Atrial fibrillation

Symptoms & causes

Atrial fibrillation (A-fib) is an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart. A-fib increases the risk of stroke, heart failure and other heart-related complications.

 

During atrial fibrillation, the heart's upper chambers (the atria) beat chaotically and irregularly — out of sync with the lower chambers (the ventricles) of the heart. For many people, A-fib may have no symptoms. However, A-fib may cause a fast, pounding heartbeat (palpitations), shortness of breath or weakness.

 

Episodes of atrial fibrillation may come and go, or they may be persistent. Although A-fib itself usually isn't life-threatening, it's a serious medical condition that requires proper treatment to prevent stroke.

 

Treatment for atrial fibrillation may include medications, therapy to reset the heart rhythm and catheter procedures to block faulty heart signals.

 

A person with atrial fibrillation may also have a related heart rhythm problem called atrial flutter. Although atrial flutter is a different arrhythmia, the treatment is quite similar to atrial fibrillation.

 

Symptoms of a fast, fluttering or pounding heartbeat (palpitations)

Chest pain

Dizziness

Fatigue

Lightheadedness

Reduced ability to exercise

Shortness of breath

Weakness

 

Atrial fibrillation may be:

 

Occasional (paroxysmal atrial fibrillation). A-fib symptoms come and go, usually lasting for a few minutes to hours. Sometimes symptoms occur for as long as a week and episodes can happen repeatedly. Symptoms might go away on their own. Some people with occasional A-fib need treatment.

Persistent. With this type of atrial fibrillation, the heart rhythm doesn't go back to normal on its own. If a person has A-fib symptoms, cardioversion or treatment with medications may be used to restore and maintain a normal heart rhythm.

Long-standing persistent. This type of atrial fibrillation is continuous and lasts longer than 12 months.

Permanent. In this type of atrial fibrillation, the irregular heart rhythm can't be restored. Medications are needed to control the heart rate and to prevent blood clots.

When to see a doctor

If you have any signs or symptoms of atrial fibrillation, make an appointment with your doctor.

 

If you have chest pain, seek immediate medical help. Chest pain could mean that you're having a heart attack

Causes

To understand the causes of A-fib, it may be helpful to know how the heart typically beats.

 

The typical heart has four chambers — two upper chambers (atria) and two lower chambers (ventricles). Within the upper right chamber of the heart (right atrium) is a group of cells called the sinus node. The sinus node is the heart's natural pacemaker. It produces the signal that starts each heartbeat.

 

In a regular heart rhythm:

 

The signal travels from the sinus node through the two upper heart chambers (atria).

The signal passes through a pathway between the upper and lower chambers called the atrioventricular (AV) node.

The movement of the signal causes your heart to squeeze (contract), sending blood to your heart and body.

In atrial fibrillation, the signals in the upper chambers of the heart are chaotic. As a result, the upper chambers shake (quiver). The AV node is then bombarded with signals trying to get through to the lower heart chambers (ventricles). This causes a fast and irregular heart rhythm.

 

The heart rate in atrial fibrillation may range from 100 to 175 beats a minute. The normal range for a heart rate is 60 to 100 beats a minute.

 

Causes of atrial fibrillation

Problems with the heart's structure are the most common cause of atrial fibrillation. Possible causes of atrial fibrillation include:

 

Coronary artery disease

Heart attack

Heart defect that you're born with (congenital heart defect)

Heart valve problems

High blood pressure

Lung diseases

Physical stress due to surgery, pneumonia or other illnesses

Previous heart surgery

Problem with the heart's natural pacemaker (sick sinus syndrome)

Sleep apnea

Thyroid disease such as an overactive thyroid (hyperthyroidism) and other metabolic imbalances

Use of stimulants, including certain medications, caffeine, tobacco and alcohol

Viral infections

Some people who have atrial fibrillation have no known heart problems or heart damage.

 

Risk factors

Things that can increase the risk of atrial fibrillation (A-fib) include:

 

Age. The older a person is, the greater the risk of developing atrial fibrillation.

Heart disease. Anyone with heart disease — such as heart valve problems, congenital heart disease, congestive heart failure, coronary artery disease, or a history of heart attack or heart surgery — has an increased risk of atrial fibrillation.

High blood pressure. Having high blood pressure, especially if it's not well controlled with lifestyle changes or medications, can increase the risk of atrial fibrillation.

Thyroid disease. In some people, thyroid problems may trigger heart rhythm problems (arrhythmias), including atrial fibrillation.

Other chronic health conditions. People with certain chronic conditions such as diabetes, metabolic syndrome, chronic kidney disease, lung disease or sleep apnea have an increased risk of atrial fibrillation.

Drinking alcohol. For some people, drinking alcohol can trigger an episode of atrial fibrillation. Binge drinking further increases the risk.

Obesity. People who have obesity are at higher risk of developing atrial fibrillation.

Family history. An increased risk of atrial fibrillation occurs in some families.

Complications

Blood clots are a dangerous complication of atrial fibrillation that can lead to stroke.

 

In atrial fibrillation, the chaotic heart rhythm can cause blood to collect in the heart's upper chambers (atria) and form clots. If a blood clot in the left upper chamber (left atrium) breaks free from the heart area, it can travel to the brain and cause a stroke.

 

The risk of stroke from atrial fibrillation increases as you grow older. Other health conditions also may increase your risk of a stroke due to A-fib, including:

 

High blood pressure

Diabetes

Heart failure

Some valvular heart disease

Blood thinners are commonly prescribed to prevent blood clots and strokes in people with atrial fibrillation.

 

Prevention

Healthy lifestyle choices can reduce the risk of heart disease and may prevent atrial fibrillation. Here are some basic heart-healthy tips:

 

Eat a nutritious diet

Get regular exercise and maintain a healthy weight

Don't smoke

Avoid or limit alcohol and caffeine

Manage stress, as intense stress and anger can cause heart rhythm problems

 

Jan Ricks Jennings, MHA, LFACHE

Senior Consultant

Senior Management Resources, LLC

Jan.Jennings@EagleTalons.net

JanJenningsBlog.Blogspot.net

412.913.0636 Cell

724.733.0509 Office

May 30, 2022

                                                                                   

Shellfish Allergy

 

 

Overview

Shellfish allergy is an abnormal response by the body's immune system to proteins in certain marine animals. Marine animals in the shellfish category include crustaceans and mollusks, such as shrimp, crab, lobster, squid, oysters, scallops, and others.

 

Some people with shellfish allergy react to all shellfish; others react to only certain kinds. Reactions range from mild symptoms — such as hives or a stuffy nose — to severe and even life-threatening.

 

If you think you have a shellfish allergy, talk to your doctor. Tests can help confirm the allergy so you can take steps to avoid future reactions.

Symptoms

Shellfish allergy symptoms develop within minutes to an hour of eating shellfish. They may include:

 

Hives, itching or eczema (atopic dermatitis)

Swelling of the lips, face, tongue and throat, or other parts of the body

Wheezing, nasal congestion or trouble breathing

Abdominal pain, diarrhea, nausea, or vomiting

Dizziness, lightheadedness, or fainting

Allergies can cause a severe, potentially life-threatening reaction known as anaphylaxis. An anaphylactic reaction to shellfish or anything else is a medical emergency that requires treatment with an epinephrine (adrenaline) injection and a trip to the emergency room.

 

Signs and symptoms of anaphylaxis include:

 

A swollen throat or a lump in your throat (airway constriction) that makes it difficult for you to breathe

Shock, with a severe drop in your blood pressure

Dizziness, lightheadedness, or loss of consciousness

 

When to see a doctor

Seek emergency treatment if you develop signs or symptoms of anaphylaxis.

 

See a doctor or allergy specialist if you have food allergy symptoms shortly after eating.

Causes

All food allergies are caused by an immune system overreaction. In shellfish allergy, your immune system mistakenly identifies a certain protein in shellfish as harmful, triggering the production of antibodies to the shellfish protein (allergen). The next time you come in contact with the allergen, your immune system releases histamine and other chemicals that cause allergy symptoms.

 

Types of shellfish

There are several types of shellfish, each containing different proteins:

 

Crustaceans include crabs, lobster, crayfish, shrimp, and prawn.

Mollusks include squid, snails, clams, oysters, and scallops.

Some people are allergic to only one type of shellfish but can eat others. Other people with shellfish allergy must avoid all shellfish.

 

Risk factors

You are at increased risk of developing a shellfish allergy if allergies of any type are common in your family.

 

Though people of any age can develop a shellfish allergy, it is more common in adults. Among adults, shellfish allergy is more common in women. Among children, shellfish allergy is more common in boys.

 

Complications

In severe cases, shellfish allergy can lead to anaphylaxis.   When you have shellfish allergy, you may be at increased risk of anaphylaxis if:

 

 

You have asthma

You have allergic reactions to exceedingly lesser amounts of shellfish (extreme sensitivity)

You have a history of food-induced anaphylaxis

Anaphylaxis can be treated with an emergency injection of epinephrine (adrenaline). If you are at risk of having a severe allergic reaction to shellfish, you always should carry injectable epinephrine (EpiPen, Adrenaclick, others).

 

Prevention

If you have a shellfish allergy, the only way to avoid an allergic reaction is to avoid all shellfish and products that contain shellfish. Even trace amounts of shellfish can cause a severe reaction in some people.

 

Avoiding shellfish

Be cautious when dining out. When dining at restaurants, always check to make sure that the pan, oil, or utensils used for shellfish are not also used to prepare other foods, creating cross-contamination. It might be necessary to avoid eating at seafood restaurants, where there is an elevated risk of cross-contamination.

Read labels. Cross-contamination can occur in stores where other food is processed or displayed near shellfish and during manufacturing. Read food labels carefully.

 

Shellfish is rarely a hidden ingredient, but it may be in fish stock or seafood flavoring. Companies are required to label any product that contains shellfish or other foods that often cause allergic reactions, but the regulations do not apply to mollusks, such as clams, oysters, and scallops.

 

Keep your distance. You may need to completely avoid places where shellfish are prepared or processed. Some people react after touching shellfish or inhaling steam from cooking shellfish.

As discussed above, you have a shellfish allergy, talk with your doctor about carrying emergency epinephrine. Consider wearing a medical alert bracelet or necklace that lets others know you have a food allergy.

 

One thing you do not need to worry about is if you will also be allergic to iodine or radiocontrast dye that's used in some imaging tests. Even though shellfish contain lesser amounts of iodine, shellfish allergy is unrelated to the reactions some people have to radiocontrast material or iodine.

 

 

Jan Ricks Jennings, MHA, LFACHE

Senior Consultant

Senior Management Resources, LLC

Jan.Jennings@EagleTalons.net

JanJenningsBlog.Blogspot.com

 

412.913.0636 Cell

724.733.0509 Office

 

April 22, 2022

 

 

 

                                                                            

Naegleria infection

 

 

Overview

Naegleria (nay-GLEER-e-uh) infection is a rare and almost always fatal brain infection. Naegleria infection is caused by an amoeba commonly found in warm, freshwater lakes, rivers and hot springs. Exposure to the amoeba usually occurs during swimming or other water sports.

 

The amoeba — called Naegleria fowleri — travels up the nose to the brain, where it causes severe brain damage. Most people who have naegleria infection die within a week of showing symptoms.

 

Millions of people are exposed to the amoeba that causes naegleria infection each year, but only a handful of them ever get sick from it. Health officials don't know why some people develop naegleria infection while others do not.

Symptoms

Naegleria infection causes a disease called primary amebic meningoencephalitis (muh-ning-go-un-sef-uh-LIE-tis) — also known as PAM. PAM is a brain infection that leads to brain swelling and the destruction of brain tissue.

 

The symptoms of naegleria infection generally begin within two to 15 days of exposure to the amoeba. Initial signs and symptoms often include:

 

Fever

Sudden, severe headache

Nausea and vomiting

Nasal congestion or discharge

Changes in smell or taste

As the disease worsens, signs and symptoms may also include:

 

Stiff neck

Sensitivity to light

Confusion

Loss of balance

Sleepiness

Seizures

Hallucinations

The disease can progress rapidly and typically leads to death within about five days of the start of symptoms.

                                                             

When to see a doctor

Seek immediate medical attention if you develop a sudden onset of fever, headache, stiff neck and vomiting, particularly if you have recently been in warm, fresh water.

Cause

Naegleria infection is caused by the Naegleria fowleri amoeba, which is most often found in bodies of warm, fresh water around the world, especially during the summer months. The amoeba is also sometimes found in soil. The amoeba enters your body through your nose via contaminated water, mud or dust, and travels to your brain through the nerves that transmit your sense of smell.

 

As states in the overview only a tiny percentage of the millions of people who are exposed to Naegleria fowleri ever get sick from it. Between 2010 and 2019, 34 infections were reported in the United States.  Why some people become infected after exposure and others don't isn't known.

 

The amoeba doesn't spread from person to person. You also can't be infected by drinking contaminated water. Salt water, such as ocean and sea water, and properly cleaned and disinfected swimming pools don't contain the naegleria amoeba.

                                                                

Risk factors

Millions of people are exposed to the amoeba that causes naegleria infection each year, but only a few people get sick from it.

 

Some factors that might increase your risk of naegleria infection include:

 

Freshwater swimming. Most people who become ill have been swimming in a freshwater lake within the previous two weeks.

Heat waves. The amoeba thrives in warm or hot water. Infections are more likely to occur in the summer months and in southern states but can also occur in more northern states.

Age. Children and young adults are the most likely age groups to be affected, possibly because they are likely to stay in the water longer and are more active in the water.

Nasal cleansing or irrigation. Very rarely, infections have occurred in people who used contaminated tap water to irrigate their sinuses or to cleanse their nose during religious practices. To ensure that your water is safe for sinus rinsing or ritual cleansing, don't use water straight from the faucet. Use boiled or distilled water instead.

Prevention

The Centers for Disease Control and Prevention (CDC) suggests that the following measures may reduce your risk of naegleria infection:

 

Don't swim in or jump into warm freshwater lakes and rivers.

Hold your nose shut or use nose clips when jumping or diving into warm bodies of fresh water.

Avoid disturbing the sediment while swimming in shallow, warm fresh waters.

                                                            

Jan Ricks Jennings, MHA, LFACHE

Senior Consultant

Senior Management Resources, LLC

Jan.Jennings@EagleTalons.net

JanJenningsBlog.Blogspot.com

412.913.0636 Cell

724.733.0509 Office

May 23, 2022

 

 

                                                                        Hypoglycemia

 

 

Overview

Hypoglycemia is a condition in which your blood sugar (glucose) level is lower than the standard range. Glucose is your body's main energy source.

 

Hypoglycemia is often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don't have diabetes.

 

Hypoglycemia needs immediate treatment. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia. But your numbers might be different. Ask your health care provider.

 

Treatment involves quickly getting your blood sugar back to within the standard range either with a high-sugar food or drink or with medication. Long-term treatment requires identifying and treating the cause of hypoglycemia.

Symptoms

If blood sugar levels become too low, hypoglycemia signs and symptoms can include:

 

Looking pale

Shakiness

Sweating

Headache

Hunger or nausea

An irregular or fast heartbeat

Fatigue

Irritability or anxiety

Difficulty concentrating

Dizziness or lightheadedness

Tingling or numbness of the lips, tongue or cheek

As hypoglycemia worsens, signs and symptoms can include:

 

Confusion, unusual behavior or both, such as the inability to complete routine tasks

Loss of coordination

Slurred speech

Blurry vision or tunnel vision

Nightmares, if asleep

Severe hypoglycemia may cause:

 

Unresponsiveness (loss of consciousness)

Seizures

 

When to see a doctor

Seek medical help immediately if:

 

You have what might be hypoglycemia symptoms and you don't have diabetes

You have diabetes and hypoglycemia isn't responding to treatment, such as drinking juice or regular (not diet) soft drinks, eating candy, or taking glucose tablets

Seek emergency help for someone with diabetes or a history of hypoglycemia who has symptoms of severe hypoglycemia or loses consciousness.

 

Causes

Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes.

 

Blood sugar regulation

When you eat, your body breaks down foods into glucose. Glucose, the main energy source for your body, enters the cells with the help of insulin — a hormone produced by your pancreas. Insulin allows the glucose to enter the cells and provide the fuel your cells need. Extra glucose is stored in your liver and muscles in the form of glycogen.

 

When you haven't eaten for several hours and your blood sugar level drops, you will stop producing insulin. Another hormone from your pancreas called glucagon signals your liver to break down the stored glycogen and release glucose into your bloodstream. This keeps your blood sugar within a standard range until you eat again.

 

Your body also has the ability to make glucose. This process occurs mainly in your liver, but also in your kidneys. With prolonged fasting, the body can break down fat stores and use products of fat breakdown as an alternative fuel.

 

Possible causes, with diabetes

If you have diabetes, you might not make insulin (type 1 diabetes) or you might be less responsive to it (type 2 diabetes). As a result, glucose builds up in the bloodstream and can reach dangerously high levels. To correct this problem, you might take insulin or other medications to lower blood sugar levels.

 

But too much insulin or other diabetes medications may cause your blood sugar level to drop too much, causing hypoglycemia. Hypoglycemia can also occur if you eat less than usual after taking your regular dose of diabetes medication, or if you exercise more than you typically do.

 

Possible causes, without diabetes

Hypoglycemia in people without diabetes is much less common. Causes can include:

 

Medications. Taking someone else's oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria.

Excessive alcohol drinking. Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia.

Some critical illnesses. Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia. Kidney disorders also can keep your body from properly excreting medications. This can affect glucose levels due to a buildup of medications that lower blood sugar levels.

Long-term starvation. Hypoglycemia can occur with malnutrition and starvation when you don't get enough food, and the glycogen stores your body needs to create glucose are used up. An eating disorder called anorexia nervosa is one example of a condition that can cause hypoglycemia and result in long-term starvation.

Insulin overproduction. A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. Other tumors also can result in too much production of insulin-like substances. Unusual cells of the pancreas that produce insulin can result in excessive insulin release, causing hypoglycemia.

Hormone deficiencies. Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism. Children can have hypoglycemia if they have too little growth hormone.

Hypoglycemia after meals

Hypoglycemia usually occurs when you haven't eaten, but not always. Sometimes hypoglycemia symptoms occur after certain meals, but exactly why this happens is uncertain.

 

This type of hypoglycemia, called reactive hypoglycemia or postprandial hypoglycemia, can occur in people who have had surgeries that interfere with the usual function of the stomach. The surgery most commonly associated with this is stomach bypass surgery, but it can also occur in people who have had other surgeries.

 

Complications

Untreated hypoglycemia can lead to:

 

Seizure

Coma

Death

Hypoglycemia can also cause:

 

Dizziness and weakness

Falls

Injuries

Motor vehicle accidents

Greater risk of dementia in older adults

Hypoglycemia unawareness

Over time, repeated episodes of hypoglycemia can lead to hypoglycemia unawareness. The body and brain no longer produce signs and symptoms that warn of a low blood sugar, such as shakiness or irregular heartbeats (palpitations). When this happens, the risk of severe, life-threatening hypoglycemia increases.

 

If you have diabetes, recurring episodes of hypoglycemia and hypoglycemia unawareness, your health care provider might modify your treatment, raise your blood sugar level goals and recommend blood glucose awareness training.

 

A continuous glucose monitor (CGM) is an option for some people with hypoglycemia unawareness. The device can alert you when your blood sugar is too low.

 

Undertreated diabetes

If you have diabetes, episodes of low blood sugar are uncomfortable and can be frightening. Fear of hypoglycemia can cause you to take less insulin to ensure that your blood sugar level doesn't go too low. This can lead to uncontrolled diabetes. Talk to your health care provider about your fear, and don't change your diabetes medication dose without discussing changes with your health care provider.

 

Prevention

If you have diabetes

Continuous glucose monitor and insulin pump

Follow the diabetes management plan you and your health care provider have developed. If you're taking new medications, changing your eating or medication schedules, or adding new exercise, talk to your health care provider about how these changes might affect your diabetes management and your risk of low blood sugar.

 

Learn the signs and symptoms you experience with low blood sugar. This can help you identify and treat hypoglycemia before it gets too low. Frequently checking your blood sugar level lets you know when your blood sugar is getting low.

 

A continuous glucose monitor (CGM) is a good option for some people. A CGM has a tiny wire that's inserted under the skin that can send blood glucose readings to a receiver. If blood sugar levels are dropping too low, some CGM models will alert you with an alarm.

 

Some insulin pumps are now integrated with CGMs and can shut off insulin delivery when blood sugar levels are dropping too quickly to help prevent hypoglycemia.

 

Be sure to always have a fast-acting carbohydrate with you, such as juice, hard candy or glucose tablets so that you can treat a falling blood sugar level before it dips dangerously low.

 

If you don't have diabetes

For recurring episodes of hypoglycemia, eating frequent small meals throughout the day is a stopgap measure to help prevent blood sugar levels from getting too low. However, this approach isn't advised as a long-term strategy. Work with your health care provider to identify and treat the cause of hypoglycemia.

 

Jan Ricks Jennings, MHA, LFACHE

Senior Consultant

Senior Management Resources, LLC

 

Jan.Jennings@EagleTalons.net

JanJenningsBlog.Blogspot.com

412.913.0636 Cell

 

May 21, 2022