Cardiac Catheterization
Cardiac catheterization is a test which is performed to obtain certain diagnostic information about the heart. Patients may require this medical therapy rather than undergo angioplasty or bypass surgery when they suffer from rare or easily controlled episodes of angina. Alternatively, cardiac catheterization is not performed in patients who have infrequent episodes of angina and in whom angina can be easily controlled. When a patient has heart failure due to suspected coronary artery disease or there is suspected coronary artery disease, cardiac catheterization is conducted. Cardiac catheterization can help:
Measure blood pressure within heart.
Know the amount of oxygen in the blood.
Check the pumping ability of the heart muscle.
Check blood flow through the heart after surgery.
Collect blood samples from the heart.
Inject dye into the coronary arteries.
To provide treatment in certain types of heart conditions like congenital heart defects and how severe it is.
To find out a coronary artery disease and if found to pinpoint the size and location of fat and calcium deposits that have built up in coronary artery from atherosclerosis.
To determine whether the patient needs bypass surgery or angioplasty.
Examine the arteries of the heart with an x-ray technique called fluoroscopy.
The patient is asked not to drink or eat anything, except a small amount of water, for atleast 6 to 12 hours before the test. The patient is tested for allergy to iodine or other medications. Patients suffering from kidney disease or diabetes or bleeding disorders must keep the cardiologist informed. The cardiac catheterization test is performed in a cath lab by a cardiologist. The actual catheterization procedure takes about 15 - 30 minutes. The patient's electrocardiogram that continuously records the electrical activity of the heart is taken. A pulse oximeter device that measures the oxygen levels of the patients' blood is monitored. An intravenous needle is inserted into the patients' vein to give fluids or medicine during the catheterization procedure. A sedative is also given through this IV line which helps the patient to relax.
Cardiac catheterization procedure involves passing a catheter, a thin flexible tube, into the right or left side of the heart. The doctor inserts this thin plastic tube into the groin - femoral artery. Other places where in the catheter may be inserted are the elbow- brachial artery or the wrist - radial artery. From there it is slowly advanced into the chambers of the heart or into the coronary arteries. The doctor watches the progress of the catheter into the heart's vessels and chambers on the imaging screen. Pressures within the heart chambers are measured and the blood and tissue samples are also removed through the catheter. A small amount of dye is also injected through the catheter into the heart chamber or into one of the coronary arteries.
Therapeutic catheterization: Certain types of heart defects can be repaired using catheterization. For instance, if the coronary arteries are blocked, the cardiologist can use a catheter, guide wire and balloon to open and improve blood flow to the heart. This is termed as percutaneous coronary intervention (PCI).
Normal result indicate that there is no significant narrowing or blockage in the coronary arteries. Abnormal results may suggest that the heart does not pump blood normally or the valves in the heart may be weak. There may be leakage between heart chambers. There is a possibility of aortic aneurysm. Some complications with cardiac catheterization include heart attack or stroke, hematoma, puncture of the heart or arrhthmias.
potassium gluconate
Indication
This is a potassium supplement useful in those prone to low blood potassium.
Side effects
Numbness and tingling of the extremities, confusion, weakness, arrhythmias, ECG changes, nausea, vomiting, diarrhoea, abdominal pain, GI ulcerations, GI bleeding, intestinal obstruction, and intestinal perforation.
Interactions and precautions
1. Should not be used in cases of severe kidney disease, acute dehydration, or those who are using potassium sparing diuretics (e.g. spironolactone, triamterene).
2. Enteric coated potassium tablets cannot be recommended due to increased risk of GI bleeding and ulceration.
3. Minimise GI symptoms by taking this medication with food.
Usual dose
Adult and adolescent: oral, elixir, 10-20 mEq of potassium diluted in one-half glass of cold water or juice, two to four times a day; or 5-10 mEq potassium in tablet form, two to four times a day; dosage adjusted to need (up to 100 mEq potassium per day). Paediatrics: individualized per physician. Gouty Arthritis
An attack of gout is caused due to deposition of uric acid in the joints. This occurs due to overproduction of uric acid or inability of the kidneys to flush out the uric acid. Gouty arthritis is characterized by pain in the joints of the feet and hands. Persons suffering from diabetes, obesity or kidney disease are also likely to suffer from gouty arthritis. Those taking drugs that interfere with uric acid excretion such as thiazide diuretics, pyrazinamide and ethambutol may develop gouty arthritis. Gout can sometimes be a heriditary condition. The excessive uric acid crystals are deposited within the joint space causing irritation and swelling. Typically persons suffering from gouty arthritis experience pain in the base of the toes. The ankles and knees are also likely to get affected. An attack of gouty arthritis differs from other arthritis conditions in that it affects one joint at a time.
Gouty arthritis attacks are painful and can recur at irregular intervals. The condition can then become chronic. The affected joint becomes red, swollen and extremely tender. Repeated attacks of gouty arthritis might lead to joint deformity and limited motion. A condition of chronic kidney failure might also result. An aspiration of the fluid from the joint space can reveal a gouty arthritis condition. This procedure is known as 'Arthrocentesis'. The fluid is examined for presence of uric acid crystals. Blood and urine tests reveal the levels of uric acid. A person suffering from acute gout attacks must maintain adequate fluid intake to reduce . A purine-rich diet can aggravate gout attacks. Reduced dietary fat and calorie intake is always beneficial. Excessive alocohol consumptions can trigger disorder of uric acid metabolism.
Person suffering from gouty arthritis can relieve symptoms by resting and elevating the affected joint. Use of ice packs can help in reducing inflammation and pain. Uric acid levels in the blood are usually treated with Probenecid (Benemid) and sulfinpyrazone (Anturane). The medications aid the excretion of uric acid into the urine. Powerful corticosteroids are prescribed in short courses for treating acute cases of gout.
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