'cardiac rehab routines'

TMT is the abbreviation for Treadmill Test. The TMT Testing takes into account, the measurement of the blood circulation inside the body (blood pressure) when a patient walks/runs on a treadmill. TMT Testing helps to determine the impact which a physical stress can have on your heart. The test is conducted to find out how efficiently your heart responds when you’re made to exercise in a cloistered environment. The test is performed on OPD basis and requires no hospitalization. Why TMT? A TMT is performed to ascertain the following conditions. • To identify a congenital heart problem like Coronary Artery Disease (CAD) wherein blood vessels/arteries get clogged, diseased or damaged • To determine the functioning of your heart post a heart-attack or angioplasty • To detect repressed heart conditions like shallow breathing, dizziness, chest discomfort and abrupt bodily weaknesses • To monitor the efficacy of medications applied to cure diseases such as angina and ischemia • To discern any abnormal heartbeat rate because of exertion caused by exercise Who Should Undergo? A treadmill stress test is helpful for patients who: • Are suspected of having a cardiovascular issue due to the presence of some symptoms • Have a family history of chronic heart diseases • Chronic or long-time smokers • Are taking heart medications • Have an existing heart condition • Have hypertension, high cholesterol problems, and diabetes What it includes? The cardiac stress test involves several elements, which can help reveal a blockage in several ways: • Electrocardiogram (ECG): These same effects alter not only the heart rate but the heart rhythm as well. With CAD, the changes are characteristic and may be identified with an ECG. • Blood oxygen level monitoring: When the blood flow is obstructed (a condition known as ischemia), the amount of oxygen delivered to the heart and carried from the lungs is decreased. • Pulse and blood pressure monitoring: When the blood flow is partially obstructed by plaque, the heart has to work harder to pump blood through the narrowed vessels. What are the Risks? • an allergic reaction to the dye, in a nuclear stress test • abnormal heart rhythms, but these usually end when the test does • Unstable angina not yet stabilized with medication • flushing or chest pain

An arrhythmia describes an irregular heartbeat – the heart may beat too fast, too slowly, too early, or irregularly. Arrhythmias occur when the electrical signals to the heart that coordinate heartbeats are not working properly. For instance, some people experience irregular heartbeats, which may feel like a racing heart or fluttering. Many heart arrhythmias are harmless; however, if they are particularly abnormal, or result from a weak or damaged heart, arrhythmias can cause serious and even potentially fatal symptoms. Arrhythmias are broken down into: • Slow heartbeat: bradycardia. • Fast heartbeat: tachycardia. • Irregular heartbeat: flutter or fibrillation. • Early heartbeat: premature contraction. What are the causes of arrhythmia? Any interruption to the electrical impulses that cause the heart to contract can result in arrhythmia. For a person with a healthy heart, they should have a heart rate of between 60-100 beats per minute when resting. The more fit a person is, the lower their resting heart rate. Olympic athletes, for example, will usually have a resting heart rate of under 60 beats per minute because their hearts are very efficient. A number of factors can cause the heart to work incorrectly, they include: • alcohol abuse • diabetes • drug abuse • excessive coffee consumption • heart disease like congestive heart failure • hypertension (high blood pressure) What are symptoms of arrhythmia? Some patients have no symptoms, but a doctor might detect an arrhythmia during a routine examination or on an EKG. Symptoms are depend on the type of arrhythmia. Some of them common are; • dizziness • chest pain • sudden weakness • shortness of breath • diaphoresis, or sweating How are arrhythmias diagnosed? Tests used to diagnose an arrhythmia or determine its cause include: • Electrocardiogram • Holter monitor • Event monitor • Stress test • Echocardiogram • Cardiac catheterization What are the types of arrhythmia? There are several types of arrhythmia: • Atrial fibrillation: This is irregular beating of the atrial chambers – nearly always too fast. Atrial fibrillation is common and mainly affects older patients. Instead of producing a single, strong contraction, the chamber fibrillates (quivers). • Atrial flutter: While fibrillation consists of many random and different quivers in the atrium, atrial flutter is usually from one area in the atrium that is not conducting properly, so the abnormal heart conduction has a consistent pattern. Neither are ideal for pumping blood through the heart. • Supraventricular tachycardia (SVT): A regular, abnormally rapid heartbeat. The patient experiences a burst of accelerated heartbeats that can last from a few seconds to a few hours. Typically, a patient with SVT will have a heart rate of 160-200 beats per minute. Atrial fibrillation and flutter are classified under SVTs. • Ventricular tachycardia: Abnormal electrical impulses that start in the ventricles and cause an abnormally fast heartbeat. This often happens if the heart has a scar from a previous heart attack. Usually, the ventricle will contract more than 200 times a minute.

A pacemaker insertion is the implantation of a small electronic device that is usually placed in the chest (just below the collarbone) to help regulate slow electrical problems with the heart. A pacemaker may be recommended to ensure that the heartbeat does not slow to a dangerously low rate. The pacemaker sends electrical pulses to your heart to keep it beating regularly and not too slowly. Having a pacemaker can significantly improve your quality of life if you have problems with a slow heart rate. The device can be lifesaving for some people. Types of pacemakers - Your doctor will decide what type of pacemaker you need based on your heart condition. Your doctor also determines the minimum rate (lowest heart rate) to set your pacemaker. • Leadless Pacemaker – Self-contained device without connecting leads (wires) and generator • Biventricular Pacemaker – also called cardiac resynchronization therapy (CRT) Why do I need a pacemaker? The heart is essentially a pump made of muscle, which is controlled by electrical signals. These signals can become disrupted for several reasons, which can lead to a number of potentially dangerous heart conditions, such as: • an abnormally slow heartbeat (bradycardia) • an abnormally fast heartbeat (tachycardia) • heart block (where your heart beats irregularly because the electrical signals that control your heartbeat aren’t transmitted properly) • cardiac arrest (when a problem with the heart’s electrical signals cause the heart to stop beating altogether) How is a pacemaker fitted? Having a pacemaker implanted is a relatively straightforward process. • It’s usually carried out under local anaesthetic, which means you’ll be awake during the procedure. • The generator is usually placed under the skin near the collarbone on the left side of the chest. The generator is attached to a wire that’s guided through a blood vessel to the heart. • The procedure usually takes about an hour, and most people are able to leave hospital on the same day or a day after surgery. What are the risks of the procedure? Possible risks of pacemaker include, but are not limited to, the following: • Bleeding from the incision or catheter insertion site • Damage to the vessel at the catheter insertion site • Infection of the incision or catheter site • Pneumothorax. If the nearby lung is inadvertently punctured during the procedure, leaking air becomes trapped in the pleural space (outside the lung but within the chest wall); this can cause breathing difficulties and in extreme cases may cause the lung to collapse.

An atrial septal defect (ASD) is an opening or hole in the wall that separates the two upper chambers of the heart. This wall is called the atrial septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side. This causes extra work for the right side of the heart, since more blood than necessary is flowing through the right ventricle to the lungs. If the ASD is small enough, it can be closed with a special device. The procedure is done in the heart catheterization lab. What causes it? Every child is born with an opening between the upper heart chambers. It’s a normal fetal opening that allows blood to detour away from the lungs before birth. After birth, the opening is no longer needed and usually closes or becomes very small within several weeks or months. Sometimes the opening is larger than normal and doesn’t close after birth. In most children the cause isn’t known. Some children can have other heart defects along with ASD. How does it affect the heart? Normally, the left side of the heart only pumps blood to the body, and the right side of the heart only pumps blood to the lungs. In a child with ASD, blood can travel across the hole from the left upper heart chamber (left atrium) to the right upper chamber (right atrium) and out into the lung arteries. If the ASD is large, the extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lung arteries can become gradually damaged. What are the symptoms? Many babies born with atrial septal defects have no signs or symptoms. Signs or symptoms can begin in adulthood. Atrial septal defect signs and symptoms can include: • Shortness of breath, especially when exercising • Fatigue • Swelling of legs, feet or abdomen • Heart palpitations or skipped beats • Stroke • Heart murmur, a whooshing sound that can be heard through a stethoscope Can the ASD be repaired? If the opening is small, it doesn’t make the heart and lungs work harder. Surgery and other treatments may not be needed. Small ASDs that are discovered in infants often close or narrow on their own. There isn’t any medicine that will make the ASD get smaller or close any faster than it might do naturally. If the ASD is large, it can be closed with open-heart surgery, or by cardiac catheterization using a device inserted into the opening to plug it. Sometimes, if the ASD is an unusual position within the heart, or if there are other heart defects such as abnormal connections of the veins bringing blood from the lungs back to the heart (pulmonary veins), the ASD can’t be closed with the catheter technique. Then surgery is needed. Procedure - The non-surgical closure of atrial septal defects (ASD) involves the following steps: • A tiny cut is made in the groin area. • A thin tube (catheter) is inserted into a blood vessel and guided to the heart. • An ASD closure device is attached to the catheter and advanced to the heart and through the defect, under the guidance of X-ray and intra-cardiac echocardiogram. • The closure device is then placed across the ASD opening and the defect is closed. Eventually, heart tissue grows around the implant and becomes part of the heart tissue.