HAVE THE ANNUAL CHECK-UP! Check your physical health!

Once you begin to understand your health status in the context of both your lifestyle behaviors and your medical history,you will be in the best possible position to work with your doctor to take charge of your health.

Get a check-up!

 Many of the procedures that your doctor carries out such as measuring weight,pulse and blood pressure,relate to your risk in developing cardiovascular disease which is an important cause of premature death in the world today.
Some of the risks such as your age,gender and family history cannot be altered but other risk factors can be modified by making changes to your lifestyle.
If you are at risk of a disease because of non-modifiable risk factors than is vital to tackle the areas where changes are possible to improve your overall health and long term wellness.

You should consider your family medical history to became aware of the medical conditions from which your parents,grandparents and other blood relatives suffered.
This will provide you with an opportunity to identify potential health issues in your own life and to take the appropriate action to modify your risk of developing those conditions yourself.

The risk of asthma,migraines,diabetes,high blood pressure and cardio vascular disease had all been shown to run in families or to have a genetic component.

Having a medical check-up

When you visit your doctor for a physical check-up,he or she will take a number of measurements,all of which will access to your current state of health.These could include: checking your pulse rate,listening to your hearth and lungs,with a stethoscope,measuring your blood pressure and checking your weight and height.
Depending on your personal and family medical history,your doctor may recommend to be taken a blood sample that will be sent to laboratory to be tested for specific conditions.

 

Congenital Heart Disease

The incidence may be up to 1% of live births and the mortality is low,becouse is readily preventable trough maternal care.
Causes:
Exposure of the embryo to adverse genetic and intrauterinefactors that interfere with development of the heart.They cause congenital malformation that involve different sites of heart and blood vessels.
Exposure during the first trimester of pregnancy is particularily important,due to rapid embryogenesis during this period:the heart develops between the 3td and 7th week.
1.Genetic factor:chromosomal abnormalities are associated with Down's Syndrome with high incidence of heart disease,specially coartation of aorta.
2.Exposure to adverse intrauterine invironment:
-Viral infection of the pregnant during first trimester(rubella for exemple).Congenital anomalies of viral infection may involve the heart causing persistent ductus arteriosus,aortic stenosis,pulmonarystenosis and others.
-Teratogenic drugs
-Inhalationof chemical pollutanta in air:
-isecticides and cigarette smoke(pasive smoking0-they are teratogenic.
-carbone monoxide,occasionally.
-Cigarette smoking and alcohol consumption during pregnancy.

Manifestations:some cases only are suspected at birth,while the other nonfatal cases are detected later,on heart appraisal(at school entry for exemple).

Prevention:
-family hystory
-genetic examination and counseling
-family planning service
-avoiding exposure to infection
-immunization
-avoid cigarette smoking and passive smoking,alcohol consumption,any drug without medical prescription and supervision,insecticide application at home.
-no exposure to radiation
prevention and control of air pollution.

Management of screened cases:
-surgical repair
-medical care:treatment to manage manifestations and prevent complications.prophylaxis to prevent infective endocarditis if is necessary.
-general measures for case:health promotion,specially adequate nutrition,guidelines for healtful lifestyle.

Coronary Heart Disease

Coronary artery and its branches provide the myocardium whit needed oxygen and nutrients,specially glucose,otherwise the heart muscle will suffer of ischemia(local anemia),and the risk of developing ischemia heart disease.

Causesof Myocardial ischemia:
-diminished blood flow in coronary artery
-diminished flow of oxygenated blood to myocardium
-increased oxygen requirement of myocardium

Risk factors:
Coronary atherosclerosis is the main cause of coronary heart disease and others.
classification of risk factors:
-unmodified factors:personal factors of age,gender,genetic and inheritance(family history).
-modified factors:potential factors that can be changed whit treatment.

Major factors:
-hyperlipidamia(serum cholesterol level)
-cigarette smoking
-hypertention
-diabetesor impaired glucose tolerance
Contributing factors:
-physical inactivity,lack of exercise
-heavy consumption of alcohol
-obesity
-personality type,mental stress and worry
-oral contraception
-socioeconomic circumstances

Characteristics:
In case of asymptomatic type the obstruction of blood flow in the coronaries is light at the beginning of disease and gives no symptoms.
In case of angina pectoris the obstraction and impaired blood flow are progressing,causing hypoxia of glucose,myocardium.
Types of angina:
-Classical angina:anginal pain appears on physical exertion and may be provoked by excitement,psychological upset and unger,exposure to cold or after heavy meals.
The attack is transient,for few minutes and disappears on rest.
-Nonclassical angina:this type arises under certain circumstances other then exertion,for exemple nocturnal angina due to coronary spasm during sleep,angina at rest,without any obvious provoking factors.
Acute myocardial infarction may arise from complete obstruction of involved vessels.

Prevention of coronary heart disease is based on prevention and control of determined risk factors:
1.Diet control:
-no excess of calories,fat and common salt
-dietary carbohydrates must be largely of the complex form: from grain and their products
-no excess of rafined sugar
-consumption of vegetable oil,rather then animal fat and margarine
-restriction of solid fats.
Marine fat oils(omega 3 tryglycerides)contain large amount of two highly unsaturated fatty acids and have potenital role in prevention of coronary heart coronary.

Hypertension (high blood pressure)

No fixed figures can be given for normal level of blood pressure,this dependes of age and activity of the individuals and environment(urban or rural life).
However hypertension can be based on the fallowing levels in mm Hg:
- recommended maximum level 140/90(specially in pregnancy)
-bordline level inbetween 140/90 and 160/95.
The two reading most be taken separately.
Hypertension is clasified in two types:
1.Primary hypertension
2.Secundary hypertension

1.PRIMARY HYPERTENSION:
No particular cause can be accused.
Risk factors:
-genetic factor:reported familial and racial tendency to hypertension suggest genetic contribution.
-foetal factors:impaired foetal health due to undernutrition and other adverse conditions.
-obesity:associated with increased systolic and diastolic pressure.
-common salt:sodium chloride content of diet play a role(hight potassium diet can protect against adverse effect of hight sodium intake).
-alcohol:elevate pressure.
-stress,worry,anxiety and psychological disorders cause only temporary,not persisting elevation of blood pressure in normotensives.
-others:hormonal,disorders and insulin resistance.
2.SECUNDARY HYPERTENSION:
Some pathological conditions are associated with hypertension:
-renal hypertension:over 80%of secundary hypertension.Renal disease may cause secundary hypertension through:sodium and water retantion,elevation of plasma renin.
-endocrine hypertention
-cardiovascular causes
-drugs:estrogen,steroids,vasopressin and others.
-collagen disease.

Hypertension in Pregnancy:
Though heart output increase in pregnancy,yet there is relatively more decline in peripheral vessel ressistance,and so blood pressure of healthy pregnants is usually lower than normal level.
The hypertension is detected on regular health of the pregnant:
-in the first half of the pregnancy:it and is usually perexisting(preconceptional)
-in the second half of pregnancy:induced hypertension that usually resolves after delivery.
Primary hypertension appears usually at 25-55 years,uncommon below 20,and secondary hypertension may appear at any age.Females are usually more affected,specially over 40 years,and they are less exposed to the risk of complications..
More then one family member may show essential hypertension,likely related to hereditary factor.
Busy,noisy,sophisticated urban life may show somewhat higher blood pressure.Cigarette smoking,alcohol intake and uncontrol dietary fat,calories,common salt and sugar are risk factors.
Uncontrolled hypertension is usually asymptomic,may be for years.
Uncomplicated cases may sometimes complain of headache,transient dizzines,and maybe palpitations.
Uncontrolled hypertension may cause serious sequeles and complications:cardiovascular,renal,ophthalmic and others
Early diagnosis and proper management are the main control measures.