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Last Friday was my 5th anniversary of my post open heart surgery annual check up.

The doctor request an Echo cardiogram to be done and also a bubble test on the Echo.

This is what you will see on an echo.

Picture Source : Here.

I know well that if I have not moved to the US, I would be death long time ago. I do not think I am still alive writing this post to you.

Why do I need echo cardiogram ? What is echo for ?

I have 2 defects , 1 is a valve problem (I was born with a hole in my tricuspid valve) and a hole in my atrium (ASD : Atrium septal defect). Atrium are the upper chambers of the heart.

Echo cardiogram is the best test to evaluate the valves and chambers of the heart in a noninvasive manner.

I highly recommend every one of you who take annual medical check up as young as 25. Do not tempt your luck.

Why ?
Coronary heart disease (CHD), also called coronary artery disease (CAD), affects about 14 million men and women in the United States.
We have 300 million population, 14million is about 5% of the population have heart disease !
Cancer is not the disease that kill Americans, it is heart disease that kill Americans.

How do you get CAD ?
Coronary artery disease is caused by the gradual buildup of fatty deposits in your coronary arteries (atherosclerosis). As the deposits slowly narrow your coronary arteries, your heart receives less blood. Eventually, diminished blood flow may cause chest pain (angina), shortness of breath or other symptoms. A complete blockage can cause a heart attack.

What are the sign and symptom ?
* Chest pain. You may feel pressure or tightness in your chest, as if someone were standing on your chest. The pain is usually triggered by physical or emotional stress. It typically goes away within minutes after stopping the stressful activity. Atypical chest pain — more common in women — may be fleeting or sharp and noticed in the abdomen, back or arm.
* Shortness of breath. If your heart can’t pump enough blood to meet your body’s needs, you may develop symptoms of heart failure — shortness of breath, extreme fatigue with exertion, and swelling in your feet and ankles.
* Heart attack. If a coronary artery becomes completely blocked, you may have a heart attack. The classic symptoms of a heart attack include crushing pain in your chest, pain in your shoulder or arm, and shortness of breath. Women are somewhat more likely than men to experience other warning signs of a heart attack, including nausea and back or jaw pain. Sometimes a heart attack occurs without any apparent signs or symptoms.

What are the risk factors ?
Men are generally at greater risk of coronary artery disease than are women. However, the risk for women increases after menopause. A family history of heart disease and simply getting older increases the risk as well.

Other risk factors for coronary artery disease include:
* Smoking
* High blood pressure
* High cholesterol
* Diabetes
* Obesity
* Physical inactivity
* Stress and anger

What are the primary prevention ?
Lifestyle changes can help you prevent or slow the progression of coronary artery disease.
* Stop smoking. Smoking is a major risk factor for coronary artery disease. Nicotine constricts blood vessels and forces your heart to work harder, and carbon monoxide reduces oxygen in your blood and damages the lining of your blood vessels. If you smoke, quitting is the best way to reduce your risk of a heart attack.
* Control your blood pressure. Ask your doctor for a blood pressure measurement at least every two years. He or she may recommend more frequent measurements if your blood pressure is higher than normal or you have a history of heart disease. Normal blood pressure is below 120 systolic/80 diastolic as measured in millimeters of mercury (mm Hg).
* Check your cholesterol. Ask your doctor for a baseline cholesterol test when you’re in your 20s and then at least every five years. If your test results aren’t within desirable ranges, your doctor may recommend more frequent measurements. Most people should aim for an LDL level below 130 mg/dL. If you have other risk factors for heart disease, your target LDL may be below 100 mg/dL. If you’re at very high risk for heart disease — if you’ve already had a heart attack or have diabetes, for example — you may need to aim for an LDL level below 70 mg/dL.
* Keep diabetes under control. If you have diabetes, tight blood sugar control can help reduce the risk of heart disease.
* Get moving. Exercise helps you achieve and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure — all risk factors for coronary artery disease. With your doctor’s OK, aim for 30 to 60 minutes of physical activity most days of the week.
* Eat healthy foods. A heart-healthy diet based on fruits, vegetables and whole grains — and low in saturated fat, cholesterol and sodium — can help you control your weight, blood pressure and cholesterol. One or two servings of fish a week are also beneficial.
* Maintain a healthy weight. Being overweight increases your risk of coronary artery disease. Weight loss is especially important for people who have large waist measurements — more than 40 inches for men and more than 35 inches for women — because people with this body shape are more likely to develop diabetes and heart disease.
* Manage stress. Reduce stress as much as possible. Practice healthy techniques for managing stress, such as muscle relaxation and deep breathing.

What are the available diagnosis tools ?
#Electrocardiogram (ECG). An electrocardiogram records electrical signals as they travel through your heart. An ECG can often reveal evidence of a previous heart attack or one that’s in progress. In other cases, Holter monitoring may be recommended. With this type of ECG, you wear a portable monitor for 24 hours as you go about your normal activities. Certain abnormalities may indicate inadequate blood flow to your heart.
# Echocardiogram. An echocardiogram uses sound waves to produce images of your heart. During an echocardiogram, your doctor can determine whether all parts of the heart wall are contributing normally to your heart’s pumping activity. Parts that move weakly may have been damaged during a heart attack or be receiving too little oxygen. This may indicate coronary artery disease or various other conditions.
#Stress test. If your signs and symptoms occur most often during exercise, your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG. This is known as an exercise stress test. In other cases, medication to stimulate your heart may be used instead of exercise.
Some stress tests are done using an echocardiogram. These are known as stress echos. For example, your doctor may do an ultrasound before and after you exercise on a treadmill or bike. Or your doctor may use medication to stimulate your heart during an echocardiogram.
Another stress test known as a nuclear stress test helps measure blood flow to your heart muscle at rest and during stress. It’s similar to a routine exercise stress test but with images in addition to an ECG. Trace amounts of radioactive material — such as thallium or a compound known as sestamibi (Cardiolite) — are injected into your bloodstream. Special cameras can detect areas in your heart that receive less blood flow.
# Angiogram. To view blood flow through your heart, your doctor may inject a special dye into your arteries before a chest X-ray. This is known as an angiogram. The dye outlines narrow spots and blockages on the X-ray images. If you have a blockage that requires treatment, a balloon or stent can be used to improve the blood flow in your heart.

All the above information are gotten from Mayoclinic.com’s section on CAD, the world most renown cardiac hospital.

Life is beautiful, take care of your health and enjoy every minute on this earth. You only walk on this earth once and make the best on this earth.
Go kayaking on the world most beautiful island, Borneo Island and call Francis of Kuching Kayak if you can join him kayaking.

** PS: The mortality rate of women died of CAD is higher than men. It is because a lot of times women did not have the classic symptom of a heart disease which men have such as chest pain or shortness of breath. A lot of times, they have symptoms such as fatigue, backache, headache which in many ways can be misdiagnosed as being tired or fatigue. By the times, they have an attack, a lot of times, it is fatal and also women blood vessels are generally much narrower or smaller than men. So, my male readers pay attention to your mother, wife and even sister’s health, you never know they will be the next casualties !

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