The Complete Herbal Guide: A Natural Approach to Healing the Body - Heal Your Body Naturally and Maintain Optimal Health Using Alternative Medicine, Herbals, Vitamins, Fruits and Vegetables (42 page)

The pain or discomfort:


        
Often occurs at rest, while sleeping at night, or with little physical exertion


        
Is unexpected


        
Is more severe and lasts longer (as long as 30 minutes) than episodes of stable angina


        
Is usually not relieved with rest or angina medicine


        
May get continuously worse


        
May signal that a heart attack will happen soon

The pain or discomfort:


        
Usually occurs at rest and during the night or early morning hours


        
Tends to be severe


        
Is relieved by angina medicine

Diagnosis

To find out if you have angina, your doctor will:


        
Do a physical exam


        
Ask about your symptoms


        
Ask about your risk factors and your family history of coronary artery disease (CAD) or other heart disease

Sometimes, your doctor can diagnose angina by noting your symptoms and how they occur. Your doctor may order one or more tests to help make a diagnosis of angina. The tests your doctor may order include:


        
EKG
(electrocardiogram).
This test measures the rate and regularity of your heartbeat. Some people with angina have a normal EKG.


        
Stress Test
. Some heart problems are easier to diagnose when your heart is working harder and beating faster than when it's at rest. During stress testing, you exercise (or are given medicine if you are unable to exercise) to make your heart work harder and beat faster while heart tests are performed. During exercise stress testing, your blood pressure and EKG readings are monitored while you walk or run on a treadmill or pedal a bicycle.


        
Other heart tests, such as nuclear heart scanning or echocardiography, also can be done at the same time. These would be ordered if your doctor needs more information than the exercise stress test can provide about how well your heart is working.


        
If you are unable to exercise, a medicine can be injected through an IV into your bloodstream to make your heart work harder and beat faster, as if you are exercising on a treadmill or bicycle. Nuclear
heart scanning or echocardiography
is then usually done.


        
During nuclear heart scanning, radioactive tracer is injected into your bloodstream, and a special camera shows the flow of blood through your heart and arteries. Echocardiography uses sound waves to show blood flow through the chambers and valves of your heart and to show the strength of your heart muscle.


        
Your doctor also may order two newer tests along with stress testing if more information is needed about how well your heart works. These new tests are
magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning of the heart
. MRI shows detailed images of the structures and beating of your heart, which may help your doctor better assess if parts of your heart are weak or damaged. PET scanning shows the level of chemical activity in different areas of your heart. This can help your doctor determine if enough blood is flowing to the areas of your heart. A PET scan can show decreased blood flow caused by disease or damaged muscles that may not be detected by other scanning methods.


        
Chest x ray:
A chest x ray takes a picture of the organs and structures inside your chest. These include your heart, lungs, and blood vessels.


        
Nuclear heart scans
: This test provides your doctor with moving pictures of the blood passing through your heart's chambers and arteries and shows the level of blood flood to the heart muscle. A small amount of a radioactive tracer is injected into your bloodstream through a vein, usually in your arm. A special camera is placed in front of your chest to show where the tracer lights up in healthy heart muscle and where it does not light up (in heart muscle that has been damaged or has a blocked artery).


        
There are different types of nuclear heart scans. Most scans have two phases—taking pictures of the heart at rest and while it is beating faster (called a stress test), although sometimes only a rest scan is done. Many heart problems show up more clearly when your heart is stressed than when it is at rest. By comparing the nuclear heart scan of your heart at rest to your heart at "stress," your doctor can determine if your heart is functioning normally or not.


        
Echocardiogram
: This test uses sound waves to create a moving picture of your heart. Echocardiogram provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow.


        
There are several different types of echocardiograms, including a stress echocardiogram. During this test, an echocardiogram is done both before and after your heart is stressed either by having you exercise or by injecting a medicine into your bloodstream that makes your heart beat faster and work harder. A stress echocardiogram is usually done to find out if you have decreased blood flow to your heart (
coronary artery disease
).


        
Cardiac catheterization
: A thin flexible tube (catheter) is passed through an artery in the groin (upper leg) or arm to reach the coronary arteries. Your doctor can determine pressure and blood flow in the heart's chambers, collect blood samples from the heart, and examine the arteries of the heart by X ray.


        
Coronary angiography:
This test is done during cardiac catheterization. A dye that can be seen by x ray is injected through the catheter into the coronary arteries. Your doctor can see the flow of blood through your heart and the location of blockages.

Treatment


        
Medicine


        
Cardiac rehabilitation

Lifestyle changes (Ways to Improve Your Condition):


        
Take rest breaks, if angina comes on with exertion.


        
Keep away from large meals and rich foods that leave you feeling stuffed, if angina comes on after a heavy meal.


        
Keep away from situations that make you upset or stressed, if angina comes on with stress. Learn techniques to handle stress that cannot be avoided.


        
Eat a healthy diet to prevent or reduce
high blood pressure
,
high blood cholesterol
, and
obesity


        
Stop smoking


        
Be physically active, as directed by your doctor


        
Lose weight, if you are
overweight or obese
.

Reasons for treatment:


        
Reduce the frequency and severity of symptoms


        
Prevent or lower the risk of heart attack and death

* * * * *

Constipation is when you are having difficulty passing your stools. If your stools are soft and pass through your intestines with no problem, then you are not constipated.

A person constipated has two or fewer bowel movements each week.  You are constipated if you do not take laxatives and have 2 or more of the following problems at least 25 percent of the time:


        
Straining


        
Feeling that you do not completely empty your bowels


        
Hard or pellet like stools

Symptoms


        
Cramping


        
Pain in the rectum caused by the strain of trying to pass hard, dry stools


        
Bloating


        
Nausea


        
Bright red blood on the stool


        
Red blood on the toilet tissue, caused by bleeding - a slight tearing of the anus as the stool is pushed through

This should stop when the constipation is controlled.

Types of constipation

There is slow transit constipation and outlet delay constipation.

Causes of Slow transit constipation


        
Travel or other change in daily routine


        
Lack of exercise


        
Immobility caused by illness or aging.


        
Pregnancy

Outlet delay constipation

Constipation is sometimes caused by poor muscle tone in the pelvic floor.  This is called outlet delay constipation. Too much straining, the requirement for unnecessary pressure on the vaginal wall, or feelings of unfinished emptying can be a symptom of this type of constipation.


        
Causes of outlet delay constipation


        
Scarring (adhesions)


        
Injury caused by physical abuse


        
Injury caused by sexual abuse.


        
Nervous system diseases


        
Stroke


        
Spinal cord injury


        
Pain from hemorrhoids


        
Pain from anal fissures


        
Delaying bowel movements because of convenience issues


        
Bowel movements causing pain

Lifestyle

People 65 and older usually get constipation more than any other age group. This is because people in this age group are more likely to have unhealthy dietary habits and increased medication use. Older adults also do not exercise as often and have less muscular activity of the intestinal tract, which increases the amount of time it takes for stool to move through the intestines. Medical problems, such as arthritis, may make sitting on the toilet uncomfortable or painful.

Constipation is also more common in rural areas, cold climates, and among the poor. Psychological problems, such as severe anxiety, depression, eating disorders, can cause constipation. Women report problems with constipation more frequently than men do.

If a stool becomes lodged in the rectum (impacted), mucus and fluid may leak out around the stool, sometimes leading to leakage of fecal material (fecal incontinence). You may experience this as constipation alternating with episodes of diarrhea.

Treatments


        
Easy exercise, nothing too strenuous


        
Drink enough of fluids, especially water

Diet

Eat a healthy diet:


        
Fruits


        
Vegetables


        
More fiber