Health Tips - Heart/Respiratory/Chest/Eye/ENT
A Routine ECG May Save an Athlete’s Life - A new study appearing in the March 2, 2010 issue of the Annals of Internal Medicine shows that the lives of athletes could be saved via a history, physical examination and an ECG.
At this time such screening for amateur athletes is not routine. Interesting most professional US based athletes are required to undergo such screening.
Dr. Matthew Wheeler, a fellow in cardiovascular medicine at Stanford University School of Medicine and primary author of the study, noted "According to our model, ECG together with a history and physical exam is the preferred strategy for screening athletes for underlying heart disease. This would save the most lives at a cost that is generally agreed to be acceptable for the U.S. health-care system."
A similar study conducted in Italy found that sudden deaths during competitions in that country fell by 90 percent after routine ECG tests were put into place.
While it is quite uncommon for young athletes to die from heart ailments, however there are many heart conditions – e.g. hypertrophic cardiomyopathy (enlarged heart) – that can result in sudden death. This can be detected via a routine ECG.
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Asthma - Asthma is a disease of the lungs that involves constriction of the muscles around the small airways as well as an inflammatory response within these airways. These reactions occur in response to environmental agents like dust, smoke etc or exercise. This constriction and inflammation greatly reduces the passage through which air flows and may cause a high pitched sound known as wheezing. This gives the characteristic symptoms of chest tightness, shortness of breath and cough.
Management is aimed at dilating the airway and reducing the inflammation. This is achieved by use of inhalers or nebulisations. In addition the inflammatory aspect is treated by using a steroid medication. The steroid may be administered in an inhaled, liquid or tablet formulation. In people who have frequent attacks the steroid inhaler is used twice daily and this prevents inflammation from building up in the airways. However, if an attack occurs, then the rescue inhaler (Ventolin/Barotec) or nebulisations are used to treat the sudden onset of symptoms.
There is no cure for asthma.
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Cataract - The lens of the eye is normally clear. If the lens becomes cloudy, the condition is known as a cataract. Rarely, cataracts may be present at or shortly after birth. These are called congenital cataracts.
Adult cataracts usually develop with advancing age and may run in families. They develop slowly and painlessly, and vision in the affected eye or eyes slowly gets worse.
Cataracts develop more quickly in the presence of some environmental factors, such as smoking or exposure to other toxic substances. They may develop at any time after an eye injury. Diseases such as diabetes also greatly increase the risk for cataracts. Certain medications, such as cortisone, can also speed up cataract formation.
Most people develop some clouding of the lens after the age of 60. Visual problems may include the following changes:
- Cloudy, fuzzy, foggy, or filmy vision
- Loss of color intensity
- Double vision
- Difficulty seeing at night
- Frequent changes in eyeglass prescription
The only treatment for cataract is surgery to remove it. This is done if you cannot perform normal activities, even with glasses.
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Cigarette Smoking - Cigarette smoking is one of the most common forms of addiction in Barbados. Nicotine, like cocaine alters brain function and chemistry, this results in chemical dependence. Therefore giving up cigarettes or other tobacco products is very difficult.
Nicotine binds to brain cells causing the release of dopamine, a brain chemical that causes the pleasure associated with smoking.
When attempting to quit, most smokers experience varying degrees of nicotine withdrawal – including nervousness, headaches, insomnia, mood swings, and poor concentration. Withdrawal symptoms last for about two to four weeks. Cravings however, last much longer, and may recur even years after quitting.
Addiction is greatest for those who start smoking during their teen years. Nearly 90 percent of adult smokers become addicted to tobacco before they reach 18-years-old.
Most persons make three or four attempts before they quit successfully. Whether quitting “cold turkey” or with the help of a smoking cessation therapy program, quitting is hard work that takes trial and error, imagination, determination, motivation and innovation. However, it can be done!
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Ear Ache & Ear Infection - There are many causes of earache including trauma, infection or inflammation of the outer or middle ear, impacted wax and dental problems: - to name but a few.
The outer ear or pinna and ear canal can become inflamed and is commonly related to swimming or minor trauma such as scratching inside the ear with an object. The ear may initially be itchy with or without a discharge and then becomes painful subsequently.
The middle ear describes the eardrum and the small space behind the eardrum which is normally filled with air but can become infected and filled with fluid or mucus. Middle ear infection is common in children, but can occur at any age. The main symptoms are earache and fever but feeling unwell, vomiting and decreased hearing are also well recognised features.
The treatment of earache involves the use of painkillers and the elimination or treatment of the underlying cause. In the case of infection, the prescription of antibiotics may be necessary to clear the infection and avoid any further complications. The infection usually clears within a few days of the appropriate treatment.
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Foreign Bodies in the Ear and Nose - A variety of objects (foreign bodies) may become lodged in the ear or nose. They may commonly include things such as dried beans, small toys, and beads.
Children under age five are the most likely to intentionally place foreign bodies in the ear or nose but it is not limited to this age group.
The symptoms caused by these objects range from discomfort and pain, to decreased hearing, and sometimes discharge from the ear or nose. With objects in the nose there is a risk of inhalation of the object into the airway. As simple as it may seem, foreign bodies in the airway, particularly in small children, can be life threatening due to the risk of airway obstruction and suffocation; if the child has difficulty breathing or is choking, immediate medical attention should be sought.
The treatment is to remove the foreign body under direct visualisation, but this may be quite a challenging procedure and certain types of foreign body are difficult to see with the naked eye. Assessment by medical personnel is therefore recommended if there is any doubt whatsoever and further specialist input may be required.
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Long Working Hours Causes Heart Disease - An 11-year study of over 6,000 British civil servants, published in the European Heart Journal, concluded that persons consistently working more than 10 hours a day are more likely to suffer serious heart problems, including heart attacks and angina when compared to those working 7 to 8 hours days.
While the study was unable to prove a link between longer hours of work and coronary artery disease (i.e. blocked arteries), however, there was a clear link between the length of hours worked and heart disease.
The study showed the risk of having an adverse event was 60 percent higher for those who worked three or more hours overtime per day.
It must be noted that working an extra one to two hours beyond a normal seven-hour day was not associated with increased risk.
The higher incidence of heart problems among those working overtime was independent of a range of other risk factors including smoking, being overweight or having high cholesterol.
The authors of the study suggested that excessive hours may be associated with work-related stress, which interferes with the body’s metabolic processes, which ultimately adversely affects the heart’s health.
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Vertigo: Quick and Easy Treatment - Benign paroxysmal positional vertigo (BPPV) is a relatively common condition of the inner ear that can result in mild, moderate or severe dizziness. The American Academy of Neurology (AAN) found that the best treatment for vertigo is the easiest and quickest one.
BPPV is believed to be caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear. The treatment involves manoeuvres that move the calcium crystals out of the sensing tube and into another inner chamber of the ear, from which they can be absorbed.
In many cases BPPV can be treated with simple manoeuvres, such as a series of head and body movements performed by a doctor or therapist while the patient sits on a bed or table. There are several manoeuvres currently in use for vertigo. The guideline found that canalith repositioning procedure, also called the Epley manoeuvre, is safe and effective for people of all ages. The Semont manoeuvre may be an effective treatment as well.
The American Academy of Neurology (AAN) web site has an updated Guideline on the management of Vertigo.
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Treating and Preventing Viral Red Eye The leading cause of a red, inflamed eye is an adenoviral infection. There is usually an associated watery discharge. The eyelids may be swollen. Sometimes looking at bright lights is painful. Those affected should see a doctor. Viral red eye usually resolves in 7 to 10 days. Treatment of conjunctivitis includes:
- Cold compresses and lubricants (e.g. artificial tears)
- Protecting eyes from dirt and other irritating substances
- Avoiding makeup
- Removing contact lenses
- Topical astringents or antibiotic drops/ointments may be used to prevent bacterial superinfection
Preventing spread of conjunctivitis includes:
- Avoiding touching infected eye(s)
- Washing hands often with soap and warm water
- Washing discharge from eyes twice a day using a fresh tissue
- Washing bed linens, pillowcases, and towels in hot water and detergent
- Wearing shades
- Avoiding sharing of towels
- Washing hands after applying the eye drops or ointment to the infected eye
- Do not use eye drops in a non-infected eye that were used for an infected one
- Keeping child home from school or day care until no longer contagious
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Warning signs of a heart attack
- Chest discomfort: Most persons experience central chest discomfort that lasts for more than a few minutes, in some instances the discomfort may go away and subsequently return. The discomfort can feel like a pressure, squeezing, fullness or pain.
- Discomfort and pain in other areas of the upper body: Such can be experienced in one or both arms, the back, neck, jaw, or stomach
- Shortness of breath: Shortness of breath often accompanies chest discomfort. In some instances it can occur before the chest discomfort.
- Other symptoms: These may include cold sweats, nausea and or light-headedness.
- Women: For women their most common heart attack symptom is chest pain or discomfort. However, women are more likely than men to experience shortness of breath, nausea/vomiting and back or jaw pain
- Diabetics: Diabetes can affect your nerves and, therefore, make heart attacks painless or “silent.” A silent heart attack means that you may not have many of the warning signs
