Wednesday, May 14, 2014

How to save your heart?

Every day we can do something good for our heart, when it so tirelessly work for us. 

Today I'll talk a little bit about small changes in lifestyle habits that can save your heart.

Regular meals, fruits, vegetables, whole grains, lower alcohol intake and smoking cessation are key issues for the health of your heart.
Diseases of the heart and blood vessels are the leading cause of death in the modern world. Because heart disease can have a stroke, and pulmonary thrombosis. Arrhythmias are harmless thing. If you sometimes feel the pounding and irregular heartbeat go and look for  medical help.




The biggest danger for your heart is obesity. When you combine it with elevated blood lipids, smoking, physical inactivity, high blood pressure and stress, your body becomes a ticking time bomb.

Obesity causes diabetes, high blood pressure, heart attack and stroke.

Cigarette smoking increases the risk for heart attack and worsen disease that already exists. When you stop smoking the risk of heart attack is reduced by 50%.

A healthy diet is important for a healthy heart. Eat regular, small meals, five times a day. Every day, eat fruits and vegetables. Do not eat the fruit you are used to. Make some changes.

Use olive oil instead of sunflower and soybean oils. Eat nuts. Almonds are very healthy for your heart.
Eat more whole grains and legumes, and various proteins. Reduce the use of pork and beef. Eat more fish, seafood and poultry without skin.
Do not discard the milk and dairy products, but choose one with less fat.
Increase your intake of fiber. A great source of fiber oatmeal, oatmeal, fruits and vegetables. Cut down on salt.
Have a sufficient amount of water. Adult man with moderate activity takes about 8 glasses of water a day, sometimes more.
Do not overdo it with coffee. Stop smoking and reduce your alcohol intake.
Rejoice in life, surround yourself with positive people, you are doing what you love and what makes you happy. Happy people are healthy people.


Do not forget that the source of all diseases, including cancer. Sort the priorities in your mind and do not be upset about insignificant things. Find activities for relaxation. Discover the secrets of meditation. Listen to the  music.
Live your life the way you want it. 

Friday, April 18, 2014

Which foods are healthy for our heart?

A healthy diet is crucial to our health. Modern lifestyle threatens us every day because we eat too much and move too little. Proper nutrition and the regulation of body weight are key factors of recommendations for the prevention of cardiovascular disease. 


Remove excess weight as you can manage! Reduce the fat in the blood and move as much as you can!
Below are some tips on foods you must avoid if you do not want to experience a heart attack in the near future.

Bobičasto voće


Change your eating habits.
Reduce oxidative stress and blood pressure using less salty foods.
Reduce intake of animal fat.

The harmful fats are saturated fats that are high in cholesterol. One leads to the formation of atherosclerotic plaques in the blood vessels. plaques shooting causing embolism and thrombosis. Heart and stroke are the results of this phenomenon.

For a healthy heart eating berries that protects the heart and contains healthy polyphenols. Drink red wine, the juice of red grapes and pomegranate.

Nuts are great for the heart and blood vessels, as they contain a lot of monounsaturated fatty acids.
Olive oil is liquid gold, because it prevents heart disease.

What foods are bad for our heart?
From your diet should eliminate:

  • Beef, pork, smoked meat, offal, sausages, bacon
  • Fast food (pizza, burgers)
  • Chips
  • White bread
  • Whole milk
  • Soft drinks
  • Full-fat cheeses


The foods you should eat for a healthy heart:

  • Fish and lean meats (veal, beef, chicken, turkey)
  • Beans, broccoli, Swiss chard
  • Olive oil
  • Lowfat cheese
  • Fruit
  • Pumpernickel bread
  • Milk with 1.5% fat
  • Kefir and low-fat yogurt
  • Red wine 1 to 2 cups per day
  • Nuts
Sometimes, especially when we are approaching the holidays it is hard to resist food that looks and smells fantastic. If you relax for a day, it will not do much damage to your body, but if it takes too long to relax cardiac, stroke and diabetes are inevitable in the future.
You are what you eat. Think of your health!

Tuesday, January 7, 2014

Little things for your heart

The heart is a magical organ that tirelessly works all his life and saved all of our sweet secret of which is the most beautiful love. Heart disease is the leading cause of death worldwide. Particular risk of developing heart problems are people who have a genetic predisposition, even if the water too hard smoke cigarettes, drink alcohol, eat fatty and salty foods, are overweight, then had a heart attack a certain event. 




In everyday life should introduce small changes that will gradually day by day improve the health of your heart and prevent the occurrence of diseases.

Reduce salt intake
Too much salt in the diet can cause problems with high blood pressure, which leads to damage of blood vessels in the body. Our diet contains much more salt than the amount recommended by contemporary researches.  If you think that you will solve the problem such as by removing the salt from the table, it is terribly mistaken. the largest amount of salt coming from stock purchased food such as salted meat, pasta, snacks and food from the restaurant. Enjoy cooking and a Dose daily amount of salt. Your heart will be very grateful.

Practice, practice, practice
In a healthy body, healthy mind! The heart is a muscle, and muscles develop with regular exercise. This condition is called and the matter is quite logical. Run, play basketball, tennis or basketball. Swimming is a great option for a physical, but also mental health. Running improves the health of the coronary blood vessels that feed your heart. Regular physical exercise reduces the risk of atherosclerosis, heart attack and stroke. Half an hour walking or jogging a day is enough. Regular physical exercise reduces the risk of cancer and bone diseases.


Chocolate is healthy for the heart
Good news for chocolate lovers, a fact that has a positive effect on the health of the heart and blood vessels. This applies to the dark chocolate, which effectively lowers blood pressure. Cocoa is healthy, contains antioxidants flavonols. Flavonols involved in the production of sodium oxide which relaxes and expands blood vessels. The result is a lowering of blood pressure. Enjoy dark chocolate, but do not overdo it!

Olive oil protects the red blood cells

Olive oil protects our red blood cells from damage. Cell damage is partly responsible for heart disease, heart attack and stroke, and red blood cells are posebnoo sensitive to oxidative damage because they are the main carriers of oxygen. Extra-virgin olive oil is valuable for your health. When you are preparing food with olive oil, be careful about the temperature. Excessive heat causes damage to the beneficial substances in olive oil. Best vraijanta that olive oil is used fresh in salads and pasta.

Turn up the music 

Music from the earliest times affect human mood, be the most beautiful emotions, relaxes and stimulates creativity. Music acts an anti-stress. Remember that stress is the biggest enemy of your health and a major cause of cancer, heart attack and stroke. Music participates in the regulation of blood pressure and heart rate. Be careful what music you listen to fast aggressive tones raises blood pressure and heart rate. Classical music relaxes, lowers blood pressure and reduced heart rate.

Tuesday, December 3, 2013

Food for your heart

The heart is one of the most important organs in the human body. Our heart tirelessly house every day and gives us time to relive all those good things that await us in the miracle we call life. 


Today, tomorrow and the next day we can each do something beneficial for our health. Proper nutrition and physical activity are essential prerequisites for a healthy and long life.



For the health of the heart and blood vessels healthy diet is crucial. Abundant, greasy and spicy food can not be friends with your health. Water is your best friend. Day should drink at least a liter of water.

Oranges, cucumbers, plums, tomatoes, pineapple, grapes and olives are special guards your heart. The above foods are especially useful for people who have high blood pressure.

Green and black tea and curry positive impact on heart health. Vitamin E always been beneficial effect on the health of your heart. It is found in nuts, dairy products, wheat and olive oil.
Folic acid hundredth blood vessels. Can be found in green vegetables, egg yolk and beets.

Apples are especially healthy for the heart.
Eat apples tonight when you watch your favorite series. Lettuce, spinach and cabbage contain a number of antioxidants that protect your blood vessels from thrombosis.
Especially important impact on your health is magnesium. Magnesium is a mineral anti-stress which today can be found in rice, whole grains, almonds, bananas, pumpkin seeds and walnuts.

For optimal blood pressure important micronutrients such as selenium, iodine, and iron. Good sources of iron include onions, lentils, beans, peas, dried fruits, dates, figs, prunes and dried apples.
Do you think today the health of your heart. 

Tuesday, November 5, 2013

What can cause pain in your chest?

How many times have you scared because of pain in the chest? This symptom is very unpleasant and brings the fear of a heart attack. I must stress the fact that any kind of pain in the chest, particularly behind the breastbone, very serious symptom and requires a medical examination.

Chest pain may be associated with a whole range of causes, such as heart disease, digestive problems or lung disease. Pain in the chest may also be musculosceletal origin. Sometimes the chest pain of psychogenic nature.




There are extremely dangerous conditions that must be excluded in the diagnosis of chest pain. These are: myocardial infarction, angina pectoris, and aortic (cracking) of the aorta.

Angina pectoris is a common disease, especially in smokers of tobacco and obesity. It occurs due to changes in coronary blood vessels. These are the blood vessels that supply exclusively our hearts. It may be the result of small thrombosis in coronary blood vessels or pain occurs due to contraction (vasoconstriction) of blood vessels. Angina pectoris, especially variant that occurs at rest, it can cause a myocardial infarction, or heart attack. The pain of angina usually occurs in the form of tightness or pressure behind the breastbone. Sometimes spreads to the left arm and the chin. Anginal pain often accompanied by dizziness, sweating, nausea, high blood pressure. The people of angina pectoris often referred to as predinfarkt. Angina pectoris is diagnosed ergonomics. After the exercise test, the decision on coronary angiography.

There are several factors that may provoke angina pains. These are mental stress, physical exertion, cold weather, a large meal. The pain of angina usually stop at nitroglycerin and lasts up to 15 minutes.
People who know they have angina must bring your nitroglycerin.
If the pain does not stop at nitroglycerin, you should contact the emergency room!


Heart attack or myocardial infarction is caused by spasm or blockage of the coronary arteries, where stops the flow of blood and oxygen to the heart. Condition in which the heart does not have enough oxygen for their needs is called ischemia. If ischemia is caused long lasting changes, or lesions and necrosis of cardiac muscle. Heart attack accompanied severe pain behind the breastbone, which never ceases to nitroglycerin. It is sometimes accompanied by nausea and vomiting, especially when be said of the myocardial wall of the lower rate.
In our work, for fear of a specific patient's decision situations in which the patient is quiet, no panic on his back and complaining of severe pain behind the breastbone. Patients with myocardial infarction are usually silent and worried about his condition. First you need to test the ECG.
In most cases, the ECG shows changes in terms of myocardial infarction, but there are forms of stroke in whom there is no change in the ECG tape.
There is also a heart attack without pain or "silent heart attack", which usually occurs in patients with long-standing diabetes.
The pain of a heart attack is usually localized behind the sternum and has a classic pattern of spread. can go to the left arm, neck, stomach, jaw, and back. sometimes occurs and hiccups.
Pain comes with the feeling of breath, choking, fear, excitement, restlessness.
If it is a very extensive myocardial then there is hemodynamic instability, cold sweat, and blood pressure immeasurable.
A heart attack is fatal mainly due to malignant arrhythmias that accompany it.

Sometimes a heart attack discovered a few years later, when the ECG treadmill or ultrasound of the heart scar register and hypokinesis of the heart wall.

Valvular heart disease (mitral valve prolapse, aortic stenosis, mitral insufficiency) can also cause chest pain, but humanity changes usually follow choking, especially intense when lying on a flat surface.

Inflammation of the lining of the heart or pericarditis may also be the cause of chest pain. Intensifies during deep breathing, coughing, lying on his back. This pain is reduced when bending over and sitting.High risk for inflammation of the lining of the heart making the water around heart failure and pericardial effusion. A large amount of fluid in the pericardium, or pericardial tamponade napkin can cause death.

Particularly dangerous and extremely painful condition is aortic dissection. The aorta is the largest blood vessel arising from the heart. Aortic aneurysm is a pathological enlargement, and the weakening of the wall longitudinal aorte. Aorta often shoot in places aneurysm. This is a medical emergency, which quickly leads to tamponade and death if an emergency surgical procedure does not fix. The pain of dissection is tearing, extremely strong, spreading to the back, neck, arms, does not change when you change the position of the body. Very soon nastuopa cardiogenic shock, and death and it is time to help very shortly.


A common cause of chest pain are digestive problems, such as a hernia of the stomach (hiatus hernia), acid reflux from the stomach into the esophagus (GERD). This pain is usually associated with heavy meal, followed by heartburn and acid reflux. Taking medications that reduce the production of stomach acid, the pain is reduced. Previously, of course, necessary to exclude a heart attack. Hernia of the stomach may also cause disturbances in heart rhythm.

Inflammation of the esophagus or esophagitis may cause pain in the chest. It occurs frequently in alcoholics. Muscle spasm of the esophagus can also cause pain behind the breastbone.

Sometimes the cause of chest pain may be lung and pleura (the pleura). The most common diseases are cancer, metastasis, inflammation, adhesions (adhesions), thromboembolism or pulmonary infarction.The pain of pleurisy, or inflammation of the pleura increases in breathing and coughing, reduced lying on the affected side. Adhesions hurt the changing times. The pain of pleurisy is a sharp, piercing and character.


Diseases that are localized in the chest wall, may also be the cause of chest pain. These are osteoporosis, scoliosis, neuromuscular disease, fractures of the ribs, komresija nerves, forced standing, sitting, computer work, stretching the muscles in excessive physical exertion. The intensity of the pain varies in pressure.

Shingles can cause pain in one half of the chest.

In a previous article describes the most common causes of pain in the chest. The occurrence of pain in the chest, it is necessary to rule out serious conditions such as myocardial infarction and aortic dissection.
First search to make the EKG, cardiac necrosis markers and echocardiography.
After these  searches cardiologist decides about medications and additional diagnostic methods. 

Friday, October 11, 2013

What's good for your heart?

The heart is a marvelous organ, every day, ticking a better and happier days. Below are some tips on food that is healthy for your heart:

1 Flaxseed reduces levels of bad cholesterol, which is particularly important for the prevention of heart and blood vessels.

2 Parsley is a herb that strengthens the muscles of the heart, rich in Vitamin C reduces the risk of heart disease, stroke, and atherosclerosis.



3 Mistletoe in small quantities great value regulates blood pressure. It improves the blood circulation, heart function. It has beneficial effects on overall metabolism, especially in the endocrine glands.Mistletoe is a natural substance that helps with headaches, dizziness, anxiety, convulsions, heart problems, angina pectoris attacks, fatigue, fear, lack of will. Mistletoe is used in small amounts and must be PROFESSIONAL MADE. This plant has a beneficial effect on the blood and helps with noise in the ears.

4 Barley has a beneficial effect on blood lipids. helps in reducing bad cholesterol values. Drinking barley reduces morbidity from cardiovascular disease.

5 Hawthorn is a very effective natural remedy for the heart. Hawthorn contains substances that increase the force of heart contractions. Since ancient times used as a natural remedy for high blood pressure.  It also has favorable effects on thrombosis of blood vessels. HAWTHORN should not be used in larger quantities:

6 Nuts are expensive, but they are very healthy. Have a positive effect on the regulation of cholesterol and prevent the occurrence of thrombosis in the circulation.

7 Almonds are also healthy for the heart because they are rich in vitamin E, healthy fats, monosaccharides and polysaccharides. Almonds are great antioxidants, that affect the prevention of atherosclerosis.

8 Apples are great for controlling blood pressure and preventing the formation of clots in the circulation.

9 Garlic is an effective remedy for lowering high blood pressure, but do not overdo it!

10  Melissa and primula are also healthy circulation.

11t Olive oil, oatmeal, salmon, beans and avocado positive effect on heart health.

Tuesday, September 17, 2013

What to eat for a healthy heart?

Heart, magical, mysterious heart and the center of the strongest muscle in our body. A unique and remarkable organ that never runs her own will, and it never stops beating even when we sleep.
Every day strikes heart beats about 100 000.

The average human heart is the size of a closed fist men but as we grow, and it grows, especially if worthwhile exercise or do some sport.  Heart is one of the most important organs in the human body, which is why it is extremely important to maintain a healthy and strong heart.



The following are foods that are important for the health of your heart:

1 Fish - Fish is very beneficial for the body, because in addition to containing polyunsaturated fat, valuable for the prevention of cardiovascular diseases, anti-stress and improve concentration, it is also a rich source of important minerals. Saltwater fish is enriched with iodine, potassium, sodium and copper, while freshwater has less sodium and iodine. All types of fish contain vitamins from group B, valuable for the proper functioning of the nervous system. It is scientifically proven that the middle-aged and elderly who daily eat fish (especially oily fish, which is skimmed and enriched with omega-3 fatty acids) are less likely to develop diseases related to heart disease, diabetes and stroke. Therefore, in any case, good and desirable to include fish in a weekly meal plan, especially oily fish.

2 Fruit and Vegetables-frequent intake of fresh fruits and vegetables is very important to maintain the health of your heart. Apple is extremely rich in quercetin, which acts anti-inflammatory and prevents the formation of blood clots, and contains a lot of vitamins and fiber. There are also blueberries that are extremely healthy for the heart and circulatory system, avocados, which lowers the bad and raises the good cholesterol in the blood, contains healthy fats and helps in the absorption of beta-carotene and lycopene, which are essential for a healthy heart, tomato with rich vitamins and lycopene, and also lowers the risk of heart disease, along with other fruits and vegetables rich in vitamin C.

3 Tofu - Foods rich in protein is always especially important to health, especially if you are looking for food that is good for your heart health. Yosha if you want food without a lot of fat and calories, it's tofu right choice range for you. Tofu is a food Javanese origin derived clotting protein from soy milk, rich in calcium, potassium and magnesium, not to mention niacin and folate. For this reason, eating tofu examines the prevention of cardiovascular disease, high blood pressure and osteoporosis. Tofu has a mild flavor and is easily combined with other foods. Absorbs other flavors and odors and is therefore the possibility of using tofu in the daily diet is practically unlimited: from the preparation of a variety of spreads, dressings, salads and cold appetizers to main meals that include soups, cream soups, steaks, moussaka, stews and as well as a variety of desserts and sweets.
Tofu is also considered an adequate substitute for meat, milk and dairy products of animal origin.

4 Nuts - walnuts, almonds and other nuts contain healthy oils, vitamin E, and other substances that maintain healthy levels of cholesterol in the blood. Almonds are also a great source of protein and natural fiber, considered to be the healthiest foods. Nuts are a great and healthy snack that makes your heart will be grateful.

5 Brown rice - rice in general, energy food, containing protide rich in essential amino acids and low in fat, and the membrane that surrounds, high in fiber, contains potassium, magnesium, selenium and manganese, as well as fatty acids and vitamins such as biotin to - Cocktail of B vitamins and vitamin B1, is essential for the health of the nervous system. But for heart health is more important though brown rice that gently but deeply calming and focusing the work, for the life of the essential organs.

6 Cereals - Cereals are rich in vitamins and natural fibers that contribute to maintaining the health of your heart. It is also good to consume and wholemeal pasta, which is healthier than the ordinary.

7 Oatmeal - degradable fibers, in addition to heart disease, the good and for the prevention of diabetes.It has been scientifically proven that eating these fibers at an early age reduces the risk of chronic diseases such as cancer, diabetes and heart disease. Therefore, many cardiologists for heart health recommend oatmeal as it is rich in degradable fiber, which helps your heart, reducing the amount of bad LDL cholesterol.
However, it is not clarified how degradable fiber reduces LDL cholesterol in the blood, but it is speculated that this is a how to act like a sponge that absorbs cholesterol in the gut and then ejects it from the body together with the faeces. In addition to LDL cholesterol, biodegradable fibers can reduce the level of triglycerides, fats that are too dangerous for heart health.

8 Dark chocolate - it is scientifically proven that just a couple of squares of dark chocolate a day can reduce the risk of heart disease, and the secret probably lies in the high level of cocoa. The researchers also found that, in the group of smokers who consumed 40 grams per day of dark chocolate, in a very short period of time established by improved function of the arteries as a result of high levels of cocoa in dark chocolate containing 74% cocoa and is also rich in antioxidants that prevent damage to the heart.

9 Legumes - are very healthy for the heart, particularly beans, especially black beans. Since more difficult to digest provides a feeling of satiety, but not recommended for food more than three times a week. Since it contains a lot of medicinal ingredients, and is rich in folic acid, a beneficial effect in the prevention of heart disease. Statistics show that people with a lack of folic acid are dying as a result of heart problems and even in 69% of cases, more than the control group. To ensure the normal amount of homocysteine ​​in the blood, the recommended consumption of foods rich in folic acid. So be sure to incorporate beans into your weekly menu.

10th And as the icing always comes at the end, remember that red wine is healthy for your heart, but of course in moderation. Since ancient times, is a known fact that red wine is very good for the health of your heart. Alcohol and other ingredients of red wine may be beneficial in the prevention of cardiac disease in the way that alcohol, in moderation, proven increases levels of "good" HDL cholesterol levels, reduces the possibility of thrombosis and protect arteries from damage. Furthermore, the wine contains antioxidants and flavonoids, a substance called resveratrol, which has potential benefits for improving heart health. There is also a grape that contains antioxidants that act against free radicals and prevent cell damage. Also contains substances that protect blood vessels from damage, strengthen capillaries, prevent lipid oxidation and myocardial heart muscle. Some of the components of red grapes stabilized venous blood vessels and thus the risk of developing varicose veins and reduce the accumulation of fat in the blood vessel walls.

Tuesday, July 23, 2013

Nutrition for a healthy heart

Diseases of the heart and blood vessels are the leading cause of death in the modern world. Although women suffer later than men, this disease affects both sexes. The development of the disease depends on several factors. Certain factors such as age, sex and genetic causes can not be affected, but on the other hand, however, many can not.



Diet that keeps your heart

Diseases of the heart and blood vessels are the leading cause of death in the modern world. Although women suffer later than men, this disease affects both sexes. The development of the disease depends on several factors. Certain factors such as age, sex and genetic causes can not be affected, but on the other hand, however, many can not.

Why cholesterol increases?

One of the causes of cardiovascular risk is high LDL cholesterol. A diet rich in fat, excessive food intake, physical inactivity and smoking affect the growth of cholesterol. As for diet, a high intake of saturated fatty acids and trans fatty acids most affected by the increase in LDL cholesterol in the blood. Saturated fats are most abundant in red meat, butter, full-fat dairy products and palm oil as trans fatty acids formed during the hydrogenation of vegetable oil, and heating oil in the frying of the food industry as biscuits, snacks and deep fried foods are the major source of trans fatty acids .

It is known that in addition to the "bad" LDL cholesterol that we have is 'good'. HDL cholesterol is responsible for the removal of cholesterol from the blood to the liver and its izučivanje from the body, while LDL cholesterol has an inverse role. LDL cholesterol back into the blood stream where it builds up in the walls of blood vessels. Accumulation of plaque in the walls of blood vessels from high cholesterol, triglycerides, blood pressure and many other factors, their diameter is tapered and reduced elasticity.When you break off a piece of debris resulting clot can completely clog the narrow blood vessels and thereby stop the flow of blood to the tissues. The blood flow to the heart resulting in myocardial infarction, and interrupt the flow to the brain causing a stroke.

Fruits and vegetables keeps the heart

For a healthy heart is necessary to regularly introduce foods that are rich in dietary fiber. Fiber helps to reduce cholesterol levels and improve the ratio between LDL and HDL cholesterol. In the intestine, the fibers have the ability to bind bile acids that are rich in cholesterol absorption and instead, out of the body. Fiber-rich foods such as beans, and many fruits and vegetables.

In addition to fiber, fruits and vegetables provide antioxidants in our diet, especially beta-carotene from carrots and vitamin C from broccoli, which have a protective effect on the body.

And Folic acid is an important nutrient that preserves the health of the heart. The high amount of the amino acid homocysteine ​​in the blood indicate heart disease. Although the mechanism of action has not been clarified so far, it is believed that increased amounts of homocysteine ​​promotes the accumulation of plaque in the arteries.

Valuable omega

For good health, it is advisable to enter every day at least one food that is considered a good source of beneficial omega - 3 fatty acids. This means entering a serving of sardines, tuna, salmon or other fatty fish from cold seas or of vegetable origin rich in omega - 3 fatty acids (eg, nuts, flax seeds). While the impact of the amount of hlesterola modest, omega-3 fatty acids, especially eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids, and have a mild antihypertensive effect and decrease the rate of formation of atherosclerotic plaques.

Heart like a Mediterranean diet

The Mediterranean diet is a diet that is now considered the most justifiable health for an individual's health, particularly in the health of the heart and blood vessels. The Mediterranean diet is rich in whole grains and fresh, seasonal vegetables and fruits. Consumed and lean meats, fish and seafood, milk and skimmed milk products and is an important part of the make and nuts and legumes. Extra virgin olive oil is an essential part of the Mediterranean diet, and it is recommended and consuming wine in moderation to 2 day DL with a recommendation to be consumed with a meal.

Studies show that a healthy life style can halve the risk of heart attack in people with a genetic predisposition to heart disease, and to reduce chances of heart attacks the strongest positive effect with a proper diet is avoiding smoking and regular exercise, maintaining a healthy body weight and moderate consumption alcohol. 

Food for heart patients

The most important in this diet is to limit the intake of fat, especially saturated (fatty meat, fatty dairy products, fried foods), which increase cholesterol and risk of heart attack or stroke. It is recommended that 25 percent of daily calories from fat, less than seven percent of daily calories from saturated fat and no more than 200 milligrams of cholesterol per day (as there are in approximately 60 grams of cheese).



Less meat, more fish

Saturated fat in the diet can be reduced by limiting the amount of meat and fatty dairy products. Choose low-fat versions of these foods. Replace most animal fats with unsaturated fats, preferably monounsaturated oils such as olive, flax or peanut oil.

TLC diet includes a lot of carbohydrates, vegetables, fruits, low-calorie and fat-free dairy products, fish, turkey and chicken (without skin).

Authors TLC diets claim that adherence to such a diet for six weeks can lower the levels of bad (LDL) cholesterol by 8 to 10 percent. Also, this diet to lose one to two pounds per week, which is actually the healthiest weight loss methods.

TABLE FOOD

- Lean red meat, chicken, turkey, fish, legumes: not more than 150 grams per day

- Eggs: no more than two yolks per week

- Fat-free milk and dairy products: two to three times a day (a cup of milk or yogurt with low-fat, 30 g of fresh skim or low-fat cottage cheese, plain cheese)

- Fruits: two to four times a day (1 piece of fruit, apple, orange, banana, or half a cup of canned fruit, or one cup of berries, melon, or 3/4 cup juice)

- Vegetables: three to five times a day (one and a half cup of raw leafy green vegetables, 1 cup of cooked or fresh vegetables; 3/4 cup low-fat vegetable soup)

- Pumpernickel bread, cereals, pasta, rice: 6 - 9 times a day (1 thin slice of bread; 1/2 rolls or whole if small; 30 g cereals 1/2 cup of cooked pasta, rice or other grains; 1/2 cups of boiled potatoes)

- Fats and oils: 6 - 8 times per day (1 teaspoon of olive oil or peanut oil, 1 teaspoon of corn, soybean or sunflower oil), two tablespoons of nuts or seeds 1 tablespoon low-fat mayonnaise

- Sweets and Cakes: Only if you have less fat and sugar

Fresh spices

They are a healthy substitute for salt, and the salt contains 2,400 milligrams of sodium in one teaspoon kavenoj. The greater the amount of sodium than you should not enter into the body during the day, if you want to keep track of your blood pressure. So - it is clear why the fresh natural flavor much better option.

Fresh chopped garlic and rosemary goes well with potatoes, parsley goes well with soup or with eggs, sage goes well with meat, thyme can be added to the popcorn. These natural herbs are also rich in antioxidants, to further protect your heart from potential heart disease. If you can not deprive the salt, it is better to use sea salt, and you can also mix (and thus mitigate) with other spices.

Are recommended and macrobiotic condiments that are very tasty and add saltiness - soy and tamari.They can be put in salads, or added to cooked dishes at the end of cooking.

Low-calorie and low-fat yogurt

Many people prefer this foodstuff is consumed at breakfast or as a snack. It contains calcium and potassium - minerals that lower blood pressure.

Garlic

These vegetables some love it, some do not, but one thing is certain - Garlic has an important role in lowering bad cholesterol. To obtain the best effect, you need to eat a few slices a day.

Olive oil

This oil is rich in unsaturated fats, which can lower cholesterol when replacing saturated fat in your diet.It is important that any reduction in the intake of saturated fats (found in cheese, the butter and fatty meats). Good substitutes are foods with olive oil (salads and dishes that are fried in the oil), avocados, nuts and other sources of unsaturated fats, especially monounsaturated fat. Olive oil has other benefits - it contains polyphenols, which prevent the bad cholesterol that sticks to artery walls. Although this is more expensive than oil sunflower, it should be part of your kitchen. The health of people do not save.

Almonds

When adults eat about 30 grams of these koštunjavih fruit per day, the level of bad cholesterol, they are reduced by 13 to 20 percent. All nuts are healthy and nutritious, but almonds are especially good for the heart because they contain a lot of vitamin E. This antioxidant has a strong effect in the prevention of atherosclerosis. They are also a good source of calcium. If you do not like raw almonds, try a little browned in the oven, it will reduce the bitterness and the flavor.


Carrot

Researchers at Harvard found that very helpful to eat every day, half a cup of carrots. This amount reduces the risk of diabetes in women by as much as 27%. 

Sunday, April 14, 2013

Tetralogy of Fallot


Tetralogia Fallot's pulmonary stenosis associated with highly placed septuni ventricular defect. In this way, the right ventricular empties into the aorta instead of into the pulmonary artery and is therefore highly unsaturated aortic blood oxygen. Early leads to cyanosis, and polioitemije batičastih fingers. Fatigue causes cyanosis. 



The clinical picture

A. The signs and symptoms in severe cases lagging growth. He is a frequent dyspnea, fatigue and facilitates čučanjemse dyspnea; occasionally, until syncope. Express the signs are cyanosis ibatičasti fingers, moderate protrusion desnogventrikla and absence of apical impulse, as ikratak, harsh noise sfstolni if ​​trirduž left edge of the sternum. The heart was not enlarged. In medium-sized openings hear a loud second sound, while jepocepan with pulmonary component of reduced amplitude.


B. Radiographic findings: sučista lung fields. Apex of the heart with a dull konkavnošću in a segment.pulmonary (heart shaped wooden shoes). Right aortic arch is set U25% cases.

C. ECG: umarena desnogventrikla hypertrophy is almost always present. Povremenose are expressed and P waves.

D. Special tests: diagnosis is based on kateterijzacije heart and from the right ventricle angiokardiografije. In this way, determined and morphological appearance. Aortography is recommended as a routine method In patients who are preparing for surgery. Time to show some unexpected aortic Granell associated defects.

Treatment

Tetralogia Fallot is treated surgically with the use of the machine for extracorporeal circulation.Operative mortality was moderately low. Patients with underdeveloped pulmonary arteries previously recommended Blalockov type of surgery. Propranolol (Inderal) is used in syncopal attacks which, in fact, caused by contraction of the infundibulum.

Forecast

In adults the most common tetralogia cainotic congenital heart defects, but children do not reach adulthood so often. The most common cause of death was pronounced hypoxemia. It is also common and vascular thrombosis caused by polycythemia. Strength syndrome is depending on the degree of stenosis and. pulmonary, if the stenosis is greater the higher the desnolevi shunt and pulmonary blood flow decreased. 

Ventricular septal defect


This congenital heart defect is in fact an opening in the upper part of the interventricular septum was due to nonunion of the aortic septum. In this way, the blood passes from the left ventricle where the high right ventricular pressure where pressure is low. In cases 1/4-1/3 shunt is not large enough to lead to strain rate. In the case of a large shunt leads to stress and the right and left ventricles. 



The clinical picture

A. Symptoms and signs: clinical presentation depends on the diameter of the defect and the presence or odsustvapovećane pulmonary vascular resistance. If the defect is small levodesni shunt is small, if the defect of resistance to the flow of blood between the two ventricles is small and the large levodesnišant, increased pulmonary shunt levodesni vaskularnarezistencija decreases and turns pansistolični noise sided šum.U 3ćem 4tom and intercostals space dužsternuma heard long, loud and coarse systolic murmur and a faucet tril. This may not be the only finding small defects. In the case of large shunts at the top of the faucet heart podizanjedesnog ventricular diastolic and mean hear "flow noise" and can be heard in the third tone.
B. Radiographic findings in large šantovadesni or left ventricular or both, as the left atrium and pulmonary arteries were enlarged, and the pulmonary flow increased.


C. ECG: may be normal or may dapokazuje hypertrophy of the right, left or obaventrikla.
D. Special tests: kateterizacijomsrca possible to diagnose even unajkomplikovanijiiin cases. The children sadekompenzacijom heart is necessary to establish a diagnosis and advise appropriate treatment.

Treatment

Ventricular septum defect can be asymptomatic with normal hemodynamics of the heart. However, the children can be a serious flaw that results in death due to cardiac decompensation. These patients should undergo surgery. Ideal case in surgery with the use of the machine for extracorporeal circulation is the one with the big levodesnim Santo, left ventricular hypertrophy, and only moderate pulmonary hypertension. When it comes expressed pulmonary hypertension (pulmonary artery pressure> 85 mm Hg), and levodesni shunt is small, then the risk of surgery is at least 50%. Surgical intervention is contraindicated if the shunt Reverse. However, if a surgical intervention is necessary in such case.cardiac decompensation caused by large levodesnim SANTO recommends placing a ring around the pulmonary artery, which will reduce shunt. Only the children of 5-6 years of age it is necessary to make a definitive correction. Based on the growing experience led to the conclusion that some defects closed spontaneously (perhaps 30 - 50%). Therefore, surgery should be delayed until late childhood, except in cases where the inability to live very strong or when it is concluded that pulmonary hypertension increases.

Forecast

Patients with typical forest can expect a normal life, except that you can always develop bacterial endocarditis in patients. With large shunts in early childhood caused congestive heart and they rarely survive 40 years of age. Reverse shunt encountered in about 25% of cases, leading to Eisenmengerovog syndrome. 

Ductus arteriosus persistens


It occurs when the ductus arteriosus development embriogenetskom not close and persisted as a shunt connecting the left branch. pulmonic and aortic usually near the left. subclaviae. The blood comes from the aorta through the ductus continuous systolic and diastolic, it is a form of fistula arterijovenskc how the work of the left ventricle increases. In some patients, obliterative changes in blood vessels in the lungs leading to pulmonary hypertension. In this case, the bi-directional shunt or desnolevi. 



The clinical picture

A. The signs and symptoms: no symptoms witness performances left ventricular decompensation. The heart is in the normal range or lakouvećano with strong action at the top. A wide pulse pressure, and diastolic pressure jenizak. To the left, on the edge of the sternum in the first intercostals space idrugom hear a continuous harsh noise "machine", accented ukasnoj systole. Trillo is common. If there is a significant increase in left ventricular present iparadoksalno splitting the second tone.
B. Radiographic findings: heart normalneveličine and contour, but there may enlarge the left atrium and left ventricle. A conspicuous bulge. pulmonary, aorta and left atrium.
C. ECG: normal findings or signs of left ventricular enlargement, which depends on the width of the duct.
D. Special tests: Cardiac catheterization can establish levodesni shunt. The catheter can pass from a.pulmonic through the duct and into the aorta through angiokardiografije possible to exclude the presence of other defects (such as. ruptured sinus Valsalvae right in the heart), which produces a similar sound as the ductus arteriosus perzistens.


Treatment

In the hands of an experienced operative mortality is low (<1%), therefore it is recommended closure duetusa both in children and in adults. Operative mortality was higher in elderly patients. Therefore, we should be cautious in advising surgical intervention, particularly if the patients are asymptomatic and left ventricular hypertrophy have. The greatest risk is subacute bacterial endocarditis.
In the event that there is an indication for pulmonary kipertenzija ligation or cutting duetusa are disputed, but the contemporary view in favor ligging in all cases, while the shunt still levodesni, while pulmonary flow increases, the pressure in a. pulmonic was <100 mm Hg.

Forecast

Floe in early childhood cause high mortality. Smaller shunts are compatible with long-life age. The most common complication was congestive decrease in heart function. You can come up and bacterial endocarditis. A small percentage of patients with pulmonary hypertension and shunt and rcverzni, so the lower extremities, especially the toes cijanotični the normal color of the fingers. In this condition the patient is in surgery. 

Atrial septal defect


The most common form of atrium septum defect lectual presence ostium secundum type defects in the middle of the septum, while less common ostium primum type (which is lower in the septum) and in these cases there are abnormalities in the mitral and tricuspid valves and.In both cases, normal oxygen saturated blood from the left atrium into the right atrium passes d thus increasing cardiac output and right ventricular pulmonary flow. The primum defect, mitral insufficiency causes left ventricular strain. 



The clinical picture

A. Symptoms and signs: the largest number of patients with moderate atrial septum defect is asymptomatic. In the event that there is a large shunt and leads to dyspnea prizamoru or cardiac decompensation. Visible sui palpable right ventricular pulsations. In II IIII intercostals space to the left of the sternum to hear a moderate systolic murmur that jerezultat increased flow through the pulmonary valve. Or at the top of the heart or in the area of ​​continuing ksifoidnog hear high diastolic mekšum, which is the result of increased flow kroztrikuspidalne valve, especially in the inspiration. Trillo is not common. The second tone is widely torn and does not change in relation to respiration.


B. Radiographic findings: large pulmonary arteries with strong pulsations, increased pulmonary vascular pattern, enlarged right atrium and iventrikl small aortic knob.

C. ECG: electrical axis deviation or right ventricular hypertrophy right in the case of the ostium secundum defekta.Inkompletan or a complete block of the right granese luck in most cases. Kodostium primum defect exists devijacijaelektrične axis to the left with a rotation in the frontal plane, the opposite of the movement kazaljkena clock.

D. Special tests: cardiac catheterization ze possible to calculate the amount of blood that šantira between the left and right atria, followed Intracardiac and pulmonary pressures and pulmonary vascular resistance. The catheter can pass through the defect into the left atrium. Angiokardiografijom can odkriti whether the ostium primum comes defect or mitral regurgitation.

Treatment

Male strijalne septum defects should not be treated surgically. Surgical treatment they require lump atrium septum defects Whose is levodesni shunt (2 or 3 times the systemic flow) with mild or no increase in pulmonary resistance. Operational risk is small so you need to operate on patients whose ratio between pulmonary and systemic flow 1.5:1.

Surgical intervention is indicated in cases of pulmonary hypertension and santa reverse because of the risk of acute cardiac decompensation.

Forecast

Patients with small SANTO can live a normal life, with a greater SANTO experience medieval age or later before it comes to the appearance of pulmonary hypertension or cardiac decompensation. Later usually lead to atrial fibrillation and pulmonary vascular resistance. Floe lead to physical disability in 40tim age. Increased pulmonary vascular resistance caused by pulmonary hypertension rarely encountered in childhood or mladićstva when it comes to the atrial septum defect type secundum, but is common in the case of the septum primum defect; 40tih after years of existence and the atrium septum defect lectual secundum type can be develop pulmonary hypertension.

Operative mortality with the use of the machine for extracorporeal circulation is low (<1%) in patients under 45 years of age, who are not and have decompensated pressure in a. pulmonic <60 mm Hg.Increases 6-10% in patients over 40 years of age, they also have heart decompensation and increased pressure in a. pulmonic> 60 mm Hg. The largest number of survivors show marked improvement. 

Bacterial endocarditis


The essence of diagnosis 

Subacute:

• A patient with rheumatic or congenital heart disease.
• Long-term fever, weight loss, joint pain and muscle pain, fatigue and anemia.
• heart murmur splenomegalia, petechiae, emboli phenomena.
• Blood culture was positive.



Acute:

• Patients with acute infection, a history that iliskorim jerađena surgery.
• High temperature, sudden changes or new noises, pojavaembolija, petechiae, splenomegalia itoksične phenomenon.

General assessment

Subacute bacterial endocarditis (SBE) is a bacterial infection of the endocardium flammable, and usually builds on rheumatic or valvular or caicifikovano changed to a congenital heart disease. The initial cause of bacteremia were respiratory infections, interventions to teeth or cystoscopy. But in most cases the source of infection is not known. Etiologic factors are usually nonhemolytic Streptococcus, Streptococcus viridans and especially S. faecalis, stapholococcus occasionally, but every other organism is viable.


Bacteria settle the endocardium valve (usually aortic and mitral) or more valves. Precipitated fibrin and platelet thrombi form so that the form of vegetation that are weathered and torn easily give emboli to the brain, peripheral artery or visceral organs. Embolični nephritis or glomerulonephritis true sometimes can lead to kidney failure. Dissemination of bacteria in the blood, but altered valve can lead to the development of mikotične aneurysm, which sometimes, however, rarely, it can rupture. May be present and active rheumatic carditis. SBE develop moderate to moderate systemic symptoms: cerebral, renal, splenic or mesenteric embolism, heart failure, or any combination of these that. After this may bacterioremia from one of the sources, and in the course of a few days or weeks.

Acute bacterial endocarditis (ABE) is a progressive infection of normal speed or variable valve and usually develops in severe bacteremia from acute infections, such as eg. pneumococcna pneumonia, postabortalna pelvic infection or abscess. It can also occur as a complication after surgery on the heart, transurethral postatecoomije, or after surgery on the infected tissue. The most common pathogens are challengers: Pneumococci, hemolytic staphvlococc, betahemolitični Streptococcus and gram negative coliform organisms.

Acute endocarditis creates great weathered forms of bacteria that lead to the occurrence of severe emboličnih with metastatic abscess, perforation fast, breaking and destruction of the changed valve chordae tendineae or rupture.

The clinical picture

A. Symptoms and signs: fever is present in all cases, although there may be afebrile period. Individually or as a whole may be present following symptoms: sweating at night, chills, malaise, fatigue, anoreksia, weight loss, vague muscle aches, artralgia, redness and swelling of joints, sudden changes in the eyes, aphasia, hemiplegia caused by cerebral embolism, abdominal pain, chest pain, changes on one side of the body caused by mesenteric, spleničnim, pulmonary embolism, renal, bleeding from the nose, bruises and symptoms of heart failure. The ABE is more turbulent flow and the patient was very intoxicated.

The SBE is usually a rheumatic or congenital heart disease. Available when the tahikardia, splenomegalia, petechiae on the skin and mucous membranes, and then finding the fundus, and bleeding under the nail more available; batičasti fingers and toes, pale or tan skin, neurologic findings following cerebral embolism, sensitive red nodules on fingers and legs. Heart murmurs can be considered irrelevant when it comes to infections trikuspidalnih valves and valvular pulmonary artery. However, with repeated pulmonary infarction due to pneumonia, heart murmurs can be very characteristic signs.In elderly patients clinical presentation is often atypical.

ABE is, in fact, a serious infection associated with fever, high fever, extreme iznemoglošću serious and multiple occurrences embolism. This can be down linked to previous causal infection (pneumonia, furunculosis, pelvic infection) or may occur suddenly after surgery. Heart murmurs can change rapidly, and heart failure expires earlier.

ABE may develop during prophylactic treatment with antibiotics and inadequate. In these cases, the changes are masked, and the first warning can occur suddenly embolism, then petechiae, unexpected heart failure, altered noises or fever.

B. Laboratory findings: if the suspected SBE is necessary to take two blood cultures daily for a period of 3-5 days. For 2-7 days of incubation, 85-95% of these cultures to isolate organisms and allow the selection of a special drug. The ABE is necessary to take 2-3 blood culture during the emergency treatment of patients, and then start with antibiotic therapy. In the case of repeated negative blood cultures (in uremic patients) is necessary to make the culture of bone marrow.

The effect of drugs on antimikorbnih positive blood cultures can be expected in 10 days.

Normochromic anemia, expressed sedimentation, leukocytosis, microscopic hematuria, proteinuria, and effusions are often found in the SBE and ABE. Especially in adult patients nitrogen retention may be the first sign. In 50 - 60% of cases there is rheumatoid factor when it comes to the SBE that has lasted for more than 6 weeks.

Complications

Complications in the presence of ABE and SBE may include peripheral arterial embolism (leading to hemiplegia or aphasia; bowel infarction, kidney or spleen, or acute arterial insufficiency of the hands or feet, congestive heart failure, renal failure, krvaljenje, anemia, and create metastatic abscesses ( especially when it comes to ABE). splenic abscess may adversely affect the effect of therapy, and even lead to the initial state.

Differential Diagnosis

SBE must be differentiated from patients with a variety of similar conditions. Hemiplegia, persistent heart failure, anemia, bleeding fondness or uremia may be caused by the SBE. If a patient has of any of these diseases in addition to temperature and even a heart murmur, it is necessary to take haemoculture.

Specific illnesses that require you to differentiate are: lymphoma, thrombocytopenic purpura, leukemia, acute rheumatic fever, diseminatni lupus erythematosus, polyarthritis nodosa, chronic meningococcemia, brucellosis, diseminantna or miliary tuberculosis, non-bacterial thrombotic endocarditis or chronic disease with weight loss.

ABE cover a severe systemic reaction to the apparent pre-existing infection. It can be recognized only if notice the rapid clinical deterioration, bacteriemia, the occurrence of sudden cardiac noise changes, heart failure and high embolične attacks, especially in the CNS, which give a picture of meningitis.

Preventive measures

Some cases of endocarditis can occur after surgery on the teeth, oropharynx, and genitourinary tract.Patients with known heart anomaly must be for the above-mentioned surgery to prepare the following:
(1) 600,000 units procaine penicillinasa 600,000 units of crystalline penicillin. They are administered one hour before surgery, and then procaine penicillin 600,000 units daily to them within two days.
(2) 500,000 units of penicillin G or oral Vper 4 or 5 times a day I danhirurške intervention and two days after the execution of the intervention.
(3) In the case of sensitivity to penicillin, iliu persons who received penicillin in the prophylaxis of rheumatic fever, it is necessary to prescribe erythromycin 250 mg orally four times daily on the day of surgery and two days after the procedure.
(4) When it comes to surgery on the genitourinary or gastrointestinal tract should be given streptomycin, 1-2 gm per day, apart from the point of therapy (1).

Treatment

A. Special measures: the value of understanding regarding the treatment of bacterial endocarditis is a bactericidal antibiotic concentrations in contact with infectious organisms, which is often localized in avascular tissue, or in a place where bacteria develop. By far the most effective drug in the treatment of bacterial endocarditis is penicillin because of its high degree of bactericidal activity against most of the bacteria that cause bacterial endocarditis and because of the small number of side reactions. When necessary, the synergistic effect of antibiotics proved to be useful. Several cases have been cured only by using bacteriostatic drugs.

Positive blood cultures do not have this value to confirm the diagnosis and to be a landmark in the treatment of sensitivity tests to different antibiotics or combination of antibiotics. Before you start the treatment you need to take two blood cultures daily for a period of 3-5 days, except in cases of very severe patients where antibiotic treatment administered immediately after the emergency treatment of patients, including blood cultures 2-3.

Note: control of the antimicrobial treatment.

Blood cultures were negative minimum initial requirements for the implementation of effective therapy.Since the start of treatment serum bactericidal activity test is the best indicator to support the selection of drug and dose. During treatment the serum of patients should be bactericidal under standard laboratory conditions. Serum diluiran 1:5 or 1:10 should be rapidly bactericidal.

First Penicillin is the drug of choice in most cases of bacterial endocarditis. At first it is necessary to prescribe parenteral all patients until an adequate serum bactericidal. Per oral administration of medication can be carried out in those cases where it is a particularly sensitive organism and it is possible to implement control per oral ingestion (5 times greater than parenteral) and you can keep an adequate level of serum.

Dosage of penicillin is depending on the sensitivity of the organism. Streptococcus viridans is sensitive to 0.1 units / ml penicillin (over 8096) can be treated bacterial endocarditis administration of penicillin G, 3-5 million units per day in 3-4 weeks. Given them 1.2 million units procaine penicillin 3 times a day.Streptococci are killed using 1.0 but not using 0.1 units / ml penicillin G, which requires (dissolved in water), 5-10 million units per day in 3-4 weeks. Antibiotic can prescribe them or iv streptococci and other organisms that die of penicillin in a concentration greater than 1.0 units / ml, requiring more than 10 million units of penicillin G, which is usually administered in the form of intravenous drip infusion (5% glucose or saline solution). You need to pay attention to the following complications: (a) Each million units of "potassium penicillin" contains about 1.7 milliequivalents potassium approaching the toxic dose, (b) at high concentrations of penicillin a lot of diffusion in the CNS and thus leads to the neurotoxic state, (c) the long-term intravenous antibiotic therapy, there is the possibility of superinfection, to avoid this it is necessary to change every 48 hours post injection and all work under strict aseptic conditions.

If bakteriemia and signs of bacterial endocarditis persistent active dose may be increased (and may provide 500 million units of penicillin G per day) until the serum is not the exam, and clinical signs do not become satisfactory. However, if a negative blood culture and serum testing has shown that it is necessary to prescribe the appropriate remedy. The signs and symptoms that occur may be caused by other factors and not only by infection.

Second The combined effect of penicillin and streptomycin or kanamvicina. - Appendix kanamvcina streptomycin or penicillin bactericidal activity increases in many of streptococcus, especially for enterococe (S. faecalis). Bacterial endocarditis With caused by the streptococcus viridans streptomvcinsulfat injected them 2-3 times a day, 10 days (penicillin is added as gorerečeno). The overall time of treatment can reduce the seovako 18-22 days (instead of the 3-4nedelje). In bacterial endocarditis caused enterococima given streptomycin 0.5 gm or 0.5 gm kanamvcin intervaluod in 8-12 hours, while penicillin G (10-60miliona units daily) or ampicillin (8-20gm per day) injected iv for 4 -5nedelja. This combined therapy has been shown capable of destroying enterococa when it comes to bacterial endocarditis, when injected negopenicillin I predstavljajedan of the most useful antibiotic synergism. And a combination of other drugs that are detected through laboratory analysis can bitiod used in the treatment of bacterial endocarditis caused by resistant microorganisms in particular, but all this must be uraditipod strict laboratory control.

3rd Cephalothin given dnevnointravenski 6-12 gm, and is used for bacterial endocarditis caused by staphylococcal infection streptococnomi zapenicillin as a substitute in allergic individuals.Hypersensitivity can occur and some other phenomena nacephalothin. Enterococci are usually resistant.

4th Methicillin given dnevnoi.v 6-24 gm. for a period of 4-6 weeks. Bacterial endocarditis-use your code caused penicillinazom created staphvlococca.Alternativni drugs are Nafcillin, 8-16 gm 4puta oxacillin and 8-16 gm four times a day Uist period. Vancomvoin GM4 is given 2-4 times daily for 2-4 weeks when it comes to bacterial endocarditis caused staphvlococcom.

5th Tetracvclin, erythromycin and other drugs that are mainly a bacteriostatic effect are the drugs of choice when it pitanjubakterijski endocarditis. If ordinirajubolesnicima having fever for unknown reasons, these drugs may temporarily potisnubakteriemiju and lead to symptomatic improvement.However, they did not care able to radically destroy the infection, but the disease progresses allow smetajuu and diagnosis. In bakterijskogendocarditisa caused by the Bacteroides species and other anaerobic bacteria or rickettsia, tetracycline may be the drug of choice. The dosage must be determined on the basis of serology and patient tolerance.

6th In bacterial endocarditis who jeizazvan gram negative bacteria flora gives the interior kanamvcin, 0.5 gm imsvakih 6-12 hours. Once combined and companion drugs to give baktericidnukombinaciju by laboratory tests. Cephalothin can be given alternatively 6-12 gm four times a day. Polymyxin B icolistin have not proven clinical bacterial endocarditis korisnimkod izazvanogPseuđomonas species of organism in spite naznačeneosetljivosti you wear. Only surgical removal of the holder of infection (a "patch" over the septal defect, prosthesis) in the cardiovascular system is able to incubate bacterial endocarditis caused pseudomonasom.Gentamicin sulfate, 3 mg / kg per day odefekta them in some cases caused by the bakterijskogendocarditisa rezistentnimgram negative bacteria. In upotrebiovih drugs need to be addressed in terms of the consequences naeventualne Nephrite, neuroili oto toxicity of their actions. If Upitanju decreased renal function dose SEMORE corrected.

7th In patients with a clinical picture typical for bacterial endocarditis but stalnonegativnom hemoculture empirically given penicillin G, 20-50 million units (daily iv plus streptomycin, 1 gm / day mode for 4 weeks). In this way a treatment of disease will show znatnapoboljšanja. If there is no improvement klničkog within 3-5 days, you should try it with other drugs (see 4, 5 and 6).

8th Monitoring results and the eventual return of the disease. At the end of a lečenjaposle 3-6 weeks, stop must be svomantimikrobnom therapy. 3 days after the blood culture is taken once daily for 4 danauzastopce, and then once a week for 4 weeks, during which time patients neophodnobrižljivo observirati. During this time may result in a greater number of Bacteriological to return, but some are still extended for nekolikomeseci. And embolism and temperature can be during and after successful treatment. alisame are not sufficient basis for re-treatment. Initially well postavljenaterapija bacteriologically proven bacterial endocarditis may prove successful even up to 90%. If the bacteriological status of refunds, the organism must be isolated and retested, and then you need to take more accurate treatment with certain drugs.

Despite the treatment of a large number of patients suffering from bacterial endocarditis progression to congestive heart failure and that within 5-10 years. This mechanical heart failure is partly due to the deformation of valves (valvular perforation, torn chordae) due to bacterial infection, and partly due to the healing process and scarring. Therefore, surgical correction of impaired cardiovascular dynamics as taking part in the management of patients.

B. General assessment: it must be taken and additional treatment as in any difficult infekciji.Ako it is difficult datitransfuziju anemia need blood or red blood cells. Anticoagulant therapy (heparin, bishydroxycoumarin) are not indicated in bacterial endocarditis nekomplikovanimslučajevima and can only contribute to complications such as short krvavijenje.

C. Treatment of complications:

First Infarction sistemnoj circulation in the body usually caused by emboli from levogsrca. Emboli from right heart leading to a heart attack the lungs. Treatment is symptomatic, and anticoagulant therapy sometimes helps. Embolektomija can be taken if odreditačna localization.
Second Heart failure - myocarditis, which is often accompanied by bacterial endocarditis and valvular deformity increases, heart failure can daubrza and requires digitization and salt restriction diet. Such patients is not advisable to prescribe fiziološkirastvor potassium or calcium. even during antibiotic therapy is necessary to think about the possibility of early valve replacement akopostoje signs of progressive and severe heart failure. Because of the poor prognosis and the development of renal progresivneaortne bakterijskogendocarditisa valve replacement can be done but only after 2-3 weeks of successful antimicrobial treatment.
3rd In many patients with endocarditis odbakterijskog the retention of nitrogen due to focal emboličnog nefritisaili glomerulonephritis. This requires ponovnukorekciju dose less frequently and occasionally lečenjeuremije until renal function is not popraviza during antimicrobial therapy.

Forecast

Bacterial endocarditis is generally fatal bacterial infection while not destroyed, but in some cases surgical solution A-V fistula or perzistensa ductus arteriosus may lead to a cure. Poor prognosis in patients with negative blood culture has and prolonged treatment, then those with very high resistance of the organism and that suffered an infection of the prosthesis. If the treatment is completed bacteriological forecast depends on adequate cardiovascular function only about 50% of patients feel good 5 years after cure of bacterial endocarditis. Among the diseased aortic valves have the gravest failure prediction and requires appropriate surgical intervention. What is the worst embolism embolism prognosis that affect the brain. Cerebral embolism and aneurysm rupture mikotične can occur even after treatment undertaken. Reduction in renal function is reversible and can be achieved by early adequate antimicrobial therapy.