Tuesday, 14 October 2008

What Is An Echocardiogram

What is an echocardiogram?

An echocardiogram is an ultrasound scan of the heart. It is sometimes just called an 'ECHO'. Ultrasound is a very high frequency sound that you cannot hear, but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers, and structures within the heart such as the valves.

What happens during the test

?You will need to undress to the waist and lie on the couch. A probe is placed on your chest (it is a bit like a very thick blunt pen). Also, lubricating jelly is put on your chest so the probe makes good contact with the skin. The probe is connected by a wire to the ultrasound machine and monitor. Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then echo ('bounce back') from the heart and various structures in the heart.The amount of ultrasound that echoes back depends on the density of the tissue the sound has hit. Therefore, the different structures send back different echoes. For example, ultrasound travels freely through fluid so there is little echo from blood in heart chambers. But, heart valves are dense tissues so ultrasound waves hitting a valve will echo back clearly.The echoes are detected by the probe and are sent to the echocardiogram machine. They are displayed as a picture on the monitor. The picture is constantly updated so the scan can show movement as well as structure. (For example, the valves of a heart opening and closing.) The operator moves the probe around over the skin surface to get views from different angles. Some abnormalities can be seen quite clearly. For example, damaged heart valves, thickened heart muscle, some congenital heart defects, etc.

The test is painless and takes about 30-45 minutes. You may have to turn on your side during the test so the operator can scan the heart from different angles.

You do not need any special preparation before the test. You eat and drink normally before and after the test. Continue to take your usual medication.

What Is A Tilt Table Test

What is a tilt table test?

Tilt table testing is designed to evaluate how your body regulates blood pressure in response to some very simple stresses.Blood pressure is regulated by a set of nerves which operate continuously and subconsciously and are part of the autonomic nervous system. This set of nerves detects certain bodily needs and they respond by causing the appropriate changes in blood pressure. The purpose of this part of the autonomic nervous system is to insure that there is always enough blood going to the brain, and to distribute blood to other organs according to their needs. For example, during exercise, blood is delivered preferentially to the muscles, whereas during eating blood is delivered preferentially to the intestines. These changes in blood pressure are accomplished by making changes in the way the heart beats and by making changes in the caliber or size of certain blood vessels.At times, the nerves which control blood pressure may not operate properly and may cause a reaction which paradoxically causes the blood pressure to drop suddenly. This reaction may produce a fainting spell or a number of symptoms including severe lightheadedness. Tilt table testing is designed to determine the likelihood that a patient is susceptible to this type of reaction.

Who needs a tilt table test?

Patients that have symptoms suggestive of a sudden drop in blood pressure may benefit from the evaluation of blood pressure regulation with a tilt table test. The tilt table test was originally designed to evaluate patients with fainting spells because many fainting spells are caused by a drop in blood pressure. Tilt table testing may also be useful for patients who have symptoms of severe lightheadedness or dizziness which don't actually cause them to faint, but force them to sit down or lie down. These symptoms, while not progressing on to an actual fainting spell, may still be indicative of a sudden drop in blood pressure. Many patients suffering from the chronic fatigue syndrome have symptoms of lightheadedness and have been referred for tilt table testing.

What does tilt table testing involve?

The first part of a tilt table test evaluates how blood pressure responds to the simple stress of standing up, or in other words, how the blood pressure responds to the stress of gravity. Patients are asked to remove their clothing above the waist, put on a hospital gown, and lie down on a special table. Patients are connected to an electrocardiogram (ECG) type machine, have a small cuff placed around a finger which measures blood pressure, and have a small intravenous line (IV) placed into a vein in the arm. We try to make the setting as relaxing as possible by dimming the lights and by turning on some soft music in the background. After everything is set up we collect baseline blood pressure and ECG data for 10 minutes while you lie quietly on the table.

How long will the tilt table test take?

The duration of the tilt table test depends in part on how you respond. Some patients demonstrate the reaction that causes their blood pressure to fall suddenly in the first 20 minutes of head-up tilt to 60 degrees. Given the time it takes to set up the equipment and collect baseline data, the shortest possible test is 30-40 minutes. Other patients finish the entire protocol without demonstrating any such reaction (a negative test); these patients therefore finish all three stages of the test. If you finish the entire test, it will take approximately 2 hours.

What is a positive test?

A tilt table test is called positive if a patient develops a drop in blood pressure associated with symptoms. The symptoms that patients experience are varied and have included lightheadedness, nausea, a cold and clammy feeling, sweating, a "spacey" feeling, or a feeling like you are about to black out. Rarely, blood pressure falls without the patient developing symptoms.

What does a positive test mean?

A positive tilt table test means that a patient is susceptible to one of the reactions that can cause a drop in blood pressure. Some of the reactions can be dangerous and require treatment, other reactions are benign and may not require treatment. Treatments vary from medication to a change in diet. The interpretation of the tilt table test is up to your physician.

How will I feel after the test?

Many patients who have a positive test feel a little unsettled and sometimes queasy for the first few minutes after the test. The vast majority of patients will return to feeling completely normal within 5 to 10 minutes after the test. Rarely, a patient may continue to experience weakness or fatigue for a longer period of time after the test. Patients that have a negative test often report that the test was tiring but otherwise feel fine. If the patient received isuprel during the test, the effects of isuprel wear off within a few minutes of stopping the infusion.

What Is A CT Scan

What is a CT scanner?

A CT (computerised tomography) scanner is a special kind of X-ray machine. Instead of sending out a single X-ray through your body as with ordinary X-rays, several beams are sent simultaneously from different angles.

How does a CT scanner work?

The X-rays from the beams are detected after they have passed through the body and their strength is measured.Beams that have passed through less dense tissue such as the lungs will be stronger, whereas beams that have passed through denser tissue such as bone will be weaker. A computer can use this information to work out the relative density of the tissues examined. Each set of measurements made by the scanner is, in effect, a cross-section through the body. The computer processes the results, displaying them as a two-dimensional picture shown on a monitor. The technique of CT scanning was developed by the British inventor Sir Godfrey Hounsfield, who was awarded the Nobel Prize for his work.

What are CT scans used for?

CT scans are far more detailed than ordinary X-rays. The information from the two-dimensional computer images can be reconstructed to produce three-dimensional images by some modern CT scanners. They can be used to produce virtual images that show what a surgeon would see during an operation. CT scans have already allowed doctors to inspect the inside of the body without having to operate or perform unpleasant examinations. CT scanning has also proven invaluable in pinpointing tumours and planning treatment with radiotherapy.

What is the CT scanner used for?

The CT scanner was originally designed to take pictures of the brain. Now it is much more advanced and is used for taking pictures of virtually any part of the body. The scanner is particularly good at testing for bleeding in the brain, for aneurysms (when the wall of an artery swells up), brain tumours and brain damage. It can also find tumours and abscesses throughout the body and is used to assess types of lung disease.In addition, the CT scanner is used to look at internal injuries such as a torn kidney, spleen or liver; or bony injury, particularly in the spine. CT scanning can also be used to guide biopsies and therapeutic pain procedures.

How is a CT scan prepared for?

If the patient is receiving an abdomen scan, for example, they will be asked not to eat for six hours before the test. They will be given a drink containing gastrografin, an aniseed flavoured X-ray dye, 45 minutes before the procedure. This makes the intestines easier to see on the pictures. Sometimes a liquid X-ray dye is injected into the veins during the test. This also makes it easier to see the organs, blood vessels or, for example, a tumour. The injection might be a little uncomfortable, and some people also experience a feeling of warmth in their arm.

How is a CT scan carried out?

The scanner looks like a large doughnut. During the scan the patient lies on a bed, with the body part under examination placed in the round tunnel or opening of the scanner. The bed then moves slowly backwards and forwards to allow the scanner to take pictures of the body, although it does not touch the patient. The length of the test depends on the number of pictures and the different angles taken.

Does a CT scan hurt?

The examination does not hurt but some people find it uncomfortable to lie in the tunnel. As there is little room inside the tunnel, people who suffer from severe claustrophobia sometimes have problems with CT scans. Let the doctors and radiographers know if this might be a problem. Other people get slightly nervous because of the whirring noise the machine makes while working.

Is a CT scan dangerous?

Far more X-rays are involved in a CT scan than in ordinary X-rays, so doctors do not recommend CT scans without a good medical reason. Some patients may experience side effects due to allergic reactions to the liquid dye injected into the veins.In very rare cases, this dye has been known to damage already weakened kidneys. It is important to let the X-ray doctors or technicians know if you have any allergies, asthma or kidney trouble, prior to having the X-ray dye injected.

How is a CT scan read?

A CT scan can give the doctor a much clearer picture of the inside of the body than an ordinary X-ray. For example, different types of tissue such as bone, muscle and fatty tissue are easy to see on a CT scan. When looking at the abdomen, the scan shows various organs such as the pancreas, spleen and liver. When it is necessary to look at the brain, the areas containing liquid - the ventricles - are also clearly defined. Very small shadows on the lungs can also be detected using CT and there are now studies looking into using it as a screening test for lung cancer.

What Is A MRI Scan?

What is an MRI scan?

MRI (magnetic resonance imaging) is a fairly new technique that has been used since the beginning of the 1980s.The MRI scan uses magnetic and radio waves, meaning that there is no exposure to X-rays or any other damaging forms of radiation.

How does an MRI scanner work?

The patient lies inside a large, cylinder-shaped magnet. Radio waves 10,000 to 30,000 times stronger than the magnetic field of the earth are then sent through the body. This affects the body's atoms, forcing the nuclei into a different position. As they move back into place they send out radio waves of their own. The scanner picks up these signals and a computer turns them into a picture. These pictures are based on the location and strength of the incoming signals. Our body consists mainly of water, and water contains hydrogen atoms. For this reason, the nucleus of the hydrogen atom is often used to create an MRI scan in the manner described above.

What does an MRI scan show?

Using an MRI scanner, it is possible to make pictures of almost all the tissue in the body. The tissue that has the least hydrogen atoms (such as bones) turns out dark, while the tissue that has many hydrogen atoms (such as fatty tissue) looks much brighter. By changing the timing of the radiowave pulses it is possible to gain information about the different types of tissues that are present. An MRI scan is also able to provide clear pictures of parts of the body that are surrounded by bone tissue, so the technique is useful when examining the brain and spinal cord. Because the MRI scan gives very detailed pictures it is the best technique when it comes to finding tumours (benign or malignant abnormal growths) in the brain. If a tumour is present the scan can also be used to find out if it has spread into nearby brain tissue. The technique also allows us to focus on other details in the brain. For example, it makes it possible to see the strands of abnormal tissue that occur if someone has multiple sclerosis and it is possible to see changes occurring when there is bleeding in the brain, or find out if the brain tissue has suffered lack of oxygen after a stroke. The MRI scan is also able to show both the heart and the large blood vessels in the surrounding tissue. This makes it possible to detect heart defects that have been building up since birth, as well as changes in the thickness of the muscles around the heart following a heart attack. The method can also be used to examine the joints, spine and sometimes the soft parts of your body such as the liver, kidneys and spleen.

How does an MRI scan differ from a CT scan?

With an MRI scan it is possible to take pictures from almost every angle, whereas a CT scan only shows pictures horizontally. There is no ionizing radiation (X-rays) involved in producing an MRI scan. MRI scans are generally more detailed, too. The difference between normal and abnormal tissue is often clearer on the MRI scan than on the CT scan.

How is an MRI scan performed?

The scan is usually done as an outpatient procedure, which means that the patient can go home after the test. During the scan it is important to lie completely still. For this reason it might be necessary to give a child an anaesthetic before they are tested. Since you are exposed to a powerful magnetic field during the MRI scan, it is important not to wear jewellery or any other metal objects.It is also important for the patient to inform medical staff if they use electrical appliances, such as a hearing aid or pacemaker, or have any metal in their body such as surgical clips, but orthopaedic metalware such as artificial hips or bone screws is not normally a problem.

Is an MRI scan dangerous?

There are no known dangers or side effects connected to an MRI scan. The test is not painful; you cannot feel it. Since radiation is not used, the procedure can be repeated without problems. There is a small theoretical risk to the foetus in the first 12 weeks of pregnancy, and therefore scans are not performed on pregnant women during this time. Because patients have to lie inside a large cylinder while the scans are being made some people get claustrophobic during the test. Patients who are afraid this might happen should talk to the doctor beforehand, who may give them some medication to help them relax. The machine also makes a banging noise while it is working, which might be unpleasant.

What Is A Chest X-ray

What is Chest X-ray (Chest Radiography)?

The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Relieve Stress With Recliner Chair Meditation Technique

Stress

Stress can exacerbate symptoms in POTS patients so it is really important to learn relaxation techniques. Therefore try the following:

Recliner Chair Meditation Technique

Sit in a recliner chair with the bare soles of your feet pressed against each other and your legs relaxed, knees pointed out to the sides of the chair. You can drape a towel or blanket over your bare feet for warmth. The hands can be locked together, laying comfortably in your lap, or pressed against the center of the chest, one on top of the other, on the center of the emotional heart. Your eyes can be fully closed or left slightly open, letting in just two small slits of light. If your eyes are fully closed be sure to keep the room brightly lit so that some light passes through the eyelids. Total darkness will evoke dullness and sleep, not meditation.Sit quietly for a period of between thirty minutes and one hour. While sitting, be gently aware of the breathing process felt at the belly. Feel your belly moving in and out slowly as you breathe. If you start to have distracting thoughts, simply bring your attention back to the belly and the process of breathing. Maintain alertness and do not let yourself drift into sleep.This meditation can be done once, twice, or even three times a day. After practicing this method for some time you may become aware of what the Japanese call the 'hara.' No one really knows what the hara is, but it may be related to the enteric nervous system. The hara is felt just behind and slightly below the navel as an ethereal ball of energy. When your consciousness is centered at the hara instead of in the head, your thinking process slows down and can even stop. When the thinking process slows down you relax deeply and experience pleasing sensations of spaciousness and comfort. Trying to stop distracting thoughts with will power alone leads to even more thoughts and a self-defeating inner struggle. By transferring your center of awareness to the hara, thoughts gradually disappear on their own, without any inner conflict.