Enlarged heart (Cardiomegaly) : Causes, Symptoms, Tests & Diagnosis

Enlarged heart (cardiomegaly) isn’t a disease, but rather a symptom of another condition.

The term “cardiomegaly” most commonly refers to an enlarged heart seen on chest X-ray before other tests are performed to diagnose the specific condition causing your cardiomegaly. You may develop an enlarged heart temporarily because of a stress on your body, such as pregnancy, or because of a medical condition, such as the weakening of the heart muscle, coronary artery disease, heart valve problems or abnormal heart rhythms.

While having an enlarged heart may not always be preventable, it’s usually treatable. Treatment for enlarged heart is aimed at correcting the underlying cause. Treatment for an enlarged heart can include medications, medical procedures or surgery.

Symptoms:

In some people, an enlarged heart causes no signs or symptoms. Others may have these signs and symptoms:

• Shortness of breath
• Dizziness
• Abnormal heart rhythm (arrhythmia)
• Swelling (edema)
• Cough
• Chest pain

Causes:

Conditions associated with an enlarged heart include:

• High blood pressure. Having high blood pressure can make it so that your heart has to pump harder to deliver blood to the rest of your body, enlarging and thickening the muscle.
• Heart valve disease. Four valves within your heart keep blood flowing in the right direction. If the valves are damaged by such conditions as rheumatic fever, a heart defect, infections (infectious endocarditis), connective tissue disorders, certain medications or radiation treatments for cancer, your heart may enlarge.
• Disease of the heart muscle (cardiomyopathy). Cardiomyopathy is the thickening and stiffening of heart muscle. In early stages of cardiomyopathy, you may have no symptoms. As the condition worsens, your heart may enlarge to try to pump more blood to your body.
• Heart attack. Damage done during a heart attack may cause an enlarged heart.
• A heart condition you’re born with (congenital heart defect). Many types of congenital heart defects may lead to an enlarged heart, as defects can affect blood flow through the heart, forcing it to pump harder.
• Abnormal heartbeat (arrhythmia). If you have an arrhythmia, your heart may not pump blood as effectively as it would if your heart rhythm were normal. The extra work your heart has to do to pump blood to your body may cause it to enlarge.
• High blood pressure in the artery connecting your heart and lungs (pulmonary hypertension). If you have pulmonary hypertension, your heart may need to pump harder to move blood between your lungs and your heart. As a result, the right side of your heart may enlarge.
• Low red blood cell count (anemia). Anemia is a condition in which there aren’t enough healthy red blood cells to carry adequate oxygen to your tissues. Left untreated, chronic anemia can lead to a rapid or irregular heartbeat. Your heart must pump more blood to make up for the lack of oxygen in the blood when you’re anemic. Rarely, your heart can enlarge if you have anemia for a long time and you don’t seek treatment.
• Thyroid disorders. Both an underactive thyroid gland (hypothyroidism) and an overactive thyroid gland (hyperthyroidism) can lead to heart problems, including an enlarged heart.
• Excessive iron in the body (hemochromatosis). Hemochromatosis is a disorder in which your body doesn’t properly metabolize iron, causing it to build up in various organs, including your heart muscle. This can cause an enlarged left ventricle due to weakening of the heart muscle.
• Rare diseases that can affect your heart, such as amyloidosis. Amyloidosis is a condition in which abnormal proteins circulate in the blood and may be deposited in the heart, interfering with your heart’s function. If amyloid builds up in your heart, it can cause it to enlarge.

Complications of enlarged heart can include:

• Heart failure. One of most serious types of enlarged heart, an enlarged left ventricle, increases the risk of heart failure. Heart failure occurs when your heart can’t pump enough blood to meet your body’s needs. Over time, the heart can no longer keep up with the normal demands placed on it. The heart muscle will weaken, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently throughout your body.
• Blood clots. Having an enlarged heart may make you more susceptible to forming small blood clots in the lining of your heart. If clots are pumped out of the heart and enter your circulatory system, they can block the blood flow to vital organs, including your heart and brain causing a heart attack or stroke. If clots develop on the right side of your heart, they may travel to your lungs, a dangerous condition called pulmonary embolism.
• Heart murmur. For people who have an enlarged heart, two of the heart’s four valves — the mitral and tricuspid valves — may not close properly because they become dilated, leading to a backflow of blood. This flow creates sounds called heart murmurs. Heart murmurs are not necessarily harmful, but they should be monitored by your doctor.
• Cardiac arrest and sudden death. Some forms of enlarged heart can lead to disruptions in your heart’s beating rhythm. Some of these heart rhythms are too slow to move your blood, and some are too fast to allow the heart to beat properly. In either case, these abnormal heart rhythms can result in fainting or, in some cases, cardiac arrest or sudden death.

Tests and Diagnosis :

If you have symptoms of a heart problem, your doctor will perform tests to determine if your heart is enlarged and to find out the underlying cause of your condition. In addition to a physical exam, these tests may include:

• Chest X-ray. X-ray images help your doctor see the condition of your lungs and heart. If your heart is enlarged, it might first be detected by a chest X-ray, but other tests will usually be needed to find out the specific cause. Your doctor can also use an X-ray to diagnose conditions other than enlarged heart that may explain your signs and symptoms.
• Electrocardiogram. This test records the electrical activity of your heart through electrodes attached to your skin. Impulses are recorded as waves and displayed on a monitor or printed on paper. This test helps your doctor diagnose heart rhythm problems and damage to your heart from a heart attack as well as give clues to other types of heart disease.
• Echocardiogram. An important test for diagnosing and monitoring an enlarged heart is the echocardiogram. An echocardiogram uses sound waves to produce a video image of your heart. In this test, all of the chambers of the heart can be evaluated to determine if you do have an enlarged heart and to try and determine the cause. This test determines how efficiently your heart is pumping, assesses your heart valves, can look for evidence of previous heart attacks and can determine if you have congenital heart disease.
• Stress test. A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise. An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure and breathing are monitored.
• Cardiac computerized tomography (CT) or magnetic resonance imaging (MRI). In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine called a gantry. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. Images of your heart are created from these signals, which your doctor will look at to determine the cause of your enlarged heart.
• Blood tests. Your doctor may order blood tests to check the levels of certain substances in your blood that may signal that you have a heart problem. Blood tests can also help your doctor rule out other conditions that may cause your symptoms.
• Cardiac catheterization and biopsy. In this procedure, a thin tube (catheter) is inserted in your groin and threaded through your blood vessels to your heart, where a small sample (biopsy) of your heart can be extracted for analysis in the laboratory. Pressure within the chambers of your heart can be measured to see how forcefully blood pumps through your heart. Pictures of the arteries of the heart can be taken during the procedure (coronary angiogram) to ensure that you do not have any blockage.

RapidArc IMRT - Advanced Radiation Technology for Cancer Treatment

Posted on February 20, 2011 by HealthnHeal

• Comprehensive Cancer Care Under One Roof
  
• Free Expert Medical Opinion from India's Top Cancer Specialists
  
• Affordable, Low Cost Cancer Treatment Packages
  
• Access to World Class Cancer Centers in India with best Doctors and nursing care
  
• Highly advanced technology with Cyberknife, Linear Accelerator, Gama Knife etc.
  
• Free guidance on Medical Travel to India
  
• Free Airport Pick-up and Drop

RapidArc IMRT -The technology, described as revolutionary, was introduced for the first time ever in the U.S. in May 2008. It will change the way radiotherapy is planned and delivered. It is a major advancement from conventional Intensity Modulated Radiotherapy Technology in that it improves dose conformity while significantly shortening treatment times compared to conventional IMRT techniques. While ensuring all the benefits of IMRT, RapidArc delivers treatment within two minutes with precision, enabling physicians to improve the standard of care and treat more patients.

In a typical IMRT procedure, the gantry of the linear accelerator rotates to several ‘fixed’ beam angles. To treat the prostate, usually five to seven specific angled beams are used, each delivering a fraction of the total radiation for that day. Since these fields are limited to certain angles, the ability to avoid or minimise radiation to normal tissue is also limited. In the RapidArc procedure, there are no angles in which the beam stops. The treatment is delivered in one single rotation of the gantry around the body. There is no limitation to where and when the beam will be ‘on’ or ‘off,’ or how fast or slow it is being delivered. So, medical physicists and radiation oncologists will have nearly unlimited choices and degrees of freedom to design sophisticated and highly conformal treatment. This will result in less normal tissue damage in the high-dose treatment fields and fewer side-effects.

Previous approaches to arc IMRT therapy were restrictive, limited as they were by the design of the machine. RapidArc technology delivers precisely sculpted three-dimensional dose distribution with a single 360-degree rotation of the linear accelerator gantry. RapidArc uses Dynamic Multi Leaf Collimator, a variable dose rate, and a variable gantry speed to generate IMRT-quality dose distribution in a single optimised arc. Clinicians can thus deliver a continuously modulated dose to the entire tumour volume while sparing relatively normal or healthy tissue.

With RapidArc, a medical linear accelerator can target radiation beams at a tumour while making one continuous rotation around the patient. Conventional IMRT treatments are slower and more difficult for radiotherapy technologists because they target tumours using a complex sequence of fixed beams from multiple angles.

RapidArc differs from existing techniques such as helical IMRT or intensity-modulated arc therapy as it delivers a dose to the whole volume, rather than slice by slice. A single arc can deliver essentially similar dose distributions compared with IMRT plans. The treatment planning algorithm ensures treatment precision.

RapidArc radiotherapy technology advances the standard of care even in complex treatment plans. For example, in a case of multi-target cancer of the nasopharynx, RapidArc plans were found to be equivalent or better at target coverage, and superior in protecting critical structures including the spinal cord, the brain stem, the eyes, the optic nerve and chiasm, the parotid glands and the brain. RapidArc allows more control to tailor the dosage to suit the size, shape, and location of a tumour. Laboratory studies suggest that faster dose delivery may kill some cancer cells more effectively.

Faster treatment also contributes to precision by reducing the time for motion within anatomical structures. The technique reduces the probability of intrafractional tumour movements caused by the patient moving during treatment. Repositioning can make the treatment even longer.

RapidArc delivers volumetric IMRT in a single arc or multiple arcs of the equipment around the patient and makes it possible to deliver advanced image-guided IMRT two to eight times faster than is possible with conventional IMRT. Radiotherapy studies correlate the ability to spare more healthy tissue with fewer complications and better outcomes. RapidArc delivery produces as little as 400 Monitor Unit per fraction. Fixed-field IMRT treatments of similar quality can generate 1,000 to 2,000 MU.

RapidArc’s single gantry rotation, besides speeding up delivery, may result in less leakage and scattered radiation and a lower overall peripheral dose than in the case of conventional IMRT treatments.

Patient care being at the heart of everything at the Cancer Institute, the decision to invest in this equipment was a straightforward one. The use of this speedier and state-of-the-art technology will enable the institute to treat more patients with less stress and more comfort to them.

For more information on affordable and high quality cancer treatment in India please contact us anytime.
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The World's Top Five Medical Tourism Destinations!!

 

India has once again been named as one of the top Medical Travel destinations for 2010 by Tourism Review and the Hotel & Resort Insider! The country received well over a million medical tourists last year and that number is set to grow even further this year. With world class JCI, ISO and NABH accredited hospitals, the country is cementing itself as the preferred choice for medical tourists. With all the leading hotel chains being represented in India, medical tourists are spoilt for choice! India is also listed by Lonely Planet as a tourism destination to visit for 2010 with sights and sounds to cater for all types tourists.

Hospitals of India has been in forefront in promoting India as a healthcare destination and has served clients from well around the world! It is supporting efforts by the Indian Government under the Government Transformation Programme (GTP) to increase the number of medical tourists and to make India the number one hub for medical tourists!!

(Picture Above: Medanta – The Medicity, 1600 Bed Super Specialty Hospital)

See article below!

Medical Tourism & Travel: The World's Top Five Destinations |

Hospitals of India - Give Blood Give Life

Why the aspirin is a wonder drug

Danny Buckland, Reposted On Saturday, January 15, 2010

It’s usually found in an unobtrusive white bottle in most bathroom cabinets. But the humble aspirin is being hailed as a medical miracle.

Breakthrough research this week showed aspirin could drastically reduce the risk of dying from many common cancers.

It’s staggering range – helping headaches through to critical conditions – means it could save millions of lives.

The British study proved that low doses of aspirin can cut death rates from cancers by about 30%, and up to 60% with prolonged use.

Professor Peter Rothwell’s team at the John Radcliffe Hospital, in Oxford, astonished the world with results from eight long-term studies involving 26,000 patients.

It reported that after five years, cancer death rates were cut by an average of 34% and up to 54% in gastrointestinal cancers. The results were seen across lung, pancreatic and oesophagus cancer as well as, to a lesser extent, brain cancer.

It is “the most amazing drug in the world”, according to Professor Alastair Watson, a consultant gastroenterologist at the University of East Anglia. “Penicillin has probably saved more lives but in terms of broad applications I don’t think anything comes close to aspirin. And it doesn’t cost much,” he said.

“Developed from willow bark, it started out as a painkiller which was good for fever and rheumatism. Then, about 20 years ago, it became clear that it was good for heart ­diseases and stroke.

“We then got to a position where virtually every patient who has had a heart attack, heart surgery, a stroke or problems with circulation in their legs is on aspirin. But to everyone’s astonishment and delight aspirin is going that extra mile.”

For pain relief, it penetrates the pain centres in the brain and switches them off while also reaching the nerve endings to neutralise the pain response mechanism. For cancers, it inhibits the damaging rogue cells by cutting off their blood supply. “It has been around for 100 years and was sold before the times of clinical trials and it is interesting to ask if it would be licensed today because of its side effects,” added Professor Watson.“Official government figures show it caused some 22 deaths in one year.

Many more had serious illness and most hospitals admit people with aspirin side effects almost every day. To put those figures into perspective, 70,000 people died from the effects of heroin in the same period.

“Aspirin is not the most dangerous drug but you cannot say it is completely safe.”

Experts caution against all middle-aged people – who stand to benefit most from the cancer application – immediately popping pills on a daily basis, and advise anyone with health concerns to get advice from their GP. But for a million Brits, the everyday ritual of swallowing a baby aspirin has life-saving implications.

“It’s about a quarter the dose you take for a headache,” said Mick Henderson, director of the Aspirin Foundation, the information service supported by Bayer, the company that developed aspirin.

He said: “Most GPs will put patients on to an aspirin if they have had a heart attack but more and more are putting them on to aspirin if they believe they are at risk from being overweight, smoking, stress or have a family history of heart attack at a relatively young age. So it can be taken even before heart attack."

“A lot of people are simply saying it is a wonder drug.”

Source: Daily Mirror Pic: Simon Stratford

US based Indian creates first artificial implantable kidney

TNN, Dec 4, 2010, Source: Times of India

NEW DELHI: US-based Indian origin researcher Shuvo Roy has created the world's first implantable artificial kidney. What's sensational about Roy's creation is that the organ, no larger than a coffee cup, will be able to mimic the kidney's most vital functions like filtering toxins out of the bloodstream, regulate blood pressure and produce the all- important vitamin D.
The artificial kidney has been tested successfully on a small number of animals. Large-scale trials on animals and humans are expected over the next five years. Once available, and if affordable, this creation by the Roy-led team at University of California will do away with the need for kidney dialysis.
This will be a boon for all patients with chronic kidney disease (CKD). At present in India, of the 150,000 new patients who suffer from end-stage renal failure annually, only 3,500 get kidney transplants and 6,000-10,000 undergo dialysis. The rest perish due to an acute shortage of dialysis centres and nephrologists to man them.
CKD is rising at a rapid pace in India and the majority of those who perish are either unable to find a suitable organ for transplantation or are unable to pay for the high dialysis costs.
According to Roy, the device has a filtration section to remove toxins from the blood, alongside a compartment with renal cells to conduct other functions of a kidney. He believes the artificial kidney could last for decades and require no pumps or batteries. Patients wouldn't require anti-rejection drugs (as is required after transplants) either because there would be no exposed natural tissues for the immune system to attack.
The University of California team is awaiting approval to conduct larger scale animal and human trials. Already, it has successfully tested the implant in a few rats and pigs.
"The payoff to the patient community is tremendous," said Roy. "It could have a transformative impact on their lives...With the right financial support, I think we could reach clinical trials in five years. But it's hard to say how long after that it becomes commercially available due to the uncertainties of the FDA and commercialization prospects.''

So what would this artificial kidney mean for developing world? ''It will be a real boon,'' said Dr S C Tiwari, director of nephrology and renal transplantation medicine at Fortis health care. He added: ''The biggest problem with CKD patients in India is that majority of them are diagnosed in the final stages where they would either require constant dialysis or a transplant. They would require dialysis three times week. However, of the 200,000 CKD patients requiring dialysis, only 10,000 get it, mainly because they can't afford it. Maybe only 1,000 such patients get it for free or at a subsidized rate in government hospitals. The artificial kidney, when available and if affordable, will be a miracle.'' Dr Madan Bahadur, nephrologist with Mumbai's Jaslok Hospital added, ''Work on creating tubular cells (that perform the biochemical work of the kidney) began a decade back. But bio-chemical engineering has so far not managed to replicate the kidney.''
According to Dr Jitendra Kumar, head of nephrology at Asian Institute of Medical Sciences, the main reason why this artificial kidney will be a real breakthrough is because it will be able to mimic the vital functions of a kidney like regulate BP and produce vitamin D — things a dialysis can't do.

India, Rwanda Sign MoU in Field of Health, Medicine

NetIndian News Network

New Delhi, November 12, 2010

India and Rwanda today signed a memorandum of understanding (MoU) for cooperation in the field of health and medicine.

The MoU was signed by Union Minister of Health and Family Welfare Ghulam Nabi Azad and Rwanda's Health Minister Richard Sezibera.

An official press release said the MoU covered areas of cooperation such as Integrated Disease Surveillance, Medical Research, Emergency Relief, Hospital Management, Laboratory and Diagnostics, Drugs and Pharmaceutical products, Traditional Medicine, Health Tourism, Telemedicine and Training.

The release said the cooperation would include exchange of information in the field of health and medicine, exchange of experts in the field of health, health manpower development in the field of epidemiology and outbreak, diagnostic laboratory support through testing clinical samples during outbreak situation, training in the mutually agreed identified areas, deputation of experts to attend international meetings held in either country, technical support in establishing laboratories/hospitals and research in mutually identified areas.

The two sides have set up a Working Group to work out the details of the cooperation and to oversee the implementation of the MoU.