and erectile dysfunctions. However, you may want to avoid it if you’re experiencing menstrual and menopausal symptoms (due to its acids level, it may cause uterine contractions). - Yerba Mate Tea – named “the new green tea” by the herbalists, this decoction is a great choice for many problems, such as loss of appetite, asthenia or anemia. Although it remains yet unknown to European public, Yerba Mate Tea is very popular in South American regions. However, don’t drink more than 2 cups per day! High dosages may lead to death! - Chamomile Tea – has curative properties which are benefic for a series of health problems, from nausea, diarrhea, upset stomach to infertility and hot flashes. This Tea for Heart Health has a pleasant taste and a lovely smell. Plus, it’s one hundred percent safe, so you can drink as much as you want. If you’re thinking about giving up on coffee, Chamomile Tea can be a great replacer. Tea for Heart Health Side Effects When taken properly, these teas are generally safe. However, exceeding the number of cups recommended per day may lead to a number of problems, such as stomach pain, nausea, headaches and even death. Before starting any kind of herbal treatment, make sure you’re well informed of the risks that may occur. Don’t take a Tea for Heart Health if you’re pregnant, breastfeeding, on blood thinners or anticoagulants. The same advice if you’re preparing for a surgery. If you’ve been taking one of these teas for a while and something doesn’t feel quite right, ask for medical assistance right away! Once you have the green light from your doctor and there’s nothing that could interfere with your treatment, choose a Tea for Heart Health that fits best your condition and enjoy its great benefits!... tea for heart health

Heart - Over-strained

See: ATHLETE’S HEART. ... heart - over-strained

Heart – Fibrous Degeneration

Distinct from fatty degeneration. Due to thickening of walls by atheroma. Heart muscle (myocardium) fibres waste away due to lack of nourishment and are replaced by fibrous tissue. The condition usually runs with kidney weakness. Incurable. Partial relief of symptoms – treatment as for arteriosclerosis.

Every cardiac prescription for this condition should include a gentle diuretic to assist kidney function. The kidneys should be borne in mind, the most appropriate diuretic being Dandelion which would also make good any potassium loss. ... heart – fibrous degeneration

Heart, Rapid Beat

See: TACHYCARDIA.... heart, rapid beat

Circulation, Disorders Of

Conditions affecting blood flow around the body (see arteries, disorders of; veins, disorders of).... circulation, disorders of

Congestive Heart Failure

See heart failure.... congestive heart failure

Athlete’s Heart

Jogger’s heart. Excessive strain on the heart as in running and other sports. Alternatives. Teas. Ginseng, Hawthorn, Marigold, Motherwort.

Tablets/capsules. Ginseng, Hawthorn, Motherwort.

Formula. Ginseng, Hawthorn, Mistletoe, Motherwort. Equal parts. Dose: Powders: 750mg (three 00 capsules or half a teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Thrice daily in water. Practitioner. Tincture Arnica: 1-3 drops in honey, once or twice daily.

First-aid on the track. Ginseng. Arnica.

Diet. See DIET – HEART AND CIRCULATION.

Supplements. Vitamin E (500-1000iu daily), Chromium, Magnesium, Potassium, Selenium. ... athlete’s heart

Heart Disease, Ischaemic

The most common form of heart disease, in which narrowing or obstruction of the coronary arteries, usually by atherosclerosis, results in a reduced blood supply (see coronary artery disease).... heart disease, ischaemic

Open Heart Surgery

Any operation on the heart in which it is stopped temporarily and its function taken over by a mechanical pump. The main forms of open heart surgery are correction of congenital heart defects (see heart disease, congenital), surgery for narrowed or leaky heart valves (see heart-valve surgery), and coronary artery bypass surgery. Once the pump is connected, the heart is opened, and the defects repaired. Surgical hypothermia is used to keep the heart cool and help prevent damage to the heart muscle from lack of oxygen (see hypothermia, surgical).... open heart surgery

Valvular Heart Disease

A defect of 1 or more of the heart valves.... valvular heart disease

Artificial Heart

see ventricular assist device.... artificial heart

Collateral Circulation

1. an alternative route provided for the blood by secondary vessels when a primary vessel becomes blocked. 2. the channels of communication between the blood vessels supplying the heart. At the apex of the heart, where the coronary arteries form *anastomoses, these are very complex.... collateral circulation

Diet - Cancer

GENERAL DIET use as a base.

Life is our most precious gift. But at some point that gift might be at risk. It is at such time that food and drink may contribute to our sense of well-being.

Rapidly accumulating evidence links cancer to a growing public awareness of the role of diet. Also, involvement of supplements in cancer prevention are a fruitful area of research.

Vital food enzymes are not destroyed in cooking when a large proportion of food is eaten raw. All food should be free from additives.

A high fat intake is a risk factor in cancer of the ovary, womb and prostate gland. It also affects the bowel flora, changing bile acid metabolism and the concentration of carcinogenic bile acid metabolites. Obesity significantly increases risk of cancer.

Epidemiological studies in man show that people with low Vitamin A levels are more susceptible to lung cancer. Cancer risk is increased by low levels of Vitamin A, particularly Beta Carotene, Vitamin E and Selenium.

Antioxidants control the activity of free-radicals that destroy body cells, and source foods containing them are therefore of value in cancer prevention. Most cancers generate a high degree of toxicity and this is where antioxidants, particularly Vitamin C are indicated. A deficiency of Vitamin C has been associated with cancer of the oesophagus, stomach, lungs and breast. This vitamin is known to increase life expectancy in terminally ill patients and is a mild analgesic for pain. Vitamin B6 may be of value for nausea.

Vitamins and minerals of value: Vitamins A, B6, C, E, Calcium, Chromium, Magnesium, Molybdenum, Selenium, Zinc.

Stimulants should be avoided: cocoa, alcohol, sugar, coffee (including decaffeinated). Tea should not be too strong as it inhibits absorption of iron. Choice should be over a wide range of foods, to eat less fat and more wholegrain cereals and raw fresh fruit and vegetables. ... diet - cancer

Diet - Cholesterol

To lower cholesterol. Avoid all animal fats and dairy products, bacon, ham, lobster, shell fish, milk (use skimmed), rich sauces, gravies, the use of cream, eggs, offal, ice cream, cheese (cottage cheese accepted), cream puffs, fried foods, crab, salami, pork, beef steak, veal, baked custard, mayonnaise made with eggs, milk chocolate, fried fish and chips. Alcohol, refined sugars. Accept: white fish, lean meat, chicken, skimmed milk, Tofu products, nuts except cashew and coconut, bread, breakfast cereals, cottage cheese, plenty of fruits and fruit juices, raw green vegetables and salad materials. For cooking – polyunsaturated oils such as sunflower, corn or Soya. No more than 3 eggs per week. 2-3 fatty fish meals each week to prevent clumping of platelets. Artichokes. Dandelion coffee. ... diet - cholesterol

Diet - General

It is sometimes not possible to achieve worthwhile results from herbal medicine without due regard to the quality and type of food that enters the body. Suggested foods are those which experience has shown to assist recovery and conserve body energies that might otherwise be diverted towards elimination of metabolic wastes.

“A good and proper diet in disease is worth a hundred medicines and no amount of medication can do good to a patient who does not observe a strict regimen of diet.” (Charaka Samhita 300AD)

A healthy diet helps maintain the immune system, builds up reserves and hastens recovery from illness.

A good general diet includes foods low in fat, salt and high in fibre. All white sugar and white sugar products (chocolates, sweets, etc) should be replaced with natural sugars (honey, dates, figs, molasses, raisins etc). It should contain plenty of raw fresh fruit and vegetables; best prepared in a juice-press.

Vegetables should be conservatively cooked in very little water with little salt in a covered vessel. At least one mixed raw vegetable salad should be taken daily. Bread can be replaced by jacket potato, Soya- bean flour products or ripe bananas. Puddings, pastry and suety meals should be avoided.

Lean meat should be restricted to two or three parts a week with liberal inclusion of oily fish. Tofu, a Soya bean product, is an excellent alternative to meat. Three or four eggs, only, should be taken weekly.

Dairy produce (milk, butter, cream) contain cholesterol which thickens the blood, blocks arteries and increases resistance against the heart and major blood vessels, and should be taken sparingly.

Accept: Garlic, Onions, Lecithin, Muesli or Oatmeal porridge for breakfast or at other times during the day, yoghurt, honey.

Reject: fried foods, biscuits, confectionery.

Salt: replace with powdered Garlic, Celery or Kelp.

Alcohol: replace with fresh fruit or raw vegetable juices. Coffee is a risk factor raising cholesterol concentration; Dandelion coffee, Rutin or any one of many herbal teas available offer alternatives.

Avoid over-eating and meals when tired. Foods should be well masticated without liquid drinks; dry- feed. Plenty of liquid drinks, water etc should be taken between meals.

Supplements: Vitamin C 200mg, Vitamin E 200iu, morning and evening. Evening Primrose oil. Efamol produce a combined Evening Primrose and Fish oil capsule.

Dietary fibre can prevent certain colonic diseases. Treatment of disease by diet is preferred to drugs because it has the advantage of being free from side-effects. ... diet - general

Elimination Diet

a diet in which foods suspected of not being tolerated are removed for a period of time and then reintroduced sequentially to identify any that then precipitate symptoms (e.g. *FODMAPS). An exclusion diet is a variant of this, in which a single food is excluded and symptoms monitored for any improvements (e.g. a lactose-free diet).... elimination diet

Exclusion Diet

see elimination diet.... exclusion diet

Heart Age

a scoring system that uses biometric data to calculate the risk of a heart attack for an individual and expresses this risk in terms of notional heart age.... heart age

Heart Rate

see pulse.... heart rate

Hypoplastic Left Heart

a congenital heart disorder in which the left side of the heart, particularly the left ventricle, is underdeveloped. The first part of the aorta may also be abnormal. Affected babies usually develop severe heart failure within the first few days of life. Diagnosis can be confirmed on *echocardiography. Prognosis is generally very poor – most babies die within the first few weeks – but milder cases may be amenable to surgery. It is the commonest cause of death in the neonatal period due to heart disease.... hypoplastic left heart

Diet - Gluten-free

Some people cannot absorb the protein gluten present in wheat, barley, rye and oats, and hundreds of foods made from them. Nutritional deficiencies may result in coeliac disease, schizophrenia, allergies and irritable bowel syndrome.

Foods containing gluten include: many breakfast cereals, shredded wheat, wheat germ flakes, white and wholemeal bread, cakes, puddings, biscuits, porridge, rye and wheat crispbreads, crumbled fish and meat, semolina, baked beans, macaroni, baby foods, soups in packets and tins, chocolate, cocoa, spaghetti, muesli, custard, sausages, batter, beer, instant coffee, bedtime drinks and all kinds of pasta.

Natural gluten-free foods include maize, peas, millet, Soya, lima beans, rice. Brown rice is the basic cereal food: cornflakes, puffed rice, rice cereals. Millet flakes, sago, tapioca. These may be prepared in skimmed milk. Gluten-free flours and bread. The potato comes into its own in the gluten-free kitchen, especially for thickening soups and casseroles.

One school of medical thought associates certain nerve dyscrasies with nutritional deficiencies, the gluten-free diet being advised for cases of multiple sclerosis, myasthenia gravis, poliomyelitis, syringomyelia, motor neurone disease.

Book. Gluten-Free cooking Recipes for Coeliacs and Others, by Rita Greer. ... diet - gluten-free

Diet - The Hay Diet

Diet plays an important role in modern herbal medicine. A faulty diet may ruin the effect of the best of medicine. In some instances it may seriously hinder recovery. The Hay Diet works well with herbal medicine and comprises three principles.

1. Starches and sugars are not eaten with protein and acid fruit. Acid fruits should be eaten with protein meals.

2. Sugars, proteins, fats and starches are eaten only in small quantities. Vegetables, salads and fruits should form 80 per cent of the diet – all these are necessary to maintain the alkaline reserve.

3. All refined sugars and starches are avoided.

Example: potatoes or bread are not eaten with meat or fish. Sugar or honey are not used on acid fruits.

Sugar and honey are only compatible with starch fruits such as bananas. There are, however, certain foods that are compatible with all meals: mushrooms, oils, butter, cream, raisins, nuts, milk, egg yolks (the white is one of the most acid foods known).

Dr Hay advised against eating refined or processed foods – white sugar, white flour, etc, and against eating one kind of meal within four hours of a meal of the same kind.

Book: “Food Combining for Health”, by Doris Grant and Jean Joice. (Thorsons)

The Hay Diet has proved beneficial for Crohn’s disease, Colitis, Indigestion, Migraine, Raynaud’s disease, Irritable Bowel Syndrome, Heart disease, Allergies and certain other disturbances. ... diet - the hay diet

Diet - High Fibre

A diet high in rich carbohydrate foods with sufficient protein to promote efficient elimination and supply vital trace elements in the form of minerals. Such foods produce moist bulky stools easy to pass and reduce blood cholesterol. It reduces LDLs and increases HDLs.

Fibre-deficient foods lead to poor elimination of body wastes and constipation, disposing the colon to a toxic state. This induces depression, a coated tongue and tiredness during the day. Such foods bring about a change in the balance of bowel bacterial flora, and form gas which may cause pouches of diverticulitis to develop. One of its less obvious effects is to enhance the risk of tooth and gum disease. Soon calcium is expelled by the urine and the intake of magnesium reduced, thus favouring the development of stone.

All plant material; leaves, stalks, seeds etc contain fibre. High-fibre foods include: whole grains, wholemeal bread, wholemeal flour (100 per cent extraction rate), crispbreads, biscuits (digestive, bran, oatmeal or coconut), raw green salad materials, potatoes boiled in their jackets, breakfast cereals (porridge, muesli, All-Bran, Shredded Wheat), brown rice, bran (2 teaspoons thrice daily; increase if necessary), fresh or dried fruit once or twice daily. ... diet - high fibre

Diet - Low Salt

Salt is present in most foods. Spices, herbs and peppers (Black or Cayenne) may be used for flavouring. No salt should be used in cooking or added at table. Salty foods such as the following should be avoided:

Reject: canned foods (except fruit), packet mixes, all bought cooked meats – sausages, bacon, ham. Cakes containing baking soda, chocolate, toffee, treacle, bought biscuits, kippers and other smoked fish, yeast extracts, chutneys, sauces, excessively salted cheeses, butter and margarine.

Accept: rice, pasta, cereals, home-made cottage cheese, eggs (3 per week), all meats, chicken, poultry, whitefish, shellfish, herring, salmon, unsalted bread, butter, margarine, vegetable oils, restricted milk and cream, all vegetables and fruits, fruit juices, brown sugar, wines.

Excess salt leads to retention of fluid in body tissues and adds to work the heart will perform. ... diet - low salt

Pulmonary Circulation

a system of blood vessels effecting transport of blood between the heart and lungs. Deoxygenated blood leaves the right ventricle by the pulmonary artery and is carried to the alveolar capillaries of the lungs. Gaseous exchange occurs, with carbon dioxide leaving the circulation and oxygen entering. The oxygenated blood then passes into small veins leading to the pulmonary veins, which leave the lungs and return blood to the left atrium of the heart. The oxygenated blood can then be pumped around the body via the *systemic circulation.... pulmonary circulation

Systemic Circulation

the system of blood vessels that supplies all parts of the body except the lungs. It consists of the aorta and all its branches, carrying oxygenated blood to the tissues, and all the veins draining deoxygenated blood into the vena cava. Compare pulmonary circulation.... systemic circulation

Diet - Macrobiotic

A plant-based diet with small amounts of poultry, fish or meat for non- vegetarians. A return to the traditional diet of local natural foods as found in some primitive communities and which is believed to increase immunity against degenerative diseases of the civilised world.

The average macrobiotic diet is made up approximately of the proportions: whole grains 45 per cent; vegetables 25 per cent; beans, legumes and seeds 10 per cent; nuts 5 per cent; fruit 5 per cent; seaweeds 5 per cent; poultry 2.5 per cent; fish 2.5 per cent.

Whole grains: wheat, barley, rye, oats, brown rice, buckwheat, millet, corn. Vegetables: green leaves and roots – grown organically. Beans, legumes and seeds: all beans, aduki, lentils, chickpeas. Seeds: sesame, sunflower, etc. Seaweeds: hiziki, wakama, dulse, Carragheen moss, kelp. Very low sugar. Moderate fats and oils. ... diet - macrobiotic

Diet - Skin Disorders

Low fat, low salt, high fibre. Dairy-free (no milk, cream, cheese, eggs). Soya milk is more suitable for children and adults than cow’s milk and provides protein, calories, calcium and vitamins. Polyunsaturates: oils of safflower, corn, Soya, sunflower seed, etc which are rich in essential fatty acids, low levels of which are frequently found in the blood of those with chronic skin disorders. Evening Primrose oil is a rich source of EFAs. Gluten-free diet has proved successful in some cases.

Accept. Goat’s milk, yoghurt, eggs – twice weekly. The high potassium and low salt content of bananas help reduce itching. Lecithin. Oily fish. Purslane is a non-fish source of EPA and suitable for the vegetarian approach. Cottage cheese. Pumpkin seeds as a source of zinc. Dandelion coffee. Artichoke: such as Schoenenberger plant juice. Salad dressing: emulsify 1 teaspoon Cider vinegar to each 2 teaspoons safflower seed oil.

Reject: Fried and greasy foods, pastries, chocolates, sweets, ice cream, spicy foods, seasoning, sausage meats, white flour products, white sugar products, alcoholic drinks, meat from the pig (ham, pork, bacon), peppers, horseradish, condiments. Powdered kelp in place of salt, powdered garlic or celery.

Foods known to contain artificial colours and preservatives. All soft drinks, except those made at home from fresh fruits or raw vegetables; coffee, strong tea, oranges. Cola drinks, chocolate, milk, cream, cheese, whey.

Supplement. Beta carotene.

Study. A flare-up can be caused by nuts, jams, fruits, artificially coloured or flavoured foods. (British Journal of Dermatology, 110, 457, (1984)) ... diet - skin disorders

Diet - Slimming

 Diet should be based on 1200 calories a day, eating habits being changed to a simple regime. Low-fat, high carbohydrate and fibre.

Eat plenty of fresh fruit and raw vegetables for vitamins and minerals as well as for fibre. As a substitute for mayonnaise use low-fat plain yoghurt. Vegetable fats should replace animal fats: instead of butter – margarine from Sunflower or Safflower oils.

Carbohydrates. At liberty: porridge, muesli, wholemeal bread and wholegrain products, pasta, potatoes, beans, peas, brown rice. These are high in fibre and low in fat. Processed foods should be avoided and those with natural goodness preferred, except for All-Bran which is rich in iron.

Protein. Meat should be taken in small quantities only – turkey, poultry, steamed fish, replace red with grilled lean white meats. Chicken is the most versatile, least expensive and most nutritious of meats. Cottage cheese is low in calories. Food should not be fried but grilled, roasted or baked.

Fluids. Juices, or drinks made with skimmed milk, herb teas. Dandelion coffee. In place of alcohol – carrot, tomato and other fresh vegetable juices.

Reject. Fried foods, white and brown sugar products, honey, sweets, contectionery, jams, biscuits, chocolates, canned fruits, thick soups. Frankfurters, beefburgers, hamburgers, everything from the pig: bacon, ham, pork, lard. Avoid between-meal snacks but chew a carrot or piece of other raw vegetable or fresh fruit.

There is increasing support for a well-balanced vegetarian diet for weight reduction as it contains no animal fats. Protein is preferred from such foods as beans, pulses, nuts, eggs; and calcium from cottage cheese and milk. The Hay Diet also has been found to be frequently effective. ... diet - slimming

Heart – Degeneration, In The Elderly

May take the form of degeneration of healthy cardiac tissue replaced by broken fatty patches. As cardiac muscle wastes fibrous tissue takes its place.

While cure is not possible, atheroma may be arrested by a cup of herbal tea: Hawthorn blossoms, Motherwort, Horsetail: single or in combination. 1-2 teaspoons to each cup boiling water; infuse 5-15 minutes; 1-2 cups daily.

Formula. Hawthorn 2; Ginkgo 2; Horsetail 1; Ginger quarter. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons. Twice daily: morning and evening in water or honey.

Diet. See: DIET – HEART AND CIRCULATION. Few grains of Cayenne pepper as seasoning on food once daily.

Stop smoking. ... heart – degeneration, in the elderly

Heart – Enlargement

A heart may dilate (enlarge) to compensate for valvular disease. One of two types: (1) Swelling (dilation) of the cavities with thickening of the walls, (hypertrophy of the heart muscle). (2) Dilation of cavities with thinning of the walls.

(1) Arises from the exertions of professional athletes. Extra strain enlarges the heart and calls for compensation. Other causes: high blood pressure and diseased valves.

(2) From anaemia, thyroid disorder, or extra strain demanded by fever. Thin walls always lead to heart weakness, robbing the organ of its maximum power.

Treatment. When compensation is delayed cardiac supportives include Bugleweed (American) to increase force of contractions of the heart and reduce the rate BHP (1983).

Right ventricular enlargement – Stone root.

Left ventricular enlargement – Lily of the Valley.

Both remedies have the advantage of being diuretics, thus aiding elimination of excess fluids.

Diet. See: DIET – HEART AND CIRCULATION. ... heart – enlargement

Heart – Extra Beats

Extra-systoles. An occasional beat or beats may arise prematurely from an abnormal focus in atrium or ventricle. Such is a common occurrence and is little cause for alarm. Simple arrythmia may be the outraged protest of a heart under the influence of alcohol, heavy meals, too much tea or coffee, smoking or excitement. If persistent, examination by a trained practitioner should be sought. For uncomplicated transient extra-systole:–

Alternatives. Teas: Balm, Motherwort, Hawthorn flowers or leaves. Tablets: Hawthorn, Motherwort, Mistletoe, Valerian.

Tincture Lily of the Valley: 8-15 drops when necessary.

Broom: Spartiol drops. (Klein) 20 drops thrice daily.

Broom decoction. 1oz to 1 pint water gently simmered 10 minutes. 1 cup morning and evening. ... heart – extra beats

Heart – Fatty Degeneration

A deposit and infiltration of fat on the heart in the obese and heavy consumers of alcohol. Distinct from true degeneration in which there is no destruction of tissue. Symptoms. Breathlessness and palpitation on slight exertion. Anginal pain: see ANGINA. Mental dullness. May follow enlargement of the heart and acute infections such as influenza.

Alternatives. Teas. Alfalfa, Clivers, Yarrow, Motherwort.

Tablets/capsules. Poke root, Kelp, Motherwort.

Formula. Equal parts: Bladderwrack, Motherwort, Aniseed, Dandelion. Dose. Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons in water thrice daily. Black Cohosh. Introduced into the medical world in 1831 when members of the North American Eclectic School of physicians effectively treated cases of fatty heart.

Diet. Vegetarian protein foods, high-fibre, whole grains, seed sprouts, lecithin, soya products, low-fat yoghurt, plenty of raw fruit and vegetables, unrefined carbohydrates. Oily fish: see entry. Dandelion coffee. Reject: alcohol, coffee, salt, sugar, fried foods, all dairy products except yoghurt.

Supplements. Daily. Broad-spectrum multivitamin including Vitamins A, B-complex, B3, B6, C (with bioflavonoids), E, Selenium. ... heart – fatty degeneration

Heart – Left Ventricular Failure (lvf)

Failure of the left ventricle to receive blood from the pulmonary circulation and to maintain efficient output of incoming blood to the arterial system. Failure to do so leads to congestion of blood in the lungs followed by fluid retention. If uncorrected, leads to kidney disturbance, low blood pressure, cyanosis (blueness of the skin). Onset may be tragically sudden.

Failure of the left ventricle may occur in cases of pericarditis, disease of the aortic valve, nephritis or high blood pressure.

Left ventricular failure is often of sudden onset, urgent, and may manifest as “cardiac asthma”.

Causes: blood clot, anaemia, thyroid disorder, coronary disease, congenital effects, drug therapy (beta blockers, etc), and to fevers that make heavy demands on the left ventricle.

Symptoms: breathlessness, wheezing, sweating, unproductive cough, faintness, bleeding from the lungs, palpitation. Cardiac asthma at night: feels he needs air; better upright than lying flat. Exertion soon tires. Sensation as if heart would stop. Blueness of lips and ears from hold-up in circulation of the blood through the lungs. Frequent chest colds. Awakes gasping for breath. Always tired. Cold hands and feet. Symptoms abate as compensation takes place. ‘Cream and roses’ complexion. The failure of left ventricle soon drags into failure of the right ventricle.

Right ventricular failure leads to congestive heart failure, with raised venous pressure in neck veins and body generally, causing oedema, ascites and liver engorgement.

Treatment. Agents to strengthen, support, and eliminate excess fluids from the body. BHP (1983) advises four main remedies: Hawthorn, Motherwort, Broom and Lily of the Valley. The latter works in a digitaloid manner, strengthening the heart, contracting the vessels, and lessening congestion in the lungs. Tinctures. Hawthorn 2; Stone root 1. Lily of the Valley 1. Dose: 15-45 drops thrice daily.

Broom tea. 2 teaspoons flowers, or 2-3 teaspoons tops and flowers, in cup water brought to boil and simmered one minute. 1 cup freely.

To remove fluid retention in the lungs, diuretics are indicated; chief among which is Dandelion root because of its high potassium content to prevent hypokalaemia. Dandelion coffee. As urinary excretion increases, patient improves.

Vitamin E. Not to be taken in left ventricular disorders.

Diet. See entry: DIET – HEART AND CIRCULATION.

UK Research. Researchers found that left ventricular failure was reduced by a quarter when patients were given magnesium intravenously for the first 24 hours after admission to the coronary care unit. They conclude that it should be given before any other heart therapy is commenced, and that patients should receive regular infusions if no other drug treatment is used. (The Lancet, 2.4.1994). This supports the use of magnesium sulphate (Epsom’s salts) by a past generation of herbal practitioners for the condition. ... heart – left ventricular failure (lvf)

Heart – Nervous

Condition with no specific organic lesion present, but one in which palpitation or cardiac distress may be precipitated by nervous or emotional stimuli.

Alternatives. Neuralgia of the Heart: Lobelia.

Palpitation with sense of suffocation: Pulsatilla.

From physical exhaustion: Ginseng.

With rapid heart beat: Lily of the Valley, Gelsemium.

Tea. Equal parts, Valerian, Motherwort, Lime flowers. Mix. 1-2 teaspoons to each cup boiling water allowed to cool. Drink cold 1 teacup 2 or 3 times daily.

Decoction. Equal parts, Valerian, Hawthorn, Mistletoe. Mix. 1 heaped teaspoon to each cup water simmered gently for 20 minutes. 1 teacup 2 or 3 times daily.

Tablets/capsules. Hawthorn, Mistletoe, Motherwort. Valerian. Passion flower. Lobelia.

Formula. Equal parts: Hawthorn, Lily of the Valley, Mistletoe. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures 2 teaspoons. Thrice daily.

Practitioner. Formula. Tincture Hawthorn 2; Tincture Gelsemium 1. Dose: 15-30 drops 2-3 times daily. Alternative formula. Tincture Valerian 2; Strophanthus 1. Dose: 15-30 drops thrice daily.

Diet. Oats (oatmeal porridge), low fat, low salt, high fibre. See also: DIET – HEART AND CIRCULATION. ... heart – nervous

Heart - Rheumatic Heart

Hearts can be damaged by rheumatic fever but they yearly become less, due to the advance of medical science, better nutrition and living conditions. Damage to the valves may not come to light until years later. Mostly a legacy from rheumatic fever in early childhood. Alternatives. Regular treatment may not be necessary except for periods of unusual tension, exposure and stress.

Teas: Nettles, Borage, Mate, Figwort, Gotu Kola, Motherwort.

Decoctions: Blach Cohosh, Cramp bark, Hawthorn, Lily of the Valley, White Willow, Sarsaparilla. Any one.

Formula. Combine Black Cohosh root half; White Willow bark 2; Gotu Kola 1; Hawthorn berries 1. 1oz to 1 pint water; bring to boil; simmer gently 15 minutes; strain when cold. Dose: half-1 cup thrice daily, and when necessary.

Ligvites. Guaiacum resin BHP (1983) 40mg; Black Cohosh BHP (1983) 35mg; White Willow bark BHP (1983) 100mg; Extract Sarsaparilla 4:1 25mg; Extract Poplar bark 7:1 17mg. (Gerard House)

Powders. Combine, Hawthorn 1; Cactus 2; Black Cohosh half; White Willow bark 1; with pinch Cayenne. 750mg (three 00 capsules or half a teaspoon) 2-3 times daily.

White Bryony. Liquid Extract: 15-60 drops, thrice daily. Good results reported.

Colchicum, Tincture. Indicated in presence of gout: Dose: 0.5-2ml in water. (Practitioner use only) Vitamin E. Should not be taken in rheumatic heart disorders.

Diet. See: DIET – HEART AND CIRCULATION. ... heart - rheumatic heart

Heart – Right Ventricular Failure (rvf)

Failure of the right ventricle to hold its own with the return flow of blood and to re-direct it through the lungs where it is re-oxygenated before entering the left ventricle for completing the circulatory cycle. Usually secondary to failure of the left ventricle. May be caused by valvular disease, especially narrowing of the orifice of the mitral valve.

Mitral disease leads to heart failure either by a narrowing of the orifice (stenosis) or a regurgitation blocks the passage of blood from the left atrium (auricle) to the left ventricle. The left atrium enlarges (hypertrophies) in an effort to counter the impediment. Real compensation – increased thrust of the blood – is provided by the right ventricle. In order to overcome a mitral impediment the right ventricle has to enlarge.

Sooner or later the right ventricle cannot enlarge any further and general heart failure sets in. Though caused primarily by a lesion of the mitral valve, it may be secondary to left ventricular failure (LVF), thyroid disorder (thyrotoxicosis), pericarditis, congenital heart disease, or any disease which weakens ventricular muscle.

Venous congestion and back pressure of RVF leads to congestion and accumulation of fluid in the lungs, cough and spitting of blood, painful swelling of the liver, nausea, loss of appetite and severe wasting.

Where the right ventricle fails to move the blood forward as it arrives from the systemic circulation, generalised dropsy sets in. Congestion of the kidneys leads to reduced urinary excretion and presence of albumin in the urine.

The picture is well known to the cardiac practitioner: blueness of the skin, congestion of the brain circulation with sleeplessness and delirium. Soon the tension of water-logged tissues results in pain and extreme anxiety. Feet are swollen and ankles pit on pressure; chest cavities fill with fluid and the abdomen swells (ascites).

Alternatives. Cardio-tonics would be given to strengthen the ventricle and diuretics to correct fluid retention: Lily of the Valley, Hawthorn, Motherwort, Broom. BHP (1983).

Due to rheumatic fever: Hawthorn.

High Blood Pressure: Mistletoe.

Effort Syndrome: Motherwort.

Tinctures. Combine, Lily of the Valley 2; Hawthorn 2; Motherwort 3. Dose: 1 teaspoon thrice daily after meals.

Diet. Low salt, low fat, high fibre. Restricted fluids, vegetarian protein foods, yoghurt. See also: DIET – HEART AND CIRCULATION.

Supplements. Potassium (bananas), Vitamin B6.

General. Stop smoking. Correction of overweight. Complete bed-rest with legs raised above level of the abdomen and patient propped-up to relieve difficult breathing. ... heart – right ventricular failure (rvf)

Diet And Disease

Several diseases are linked with diet. Diseases due to a deficiency are rare in developed countries, but many disorders are due partly to overconsumption of certain foods. A diet high in fats may contribute to atherosclerosis and heart disease. A high-fat diet has also been linked with cancer of the bowel (see colon, cancer of) and breast cancer. Obesity increases the risk of many other disorders, including diabetes mellitus and stroke.

Overconsumption of alcohol can lead to various alcohol-related disorders. A high salt intake predisposes a person towards hypertension. Some components of the diet protect against disease. For example, fibre protects against diverticular disease, chronic constipation, and haemorrhoids.

Many people’s diets contain too few natural vitamins. Pregnant women need high intakes of folic acid to reduce the risk of neural tube defects.

Although many illnesses are commonly ascribed to food allergy, it is only rarely that a definite link is proved. (See also nutritional disorders).... diet and disease

Fetal Circulation

Blood circulation in the fetus is different from the normal circulation after birth (see circulatory system). The fetus neither breathes nor eats. Therefore, oxygen and nutrients are obtained and waste products such as carbon dioxide are removed via the placenta. Fetal blood reaches the placenta through blood vessels in the umbilical cord. The maternal and fetal circulations are separated by a thin membrane in the placenta, which allows the exchange of nutrients and waste products.

The other fundamental difference in circulation is that most blood bypasses the lungs in the fetus through 2 special channels in the fetal heart.

Blood passes from the right atrium of the heart to the left atrium through the foramen ovale.

Another channel, known as the ductus arteriosus, allows blood to pass from the pulmonary artery to the aorta.

Both channels normally close after birth.

In rare cases, they fail to close, causing a congenital heart disorder (see heart disease, congenital).... fetal circulation

Fetal Heart Monitoring

The use of an instrument to record and/or listen to an unborn baby’s heartbeat during pregnancy and labour. Monitoring is carried out at intervals throughout pregnancy if tests indicate that the placenta is not functioning normally or if the baby’s growth is slow. During labour, monitoring can detect fetal distress, in which oxygen deprivation causes abnormality in the fetal heart-rate.

The simplest form of fetal heart monitoring involves the use of a special fetal stethoscope. Cardiotocography, a more sophisticated electronic version, makes a continuous paper recording of the heartbeat together with a recording of the uterine contractions. The heartbeat is picked up either externally by an ultrasound transducer strapped to the mother’s abdomen or, as an alternative during labour, internally by an electrode attached to the baby’s scalp that passes through the vagina and cervix.... fetal heart monitoring

Heart, Artificial

An implantable mechanical device that takes over the action of the heart or assists the heart in maintaining the circulation. There are 3 main types of artificial heart.

An intra-aortic balloon pump, comprising a balloon in the aorta that inflates with each heartbeat, increases the volume of blood entering the circulation. A left ventricular assist device takes blood from the left ventricle and pumps it electrically into the abdominal aorta. There are also mechanical hearts, which are powered from outside the body, usually by compressed air.

Problems with artificial hearts include the formation of blood clots within the device, and infection.

They are therefore used as a temporary measure until a heart transplant can be performed.... heart, artificial

Heart, Disorders Of

A wide range of disorders can disrupt the heart’s action.

In general, genetic factors do not play a large part in causing heart disorders, however they do contribute to the hyperlipidaemias that predispose a person to atherosclerosis and coronary artery disease. Structural abnormalities in the heart are among the most common birth defects (see heart disease, congenital).

Infections after birth may result in endocarditis or myocarditis. Tumours arising from the heart tissues are rare. They include noncancerous myxomas and cancerous sarcomas.

The heart muscle may become thin and flabby from lack of protein and calories. Thiamine (vitamin B1) deficiency, common in alcoholics, causes beriberi with congestive heart failure. Alcohol poisoning over many years may cause a type of cardiomyopathy. Obesity is an important factor in heart disease, probably through its effect on other risk factors, such as hypertension, diabetes, and cholesterol.

The coronary arteries may become narrowed due to atherosclerosis, depriving areas of heart muscle of oxygen. The result may be angina pectoris or, eventually, a myocardial infarction.

Some drugs, such as the anticancer drug doxorubicin, tricyclic antidepressants, and even drugs used to treat heart disease, may disturb the heartbeat or damage the heart muscle.

Many common and serious heart disorders may be a complication of an underlying condition, such as cardiomyopathy or a congenital defect. Such disorders include cardiac arrhythmia, some cases of heart block, and heart failure. Cor pulmonale is a failure of the right side of the heart as a consequence of lung disease.... heart, disorders of

Heart Imaging

Techniques that provide images of heart structure. Imaging is used to detect disease or abnormalities. A chest X-ray, the simplest and most widely used method of heart imaging, shows heart size and shape, and the presence of abnormal calcification. Pulmonary oedema and engorgement of the vessels connecting the heart and lungs are also usually detectable.

–

Echocardiography is useful for investigating congenital heart defects and abnormalities of the valves or heart wall. An ultrasound technique using the Doppler effect allows measurement of blood flow through valves. Radionuclide scanning and CT scanning provide information about the efficiency of heart function. Angiography may be used to show the heart chambers and to assess the condition of the coronary arteries and valves. High-quality images of the heart can be obtained by MRI.... heart imaging

Heart–lung Machine

A machine that temporarily takes over the function of the heart and lungs to facilitate operations such as open heart surgery, heart transplants, and heart–lung transplants.

A heart–lung machine consists of a pump (to replace the heart’s function) and an oxygenator (to replace the lung’s function). It bypasses the heart and lungs, and the heart can be stopped.

Use of a heart–lung machine tends to damage red blood cells and to cause blood clotting. These problems can be minimized, however, by the administration of heparin, an anticoagulant drug, beforehand.heart–lung transplant A procedure in which the heart and lungs of a patient are removed, and replaced with donor organs. This surgery is used to treat diseases in which the lung damage has affected the heart, or vice versa. Such diseases include cystic fibrosis, fibrosing alveolitis, and some severe congenital heart defects (see heart disease, congenital). A heart–lung machine is used to take over the function of the patient’s heart and lungs during the operation, which is no more dangerous than a heart transplant.

heart-rate The rate at which the heart contracts to pump blood around the body. Most people have a heart-rate of between 60 and 100 beats per minute at rest. This rate tends to be faster in childhood and to slow slightly with age. Very fit people may have a resting rate below 60 beats per minute.

The heart muscle responds automatically to any increase in the amount of blood returned to it from active muscles by increasing its output. During extreme exercise, heart-rate may increase to 200 contractions per minute and the output to almost 250 ml per beat.

The heart-rate is also regulated by the autonomic nervous system. The parts of this system concerned with heart action are a nucleus of nerve cells, called the cardiac centre, in the brainstem, and 2 sets of nerves (the parasympathetic and sympathetic).

At rest, the parasympathetic nerves – particularly the vagus nerve – act on the sinoatrial node to maintain a slow heart-rate. During or in anticipation of muscular activity, this inhibition lessens and the heart-rate speeds up.

Sympathetic nerves release noradrenaline, which further increases the heart-rate and force of contraction. Sympathetic activity can be triggered by fear or anger, low blood pressure, or a reduction of oxygen in the blood.

Release of adrenaline and noradrenaline by the adrenal glands also acts to increase heart-rate.

The rate and rhythm of the heart can be measured by feeling the pulse or by listening with a stethoscope; a more accurate record is provided by an ECG.

A resting heart-rate above 100 beats per minute is termed a tachycardia, and a rate below 60 beats per minute a bradycardia. (See also arrhythmia, cardiac.)... heart–lung machine

Heart Sounds

The sounds made by the heart during each heartbeat. In each heart cycle, there are 2 main heart sounds that can clearly be heard through a stethoscope. The first is like a “lubb”. It results from closure of the tricuspid and mitral valves at the exits of the atria, which occurs when the ventricles begin contracting to pump blood out of the heart. The second sound is a higher-pitched “dupp” caused by closure of the pulmonary and aortic valves at the exits of the ventricles when the ventricles finish contracting.

Abnormal heart sounds may be a sign of various disorders.

For example, highpitched sounds or “clicks” are due to the abrupt halting of valve opening, which can occur in people with certain heart valve defects.

Heart murmurs are abnormal sounds caused by turbulent blood flow.

These may be due to heart valve defects or congenital heart disease.... heart sounds

Heart Transplant

Replacement of a patient’s damaged or diseased heart with a healthy heart taken from a donor at the time of death. Typically, transplant patients have advanced coronary artery disease or cardiomyopathy. During the operation, the function of the heart is taken over by a heart–lung machine.

Most of the diseased heart is removed, but the back walls of the atria (upper chambers) are left in place.

The ventricles (upper chambers) are then attached to the remaining areas of the recipient’s heart.

Once the immediate post-operative period is over, the outlook is good.

Patients face the long-term problems associated with other forms of transplant surgery.

(See also heart–lung transplant.)... heart transplant

Heart Valve

A structure at the exit of a heart chamber that allows blood to flow out of the chamber, but prevents backwash. There are 4 heart valves: aortic, pulmonary, mitral, and tricuspid. Their opening and closing during each heart cycle produces heart sounds.

Any of the 4 heart valves may be affected by stenosis (narrowing), which causes the heart to work harder to force blood through the valve, or by incompetence or insufficiency (leakiness), which makes the valve unable to prevent backwash of blood. These defects cause characteristic heart murmurs.

Heart-valve defects may be present at birth (see heart disease, congenital), or they may be acquired later in life. The most common congenital valve defects are aortic stenosis and pulmonary stenosis. Acquired heart-valve disease is usually the result of degenerative changes or ischaemia affecting part of the heart and leading to aortic stenosis or mitral incompetence. Rheumatic fever can cause mitral stenosis, mitral incompetence, aortic valve defects, tricuspid stenosis and tricuspid incompetence. The heart valves may also be damaged by bacterial endocarditis.

Heart-valve disorders commonly lead to heart failure, arrhythmias, or symptoms resulting from reduced blood supply to body tissues.

Heart-valve defects may be diagnosed by auscultation, chest X-ray, ECG, or echocardiography and may be corrected by heart-valve surgery.... heart valve

Heart-valve Surgery

An operation to correct a heart valve defect or to remove a diseased or damaged valve. A heart valve may have to be repaired, widened, or replaced because it is either incompetent (leaky) or stenotic (narrowed). Widening of a valve may involve valvotomy or valvuloplasty. A damaged valve can be replaced by a mechanical one (fashioned from metal and plastic), a valve constructed from human tissue, a pig valve, or a valve taken from a human donor after death. A heart–lung machine is used during replacement.After heart-valve surgery, symptoms such as breathlessness may take weeks to improve and require medication to be continued. Some people need longterm treatment with anticoagulant drugs to prevent the formation of blood clots around the new valve.... heart-valve surgery

Hypoplastic Left-heart Syndrome

A very serious form of congenital heart disease (see heart disease, congenital). The baby is born with a poorly formed left ventricle, often associated with other heart defects. The aorta is malformed and blood can reach it only via a duct (the ductus arteriosus) that links the aorta to the pulmonary artery.

At birth, the baby may seem healthy. However, within a day or 2 the ductus arteriosus naturally closes off and the baby collapses, becoming pale and breathless. In most cases, hypoplastic left-heart syndrome cannot be treated surgically, and most affected babies die within a week. A few infants have been treated with heart transplants.... hypoplastic left-heart syndrome

Circulation, Muscles And Joints:

Accumulation of toxins (M,S,B):

Angelica, white birch, carrot seed, celery seed, coriander, cumin, sweet fennel, grapefruit, juniper, lovage, parsley.

Aches and pains (M,C,B):

Ambrette, star anise, aniseed, French basil, West Indian bay, cajeput, calamintha, camphor (white), chamomile (German & Roman), coriander, eucalyptus (blue gum & peppermint), silver fir, galbanum, ginger, immortelle, lavandin, lavender (spike & true), lemongrass, sweet marjoram, mastic, mint (peppermint & spearmint), niaouli, nutmeg, black pepper, pine (longleaf & Scotch), rosemary, sage (clary & Spanish), hemlock spruce, thyme, turmeric, turpentine, vetiver.

Arthritis (M,S,C,B):

Allspice, angelica, benzoin, white birch, cajeput, camphor (white), carrot seed, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), clove bud, coriander, eucalyptus (blue gum & peppermint), silver fir, ginger, guaiacwood, juniper, lemon, sweet marjoram, mastic, myrrh, nutmeg, parsley, black pepper, pine (longleaf & Scotch), rosemary, Spanish sage, thyme, tumeric, turpentine, vetiver, yarrow.

Cellulitis (M,S,B):

White birch, cypress, sweet fennel, geranium, grapefruit, juniper, lemon, parsley, rosemary, thyme.

Debility/poor muscle tone (M,S,B):

Allspice, ambrette, borneol, ginger, grapefruit, sweet marjoram, black pepper, pine (longleaf & Scotch), rosemary, Spanish sage.

Gout (M,S,B):

Angelica, French basil, benzoin, carrot seed, celery seed, coriander, guaiacwood, juniper, lovage, mastic, pine (longleaf & Scotch), rosemary, thyme, turpentine.

High blood pressure & hypertension (M,B,V):

cananga, garlic, true lavender, lemon, sweet marjoram, melissa, clary sage, yarrow, ylang ylang.

Muscular cramp & stiffness (M,C,B):

Allspice, ambrette, coriander, cypress, grapefruit, jasmine, lavandin, lavender (spike & true), sweet marjoram, black pepper, pine (longleaf & Scotch), rosemary, thyme, vetiver.

Obesity (M,B):

White birch, sweet fennel, juniper, lemon, mandarin, orange (bitter & sweet).

Oedema & water retention (M,B):

Angelica, white birch, carrot seed, cypress, sweet fennel, geranium, grapefruit, juniper, lavage, mandarin, orange (bitter & sweet), rosemary, Spanish sage.

Palpitations (M):

Neroli, orange (bitter & sweet), rose (cabbage & damask), ylang ylang.

Poor circulation & low blood pressure (M,B):

Ambrette, Peru balsam, West Indian bay, benzoin, white birch, borneol, cinnamon leaf, coriander, cumin, cypress, eucalyptus blue gum, galbanum, geranium, ginger, lemon, lemongrass, lovage, neroli, niaouli, nutmeg, black pepper, pine (longleaf & Scotch), rose (cabbage & damask), rosemary, Spanish sage, hemlock spruce, thyme, violet.

Rheumatism (M,C,B):

Allspice, angelica, star anise, aniseed, Peru balsam, French basil, West Indian bay, benzoin, white birch, borneol, cajeput, calamintha, camphor (white), carrot seed, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cinnamon leaf, clove bud, coriander, cypress, eucalyptus (blue gum & peppermint), sweet fennel, silver fir, galbanum, ginger, immortelle, juniper, lavandin, lavender (spike & true), lemon, lovage, sweet marjoram, mastic, niaouli, nutmeg, parsley, black pepper, pine (longleaf & Scotch), rosemary, Spanish sage, hemlock spruce, thyme, turmeric, turpentine, vetiver, violet, yarrow.

Sprains & strains (C):

West Indian bay, borneol, camphor (white), chamomile (German & Roman), clove bud, eucalyptus (blue gum & peppermint), ginger, immortelle, jasmine, lavandin, lavender (spike & true), sweet marjoram, black pepper, pine (longleaf & Scotch), rosemary, thyme, turmeric, vetiver.... circulation, muscles and joints:


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