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Cognitive Disorders Following Traumatic Brain Injury

on Sat, 07/11/2015 - 17:54

Cognitive Disorders Following Traumatic Brain Injury

What is a cognitive disorder following a traumatic brain injury?

A cognitive disorder is when your brain does not function properly after a traumatic brain injury (TBI). TBI often damaged the front of his brain, which is part of the brain used for thinking and memory. You may have trouble doing the same things you did before the TBI.

What are the symptoms of a cognitive disorder?

Your symptoms may improve, stay the same or worsen over time. They may go away and come back again. It is possible that you present any of the following:


Difficulty paying attention

Difficulty thinking clearly or do two things at once

Memory Problems

Decrease in speed and ability to learn


Trouble sleeping or fatigue

Changes in appetite

Poor balance

Headaches or other pains

Problems with your ability to smell, taste, hear or see

Difficulty maintaining heat or cold





Difficulty controlling their feelings, actions and behavior

How cognitive disorders diagnosed?

Your brain healthy for many months after TBI. It is possible that health care providers need to monitor regularly examine brain function. You may need any of the following:

A test of conscience could be used to measure how well you move or speak. They could also be tested to check his memory.

A computed tomography (CT) or magnetic resonance imaging (MRI) may show damage to his brain. It may be given contrast dye to help the hurt look better in pictures. Tell your health care provider if you have ever had an allergic reaction to the dye. Do not enter an MRI room with any metal. Metal can cause serious injury. Tell your health care provider if you have any metal in or on your body.

How cognitive disorders treated?

Treatment depends on the severity of their condition. You may need medication to help decrease your symptoms, such as headaches or other pains and brain injury.

How I can control my symptoms?

Attend physical therapy, speech or occupational. A physical therapist teaches you exercises to help improve movement and strength and reduce pain. A speech therapist teaches you ways to improve your language. An occupational therapist teaches skills to help with their daily activities.

Attend group and individual therapy. A therapist can help you cope with your feelings after TBI.

Improve your memory. Write things frequently. Use a calendar or an agenda to remember what you need to perform daily activities. Set a daily routine.

Enough sleep and rest. Do not rush to return to their daily activities.

When should I contact my health care provider?

You are drowsier or has trouble waking up more than normal.

Signs and symptoms worsen.

Your arms or legs feel weak, or you lose feeling in a part of the body.

You have new problems with balance and movement.

You have signs and symptoms for more than six weeks after TBI.

You have questions or concerns about your condition or care.

When you should seek immediate medical care or call 911?

You have blood or clear fluid coming out of your ears or nose.

Her pupils have the same size.

You stop responding to others or have a seizure.

His speech is awkward or inconsistent.

You are confused or cannot think clearly.

You have severe pain.

You have severe vomiting.

You like hurting himself or others.

Congestive heart failure

on Sat, 07/04/2015 - 19:22

What is heart failure?

Heart failure is a condition in which the heart is unable to pump blood with enough force and speed to meet the needs of tissues. In some cases, the heart pumps blood fast enough to meet the body's needs, but at the cost of extra work. It does this by increasing the pressure in the heart and blood vessels. Increased pressure stresses wear heart. This condition is known as congestive heart failure or heart failure name. Heart failure The term seems to mean that the heart has stopped working altogether, but that is wrong. In general, congestive heart failure means the heart has failed operation. This can occur over several years, but can also occur quickly. In heart failure, blood flow to the heart decreases. This makes the blood flow that supply the heart. When blood flow to the heart slows, it causes an accumulation of fluid in the tissues.

What causes heart failure?

Conditions that can cause heart failure include:

coronary artery disease, the arteries that supply blood to the heart narrow and become obstructed;

heart attack, when part of the heart muscle dies and is replaced by scar tissue, preventing the myocardium to function properly;

hypertension, where increased pressure causes extra work for the heart, which in time can thicken and to know a failure;

valvular heart disease, which can reduce the efficiency with which the heart is able to function;

diabetes, which increases the risk of heart disease of any kind, due to its effect on blood vessels;

Infection of the heart or heart valves;

heart defects present at birth, called congestive heart failure.

Any of the above conditions can lead to heart failure. Risk increases in the presence of several diseases.

What are the most likely to have heart failure?

Anyone who has any of the following risk factors are more likely to experience heart failure:




Coronary heart disease or "hardening of the arteries" called atherosclerosis



History of heart attack or other heart disease

About 500 000 people in Canada suffer from heart failure and nearly 50 000 new cases are diagnosed each year. It is slightly more common in men than women. It is twice as common in African Americans than in Caucasians.

What are the different types of heart failure?

There are two types of heart failure

Systolic heart failure. In this case, the heart has difficulty pumping blood through the body. Blood flows from the lungs to the heart can flow back. This leads to an accumulation of fluid in the lungs and other body parts. This can also cause fatigue and difficult endeavor.

Diastolic heart failure. In this case, the heart fails to relax properly. The heart can not fill with blood because of stiffness myocardium. This condition causes fluid accumulation in different parts of the body such as legs, ankles and feet, and sometimes the lungs.

What are the signs and symptoms of heart failure?

Most symptoms of heart failure are related to:

fluid accumulation in tissues;

lack of oxygen and nutrients due to accumulation of fluid in the lungs;

lack of nutrients due to a decrease in blood supply.

In the early stages, the heart tries to compensate for reduced pumping capacity by an increase in volume and thickness and pump faster to increase blood flow. This may help prevent the onset of years. But time is not enough, and the symptoms begin to appear.

Symptoms of heart failure include:

Dyspnea (shortness of breath). This symptom results from an accumulation of fluid in the lungs. When pronounced, it is sometimes described as a sensation of drowning. This symptom is often aggravated by activity, lying or appears at night.

Fatigue. This happens when the muscles and other tissues do not receive enough oxygen and nutrients through the blood.

Edem. This symptom, which means a swelling in consequence of fluid accumulation, occurs most often in the feet, legs, stomach or lungs. This accumulation of fluid can lead to sudden weight gain.

Coughing, wheezing or gasping. This symptom results from an accumulation of fluid in the lungs. Cough sputum mucus can sometimes pink tinged with blood.

How is heart failure diagnosed?

The diagnosis of heart failure requires a physical examination and medical history of the study by a health professional. The most common signs are shortness of breath, fatigue and swelling of the ankles and feet. These symptoms lead the healthcare provider to suspect heart failure. The physical examination will include a research and auscultation of heart sounds and respiratory sounds that focus on heart failure. Health Professional search also risk factors such as:

Coronary heart disease or "hardening of the arteries" called atherosclerosis




Other heart problems

If the symptoms and examination does not confirm the presence of heart failure, the medical professional will prescribe additional tests. A chest radiograph is one of these comments. An echocardiogram is different. This painless test uses sound waves to check heart structure and movements. Both tests can help rule out other causes of these symptoms.

What are the treatment options for heart failure?

Treatment of heart failure can improve quality of life and extend human life expectancy. To choose the proper treatment, medical staff should reflect the type of heart failure and its cause. It will consider the patient's age, health condition and his prospects. Schemes include changes in lifestyle. These changes can help control heart failure. These may include:

Quit Smoking

Lose weight or maintain a healthy weight range

Avoid drinking alcohol

Eating foods low in salt and fat

Liquids fall

Adopt an active life as a healthcare professional guidelines

A person with heart failure should also take one or more types of medication. Several drugs have proved useful in cases of heart failure

-Conversie Angiotensin enzyme (ACE). This type of drug widens the blood vessels. It helps to facilitate the work of the heart.

Angiotensin II antagonists (ARA). ARBs are used in patients intolerant to ACE inhibitors. They also expand the blood vessels and thus facilitate the work of the heart.

Diuretics. This reduces the amount of fluid in the body and decreases the pressure in the blood vessels.

Beta-blockers (beta-adrenergic receptor antagonists) it helps slow the heart beat frequency, which reduces blood pressure.

Digitalis (digoxin). These drugs help strengthen the heartbeat.

Vasodilators (such as hydralazine, isosorbide and nitrates). They contribute to relieve pressure in blood vessels. When blood vessels are relaxed, blood flows more easily there.

Anticoagulants (such as warfarin or heparin) They are sometimes prescribed for people with a history of blood clots, very rapid heartbeat called atrial fibrillation, or cerebrovascular accident (CVA).

Other treatments may be needed if the patient does not respond to lifestyle changes and medication. These other treatments may include surgery, installation of special electronic pacemakers or other medical devices or heart transplants.

We should treat heart failure?

Yes I Do. Untreated heart failure will worsen. Untreated patients are also at an increased risk of heart attack or sudden death. To increase their chances of survival, people who suffer from heart failure should take care of their health. It is essential to regularly consult a doctor and scrupulously respect the guidelines. Take prescribed medications may help the heart pump more efficiently.

Patients should know the warning signs of heart failure. In case of recurrence or worsening of the signs, patients should alert without waiting for a medical professional. These signs include:

Sudden weight (1.5 kg or more in a day or 2.5 kg or more a week)

Increasing dyspnea even at rest

Swollen legs and feet

Sleep disorders due to difficulty breathing when lying down

Frequent bouts of dry cough


Even when optimally supported and treated, heart failure may worsen. However, the chances of a healthy life are much better with an effective treatment.

What questions might I ask

the healthcare provider about treating heart failure?

If you or a loved one had received a diagnosis of heart failure, you may notice in writing in advance all the questions you want to ask the care provider at your next visit. Here are some suggestions to get you started:

How serious is my heart failure?

I do better?

What should I expect in terms of the prognosis?

What are my treatment options?

In your opinion, what will work best for me? What?

How effective will this treatment?

What are the side effects of this medicine?

How to treat the side effects that they submit?

How heart failure and its treatment affect my daily activities?

How long can I expect to see results?

What warning signs should report immediately?

Congestive heart failure

on Sat, 07/04/2015 - 18:31

Heart failure

Heart failure is the inability of the heart to pump enough blood to meet the body's needs. This is a serious health problem which results, among others, by shortness of breath and fatigue disproportionate to the product effort. It usually occurs in individuals whose health is weakened for years by cardiac or respiratory disorders or hypertension.

The number of cases of heart failure has increased over the last 30 years11. Among the reasons for this increase, there was improved treatment of heart disease and prolonging life expectancy of sufferers. Although there is no recent statistics, heart failure is a major cause of mortality in the elderly. The survival rate five years after diagnosis is approximately 50%.


Congestive heart failure occurs when the heart no longer has as much force to expel blood in the arteries and it fills less blood because it is stiffened or dilated. Each contraction of the heart is therefore less effective. The blood takes longer to pass through the arteries and is stagnating in the veins. It is because of this congestion of blood in the veins it is called heart failure "congestive". Usually, heart failure reached one or other of the two ventricles, the right or left. In some cases it may happen that the two ventricles are affected.

The left heart failure. This is the most common form. Fluid accumulates in the tissues and are concentrated mainly in the lungs, causing breathing difficulties marked (breathlessness, wheezing, etc.). Hypertension untreated or improperly treated for several years and coronary artery disease (a heart weakened by attacks of angina or heart attack) are the main perpetrators;

The right heart failure. This time, the accumulation of fluids is localized mainly in the legs and ankles, causing their swelling. It is often caused by left heart failure, but can also be the consequence of a pulmonary disease, such as chronic bronchitis, emphysema or pulmonary embolism.

The heart consists of four chambers:

the 2 smallest, called atria, receive blood from the lungs (left atrium) and the rest of the body (right atrium);

the 2 largest, called ventricles, expelling blood from the atria to the lungs (right ventricle) and the rest of the body (left ventricle).

To see how the blood moves through the heart, look at our animation by clicking on the illustration at the beginning of the plug.

When blood flow is less, the heart compensates by contracting stronger and accelerating its beats. The heart muscle enlarges in order to pump more blood. The kidneys, which also receive less blood, respond by limiting fluid loss through urine. This is called water retention. Water retention results in swelling and increased blood volume, which in turn contributes to fatigue the heart. Fatigue and breathlessness are installed. Over time, the heart can no longer provide the extra effort.


In the vast majority of cases, heart failure is chronic. Fatigue is often the first symptom to appear. With the progression of the disease, shortness of breath on exertion appears, then also at rest.

Sometimes treatment of the cause of heart failure makes it disappear (for example, a heart defect corrected by surgery). In other cases, the drugs and the adoption of healthy lifestyles provide greater comfort and allow to resume some abandoned activities.

New York Heart Association defines 4 stages of evolution of heart failure based on the degree of physical activity toléré2.

Stages of evolution of the disease

Limited physical activity


Class I (mild)

No limitations

No abnormal shortness of breath at the slightest exertion or fatigue in everyday life.

Class II (mild)

Slight limitation

No discomfort at rest but symptoms appear during physical activities of moderate intensity.

Class III (moderate)

Frank Limitation

The symptoms appear during physical activities, even slight. Comfortable at rest only.

Class IV (severe)

Major limitation

Symptoms occur even at rest.

Possible Complications

They vary according to the person's health status, age, cause of heart failure and its severity.

Untreated, heart failure can quickly lead to serious complications. The fluid accumulates in the lungs and make breathing difficult. The risk of arrhythmia and cardiac arrest increase. Also, if a blood clot forms in the veins, it can clog the pulmonary artery (pulmonary embolism), a potentially deadly problem. Finally, if untreated, heart failure can damage the liver and kidneys, which are of vital organs.

Diagnosis of heart failure

Clinical examination that allows the doctor to diagnose heart failure may be supplemented by further investigation to determine its cause and severity.

Blood test. The dosage of the various components of the blood (cholesterol, glucose, potassium, creatinine, etc.) for information about the cause of heart failure and the status of sensitive organs such as the kidney or liver. The B-type natriuretic peptide (BNP) can also be measured to determine the degree of the deficiency;

Chest X-ray. The silhouette of the heart visible in the radiograph informs its state (its volume, for example) along with possible causes of a malfunction. In addition, this test can verify the presence of fluid in the lungs;

Electrocardiogram. This examination is to measure the electrical activity of the heart. It is not invasive and does not cause any pain. It can detect arrhythmias and electrical conduction defects within the heart. It can be practiced at rest or during exercise;

Echocardiography. This is an ultrasound of the heart. This allows visual examination of the heart to check its status: the existence of a defect, the size of the ventricles, the state of the heart valves, the traces of an old infarction, etc.

Congestive Heart Failure

on Sat, 07/04/2015 - 17:30

Congestive heart failure


Congestive heart failure (CHF) is the main complication of heart disease. It is a pathological condition caused by damage to cardiac pump function (transient or sustained). The heart is not able to carry enough blood to meet the metabolic needs of the tissues.

 Types of ICC:

- Systolic failure - failure contractile function of the left vent 626f510g riculului resulting in ejection fraction decrease.

- Diastolic failure - failure left ventricular relaxation function resulting in ventricular filling pressure increase, reducing the volume of ejection.

- Left ventricular failure - caused by decreased left ventricular ejection.

- Right ventricular failure - caused by right ventricular dysfunction defined by lung or left ventricular failure.

 Systems affected: - cardiovascular, pulmonary.

Heredity: N / I.

Incidence / Prevalence - ICC comes a certain stage in almost all cases of heart disease. During the event, however, will depend on the etiology of the disease. ICC prevalence increases with age. Manifest forms attesting frequently after age 60. For European populations ICC prevalence is 0.4 to 2%.

Vârsta- predominant etiologic depends on the cause.

Dominance of sex- Men> Woman aged 40-75 years; Men = Women at age> 75 years.

 Signs and symptoms

- Early stage: exertional dyspnea; decreased physical capacity; fatigue; asthenia; tachypnea moderate exertion; Rales nesonore based small lungs (especially after exercise);

- Advanced stage: dyspnea, tachypnea at rest; nocturnal cough; Paroxysmal nocturnal dyspnea; orthopnoea; The nocturnal wheeze "wheezing" anamnczci without asthma or respiratory infection (cardiac asthma); anorexia; heaviness in the right costal margin, hepatomegaly; multiple rales in the lungs basis; effusion peaks, often right; swelling in the legs, cold hands; gallop rhythm; diastolic hypertension; increased pressure in the jugular veins (jugular venous distension, hepato-jugular reflux); cardiomegaly.

- Severe impairment: brain disorders; cyanosis; ascites; hypotension; alternating pulse; anasarca; rozata sputum, frothy; Noise II emphasis on pulmonary artery; Chein-Stokes breathing.


- Common: ischemic heart disease, hypertension, rheumatic carditis, valvular heart disease, cardiomyopathy.

Less common causes.

- Infectious agents: viruses, bacteria, fungi.


- Infiltrative diseases: amyloidosis, hemochromatosis, sarcoidosis.


- Toxic: cocaine, heroin, alcohol, amphetamines, doxorubicin, cyclophosphamide, sulfonamides, lead, arsenic, cobalt, phosphorus, ethilenglicolul.


- Nutritional deficiencies: protein, thiamine and selenium.


- Electrolytic: hypocalcemia, hipophosphatemia, hyponatremia, hypokalemia.


- System disease lupus erythematosus, rheumatoid arthritis systemic roza, poliarteriita nodosa, allergic vasculitis, Takayasu pressure, polymyositis, Reiter's syndrome.


- Endocrine and metabolic diseases: diabetes, hyperthyroidism, hypothyroidism, hypoparathyroidism with hypocalcemia, pheochromocytoma, acromegaly.


- Tachyarrhythmias: supraventricular tachyarrhythmias uncontrolled atrial fibrillation tahisistolica.


 Ladder NYHA


Class I - physical activity is not limited. Ordinary physical activity does not cause symptoms.


Class II - moderate limitation of physical activity. Ordinary physical activity causes symptoms of fatigue, palpitation, dyspnea or angina pain.


Class III - marked limitation of physical activity. The patient feels comfortable at rest, moderate physical activity cause the appearance of symptoms mentioned above.


Class IV - no physical strain does not cause discomfort country. Symptoms may be present at rest.


 Risk factors - infections; arrhythmias; insufficient nutrition; beta-blocker medications; calcium channel blockers; nonsteroidal anti-inflammatory; steroids; pulmonary artery embolism; Acute myocardial ischemia, myocardial infarction; thyrotoxicosis / hipotireoza; anemia; kidney failure; pregnancy.

Differential Diagnosis

Nephrotic syndrome is excluded by the absence of kidney disease, edema, asymptomatic proteinuria in history.

Cirrhosis: anamnesis excluded by the absence of liver disease, liver stigmelor exclusion risk factors of liver disease.

 Laboratory investigations

- Blood count,

- Urogram,

- Na +, K + levels,

- Creatinine,

- Urea,

- General protein and serum albumin (in patients with edema).

- Lipids (if you have not been determined last 5 years)

- T4 and TTH * in patients with atrial fibrillation, with signs of thyroid disease in patients aged> 65 years.

- Serum Ca 2+ and Mg 2+ in patients receiving diuretics,

- * Thyroid stimulating hormone.

Disorders that may alter lab results: N / I.

Medicines that may change the results of laboratory: N / I.

 Investigations instrumental

ECG (ischemic ST-T changes, rhythm disorders, signs of pericarditis)

Chest X-ray: baseline - increased heart size in advanced stages - interstitial pulmonary edema, Kerley B lines, perivascular edema, pleural effusion severe changes - alveolar edema, pattern "butterfly" of pulmonary edema.

 Diagnostic Procedures - ECO-cardiograph.

Treatment - ICC general aim of treatment is to reduce existing functional class and maintains the compensation, affecting as little patient quality of life.

 Appropriate medical care

In most cases ensure home. Indications for consultation cardiologist:

- NYHA class III or IV refractory to treatment.

- Rapid progression of symptoms despite medical therapy with high doses.

- Patients with syncope of unknown causes or those who were treated with cardioversion.

- Patients who can not, for some reason, tolerate medication with vasodilators.

- The need for intravenous inotropic remedies.

- Young patients with NYHA class I - II associated with severe LV dysfunction with severe dilated valvular regurgitation LV or marked.

Indications for hospitalization:

- ICC outpatient treatment resistance;

- Present clinical or electrocardiographic signs of acute myocardial ischemia;

- Acute pulmonary edema and respiratory failure;

- Associated pathologic serious;

- Anasarca;

- Marked hypotension or syncope;

- Thromboembolic complications;

- Clinically significant arrhythmias;

- Inadequate social support for safe conduct in ambulatory conditions.

 General measures

- Immediate initiation of treatment;

- Highlighting correctable causes and treatment;

- Elimination of precipitating factors.

 Regime - in advanced states in positions semisezânda bed rest, use strampilor antiembolici, gradual increase in activity (as improving manifestations ICC).

Exercise can relieve dosed functional status in certain clinical situations (except acute myocarditis and acute stage of MI). The program must be consistent with reabilitolog specialist.

 Diet - limiting liquids (not all require this indication), in the presence of edema - fluid restriction up to 2000 ml / day (includes liquids from solid foods).

NACE limitation up to 2g / day.

 Patient education / family

- Explain the nature and causes of circulatory failure symptoms.

- Cases circulatory failure.

- How to recognize the symptoms.

- Limit consumption of salt up to 2000 mg / day and no more than 700 mg a diet.

- Daily monitoring of body mass (consultation in case of accumulation of 800-900g body weight per day or 2.5 kg / week).

- Arguments to follow treatment.

- The importance of following drug treatment and non-medical indications.

- Effects of prescribed drugs, dose and time of administration, adverse effects, signs of overdosing / poisoning, the patient shares in case of omission of a dose.

- The level of physical activity, sexual activity.

- Avoid alcohol.

- Abstaining from smoking.

- Family members will be informed how to behave in case of sudden death.

 Monitoring - monitoring the patient varies depending on clinical circumstances. Initially every two weeks after the patient is stabilized. Tighter control of clinical signs, electrolytes, urea and serum creatinine.

 Possible complications

- Digital poisoning.

- Severe electrolyte disturbances.

- Atrial and ventricular arrhythmias.

- Failure mezenteriale traffic.

- Protein enteropathy.

 Prognosis and evolution

The treatment results usually are good. Long-term prognosis:

Class II - annual mortality - 10.5%

Class III - 10-20%

Class IV - 20-50%.

Cardiovascular system and Cardiovascular diseases

on Fri, 07/03/2015 - 20:06

Cardiovascular system and Cardiovascular diseases

It consists of the heart and blood vessels (arteries and veins).

The heart

It is a muscle that functions as an extremely powerful pump to drive blood through the arteries and suck the blood from the veins come. The size of the fist, weighs about 300 grams and pump 5 liters of blood per minute. The heart represents only 0.4% of total body weight but consumes 10% of the oxygen provided by breathing.


These are the vessels that carry blood from the heart to all organs. The transported blood through the arteries carries oxygen to organs and provides essential nutrients for their proper functioning.


These are the vessels that carry blood from the organs to the heart. The blood transported through the veins is filled with carbon dioxide. It is powered by the heart into the lungs, where it discharges carbon dioxide and replenishes the supply of oxygen.


This is the main artery disease, the cause of many cardiovascular diseases.


Atherosclerosis is characterized by the progressive deposition of cholesterol (atheroma) in the wall of the arteries. The formation of atherosclerotic plaques has three main consequences: decrease in the diameter of the arteries, which close gradually (sclerosis); hardening and lower dilation of the arteries, which eventually contract (spasm); blood clots in the arteries, which become blocked completely (thrombosis).


Atherosclerosis has no characteristic symptoms. Localized pain, shortness of breath, dizziness ... may appear. It is usually found through cardiovascular disease: myocardial infarction, stroke ...

Risk factors for atherosclerosis

Many factors influence the development of atherosclerosis: high cholesterol, high blood pressure, diabetes, smoking, stress, lack of physical activity ....


Preventive treatments are based on stopping smoking, eating a balanced diet and regular physical activity.

High blood pressure

According to the World Health Organization, hypertension is the second factor decreasing the number of healthy years of life just behind the front smoking and alcoholism. It is estimated that 7, 5 million French have high blood pressure.


Blood pressure is the force exerted by the blood flow in the arteries; the pressure is highest when the heart contracts to send blood into the arteries (systole). This is the systolic pressure; Minimum pressure is when the heart relaxes and sucks the blood from the veins came (diastole). Is the diastolic pressure. A measurement of the blood pressure comprises two digits. The first, which is the highest corresponds to the systolic pressure, the lowest corresponds to the diastolic pressure. Normal blood pressure is 120/80 mmHg. There is talk of blood pressure when the pressure readings at or above 140/90 mmHg. Hypertension is a major risk factor for stroke and myocardial infarction. It can also eventually cause kidney and eye damage.

Symptoms of hypertension

In general, blood pressure does not cause symptoms. Headache, especially on waking, dizziness, blurred vision, heart palpitations or nosebleeds can sometimes appear.

Risk factors for hypertension

Hypertension results from a large number of additive causes: age, overweight, diet high in fat and / or salt, physical inactivity, excessive alcohol consumption, smoking, stress ...

Certain drugs can also be the cause of hypertension.

Treatment of hypertension

High blood pressure can not be cured but can be controlled. The treatment is based on two main axes: respect for a healthy lifestyle: decreased salt intake, regular exercise, stopping smoking .

Medication against hypertension. Five major classes of drugs can be used in patients: diuretics, beta blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, alpha-blockers.


The cerebrovascular accident (CVA) is the third cause of death in France, and the second cause of death worldwide. Each year, 130,000 French are affected by stroke. A "stroke plan" was recently set up by the government to fight against this disease.


A stroke is blockage or rupture of a vessel that carries blood to the brain.

There are two types of stroke:

ischemic stroke, or cerebral infarcts, when a blood vessel becomes blocked (cerebral thrombosis) or is clogged by a blood clot formed elsewhere (cerebral embolism);

cerebral hemorrhage, due to a vessel bursting. Consequently, brain cells no longer receive oxygen and nutrients they need. They can be damaged, and some die.

Stroke symptoms

Symptoms depend on the affected area and the extent of the injury, the following symbols are the most common: dizziness, vertigo and loss of balance; numbness or paralysis of a limb, face or any part of the body; sudden difficulty speaking and understanding what is meant; blurred vision; violent sudden onset sore head, nausea, vomiting. Stroke is a medical emergency. In case of a sudden onset of these symptoms, call 15:

- Loss of strength or numbness in the face;

- Loss of strength or numbness in the arm;

- Speech impediment.

In case of combination of these three symptoms with sudden onset of disorders of balance, intense headache, or decreased vision, call 15.

Treatment of stroke

Strokes can cause irreversible brain damage due to oxygen deprivation suffered by the nerve cells. These are renewed only very little, and they die from lack of oxygen leads to functional losses. An emergency surgery is performed to dissolve as soon as possible the clot that is formed. For ischemic stroke, anticoagulant is prescribed. In case of bleeding, the accumulated blood is removed. Thereafter, the diseased area of ​​the vessel is either withdrawn or expanded in order to limit the risk of recurrence. Rehabilitation sessions are conducted to address any cognitive or behavioral sequelae of stroke.

Risk Factors for Stroke

Age is the first stroke risk factor: its incidence doubles every ten years from 55 years.

The main avoidable risk factors are:


excessive alcohol consumption;

the lack of activity (sedentary).

High blood pressure, excess cholesterol (hypercholesterolemia) and diabetes are also risk factors for stroke occurred.

Myocardial infarction

Each year, more than 100,000 French had a myocardial infarction, or heart attack. This is often the first sign of the existence of a cardiovascular disease.


Myocardial infarction is the destruction of part of the heart muscle, the myocardium. It is caused by obstruction of the coronary arteries that bring oxygen-rich blood to the heart: the heart muscle is no longer irrigated oxygen, causing its necrosis or death.

Symptoms of myocardial infarction

The main symptom of myocardial infarction is a strong pain in the chest that occurs suddenly, and can sometimes be felt in the arms, wrists and jaw. Breathlessness, pallor and sweating may also occur.

Treatment of myocardial infarction

Myocardial infarction is a medical emergency: the more time passes, the heart remains long without oxygen, and it may become necrotic. Intervention techniques used depend on the severity of the heart attack, but they all aim to unblock the artery as soon as possible: Angioplasty involves inserting a small inflatable balloon in the artery. Once inflated, it crushes the plaque that closed the artery and increases the diameter of the latter. It is then deflated to restore circulation; the stenting involves placing a mini-spring in the artery to prevent it becomes blocked again; thrombolytic therapy is to destroy the clot that clogs the artery by melting by injection of a drug; the bridge is a surgical procedure that links two arteries to bypass the portion of the damaged artery. Rehabilitation is then performed to remuscler heart.

Risk factors for myocardial infarction

The main risk factors for myocardial infarction are smoking, high cholesterol, stress. Arteritis of the lower limbs. It affects 1% of French before age 50 and mostly men beyond their fifties.


The peripheral arterial obstruction is a leg arteries.


The first symptoms of cardiovascular disease are pain in the calves during walking. At a more advanced stage, the latter appear to rest and occur at night. Finally, when the occlusion becomes acute, the affected leg becomes pale, cold and helpless. A sharp pain is felt. The leg gangrene, and amputation is sometimes necessary.


Acute arteritis (pale, cold leg and impotent) is a medical emergency and must be taken care of quickly: the more time passes, the leg remains non-oxygenated, and it may become gangrenous.

The emergency treatment is to unblock the blocked artery, by angioplasty, stenting or thrombolysis.

In the longer term, regular walking is recommended, as well as smoking cessation.

Arteritis of the risk factors of lower limbs

The main risk factor for peripheral arterial disease is smoking.

Cardiac rehabilitation

What is cardiac rehabilitation

Cardiovascular rehabilitation program is called a set of measures allowing a heart patient to regain autonomy recovering its capabilities through physical exercises and long-term measures. Rehabilitation takes place in Suite Care facilities and specialized rehabilitation in cardiovascular pathology (SSR).

Objectives of cardiac rehabilitation

People with cardiovascular disease have their physical abilities greatly decreased, which may affect their quality of life. The main objective is to find a satisfactory autonomy, or at least improve it. Secondary objectives are to recreate a social link for people at the margins, improve mental function, prevent depression and enabling people to "return to life" after an acute cardiovascular event like a heart attack.

Who is cardiac rehabilitation

These programs are for people with heart disease, but are especially suitable for older people. Some exercises such as resistance training gently, or water aerobics are particularly preferred, but especially allow smooth muscle strengthening and improved battery life.

Yet these programs are fairly often prescribed to the elderly, for several reasons:

The line is thin between cardiovascular disease and the "normal" degradation capacity of the heart, age complicates the diagnosis and orientation of the person

People at the margins, isolated, are not always medically supervised

Some diseases such as senile dementia may seem incompatible, then it is enough most of the time to adapt the program to the person

It is important to see a doctor to get a prescription or a cardiovascular rehabilitation program in case of illness, an adapted physical activity to maintain good physical health.