Myocardial bridging where portion of coronary is buried in myocardium, causes narrowing of artery when heart muscle contracts during systoly leading to decreased blood flow and pain. Usually benign with mild symptoms. If severe significant symptoms are present deroofing of myocardial bridge segment or bypass grafting is required.
Precautions
Some anti-depressant drugs should be used cautiously in the elderly as they give rise to dizziness, constipation, decrease of blood pressure in the erect posture.
Persons requiring to be mentally alert (eg. those operating machinery or driving) should also be careful as some anti-depressants are sedative.
Treatment
Anti-depressant drugs are very effective and can bring about improvement in a large number of cases. The choice of the anti-depressant drug used depend on the age of the patient, presence of associated symptoms (like anxiety or excitement), need for sedatives and the side effects which are to be avoided. These drugs require a minimum of two to three weeks to start acting, and good recovery in most cases occurs within four to eight weeks. The treatment should be continued for eight to twelve months at least.
Stress ECG Test is useful to detect any evidence of decreased myocardial blood flow when patient symptoms are not clear cut and when ECG and Echo are not suggestive of coronary artery disease. It is useful to assess severity and prognosis of coronary artery disease. Also useful in advising fitness and workload for patients during rehabilitation period.
Left ventricular hypertrophy is increased myocardial wall thickness due to increased load on the heart muscle due to high BP or left ventricular outflow obstruction. Increased muscle mass with fibrosis and inadequate myocardial capillary growth results in imbalance between myocardial blood supply and demand which may present like angina, arrhythmia and diastolic dysfunction which may cause abnormal filling pressures and failure in long term cases.
September 11th 2009 03:59
This indicates usually serious birth defects of the heart, which are associated with low birth weight, and delayed milestones, failure to thrive. Such babies are prone for higher incidences of early mortality rate. This is usually due to mixing up of oxygenated blood with deoxygenated blood. ECG, X-Ray and echo color Doppler evaluation will reveal the diagnosis. It is also helpful in deciding whether surgical treatment is possible or not, and whether surgical treatment is totally or partially corrective or palliative procedure.