Risk Factors for M.I.

Risk factors

By Mayo Clinic staff Certain factors contribute to the unwanted buildup of fatty deposits (atherosclerosis) that narrows arteries throughout your body, including arteries to your heart. You can improve or eliminate many of these risk factors to reduce your chances of having a first or subsequent heart attack.
Heart attack risk factors include:

• Age. Men who are 45 or older and women who are 55 or older are more likely to have a heart attack than are younger men and women.
• Tobacco. Smoking and long-term exposure to secondhand smoke damage the interior walls of arteries — including arteries to your heart — allowing deposits of cholesterol and other substances to collect and slow blood flow. Smoking also increases the risk of deadly blood clots forming and causing a heart attack.
• Diabetes. Diabetes is the inability of your body to adequately produce insulin or respond to insulin need properly. Insulin, a hormone secreted by your pancreas, allows your body to use glucose, which is a form of sugar from foods. Diabetes can occur in childhood, but it appears more often in middle age and among overweight people. Diabetes greatly increases your risk of a heart attack.
• High blood pressure. Over time, high blood pressure can damage arteries that feed your heart by accelerating atherosclerosis. The risk of high blood pressure increases as you age, but the main culprits for most people are eating a diet too high in salt and being overweight. High blood pressure can also be an inherited problem.
• High blood cholesterol or triglyceride levels. Cholesterol is a major part of the deposits that can narrow arteries throughout your body, including those that supply your heart. A high level of the wrong kind of cholesterol in your blood increases your risk of a heart attack. Low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) is most likely to narrow arteries. A high LDL level is undesirable and is often a result of a diet high in saturated fats and cholesterol. A high level of triglycerides, a type of blood fat related to your diet, also is undesirable. However, a high level of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), which helps the body clean up excess cholesterol, is desirable and lowers your risk of heart attack.
• Family history of heart attack. If your siblings, parents or grandparents have had heart attacks, you may be at increased risk. Your family may have a genetic condition that raises unwanted blood cholesterol levels. High blood pressure also can run in families.
• Lack of physical activity. An inactive lifestyle contributes to high blood cholesterol levels and obesity. People who get regular aerobic exercise have better cardiovascular fitness, which decreases their overall risk of heart attack. Exercise is also beneficial in lowering high blood pressure.
• Obesity. Obese people have a high proportion of body fat (a body mass index of 30 or higher). Obesity raises the risk of heart disease because it's associated with high blood cholesterol levels, high blood pressure and diabetes.
• Stress. You may respond to stress in ways that can increase your risk of a heart attack. If you're under stress, you may overeat or smoke from nervous tension. Too much stress, as well as anger, can also raise your blood pressure.
• Illegal drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.

S3 Cardiac Auscultation

http://www.youtube.com/watch?v=5Tz4eth26jc

Causes

S₃ is thought to be caused by the oscillation of blood back and forth between the walls of the ventricles initiated by the inflow of blood from the atria. The reason the third heart sound does not occur until the middle third of diastole is probably because during the early part of diastole, the ventricles are not filled sufficiently to create enough tension for reverberation. It may also be a result of tensing of the chordae tendineae during rapid filling and expansion of the ventricle.

Associations

It is associated with heart failure,^[5] caused by conditions which have:

Rapid ventricular filling

• Mitral regurgitation - this is when one of the mitral valve leaflets that usually stop blood flowing from the left ventricle to the left atria fails, allowing blood into the atria during systole. This means that the left atria will be overfilled, leading to rapid ventricular filling when the mitral valve opens.^[6]
• Elevated left atrial and left ventricular filling pressures, usually a result of a stiffened and dilated left ventricle
• Ventricular septal defect - this is a hole in the wall between the two ventricles, which allows rapid filling from the other ventricle.

Poor left ventricular function

• Post-MI - the death of tissue in the ventricular wall due to loss of blood supply causes wall areas which do not move as well as normal (hypokinesia), or not at all (akinesia), meaning they relax more slowly, so the ventricular filling is relatively too rapid.
• Dilated cardiomyopathy - the ventricular walls are abnormal for a variety of reasons, and become thin and stiff so do not relax well.

S3 can also be due to tricuspid regurgitation, and could indicate hypertensive heart disease.
In conditions affecting the pericardium or diseases that primarily affect the heart muscle (restrictive cardiomyopathies) a similar sound can be heard, but is usually more high-pitched and is called a 'pericardial knock'.
The S3 can also be confused with a widely split S2, or a mitral opening snap, but these sounds are typically of much higher pitch and occur closer to the onset of S2.

Normal Vital Signs

Vital signs

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Vital signs include the heart beat, breathing rate, temperature, and blood pressure. These signs may be watched, measured, and monitored to check an individual's level of physical functioning.
Normal vital signs change with age, sex, weight, exercise tolerance, and condition.
Normal vital sign ranges for the average healthy adult while resting are:

• Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg
• Breathing: 12 - 18 breaths per minute
• Pulse: 60 - 100 beats per minute
• Temperature: 97.8 - 99.1 degrees Fahrenheit / average 98.6 degrees Fahrenheit

Causes of Iron Deficiency Anemia

What Causes Iron-Deficiency Anemia?

Not having enough iron in your body causes iron-deficiency anemia. Lack of iron usually is due to blood loss, poor diet, or an inability to absorb enough iron from food.

Blood Loss

When you lose blood, you lose iron. If you don't have enough iron stored in your body to make up for the lost iron, you'll develop iron-deficiency anemia.
In women, long or heavy menstrual periods or bleeding fibroids in the uterus may cause low iron levels. Blood loss that occurs during childbirth is another cause of low iron levels in women.
Internal bleeding (bleeding inside the body) also may lead to iron-deficiency anemia. This type of blood loss isn't always obvious, and it may occur slowly. Some causes of internal bleeding are:

• A bleeding ulcer, colon polyp, or colon cancer
• Regular use of aspirin or other pain medicines, such as nonsteroidal anti-inflammatory drugs (for example, ibuprofen and naproxen)
• Urinary tract bleeding

Blood loss from severe injuries, surgery, or frequent blood drawings also can cause iron-deficiency anemia.

Poor Diet

The best sources of iron are meat, poultry, fish, and iron-fortified foods (foods that have iron added). If you don't eat these foods regularly, or if you don't take an iron supplement, you're more likely to develop iron-deficiency anemia.
Vegetarian diets can provide enough iron if you eat the right foods. For example, good nonmeat sources of iron include iron-fortified breads and cereals, beans, tofu, dried fruits, and spinach and other dark green leafy vegetables.
During some stages of life, such as pregnancy and childhood, it may be hard to get enough iron in your diet. This is because your need for iron increases during these times of growth and development.

Inability To Absorb Enough Iron

Even if you have enough iron in your diet, your body may not be able to absorb it. This can happen if you have intestinal surgery (such as gastric bypass) or a disease of the intestine (such as Crohn's disease or celiac disease).
Prescription medicines that reduce acid in the stomach also can interfere with iron absorption.