Fetal Echocardiography: Purpose, Procedure and Risks

Fetal Echocardiography: Purpose, Procedure and Risks
Fetal Echocardiography is a non-invasive that uses sound waves to assess the condition of the heart of an unborn and developing baby. The test is very similar to an ultrasound and helps in better evaluation of the structure and functioning of the heart of an unborn child. The test is usually performed on women who are in their second trimester (in 18 to 24 weeks) of pregnancy. However, it can also be done during the later stages of pregnancy, if the need arises. Fetal echocardiography is also used to check for any heart defects in the child before birth.  In fetal echocardiography (echo) the sound waves echo back from the structure of the baby’s heart, which are then analysed by the help of a machine that converts these sound waves into images of the heart’s internal structure. This helps in a detailed analysis of the baby’s heart, its health, functioning, blood flow and also checks for any deformities or abnormalities in the heartbeat or rhythm. The test is safe and painless and is performed to minimize risks of heart defects at birth. Purpose of Fetal Echocardiography Fetal echocardiography is not compulsory and is recommended to pregnant women in whom a basic ultrasound might not have been able to deliver conclusive results of the child’s heart. It can also be recommended in cases, where an abnormality or an abnormal heartbeat is detected in the foetus.  Cases where fetal echocardiography is highly recommended include, but are not limited to: Women who have a family history of heart diseasesWomen whose first child has a heart conditionWomen who consume alcohol or drugs during pregnancyWomen who have taken or have been exposed to medications and drugs that can cause heart abnormalitiesWomen who have medical health conditions involving diabetes of type 1, rubella, etc.Women who have certain infection during pregnancyWomen have abnormal test results Women who conceive using assisted reproductive technologyFoetus diagnosed with a genetic problemAbnormalities in ultrasoundWomen who become pregnant at an advanced stage Procedure of Fetal Echocardiography The test is non-invasive, safe and usually takes about 30 minutes to be performed. There are no preparations that need to be done before the test and is very similar to a routine pregnancy ultrasound. Fetal echocardiography is done through the abdomen or the vagina; if done through the former, it is called abdominal echocardiography, while the latter is called transvaginal echocardiography. In abdominal echocardiography, you will be required to lie down. Then a special lubricating gel will be applied on the bare belly which will enable the technician to use an ultrasound transducer to send and receive signals from the sound waves over the skin. The transducers sends sound waves through the body, which eco upon hitting the child’s heart are reflected back to the transducer and are then converted into images on a screen. The transducer is moved all over the stomach to get complete images of the heart.  In case of transvaginal echocardiography, a small probe is inserted into the vagina which sends sound waves...
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Family History and Heart Disease

Family History and Heart Disease
Family history and heart diseases are strongly linked to each other. A person with a family history of heart diseases is more likely to develop heart problems and complications than a person without a family history of heart diseases. However, it is not the sole factor that can contribute towards heart disease in a person; it is also accompanied with several other risks.  A family history of heart disease implies that one or more of the blood relatives had or has heart disease. More the number of family members with heart diseases, higher the risk of a person developing heart complications. Moreover, closer the relation of the family members to a person and younger the age, higher is the risk of developing heart problems. Younger age in this perspective is a man under the age of 55 years and a woman under the age of 65 years. Along with family history, other risk factors such as smoking, diabetes, etc. increase the chances of a person contracting heart disease, as well as other complications such as genetic cholesterol abnormality, obesity, high blood pressure, diabetes, etc.  Family history and heart diseases are co-related because of genetics. Genetics impact the cardiovascular system in multiple ways and influence many cardiac risk factors including lipid levels, obesity, Type 2 diabetes and more. However, genetics do not act alone and are triggered by multiple lifestyle factors such as diet, exercise, weight, pollution and exposure to harmful radiation, pesticides, etc.  That said, it is possible to overcome the risk of family history and heart diseases provided some important preventive steps are followed: Know the full family history: A comprehensive family history assessment is critical to know what puts you at higher risk and also what kind of heart problems are likely to be passed on. An extended evaluation of family will span across three generations, including children, siblings, parents, aunts and uncles, cousins, nieces/nephews and grandparents. It is important to know the current and past health status of these generations, their cardiovascular problems, and at what age did they experience the problem.  Get tested and consultation early: Once you have the thorough family history, it is important to consult a doctor and discuss the tests required to eliminate or know risks and potential threats. Some tests and exams that can be conducted include – lipid profile, lipoprotein, C-reactive protein, coronary calcium exam, ECG, ultrasound, etc. These tests help to evaluate the overall functioning and structure of the heart, including arterial build-up. Moreover, genetic testing can be used to identify genetic issues, which can be treated early on. Preventive approach: Based on the family history and the results of the test, the doctor will suggest targeted treatment and preventive measures to minimize the risk of developing heart diseases; such as in case a patient has premature accumulation of fat in the coronary arteries, the doctor might suggest statin therapy, even if the other values are normal. Moreover, this also helps to eliminate the risk of aggressive problems that need to be...
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CPR (Cardiopulmonary resuscitation) – How to do CPR when the heart suddenly stops

CPR (Cardiopulmonary resuscitation) – How to do CPR when the heart suddenly stops
Even after the advancements in emergency cardiac care, the sudden cardiac arrest still remains as one of the top causes of death in India and worldwide. One of the most common reasons for a cardiac arrest includes disturbance in the electrical rhythm, also known as ventricular fibrillation, which can be treated with an electrical shock to the chest. In emergency situations, when an electrical shock cannot be immediately given to the patient, CPR comes in very handy and can help to keep the blood and oxygen running in the body. If CPR is not initiated timely, at least in the first 6 minutes, a person can die in less than 10 minutes. Moreover, CPR buys more time until a defibrillator becomes available. Also, keeping the blood flow active – even partially – improves the chances of successful resuscitation.  Cardiopulmonary resuscitation is an emergency lifesaving technique that is performed when the heart stops beating. This procedure is performed immediately to keep the flow of blood and oxygen running through the body when the person’s heart and breathing have stopped due to various reasons such as heart attack or drowning. CPR can be initiated by any person – a bystander or medical personnel - and involves basic chest compressions and rescue breathing. CPR has to be initiated in the order of CAB – Compressions, Airway and Breathing.  How to do CPR when the heart suddenly stops? CPR can be performed via two methods – Hands-only and mouth-to-mouth resuscitation. It is recommended that an untrained person performs only a hands-only CPR.  Hands-only CPR Hands-only CPR is the primary recommendation for untrained people. It involves the following steps: Surveying the scene: Foremost, the person willing to help should assess if it is safe to help and reach the person in need.  Open airways and ask for a response: Shake the shoulders of the concerned person and enquire if they are okay. In case of a child or infant, check the reaction by tapping the foot. In case the person is not responsive, immediately call an ambulance. However, if the person in question is a child between 1-8 years or is a victim of drowning, it is critical to begin CPR first and then call for an emergency. Assess the heart with an automated external defibrillator (AED): In case an automated external defibrillator is readily accessible, use it to check the rhythm of the heart. An AED machine will also guide you to deliver one electric shock before performing chest compressions. But in case of children between ages 1 to 8, it is best to perform chest compressions for the first two minutes before using the AED machine. For infants and children under the age of one year, AED is not recommended, and only CPR should be followed. In case, AED is not available, chest compressions should be immediately started irrespective of the age or condition. Place hands appropriately: In case of an adult, put the heel of one of your hands in the middle of the chest, while placing...
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