Category: Health

Corns and calluses develop from repeated friction, rubbing or irritation and pressure on your skin. They most frequently occur on your hands, feet and toes. The most common cause is shoes that don’t fit properly. With a little bit of attention and care, you can prevent most cases of corns or calluses.

What are corns and calluses?

Corns and calluses are a buildup of hard, thick areas of skin. Although these hardened areas of skin can form anywhere on your body, you’ll usually see them on your feet, hands or fingers.

What’s the difference between a corn and a callus?

Corns and calluses are essentially the same tissue. Corns tend to be small and round. You’re most likely to see corns on the top or sides of your toes.

Calluses are hard, thick patches of skin. Compared with corns, calluses are larger and have a more irregular (more spread out) shape. You’re most likely to see calluses on the bottom of your feet on the bony areas that carry your weight — your heels, big toes, the balls of your feet and along the sides of your feet. Some degree of callus formation on the bottom of your foot is normal.

You’ll also see calluses often on your hands. For instance, a callus forms where there’s repeated friction or rubbing — like on the tips of fingers of guitar players or the hands of gymnasts, weightlifters or craftsmen.

What are the different types of corns?

There are several types of corns:

• Hard corns: These are small, hard dense areas of skin usually within a larger area of thickened skin. Hard corns usually form on the top of your toes — areas where there’s bone pressure against your skin.
• Soft corns: These corns are whitish/gray and have a softer, rubbery texture. Soft corns appear between your toes.
• Seed corns: These corns are small and usually form on the bottom of your feet.

What do corns and calluses look like?

Corns and calluses have many distinct features. Corns look like:

• Small, round, raised bumps of hardened skin surrounded by irritated skin.
• Raised areas or bumps that may be painful or cause discomfort.

Calluses are:

• Thick, hardened, larger and typically more flattened patches of skin.
• Less sensitive to touch than the surrounding skin.

Both corns and calluses can cause:

• Hardened areas of skin where there’s repeated friction or pressure on your skin.
• Pain, redness and blisters.

Are corns and calluses painful?

Corns and calluses may or may not be painful. Some corns and calluses aren’t painful when they first develop but then become painful over time as they thicken. The raised areas of skin — especially of corns — can be tender or sensitive to touch or pressure. Calluses tend to be less sensitive to touch than the normal skin around them. Sometimes, cracks (called fissures) form in a callus. Fissures can be painful. If you have a corn or callus that becomes infected, you’ll likely feel pain or at least some discomfort.

What causes corns and calluses?

Corns and calluses have many of the same causes. These include:

• Shoes that don’t fit properly. This is the most common cause of corns on the top of your feet. Shoes that are too tight or have areas that rub against your skin cause shearing, friction and pressure. People who frequently wear high-heeled shoes often develop calluses on the balls of their feet from the downward pressure on this area when walking.
• Standing, walking or running for long periods of time.
• Physical hobbies, sports activities or work/labor that puts pressure on your feet and/or causes repeated friction on an area of skin on your hands or fingers.
• Going barefoot.
• Not wearing socks with footwear.
• Having socks and/or shoe linings that slip and bunch up under your feet while in shoes.
• Walking with improper posture — walking too heavily on the inner or outer edge of your foot.
• Structural foot deformities or changes to the shape of your foot (hammertoes, tailor’s bunions, bunions or deformities from birth).

How do corns and calluses form?

Corns and calluses develop from repeated friction, rubbing, pressure or irritation and pressure on your skin. Corns and calluses typically form on the bony, walked-on areas of your feet. On your hands, they (more likely calluses) form on the areas where there’s ongoing rubbing against your skin.

The hardened layers of skin of corns and calluses are actually your body’s way of protecting the underlying skin from irritation and pressure.

Who is more likely to get corns and calluses?

You’re more likely to develop corns and calluses if:

• You already have medical conditions that change the normal alignment of the bones in your feet. For example, arthritis in your feet, bunions, bone spurs or hammertoes.
• You walk without socks.
• You wear shoes that are too narrow for your foot.
• You have atrophy or loss of your natural cushioning/padding.

What are the complications of having corns and calluses?

Untreated (or unsuccessfully) treated corns and calluses might grow larger until you fix what caused them to develop in the first place.

Corns or calluses can cause infections. This can be painful and make walking difficult. You may need antibiotics or even surgical treatment.

How are corns and calluses diagnosed?

A healthcare provider can diagnose corns or calluses by looking at your skin. No tests are required. A simple visual exam of your skin is usually all your provider needs. Your provider may ask you questions about your job, how much walking and standing you do, and in what activities you participate. If your corn or callus is on your foot, your provider may ask you to walk to check your posture and the way you walk, ask about your footwear and ask how you take care of your feet.

How do I remove corns and calluses?

Treatment depends on your symptoms and what caused the corn or callus. But for the typical corn or callus, removing the buildup of skin is an effective treatment. Follow these steps:

1. Soak the area with the corn or callus (let’s use your foot as an example) in warm water until the skin softens — usually five to 10 minutes.
2. Wet a pumice stone or emery board.
3. While the skin on your foot is still soft, gently move the pumice stone or emery board across the corn or callus to remove dead tissue. Continue to file down the corn or callus, moving the stone or board in one direction. Be careful. Don’t remove too much skin. This could lead to bleeding and an infection.
4. Apply a moisturizing cream or lotion to the corn or callus and surrounding dead skin every day. Look for products that contain urea or ammonium lactate. These ingredients will soften the skin over time.

Other care tips include:

• Surround your corn or callus with donut-style adhesive pads or make your own donut pad from moleskin. (The corn should be in the center hole area of the donut.) You can purchase moleskin padding and other corn and callus products at your local drugstore. Padding helps protect the corn or callus from irritation and relieves pain and pressure.
• Wear properly sized and shaped footwear. Wear shoes with increased width and height in the toe area. Consider buying footwear at the end of the day when your feet are slightly swollen.
• Keep your toenails trimmed. Long toenails can make your toes push against the top of your shoe causing friction and increased pressure. Cut toenails straight across. Don’t round the corners.
• If your corns or calluses are painful, apply a cold pack to reduce the pain and swelling for no more than 10 to 20 minutes at a time.
• Never try to cut out, shave away or remove corns or calluses with a sharp object.
• Don’t try to treat corns or calluses if you have diabetes, have poor circulation, are prone to infections or have delicate skin. See your healthcare provider.

Should I try over-the-counter medications to treat my corns or calluses?

Over-the-counter products used to dissolve corns and calluses contain harsh chemicals. If you aren’t precise in applying the chemical, it can injure the surrounding healthy skin. If you have diabetes, don’t self-treat. See your healthcare provider, due to the foot complications possible with diabetes.

Is surgery ever needed for corns and calluses?

You can manage most corns and calluses by following the simple tips listed in this article — namely, remove any corns or calluses with a pumice stone after soaking your feet in warm water.

Your healthcare provider may consider surgery if you have a structural deformity in your foot or toes that results in the repeated development of corns or calluses. In this case, a surgeon may need to remove or realign bone tissue. Other reasons for surgery are if the corns or calluses are extremely painful, if they prevent you from walking comfortably or normally, or if they cause reoccurring infections, wounds or tissue breakdown.

Can corns and calluses be prevented?

Your feet are an often overlooked part of your body until a problem develops. With a little bit of attention and care, you can prevent most cases of corns and calluses. Things to keep in mind include:

• Wear shoes that are comfortable and fit well. Shoes should support your feet, be well-cushioned and have shock-absorbing soles. The toe area of shoes should have enough length and width so your toes aren’t rubbing against the shoe or other toes. This would also mean avoiding high-heeled narrow-toed shoes that push your toes forward causing them to rub against the shoe or each other. Avoid hard-soled or leather-soled shoes unless they have enough padding (or you add padding) to cushion your feet.
• Wear socks with your footwear. Make sure socks are snug enough that they don’t bunch up under your feet.
• Use cushioned or padded insoles. If you had corns or calluses in the past, you may want to ask your healthcare provider about customized insoles. These inserts can even out weight-bearing forces on the bottom of your foot to prevent calluses from forming. Also, use lamb’s wool (not cotton) between your toes to relieve friction and soften corns.
• Wear gloves when you’re doing manual labor or working with heavy or rough materials that can damage the skin on your hands or fingers.
• Inspect your feet daily and keep them clean. Wash your feet in warm, soapy water, dry them and apply a moisturizing foot cream. This helps keep your skin soft and supple.

In addition, keep your toenails trimmed, don’t walk barefoot and apply a daily foot powder to keep your feet dry if you have sweaty feet.

After corns and calluses heal, can they come back?

As corns and calluses are the result of friction, irritation or pressure against your skin, they can return at any time if you haven’t addressed the cause. In other words, if poorly fitted shoes were the cause and you continue to wear those same shoes, the corns and calluses will likely return.

Fortunately, you can successfully manage most corns and calluses at home with a little care and attention. If you’re concerned about a growth on your foot, see a healthcare provider. They’re in the best position to examine your feet, ask about or test for other medical conditions you may have, treat your feet and advise you how to take care of them.

When should I see my healthcare provider if I have corns or calluses?

You should see your healthcare provider if:

• You have diabetes. People with diabetes can have a lack of feeling, or peripheral neuropathy, making it difficult to detect appropriate pain sensations. People with diabetes may have poor blood circulation in their legs and feet, which makes healing more difficult. Corns and calluses could even become infected.
• You have other underlying diseases or conditions that increase your risk of infection or if you have delicate skin.
• Home treatments don’t work to manage your corns or calluses.
• You think you may have abnormal bone structure or alignment as the reason corns and calluses have repeatedly formed.
• Your corns or calluses are painful, the pain worsens or you think you have an infection. Signs of infection include redness, pain, swelling and oozing/pus from the corn or callus.
• Your foot pain is intense or you have discomfort when walking and don’t know what might be causing it.

What questions should I ask my healthcare provider?

Questions you may want to ask your healthcare provider include:

• Do I have a corn or a callus?
• How do you think I got a corn or callus?
• What home remedies do you recommend for treating my corn or callus?
• How can I prevent getting corns and calluses in the future?

What’s the difference between a wart and a callus?

A type of wart called a plantar wart may appear on the soles of your feet. These warts look like calluses with tiny black dots in the center. But warts develop when the human papillomavirus, or HPV, enters a cut or break in your skin and causes an infection. Calluses don’t develop due to a virus, but rather just from friction on your skin.

A note from QBan Health Care Services

Those shoes may look cute, but if they’re too tight, you shouldn’t wear them — you could develop a corn or a callus. If it’s too late and you already have one, the good news is, most corns and calluses aren’t serious. You can typically treat them at home. But if you have diabetes or another underlying condition that increases your risk of infection, call your healthcare provider for treatment.

Impetigo is a common skin infection that most often affects young children. Bacteria including Staphylococcus aureus (S. aureus or “staph”) and Group A streptococcus (“strep”) cause the infection, which can lead to itchy sores and blisters. Treatment includes antibiotics. Within a few days of treatment, your child should start to feel better.

What is impetigo?

Impetigo (pronounced “im-peh-TIE-go”) is an itchy, sometimes painful, skin infection. When your child gets a cut, bite or scratch that opens their skin, bacteria can enter and cause a bacterial infection. But impetigo can infect skin even if it’s not broken or punctured.

Impetigo happens more often in warmer months when children are outside. Typically, the first signs of impetigo are sores and blisters on your child’s mouth and nose. It can also appear on your child’s scalp, hairline, legs and arms.

Types of impetigo

There are a few different types of impetigo, including non-bullous, bullous and ecthyma.

Non-bullous impetigo

Non-bullous is early-stage impetigo. It’s the most common type. The non-bullous impetigo early stages include:

1. Developing one or more itchy sores that quickly burst.
2. Red or raw skin where sores have broken open.
3. Swollen glands near the sores.
4. Forming honey-colored crusts over the sores, but the skin eventually heals without scarring.

Bullous impetigo

Bullous impetigo is a rarer type of skin infection. It’s more common in infants. More than 90% of cases of bullous impetigo affect children younger than age 2. The stages of this type include:

1. Large, fluid-filled blisters form on your child’s skin, but no redness appears around the surrounding skin.
2. The blisters become clear and limp and then break open.
3. Crusty sores form on your child’s skin, and their skin heals without scarring.

Ecthyma

Untreated impetigo can develop into ecthyma. Ecthyma is a more serious type of skin infection. It goes deeper into your child’s skin. The stages typically include:

1. Painful blisters form on your child’s skin that turn into deep, open sores.
2. Thick crusts develop on your child’s skin, and redness often appears near the surrounding skin.
3. After your child’s skin heals, scars may form because the infection went deeper into their skin.

How common is impetigo?

Impetigo is the most common skin infection in kids between the ages of 2 and 5. Older children can also get it. It accounts for about 10% of skin conditions in children.

Can adults get impetigo?

Yes, impetigo can affect adults. In adults, the condition may occur after another skin issue. Sometimes it develops after you’ve had a cold or another virus. You may be at higher risk if you:

• Live in a tropical climate with hot, humid summers and mild winters.
• Have a scabies infection.
• Participate in skin-to-skin contact sports where cuts and scrapes are common.
• Live in close contact with others. Infections often occur among people living in the same house.

Impetigo vs. cold sore

Impetigo and cold sores are both common skin infections that can cause blisters. Cold sores usually occur around your mouth and consist of small blisters. Impetigo can form around your mouth but also on other parts of your face and body. It causes larger blisters. A bacteria causes impetigo, whereas cold sores are a symptom of the herpes simplex virus (HSV).

Impetigo vs. weeping eczema

Impetigo and weeping eczema are both common skin conditions. Impetigo is a type of skin infection, whereas eczema is a type of dermatitis. Impetigo causes crusty, honey-colored sores and blisters. Weeping eczema sometimes causes blisters with clear or straw-colored fluid. The blisters may be purple or red and they can ooze or “weep” the fluid.

When do impetigo symptoms start?

Typically, symptoms of impetigo develop within three days once the bacteria infect your child’s skin. Impetigo on the face starts around the mouth and nose. However, impetigo on the scalp or hairline can also occur.

What does impetigo look like?

Impetigo includes blisters, rashes and other skin wounds (lesions). The condition includes the following characteristics:

• Impetigo blisters may be pus-filled and burst easily. The fluid may be yellow or tan and it may seep out and form a crust.
• Impetigo rash can spread and cause red, raw skin.
• Skin lesions on your child’s lips, nose, ears, arms and legs may appear. The lesions can spread to other parts of their body.
• Swollen lymph nodes near the infected area may develop.

If you or your child has impetigo caused by Staph bacteria, you may notice:

• Reddish skin surrounding red blisters, full of liquid or pus that eventually looks cloudy.
• Blisters that burst easily and leak.
• Raw, shiny areas that scab over with a yellowish-brown crust.

What causes impetigo?

Impetigo causes include certain types of bacteria that lead to infection. The most common impetigo bacteria include:

• Staphylococcus aureus (S. aureus or “staph”): S. aureus causes 80% of non-bullous impetigo cases.
• Group A streptococcus (“strep”): Group A strep causes 10% of non-bullous cases.

The bacteria usually enter your child’s skin through a cut, scrape, rash or insect bite. After they enter your child’s body, the bacteria continue growing in their skin. This can lead to inflammation and infection in the top layers of your child’s skin.

Your child may also get impetigo by scratching something itchy on their skin, such as chickenpox or eczema. When they scratch, it breaks the skin, making it easy for bacteria to get in.

Impetigo may also occur without any skin breakage. Instead, it can occur after you’ve experienced another skin condition, such as:

• Head lice.
• Scabies.
• Eczema.

Adults can also get impetigo through health conditions such as tattoo infections.

Can stress cause impetigo in adults?

No, stress doesn’t cause impetigo. However, stress can weaken your immune system. With a weakened immune system, it’s easier for bacteria to infect you and harder for your body to fight them.

Is impetigo contagious?

Impetigo is highly contagious. Most people get it through direct skin-to-skin contact. You can get impetigo by coming into contact with sores, mucus or nasal discharge from someone who has it. Children and athletes, such as football players and wrestlers, often get it this way.

People can also spread impetigo by sharing items such as towels, clothing or other personal items with an infected person.

How long is impetigo contagious?

Without treatment, impetigo can be contagious for weeks. After starting impetigo treatment, the condition is contagious until:

• The rash disappears.
• Scabs fall off.
• You’ve finished at least two days of antibiotics.

What are the complications of impetigo?

Complications are rare. Certain strains of strep bacteria that cause impetigo can also cause glomerulonephritis. This inflammatory kidney disease can produce high blood pressure and blood in your pee (hematuria). Other complications of impetigo may include:

• The rash spreading to deeper skin layers.
• The bacterial infection spreading to other parts of your body.
• Permanent skin damage and/or scarring.

How is impetigo diagnosed?

A healthcare provider will diagnose impetigo based on how your child’s sores look. They may take a skin culture to send to a laboratory. This will help your provider determine the right antibiotic to prescribe your child.

How do you treat impetigo?

Impetigo treatment includes antibiotics. A provider may prescribe topical antibiotics to put directly on your child’s skin. Impetigo treatments may also include an oral antibiotic (a liquid or pill taken by mouth) if the impetigo covers a large area of your child’s skin or multiple body parts.

Impetigo medication may include:

• Topical mupirocin (Bactroban® or Centany®) ointment.
• Oral antibiotics such as cephalosporins, clindamycin (Cleocin®) and sulfamethoxazole (Bactrim™).

How to get rid of impetigo in 24 hours

Impetigo won’t go away for everyone in 24 hours. However, some studies have shown that the condition goes away quicker when you use an antibiotic cream. Providers recommend these creams to help the symptoms go away fast and to help stop the infection from spreading. Therefore, the sooner you receive treatment, the better.

What impetigo treatments are over-the-counter?

You’ll need prescription antibiotic medication to treat most forms of impetigo. For minor skin infections that haven’t spread, you can try treating the area with an over-the-counter (OTC) antibiotic cream or ointment that contains bacitracin. Then, place a nonstick bandage over the area to help prevent the infection from spreading.

Taking care of your child’s skin can help clear up an impetigo infection faster. Skincare steps you can take to get rid of an impetigo infection quickly include:

• Dab the infected skin with warm soapy water to gently remove crusts.
• Apply the prescribed antibiotic the way your provider suggested.
• Place a bandage over the infected area. This will help promote healing and prevent the infection from spreading.

Will impetigo go away on its own?

Impetigo may go away on its own in a few weeks. Still, healthcare providers recommend treating it for several reasons:

• You reduce your risk of developing complications.
• You reduce your risk of spreading the infection to others.
• Without treatment, the infection can go deeper into your skin and possibly cause new sores or blisters to develop.

Can I prevent impetigo?

The best ways to prevent infections include:

• Keep your hands clean: Wash your hands regularly. Use an alcohol-based sanitizer if you don’t have soap and water.
• Practice good hygiene: Clip your (and your child’s) fingernails regularly to avoid scratching. Sneeze into a tissue and/or your elbow and then throw the tissue away. Bathe daily (or as often as possible), especially if you or your child has eczema or sensitive skin.
• Avoid scratching: Don’t scratch cuts or wounds. If your child gets a cut, scratch or wound, keep them from scratching it.
• Clean wounds: Clean cuts, scrapes and injuries with soap and water. Then put an antibiotic cream or ointment on the wound.
• Keep linens clean: Wash underwear, towels and sheets in hot water.

What’s the outlook for someone who gets impetigo?

Antibiotics can treat impetigo, but the condition can return, especially in young children. Children are especially prone to scratching and opening their scabs, putting them at a higher risk of re-infection. However, most kids recover with no complications after they receive treatment.

How long does impetigo last?

With treatment, your child usually isn’t contagious after 48 hours. The sores may take some time to heal completely, but the infection rarely leaves scars.

Without treatment, impetigo may clear up on its own in a few weeks. But there’s a greater risk of developing complications and you may see new sores and blisters.

How long does impetigo live on surfaces?

The bacteria that cause impetigo can live on dry surfaces for weeks or even months.

When can I go back to work/school?

Impetigo is very contagious. Your child should stay home from school for 48 hours after starting an antibiotic. Adults don’t need to stay home from work, but they should avoid contact with other people and keep their sores and blisters covered.

How can I take care of myself if I have impetigo?

If your healthcare provider diagnosed you or your child with impetigo, these treatment tips can help:

• Keep sores covered: Bandage sores or wear long sleeves and pants.
• Take all medication: Use your antibiotics for the full length of time your provider prescribed them to prevent re-infection.
• Stay clean: Wash the skin gently a few times a day using antibacterial soap. This will remove crusts and drainage.
• Avoid touching the rash: If you do touch it, wash your hands and the exposed area with soap and water.
• Isolate children: If your child has impetigo, keep them away from other children for at least the first 48 hours of treatment. They shouldn’t go to school or daycare.
• Avoid hot tubs and swimming pools: The rash can spread if others come into contact with your child’s skin, swimsuit or towel.

A note from QBan Health Care Services

Impetigo is a common skin condition that usually affects young children. Impetigo is very contagious, so keep your child home until they’ve had at least two days of antibiotics. The medicine will clear up the rash. To prevent impetigo, practice good hygiene. Clean and cover any cuts or scratches to keep them from getting infected.

The flu is a common respiratory illness you get from the influenza virus. Symptoms often include fever, head and body aches, coughing and a stuffy or runny nose. You’re at risk for serious complications if you have an underlying health condition or are pregnant. Getting vaccinated every year is the best way to avoid getting sick with the flu.

What is the flu (influenza)?

The flu is an illness you get from the influenza virus. It causes symptoms like head and body aches, sore throat, fever and respiratory symptoms, which can be severe. Flu is most common in winter months, when many people can get sick at once (an epidemic).

When is flu season?

Flu season — when cases of the flu go up dramatically — in the Northern Hemisphere (which includes the U.S.) is October through May. The highest number of cases (peak) usually happens between December and February.

How common is the flu?

The flu is one of the most common infectious diseases. Every flu season, about 20 to 40 million people in the U.S. catch the flu.

What is the difference between the flu and the common cold?

The flu and the common cold can have similar symptoms, like runny nose and cough. But cold symptoms are usually mild and flu symptoms can be severe and lead to serious complications. Different viruses cause colds and the flu.

How do I know if I have the flu or COVID-19?

Since they have similar symptoms, the only way to know for sure if you have the flu or COVID-19 is to get tested. They both have a risk of serious illness. But different viruses cause these infections, and providers treat them with different medications.

Who is at higher risk for complications from the flu?

Certain health conditions can put you at higher risk for severe illness from the flu. This includes life-threatening complications that require hospitalization. You’re at higher risk for serious illness if you:

• Have asthma, COPD or another chronic lung disease.
• Have a history of kidney, liver, neurological, heart or blood vessels disease, including stroke.
• Have a condition that causes issues with muscle function or makes it difficult to cough, swallow or clear fluids from your airways.
• Have diabetes.
• Have a weakened immune system (from HIV/AIDS, cancer or immunosuppressive medications).
• Have a blood disorder, like sickle cell disease.
• Have a BMI greater than 40 (have obesity).
• Are under 5 years old or over 65 years old.
• Are pregnant.
• Are under 19 years old and take aspirin regularly.
• Live in a long-term care facility.

Non-Hispanic Black people, non-Hispanic American Indians, Alaska Native people and Hispanic or Latino people have the highest rates of severe illness from the flu compared to non-Hispanic White people and non-Hispanic Asian people.

What are the symptoms of the flu?

Symptoms of the flu usually come on quickly, and can include:

• Fever.
• Chills.
• Body aches.
• Cough.
• Headache.
• Sore throat.
• Runny or stuffy nose (congestion).
• Tiredness or feeling run down.
• Diarrhea or vomiting (usually only in kids).

You may not have all of these symptoms.

What causes the flu?

The influenza virus causes flu. Influenza A, B and C are the most common types that infect people. Influenza A and B are seasonal (most people get them in the winter) and have more severe symptoms. Influenza C doesn’t cause severe symptoms and it’s not seasonal — the number of cases stays about the same throughout the year.

H1N1 (“swine flu”) and bird flu are both subtypes of influenza A.

Is the flu contagious?

Yes, the flu is contagious (it spreads from person to person). For every person infected, they spread the flu to one to two more people.

How does the flu spread?

The influenza virus spreads from direct or indirect contact with someone else who’s infected. Common ways to get the flu include:

• From someone nearby coughing, sneezing or talking. Droplets can either get onto your hands or move through the air to get into your nose or mouth. The flu then moves into your lungs.
• By touching a surface that’s contaminated by the flu virus, then touching your face, nose, mouth or eyes. This includes things like door knobs, desks, computers and phones.
• By touching the hands or face of someone who has the flu, then touching your face, nose, mouth or eyes.

How long after exposure will I get the flu?

If infected, you’ll usually get symptoms of the flu one to four days after exposure (incubation period).

How is the flu diagnosed?

Your provider diagnoses the flu by listening to your symptoms and testing a sample of mucus from your nose. They’ll put a long stick with a soft tip (swab) in your nose to test for influenza. Results may take a few minutes or your provider may send the sample to a lab, where you’ll get results in a day or two.

How is the flu treated?

Providers can treat the flu with antiviral medications under certain circumstances. Antivirals can reduce your risk of severe illness and shorten the amount of time you’re sick. Many people can treat the flu without prescription medications. Providers prescribe antivirals if you:

• Have had symptoms for under 48 hours. Antivirals are less likely to work if you start them after two days of symptoms. The virus has already made more copies of itself and your body has started to fight it off with its own antibodies.
• Have an underlying condition or are at risk for severe illness. Providers may prescribe antivirals even if you’ve had symptoms for longer than 48 hours.
• Have severe symptoms, even if you’ve been sick for longer than 48 hours.
• Live with or care for people who are at risk for severe complications of the flu.

What medications treat the flu?

Antiviral drugs for influenza include:

• Oseltamivir phosphate (Tamiflu®). You take oseltamivir by mouth as a pill or a liquid. You usually take it for several days.
• Zanamivir (Relenza®). You breathe zanamivir in through your mouth with an inhaler. You usually have to take it for several days. Zanamivir isn’t recommended for people with breathing issues, like asthma or COPD.
• Peramivir (Rapivap®). Your provider gives you peramivir directly into your veins using an IV. You usually only need one dose of peramivir.
• Baloxavir marboxil (Xofluza®). You take baloxavir marboxil by mouth as a pill or a liquid. You only take one dose. Baloxavir isn’t recommended if you’re pregnant, breastfeeding/chestfeeding, hospitalized or have certain medical conditions.

Tell your provider about any health conditions you have before starting an antiviral medication.

Side effects of treatment

Each antiviral medication has different side effects, but common ones include nausea and diarrhea. Inhaled medications can cause spasms that tighten and narrow your airways (bronchospasm).

How do I manage symptoms of the flu?

Many people can manage the symptoms of flu at home with over-the-counter (OTC) medications and other therapies, including:

• Getting plenty of rest.
• Drinking fluids like water or broth to help prevent dehydration.
• Applying heat packs or hot water bottles can help with aching muscles.
• Taking acetaminophen (Tylenol®) or NSAIDs (Advil®, Motrin®, Aleve®) can help lower your fever and relieve head and body aches.
• Using spray or oral decongestants like phenylephrine or pseudoephedrine can help with a runny or stuffy nose.
• Taking cough suppressants (antitussives) like dextromethorphan can help calm a nagging cough.
• Using expectorants like guaifenesin make it easier to clear mucus out of your lungs.

Not everyone should take certain OTCs, so check with your provider before you use them. It’s also a good idea to make sure certain medications are okay to use together or with supplements. Don’t give aspirin to children under the age of 16 unless their provider says it’s okay.

How can I prevent the flu?

The best way to prevent the flu is to get the flu vaccine every year. Vaccines train your immune system to recognize infections and fight them off before you get sick. The influenza virus can change (mutate) a little bit every year, which is why you need to get vaccinated every year.

Even if you get sick with a different version of the flu than the one in the vaccine, vaccination reduces your risk of getting seriously ill. Your provider can give you the flu vaccine as a shot or as a mist they spray into your nose.

Other ways to reduce your risk of getting the flu include:

• Wash your hands often with soap and water. If you aren’t able to use soap and water, use an alcohol-based hand sanitizer.
• Cover your nose and mouth when you sneeze or cough. Cough or sneeze into your elbow or a tissue rather than your bare hand.
• Avoid being around other people when you or they are sick with the flu or other infectious diseases.
• Consider wearing a mask if you’re sick and can’t avoid being around others.
• Avoid touching your face, eyes, nose and mouth.
• Don’t share food or eating utensils (forks, spoons, cups) with others.

What can I expect if I have the flu?

Most people are able to manage flu symptoms at home and recover within a few days to a week. Because it can cause severe illness, it’s important to keep an eye on your symptoms and get medical attention if you need it. This is especially important if you have an underlying health condition.

If you’re sick with the flu, you should avoid being around others, except to seek medical care.

How long does the flu last?

Flu can last from a few days to two weeks. Symptoms like fever and body aches can come on suddenly but usually go away faster than other symptoms. A cough or runny nose can last longer.

How long is the flu contagious?

You can be contagious with the flu from a day before your symptoms start to up to a week after. You’re most contagious for three to four days after your symptoms start. People with weakened immune systems and infants may be contagious for longer.

When can I go back to work/school?

To avoid spreading the flu to others, you shouldn’t go back to work or school until it’s been at least 24 hours since you’ve had a fever (without taking fever-reducing medications). Your employer or school may have different requirements for returning.

Complications

The flu virus itself can cause complications or it can weaken your immune system and allow bacteria to infect different parts of your body (secondary infection). Complications and secondary infections include:

• Ear infections.
• Sinus infections.
• Severe lung infection (pneumonia). Pneumonia can lead to acute respiratory distress syndrome (ARDS) and other life-threatening conditions.
• Pregnancy loss (miscarriage).
• Neural tube defects (NTDs) in the developing fetus of a pregnant person.

How many people die from the flu each year?

In a typical flu season in the U.S., it’s estimated that between 20,000 and 50,000 people die from the flu. Another 300,000 to 500,000 require hospitalization for serious illness.

When should I see my healthcare provider?

If you think you have the flu, it’s important to get tested early on so that antiviral medications are most effective if your provider prescribes them. Contact a healthcare provider right away if:

• You have flu symptoms and an underlying condition that puts you at higher risk for severe illness.
• Your symptoms don’t start to improve after seven to 10 days or if you have a fever lasting longer than three days.
• You’re pregnant and have a fever or other flu symptoms.

When should I go to ER?

Go to the ER or seek immediate medical attention if you have symptoms of severe illness, including:

• High fever (over 103 F/40 C).
• Difficulty breathing.
• Not peeing or peeing very little.
• Pain in your chest or stomach (abdomen) that doesn’t go away.
• Persistent dizziness.
• Confusion.
• Severe muscle pain or weakness.
• Seizures.
• Bluish skin, lips or nails (cyanosis, which can be a sign of low oxygen levels in your blood or tissues).
• Fever or cough that gets better or goes away but then get worse.
• Worsening of other health conditions.

What questions should I ask my doctor?

• How do I take my medication?
• What over-the-counter medications can I use?
• How do I treat my symptoms at home?
• What severe symptoms should I look out for?
• When should I go to the ER?
• When should I follow up with you?
• How long might it take to feel better?

Is the stomach flu influenza?

No, gastroenteritis, commonly called “stomach flu,” isn’t caused by the influenza virus. It’s not related to the seasonal flu.

A note from QBan Health Care Services

While the flu is very common, it’s also important to remember that it can lead to life-threatening complications. Getting your flu shot is the best way to avoid getting sick and protect your loved ones and neighbors, too. If you have underlying health conditions or are pregnant, talk to your provider about reducing your risk of flu. Having the flu isn’t fun for anyone, but most people can get through with some movies and chicken soup at home.

The common cold is an infection of your nose, sinuses, throat and windpipe. Colds spread easily, especially within homes, classrooms and workplaces. More than 200 different viruses can cause colds. There’s no cure for a common cold, but it usually goes away within a week to 10 days. If you don’t feel better in 10 days, see a healthcare provider.

What is the common cold?

A cold is a contagious upper respiratory infection that affects your nose, throat, sinuses and windpipe (trachea). You may have heard that the common cold is a coronavirus. In fact, more than 200 different types of viruses can cause a cold. The most common cold virus is the rhinovirus.

We call colds “common” because as their name implies, they’re widespread. You’ll probably have more colds in your lifetime than any other illness. Adults catch two to three colds a year, while young children come down with a cold four or more times a year.

What are the symptoms of the common cold?

Common cold symptoms typically appear in stages. The common cold stages include early, active and late.

Stage 1: Early (Days 1 to 3)

Within one to three days of picking up a cold virus, you may notice a tickle in your throat. About half of all people with colds report a tickly or sore throat as their first symptom. Other common cold symptoms you may experience during this early stage include:

• Sneezing.
• Runny nose.
• Stuffy nose (nasal congestion).
• Cough.
• Hoarseness.

Stage 2: Active (Days 4 to 7)

Symptoms typically worsen or peak during this stage. In addition to the symptoms in stage 1, you may experience:

• Body aches.
• Headache.
• Runny eyes and nose.
• Fatigue.
• Fever (more common in children).

Stage 3: Late (Days 8 to 10)

Colds usually begin to wind down during this stage. You may be free and clear at this point. But some symptoms can persist. Some people develop a nagging cough that can last up to two months after a respiratory infection.

If your symptoms get worse and/or your fever returns, make a trip to a healthcare provider. You may have developed another infection or a complication, such as bronchitis, sinusitis or pneumonia.

What are the symptoms of the common cold in babies?

Symptoms of colds in babies may include:

• Runny nose (the discharge may start clear; later, it becomes thicker and may be gray, yellow or green).
• Sneezing.
• Fever of 101 to 102 degrees Fahrenheit (38.3 to 38.9 degrees Celsius).
• Loss of appetite.
• Increased drooling because of sore throat and difficulty swallowing.
• Cough.
• Irritability.
• Slightly swollen glands.

How do cold symptoms differ from more severe infections in babies and children?

If your child has any of the following symptoms, call their healthcare provider. These symptoms could mean that your child has something more serious than a cold:

• Fever in an infant 2 months or younger.
• Difficulty breathing (especially if your baby’s or child’s nostrils widen with each breath).
• Fast or labored breathing.
• Wheezing.
• Ribs showing with each breath.
• Blue lips.
• Not eating or drinking, which could mean dehydration.
• Ear pain.
• Excessive crankiness or sleepiness.
• A cough that lasts more than 3 weeks.
• Your baby seems to be getting sicker.

What causes the common cold?

Rhinoviruses cause up to 50% of common colds. There are more than 100 different rhinoviruses. But other types of viruses, such as coronaviruses, can also cause colds. More than 200 different viruses can cause a cold.

Is the common cold contagious?

Yes. Colds spread easily from person to person. For you to become infected, the virus has to get to one of your mucous membranes — the moist lining of your nostrils, eyes or mouth. That happens when you touch a surface or breathe moist air that contains the cold virus.

For example, when a person who’s sick sneezes or coughs, they launch droplets of fluid containing the cold virus into the air. If you breathe in those droplets, the cold virus takes root in your nose. You can also leave virus particles on surfaces you touch when you’re sick. If someone else touches those surfaces and then touches their nostrils, eyes or mouth, the virus can get in.

How long is the common cold contagious?

You can be contagious for up to two weeks, even spreading a cold a day or two before you have symptoms. But you’re most contagious when your symptoms are at their worst — usually the first three days you feel sick.

What is the common cold incubation period?

The incubation period is the time between when you’re infected and when your symptoms first appear. The common cold incubation period is between 12 hours and three days after exposure to the virus.

Why do children and babies get more colds?

The common cold in children and babies occurs more often because they haven’t been exposed to as many viruses as adults. Their immune systems have to learn how to recognize and fight new germs.

Before turning 2 years old, a baby can get as many as eight to 10 colds a year. By the time you become an adult, you’ve had many colds. It’s easier for your immune system to identify and attack similar viruses.

In addition, children are in close contact with other children. Kids typically don’t cover their coughs and sneezes or wash their hands before touching their faces — steps that prevent the virus from spreading.

Cold viruses can live on objects for several hours. Babies often pick up objects that other babies have touched. If a baby touches something that has cold germs on it, then touches their mouth, eyes or nose, the germs can infect them.

How is the common cold diagnosed?

A healthcare provider will ask you about your symptoms and perform a physical exam. During the exam, the provider will check for signs, such as:

• Swelling in your nostrils.
• A stuffy nose.
• A red, irritated throat.
• Swollen lymph nodes in your neck.
• Clear lungs.

What tests will be done to diagnose the common cold?

Typically, a physical exam is enough to determine if you have a cold. You may need tests if the provider suspects you have COVID-19, the flu or another condition. The provider may give you a nasal swab test (cotton swab rubbed inside your nose) to check for these viruses. Chest X-rays can rule out other conditions, such as bronchitis or pneumonia.

How is the common cold treated?

There’s no cure for a cold. You have to let it run its course. Most colds go away on their own within seven to 10 days and don’t turn into anything more serious. Common cold treatment includes over-the-counter (OTC) medications to help reduce your symptoms and keep you comfortable until you recover.

Why can’t antibiotics cure a cold?

Antibiotics are medications that fight infections caused by bacteria. Because viruses cause colds, antibiotics don’t work for colds. Sometimes, children may develop complications from bacteria, such as an ear infection or pneumonia. Healthcare providers may prescribe antibiotics to treat these illnesses.

What cold medicines relieve symptoms?

There are many OTC common cold medication options available to treat your symptoms. But some of these medications aren’t safe for children. Check with a healthcare provider before giving your child OTC medications. Be careful not to combine medicines that treat multiple symptoms. You could get too much of some ingredients, which could cause other health problems, including organ damage.

Medications that may relieve cold symptoms include:

• Pain relievers: Acetaminophen (Tylenol®) and NSAIDs such as ibuprofen (Advil®) may relieve headaches and fever.
• Decongestants: You can use medications like pseudoephedrine (Contac Cold 12 Hour® and Sudafed®).
• Antihistamines: Diphenhydramine (Benadryl®) and other antihistamines may stop sneezing and a runny nose.
• Cough suppressants: Medications such as dextromethorphan (Robitussin® and Vicks DayQuil Cough®) and codeine can help reduce coughing. Providers don’t routinely recommend these for children under 5 years of age.
• Expectorants: Guaifenesin (Mucinex®) and other expectorants may help thin and loosen mucus.

How are common colds in babies treated?

Unless prescribed by their provider, don’t give your baby any over-the-counter cough or cold medicines. To treat common cold in babies:

• Keep your baby comfortable.
• Give your baby fluids. For babies 6 months or younger, let them drink breast milk (chest milk) or formula. At 6 months, your baby can also have some water.
• Let your baby get plenty of rest.

Since most children can’t blow their nose until about age 4, the following methods may help ease your baby’s stuffy nose:

• Saline and suction: About 15 minutes before a feeding, use over-the-counter saline (salt water) drops to loosen up the mucus in your baby’s nostrils. Suction out the liquid and mucus a few minutes later with a rubber bulb or oral suction device. This will clear the mucus out of your baby’s nose and allow them to breathe and suck at the same time.
• Petroleum jelly: Dab petroleum jelly on the outside of your baby’s nostrils to reduce irritation. Don’t block the inside of your baby’s nostrils. (Unless their provider recommends it, don’t use nasal sprays on your baby. They may work for a bit but will make their congestion worse with continued use.)
• Humidifier or vaporizer: Moisten the air in your baby’s room with a humidifier or vaporizer. The clean, cool mist will help moisten the air and decrease the drying of your baby’s nasal passages and throat. Clean and dry the humidifier thoroughly before using it to get rid of bacteria or mold that may have collected in the device. Ensure you have the appropriate filter, and check if it needs to be replaced. Don’t use hot water vaporizers because of the risk of burns.
• Steam: If you don’t have a humidifier, take your baby into a steamy room such as a bathroom. Turn on the hot water, close the door and sit together in the steamy room for about 15 minutes. Don’t leave your baby alone in the room. Be safe around water. Giving your baby a warm bath may also work.

Babies can continue their normal activities if they seem well enough to do so. If they have a fever or complications, it’s best to keep them at home.

Can the common cold be prevented?

There are several steps you can take to prevent a cold, including:

• Washing your hands: Wash your hands frequently, especially before eating or preparing food. Also, wash your hands after using the bathroom, wiping your nose or coming into contact with someone who has a cold.
• Avoiding touching your face: Cold viruses spread from your hands to your eyes, nose and mouth.
• Cleaning frequently used surfaces: Viruses can live on doorknobs and other places people often touch.
• Using hand sanitizers: When you can’t wash your hands with soap and water, use alcohol-based hand sanitizer.
• Strengthening your immune system: Get enough sleep, eat a healthy diet and exercise so your body is ready to fight off germs.
• Staying home: To make sure you don’t spread the cold to others, stay home when you’re sick.

How can colds in babies be prevented?

The best way to prevent your baby from catching a cold is to keep them away from people who have colds. If possible, keep your baby home. A virus that causes a mild illness in an older child or an adult can cause a more serious one in an infant.

Hand washing is the most important way to reduce the spread of colds:

• Adults who have contact with babies and young children should wash their hands after coughing, sneezing or wiping their nose.
• Wash your hands after touching someone who has a cold.
• After wiping your baby’s nose, wash your hands and your baby’s hands.
• Clean toys regularly and avoid sharing toys that babies place in their mouths.
• If soap and water aren’t available, use pre-moistened hand wipes or hand sanitizers. (Be sure to keep hand sanitizers away from children. They may be harmful if swallowed.)

Keep your baby up-to-date on all of the recommended immunizations. They won’t stop colds, but they can help prevent some complications, such as bacterial infections of their ears or lungs.

Pediatricians recommend the flu (influenza) vaccine each year for babies who are at least 6 months old. The shot protects against the flu but not against other respiratory viruses. The COVID-19 immunization is available as well for infants starting at 6 months of age.

How long does a common cold last?

Most colds go away on their own within seven to 10 days. Most people recover quickly and the common cold doesn’t lead to anything more serious.

Can a cold kill you?

The common cold isn’t fatal. In some people — especially those with weakened immune systems — a cold could lead to other conditions that could cause severe health problems. Those complications include:

• Asthma.
• Sinus infections.
• Ear infections.

What are the best common cold remedies?

You may have heard that supplements and herbal remedies, such as zinc, vitamin C and echinacea can treat and prevent colds.

Researchers haven’t found that any of those remedies can prevent colds. But zinc may shorten the illness and reduce symptoms. However, it may cause permanent loss of smell, especially when you use it in nasal sprays.

The best common cold self-care remedy is to get plenty of rest. Consider taking time off from work or school for at least the first few days of illness. Not only will you have more time to rest, but you’ll avoid spreading germs to others.

Also, make sure you’re drinking plenty of fluids to keep your nose and throat moist. Avoid alcohol and caffeine because they have a drying effect.

When should I see a healthcare provider for the common cold?

Contact a healthcare provider if you have any of the following symptoms:

• High fever.
• Chest pain.
• Ear pain.
• Asthma flare-up or difficulty breathing.
• Symptoms lasting more than 10 days or getting worse.

When should my baby see their provider for the common cold?

Call your baby’s healthcare provider or go to the nearest emergency room if your baby:

• Develops a high fever.
• Stops eating.
• Is vomiting.
• Has ear or stomach pain.
• Cries more than usual.
• Is sleepier than usual.
• Starts wheezing.
• Has trouble breathing.

Does having a cold affect pregnancy?

Having a cold during pregnancy isn’t usually dangerous. But you do need to be careful with what cold medications you take to treat symptoms. Your healthcare provider can let you know which ones are safe to use during pregnancy.

If you think you may have the flu or you develop a fever, you should contact your provider right away. You may need immediate treatment.

Common cold vs. Covid — what’s the difference?

Coronaviruses are a group of viruses that can cause upper respiratory infections. While rhinoviruses cause most types of common cold, coronaviruses do cause some. Most people recover quickly from these common colds.

Coronaviruses may also travel into your lungs and lead to pneumonia and other complications that can be fatal. The novel (new) coronavirus discovered in 2019 causes a specific disease known as COVID-19. Early symptoms that make COVID-19 different from the common cold include:

• Fever.
• Chills and shaking.
• Shortness of breath (dyspnea).
• Loss of taste or smell (anosmia).
• Diarrhea.

However, the omicron variant of COVID-19 causes slightly milder symptoms, making it easier to confuse with a cold. Omicron symptoms similar to the common cold include:

• Runny nose.
• Cough.
• Sore throat.
• Headache.
• Nasal congestion.

Common cold vs. flu — what’s the difference?

It can be hard to tell whether you have a cold or the flu since many of the symptoms are the same. Both are widespread during the colder months and affect your upper respiratory system. But different viruses cause cold and flu. The flu comes from the influenza virus, while many other types of viruses cause colds.

The main difference between cold and flu is that you’re more likely to have a fever and chills with flu. Adults don’t usually get a fever with a common cold, although kids sometimes do.

The flu also causes body aches and more severe symptoms than a cold. Although both the cold and flu can lead to complications, flu complications can be life-threatening.

Common cold vs. chest cold — what’s the difference?

A chest cold, or short-term (acute) bronchitis, causes irritation and a buildup of mucus in your lungs. Common colds turn into chest colds when the virus travels from your nose and throat to your lungs. Occasionally, bacteria cause chest colds.

You can have a cough with a common cold or a chest cold. But chest colds produce a wet cough, meaning you may feel or cough up phlegm. You may also have:

• A cough that keeps you up all night.
• Shortness of breath.
• A sore chest.

A note from QBan Health Care Services

Although it may cause discomfort, the common cold is usually harmless. You can manage the symptoms of a cold with medications. Speed up your recovery by getting plenty of rest and fluids, and avoid being around others. If you don’t feel better in 10 days, see a healthcare provider.

Heart valve disease is a fairly common problem with the valves that keep your blood flowing in one direction through your heart. Medicines can help with the blood flow problems from a heart valve that isn’t working right, but sometimes that’s not enough. Your healthcare provider can tell you if you need to have your valve repaired or replaced.

What is heart valve disease?

Heart valve disease refers to any of several conditions that prevent one or more of the valves in your heart from working right. Left untreated, heart valve disease can cause your heart to work harder. This can reduce your quality of life and even become life-threatening. In many cases, your healthcare provider can do surgery or a minimally invasive procedure to repair or replace your heart valves, restoring normal function and allowing you to return to normal activities.

The four valves in your heart make sure blood flows in only one direction through your heart. Your heart’s valves are:

• Mitral (between your left atrium and left ventricle).
• Tricuspid (between your right atrium and right ventricle).
• Aortic (between your left ventricle and aorta).
• Pulmonary (between your right ventricle and pulmonary artery).

Oxygen-poor blood comes back from your body to your heart’s right atrium, then goes through your tricuspid valve and into your right ventricle. From there, it goes through your pulmonary valve and pulmonary artery to get oxygen from your lungs.

Blood with oxygen returns through your pulmonary veins to your heart’s left atrium. Your mitral valve lets the blood travel from the left atrium to your left ventricle. From there, oxygen-rich blood goes through your aortic valve and out through your aorta to the rest of your body.

Your valves consist of small flaps of tissue (called leaflets) that open to allow blood to move forward through your heart during half of your heartbeat. These leaflets close to prevent blood from flowing backward during the other half of your heartbeat. Your mitral valve has two leaflets, but the others have three leaflets.

The leaflets in two of your valves (the mitral and tricuspid) also have tough, fibrous strands of tissue called chordae tendineae that connect the valve leaflets to the papillary muscles inside the walls of your ventricles. The chordae tendineae and papillary muscles keep the leaflets stable against any backward flow of blood.

What are the types of heart valve disease?

There are different types of heart valve disease, and it is possible for more than one valve to be affected.

Valvular stenosis

With valvular stenosis, the tissues forming the valve leaflets become stiffer, narrowing the valve opening and reducing the amount of blood that can flow through it. Mild narrowing may not reduce the overall functioning of your heart. However, the valve can become so narrow (stenotic) that it reduces your heart’s function, makes your heart pump harder and puts it under strain. As a result, the rest of your body may not get enough blood flow.

Valvular insufficiency

Valvular insufficiency (or regurgitation, incompetence, “leaky valve”), happens when the leaflets don’t close completely, letting blood leak backward across the valve. This backward flow is referred to as “regurgitant flow.” Your heart has to pump harder to make up for this backward flow, and the rest of your body may get less blood flow.

You can get a backward flow if you have mitral valve prolapse, a common problem in which the valve flaps go back into your left atrium when your heart beats.

Valvular atresia

Valvular atresia happens when a heart valve doesn’t form correctly before birth. This is usually diagnosed very early in infancy.

How common is heart valve disease?

About 2.5% of Americans — many of them older adults — have heart valve disease. Each year, roughly 28,000 people die from heart valve disease in the United States. Mitral valve prolapse is a common heart valve problem.

How does heart valve disease affect my body?

When a heart valve isn’t working right, it puts a strain on your heart because it makes it work harder. Also, it can cause less blood flow to your body.

What are the symptoms?

It’s common for people with heart valve disease to be without symptoms. But when the heart valve problem worsens, your heart beats harder to make up for the reduced blood flow. Over time, heart valve disease may get bad enough that these symptoms begin to appear:

• Increasing shortness of breath, especially with physical activity or lying down.
• Palpitations (skipped beats or a flip-flop feeling in the chest).
• Edema (swelling of the ankles, feet or abdomen).
• Weakness or dizziness.
• Quick weight gain.
• Chest discomfort, especially when you exert yourself.
• Fatigue.
• If the valve disease is caused by infection, you may notice fevers, chills, or body aches.

What causes heart valve disease?

Common heart valve disease causes include:

• Rheumatic fever from strep throat that wasn’t treated.
• Heart attack that damages your heart.
• High blood pressure (advanced).
• A congenital problem that’s been present since birth, such as a pulmonary or aortic valve that didn’t develop right.
• Degeneration or calcification of the valve tissue, with loss of function over time.
• Thoracic aortic aneurysm(dilation of the aorta, which stretches the aortic valve leaflets and can cause leakage).
• Heart failure.
• Infection in your heart (infective endocarditis).

How is heart valve disease diagnosed?

When your healthcare provider does a physical examination and listens to your heart through a stethoscope, they may find these signs of heart valve disease:

• Fluid in your lungs.
• An enlarged heart.
• A heart murmur, which could mean blood is moving through a stenotic or leaky valve.
• Swelling in your ankles.

Several medical tests can also show heart valve disease. Repeating tests over time can help your provider see the progress of your valve disease and help them make decisions about your treatment.

What tests will be done to diagnose heart valve disease?

Tests for heart valve disease diagnosis include:

• Echocardiogram (ultrasound of the heart) — A moving image of your heart’s valves and chambers using sound waves from a handheld wand placed on your chest.
• Transesophageal echocardiogram (TEE) — An ultrasound of your heart, performed by inserting a probe with an ultrasound transducer down your esophagus. This can provide clearer images than a regular echocardiogram because the esophagus sits very close to the heart.
• Exercise stress echocardiogram — After walking on a treadmill or riding a bike, an echocardiogram is performed to see how the valves and heart function respond to exercise.
• Chest X-ray — A quick X-ray scan of your chest.
• Cardiac catheterization (angiogram) — X-ray movies of your coronary arteries, heart chambers and heart valves. An injection of contrast dye into a catheter in your arm or leg helps produce the images.
• Electrocardiogram (EKG or ECG) — Using small electrode patches attached to your skin to get the information, this records the electrical activity of your heart on graph paper.
• Magnetic resonance imaging (MRI) — Radio waves and a magnet work together to create high-quality images of your heart.

How is heart valve disease treated?

A heart valve problem can be serious if it’s not treated. Although you can’t undo damage to a heart valve, you can treat the issue.

Heart valve disease treatments depend on the underlying cause and may include:

• Protecting your valve from further damage.
• Taking medications.
• Having surgery or invasive procedures if necessary.
• Seeing your heart doctor for regular visits.

The decision to prescribe medical treatment, surgical repair or surgical replacement depends on several factors, including:

• The type of valve disease.
• The severity of the damage.
• Your age.
• Your medical history.

If you’re pregnant and have heart valve disease, you can get extra rest and/or take certain medicines that are safe for your baby.

If you know about your valve disease before pregnancy, you should ask your healthcare provider if any tests or visits with a cardiologist are recommended before trying to become pregnant. This can help ensure that you are treated appropriately before and during pregnancy. If you have a severe valve problem, your doctor may recommend valve repair or replacement before pregnancy.

Surgical repair or replacement

Heart valve disease is a mechanical problem in the opening or closing of the leaflets, and you may eventually need surgery to repair or replace your valve. Some infants and children who are born with a valve problem need surgery during childhood.

Usually, the surgeon and cardiologist will know which treatment will be best before surgery day. Other times, the surgeon makes the decision during surgery, when they can see your valve.

Often, valve surgery may be combined with other procedures (such as more than one valve procedure, bypass surgery or surgery to treat atrial fibrillation) to fully treat your heart disease.

Heart valve repair allows your surgeon to fix your faulty valve, often without the use of artificial parts. In some cases, such as a narrow mitral valve, your provider may use a balloon on a catheter to widen your valve.

The advantages of valve repair are:

• Lower risk of infection.
• Decreased need for lifelong blood thinner medication.
• Preserved heart muscle strength and function.

Surgeons have to replace valves they can’t repair. Replacing your heart valve involves removing your old valve and sewing a new valve to the ring-shaped part of your old valve. The new valve could be a mechanical or biological (made with tissue from a human, cow or pig) valve. These replacement valves can provide adequate function when repair can’t. However, depending on the type of valve your provider uses, you may have to take certain medications to prevent blood clots or get a new valve again in 10 or 15 years.

Depending on the type of valve problem and your other medical conditions, you may be a candidate for minimally invasive valve repair or replacement. Ask your cardiologist if a minimally invasive procedure may be right for you.

What medications are used?

Although medicines can’t cure heart valve disease, they — and a healthier lifestyle — can help with symptoms and decrease your chance of having a stroke or sudden cardiac arrest. You may be able to stop taking some medications after valve surgery, but you may need to take other medicines for the rest of your life.

Your healthcare provider may prescribe medications to help you with:

• Preventing arrhythmias or blood clots.
• Bringing down your blood pressure or cholesterol levels.
• Treating heart failure or coronary artery disease.

Your provider will review your medication information with you before you leave the hospital. It’s important to know:

• The names of your medications.
• Their purpose.
• How often and at what times to take them.

Complications/side effects of the treatment

Older people and those whose health is not good to begin with have a higher risk of complications from valve replacement surgery.

Complications, which are rarely fatal, may include:

• Infection.
• Atrial fibrillation or another type of abnormal heart rhythm.
• Bleeding.
• Blood clots.
• Kidney failure.
• Stroke or transient ischemic attack (TIA).

How long does it take to recover from heart valve surgery?

You may be in the hospital for about five to seven days after heart surgery. After that, it can take approximately four to eight weeks to recover. Your provider may recommend cardiac rehabilitation, a carefully monitored exercise program to assist with your recovery.

How can I reduce my risk of heart valve disease?

Although you can’t change some risk factors, like growing older, there are things you can do that may reduce your risk of heart valve disease. These include:

• Getting treatment quickly for infections.
• Being physically active.
• Eating healthy foods.
• Staying at a healthy weight.
• Continuing to take medicine for high blood pressure and/or high cholesterol if you have those conditions.
• Not using tobacco products.
• Not using recreational drugs, especially IV drugs which increase your risk for heart valve infection.

Protecting your valve from further damage

People with heart valve disease should talk to their healthcare provider about the increased risk of getting infective endocarditis. This infection can greatly damage or destroy your heart valves and can be fatal. You are at risk even if you had surgery to repair or replace your valve. To prevent infective endocarditis:

• Tell your medical and dental providers that you have valve disease.
• Call your provider if you have symptoms of an infection.
• Take good care of your teeth and gums.
• Ask your heart doctor if you should take antibiotics before any dental procedures, major or minor surgeries, or invasive tests.

What can I expect if I have heart valve disease?

If you have heart valve disease, you’ll have it for your whole life. However, your experience of heart valve disease depends on the valve affected and the severity of the problem. Some people may have valve disease and never experience any symptoms. Others may have many symptoms and require valve repair/replacement. It is important to follow up regularly with a healthcare provider to monitor the progression of your valve disease over time. Untreated valve disease may eventually lead to:

• Heart failure.
• Blood clots.
• Stroke.
• Sudden cardiac arrest.

Even if your healthcare provider repairs or replaces your valve, you’ll still need to take medicine and possibly have another replacement in 10 or 15 years.

How do I take care of myself?

Keep taking any medicines your healthcare provider prescribed for you and go to all follow-up appointments.

When should I see my healthcare provider?

You’ll need to schedule regular follow-up appointments with your cardiologist to make sure your heart valves work as they should. Ask your provider how frequent these appointments should be. Contact your provider sooner if your symptoms become more severe or frequent. You should also tell your provider if you have infective endocarditis.

You may also need to repeat tests, such as an echocardiogram.

When should I go to the ER?

You should call 911 if you have these symptoms after heart valve surgery:

• Fainting.
• Fever or chills.
• Feeling sick to your stomach, throwing up or having diarrhea.
• Chest pain.
• Heart rate of more than 150 beats a minute.
• Severe headache or arm/leg weakness/numbness without warning.
• Shortness of breath that doesn’t get better with rest.
• Bright red blood in what you cough.
• Dark black stool or bright red blood in your stool.

What questions should I ask my doctor?

• Would lifestyle changes help me?
• What kinds of exercise are safe for me to do?
• How soon after surgery can I exercise?

A note from QBan Health Care Services

Although heart valve disease is a lifelong condition, you can manage it with medications and/or surgery. Your healthcare provider can talk with you about the best option for your situation. Regardless of what your provider does, you can do your part, too. You can get more exercise, eat heart-healthy foods and avoid using tobacco products. Be sure to keep taking any prescribed medicines and go to all of your follow-up appointments.

Pericardial effusion is an accumulation of fluid in the pericardium, the sac that holds your heart. When it happens quickly or involves a large amount of fluid, the excess fluid can take up too much space in the pericardium, compressing your heart and causing a life-threatening condition known as cardiac tamponade.

What is the condition?

Pericardial effusion is a buildup of fluid in the space around the heart. It can happen for a wide range of reasons, including infections, injuries or other medical conditions. If the buildup is severe or happens quickly, it can compress your heart and cause cardiac tamponade, a life-threatening medical emergency.

What is the difference between pericardial effusion and cardiac tamponade?

The pericardium is a double-walled sac that surrounds the heart. Between the inner wall of the pericardium and your heart is a thin layer of fluid, which cushions and protects your heart from outside forces (much like bubble wrap around a fragile item inside a shipping box).

Under normal circumstances, the pericardium has just enough fluid to cushion your heart, but not so much fluid that your heart can’t expand and fill up with blood with every heartbeat. Cardiac tamponade happens when there’s too much fluid inside the pericardium, which means your heart has no room to expand and fill up with blood. Without quick treatment, it can cause your heart to stop, which is eventually fatal within minutes to hours.

What is the difference between pericardial effusion and pleural effusion?

Pleural effusion is similar to pericardial effusion, but it happens in a different place inside your chest. The pleural cavity is the sac that surrounds your lungs, and a pleural effusion is when fluid fills up that space. A pleural effusion keeps your lungs from expanding as they should, which makes it harder for you to breathe.

Who does it affect, and how common is this condition?

Pericardial effusion can happen for a wide range of reasons. Because of that, it can happen to people of any age or background. It’s also a relatively common condition. However, there’s very little data on exactly how common it is. Sometimes, pericardial effusion is an incidental finding on an imaging test, meaning healthcare providers discover it without intending to.

How does this condition affect my body?

Every heartbeat starts with a pause where your heart muscle relaxes and expands. That lets the chambers of the heart fill up with blood before they squeeze. As the pericardium fills up, there’s less space for your heart to expand. Eventually, your heart doesn’t have room to expand so its chambers can fill up with blood.

An easy way to see how pericardial effusion affects your heart is by trying to blow up a balloon inside of a plastic bottle. In this example, your heart is the balloon and the bottle is the pericardium. When the bottle is empty, there’s more space for the balloon to inflate. If you add water to the bottle, there’s less space and you can’t blow up the balloon as much. If you keep filling the bottle, eventually you can’t blow up the balloon at all.

As your heart pumps less and less blood, it speeds up to try to make up for its limited pumping ability. Over time, your heart can’t keep up, and you go into cardiogenic shock, which makes your heart stop. Without treatment, cardiogenic shock is deadly.

What are the symptoms of pericardial effusion?

Pericardial effusions may not cause any symptoms, especially when they’re small or happen slowly. Symptoms are more likely when an effusion happens quickly, involves a large amount of fluid or causes cardiac tamponade. The main symptoms of pericardial effusions and cardiac tamponade include:

• Shortness of breath (dyspnea).
• Chest pressure or pain.
• Fast heartbeat or heart palpitations (the unpleasant feeling of your own heartbeat without feeling for your pulse).
• Lightheadedness or dizziness.
• Fainting (syncope).
• Fatigue.
• Anxiety, confusion or other behavior changes (because of low blood flow to the brain).
• Cyanosis (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels).

If a pericardial effusion is large enough, it can press on surrounding tissues or nerves. That can cause symptoms like:

• Trouble swallowing (dysphagia).
• Hiccups.
• Coughing or hoarseness.

What causes pericardial effusion?

Pericardial effusion can happen for many different reasons. It often happens along with (or because of) inflammation of the pericardium (pericarditis).

Possible causes of pericardial effusion include:

• Infections. Pericardial effusion often happens because of viral or bacterial infections, including human immunodeficiency virus (HIV) and tuberculosis (though this is less common in developed countries). It can also happen because of fungal infections or parasites.
• Cancer. Tumors in the heart or that spread from elsewhere in your body can cause damage to the pericardium.
• Immune system conditions or inflammatory disorders. These include lupus, rheumatoid arthritis or Sjögren’s syndrome.
• Hormonal disorders or problems. An example of this is hypothyroidism (where your thyroid gland isn’t producing enough thyroid hormone).
• Trauma. Injuries to the chest, including blunt impacts (like car crashes) and punctures from knives or bullets, can cause pericardial effusion.
• Heart or circulatory problems. These include heart attacks or aortic dissection (where layers on the inside of your aorta separate or tear).
• Medical causes. Pericardial effusion can happen after heart surgery, radiation therapy for cancer or as a side effect of some medications.
• Other. Pericardial effusion can also happen with heart failure, chronic kidney disease or kidney failure, liver cirrhosis or for unknown reasons.

Is pericardial effusion always a serious problem?

Pericardial effusion is usually a significant condition, but it isn’t always a medical emergency. Pericardial effusions may be small or large, and sometimes smaller effusions go away on their own. Whether or not it’s a life-threatening emergency depends on what caused it, the amount of fluid involved, and how fast that fluid fills the pericardium.

When an effusion happens quickly, it needs less fluid to become dangerous and cause cardiac tamponade. That’s because the pericardium doesn’t have time to stretch and expand to accommodate more fluid inside it. When a pericardial effusion happens slowly, it can take weeks or even months before it becomes a problem.

One factor that determines if a pericardial effusion is serious is why it happened in the first place. When it happens because of injuries or heart and circulatory problems (or any reason that can cause an effusion to develop quickly), pericardial effusion needs quick treatment to avoid dangerous complications like cardiac tamponade.

Is it contagious?

While pericardial effusion isn’t contagious on its own, it can happen because of contagious infections.

How is pericardial effusion diagnosed?

If you have symptoms, a doctor will diagnose pericardial effusion based on a combination of the symptoms you describe, your medical history, medical testing, and examining you for any signs and symptoms of this condition. Some of the key signs include an unusual drop in your blood pressure when you breathe in, muffled or unusual heart sounds, or bulging of the jugular vein in your neck.

If you don’t have symptoms, the most likely way a doctor will diagnose pericardial effusion is if they happen to see it on medical imaging for another reason. This kind of diagnosis is called an incidental finding, and an example of this is a pericardial effusion that’s visible on a chest X-ray after a car accident.

A wide range of tests is possible when healthcare providers evaluate your symptoms or suspect a pericardial effusion.

Imaging tests

• Echocardiogram.
• Chest x-ray.
• Computed tomography (CT) scan of the chest.
• MRI of the heart.

Electrocardiogram

This test measures the electrical activity of your heart through a set of sensors (usually 10) called electrodes, which attach to the skin of your chest. The electrodes detect your heart’s electrical activity and show it as a wave on either a paper printout or a screen display. Doctors can tell when your heart isn’t beating properly because its electrical activity changes in certain ways, some of which are very distinctive.

Lab tests

Lab tests usually come after a provider diagnoses pericardial effusion. These tests focus on finding out why you have a pericardial effusion. The possible tests include:

• Complete blood count.
• Troponin.
• B-type natriuretic peptide.
• Thyroid-stimulating hormone.
• Immune system tests (to look for immune system disorders or inflammatory conditions).

In some cases, tests on the fluid taken out of your pericardium are also possible. Testing the fluid can sometimes help doctors understand the underlying cause behind the effusion.

How is it treated, and is it curable?

Pericardial effusions are often treatable. Whether or not they’re curable depends on how severe they are and why they happened. Your healthcare provider is the best person to tell you what to expect from the treatment, including whether or not your effusion is curable.

What are the possible treatments?

Treatment of a pericardial effusion depends on how severe it is and what caused it. Small effusions or those that don’t happen for a dangerous reason often don’t need treatment.

When a pericardial effusion is large or causes cardiac tamponade, it becomes a medical emergency that needs immediate treatment. Potential treatments include:

• Needle aspiration (pericardiocentesis): After numbing a specific area on your chest and using imaging tools (like echocardiography or fluoroscopy) for guidance, a healthcare provider will insert a needle into your chest until it is just inside the pericardium. They’ll then aspirate (pull out) the excess fluid inside. Sometimes, a thin, tube-like device is left inside the pericardium to drain fluid for a few days until it is all gone.
• Surgery. In some cases, surgery is the best way to remove the extra fluid inside the pericardium. Surgery can happen in an emergency, or it can be a scheduled procedure when an effusion causes symptoms but is slow-growing and not dangerous. A common surgical procedure for this is video-assisted thoracic surgery (VATS), which creates a pericardial “window” to allow draining fluid to spill into the larger pleural cavity so it doesn’t fill up the pericardial space.

In cases where an effusion isn’t dangerous and doesn’t need any of the above treatments, it’s often possible to treat it with medications or other types of treatments. The treatments depend on the underlying cause. These include, but aren’t limited to, the following:

• Antibiotics. These help by treating underlying infections, such as tuberculosis, which can cause pericarditis and effusions.
• Anti-inflammatory drugs. These help reduce inflammation and swelling.
• Chemotherapy and radiation therapy. These help when pericardial effusion happens because of cancer.
• Diuretics and other heart failure medications. These help when heart failure is the cause behind a pericardial effusion.

Are there potential side effects or complications to the treatments?

The possible side effects with treatments for pericardial effusion depend strongly on which treatments or medications you receive. Your healthcare provider is the best person to tell you about what side effects are possible with the medications you take because they can tailor the information to fit your specific needs and circumstances.

A possible complication is pericardial decompression syndrome when you undergo a procedure or surgery to treat a pericardial effusion. While it isn’t common, it is severe and life-threatening. It usually happens when fluid removal happens too quickly from a large effusion. To avoid this, your healthcare provider may drain the effusion more slowly.

How to take care of myself/manage symptoms?

Pericardial effusion isn’t something you should try to treat on your own unless you’ve spoken with a healthcare provider. That’s because it isn’t possible to diagnose it without specific medical tests and imaging. After getting this diagnosis, you can ask your healthcare provider what you can do to manage your symptoms and limit their impact on your life.

How soon after treatment will I feel better, and how long does it take to recover?

How long it takes you to feel better and recover depends on three main factors:

• The cause of the effusion.
• The severity of the effusion.
• The treatments you received.
• Your overall health and whether or not you have any other related medical conditions.

In cases where you have symptoms of cardiac tamponade, you should start to feel better as fluid removal decreases the pressure on your heart. In general, your healthcare provider is the best person to tell you the likely recovery time and when you should start to feel better.

How can I reduce my risk of developing this, or prevent it from happening entirely?

Pericardial effusion is unpredictable, so it’s usually impossible to prevent it. However, you can indirectly reduce your risk by avoiding circumstances that could cause one to happen. Those circumstances are:

• Letting an infection go untreated for too long.
• Engaging in risky activities, such as sports or outdoor activities with a greater risk of injury, without taking safety precautions like wearing protective equipment.

What’s the outlook for this condition?

If you have a small or medium-sized pericardial effusion that is shrinking or not changing size, and you don’t have symptoms, you may not need any treatment. In these cases, your healthcare provider will probably want to monitor the effusion size and only recommend treatment if you develop symptoms or if there are other signs that it might be a problem.

If you have an effusion that’s growing more quickly, that’s causing symptoms, or that’s happening because of more serious conditions (especially trauma or cancer), you will probably need treatment sooner rather than later. If you have symptoms of cardiac tamponade, you need emergency medical attention immediately.

Overall, effusions that happen for unknown reasons tend to have a good prognosis. Effusions that happen because of trauma or cancer are more likely to have complications and are usually harder to treat.

How long does pericardial effusion last?

Large effusions and effusions that grow quickly are serious conditions that need quick medical care. That means these should not last any longer than it takes to diagnose and treat them, especially in emergency cases.

Chronic effusions, especially smaller ones that don’t cause symptoms, can last for weeks, months or even years. Depending on the circumstances, your healthcare provider may recommend regular follow-up visits to monitor the size of the effusion and whether or not it poses any risks to your health.

How do I take care of myself?

If you have a pericardial effusion, it’s important to watch for any symptoms or changes in your overall health. You should also follow your healthcare provider’s guidance, especially when it comes to taking medication and managing your recovery.

When should I call my healthcare provider?

Your healthcare provider can schedule follow-up visits to monitor your condition, if necessary. They can also give you guidance on how to manage your symptoms and when you should call their office.

When should I go to ER?

You should go to the hospital emergency room immediately if you have any of the following symptoms, which can be signs of cardiac tamponade:

• Chest pain.
• Trouble breathing or breathing rapidly.
• Changes in skin color, especially going pale, gray or blue-tinted skin.
• Fainting, dizziness or lightheadedness.
• Heart palpitations (where you become unpleasantly aware of your heartbeat).
• A pulse of more than 100 beats per minute while resting (tachycardia).

A note from QBan Health Care Services

Pericardial effusion is a condition that can happen to people at any stage in life and for many different reasons. This condition can have little to no effect on your life when effusions are small and don’t get bigger, or they can be medical emergencies when they affect how your heart functions. With quick diagnosis and treatment, many cases — depending on the underlying cause — are treatable, and some are curable.

Pericarditis is an inflammation of the pericardium or sac that contains your heart. Most people do well with prompt treatment, rest and medication. Others may need a procedure to drain fluid from their pericardium. In most cases, people make a full recovery. However, it can take weeks or months.

What is pericarditis?

Pericarditis is an inflammation of the pericardium, the thin, two-layered, fluid-filled sac that covers the outer surface of your heart. Pericarditis usually develops suddenly and may last from weeks up to several months. The condition usually clears up after three months, but sometimes attacks can come and go for years. Sometimes there is extra fluid in the space between the pericardial layers, which is called pericardial effusion.

Types of pericarditis

• Acute pericarditis: Inflammation of the pericardium that develops suddenly along with the sudden onset of symptoms.
• Chronic pericarditis: Inflammation of the pericardium that lasts for three months or longer after the initial acute attack.
• Constrictive pericarditis: A severe form of pericarditis in which the inflamed layers of the pericardium stiffen, develop scar tissue, thicken and stick together. Constrictive pericarditis interferes with your heart’s normal function. This usually happens after multiple episodes of acute pericarditis over time.
• Infectious pericarditis: develops as the result of a viral, bacterial, fungal or parasitic infection.
• Idiopathic pericarditis: Pericarditis that doesn’t have a known cause.
• Traumatic pericarditis: develops as the result of an injury to the chest, such as after a car accident.
• Uremic pericarditis: develops as the result of kidney failure.
• Malignant pericarditis: develops as result of a cancer growing in your body.

Myocarditis vs. pericarditis

Both of these are types of inflammation in your heart, but they’re in different places. Myocarditis is in your heart muscle. Pericarditis happens in your pericardium (the lining around your heart). Most often, a virus causes myocarditis and pericarditis. Both can give you chest pain, but with pericarditis, your chest pain should feel better when you sit up and lean forward. With myocarditis, you’ll usually feel tired and weak.

Who does pericarditis affect?

Pericarditis can affect anyone, but it’s most common in men and people assigned male at birth who are between the ages of 16 and 65. An estimated 28 people per 100,000 get pericarditis each year.

How does pericarditis affect my body?

When you have pericarditis, the membrane around your heart is red and swollen, like the skin around a cut that becomes inflamed. The pericardium is a thin, two-layered, fluid-filled sac that covers the outer surface of your heart. It provides lubrication for your heart, shields it from infection and malignancy, and contains your heart in your chest wall. It also keeps your heart from overexpanding when blood volume increases, which keeps your heart functioning efficiently.

What are the symptoms of pericarditis?

Pericarditis symptoms include chest pain that:

• Is sharp and stabbing (This happens when your heart rubs against your pericardium).
• May get worse when you cough, swallow, take deep breaths or lie flat.
• Feels better when you sit up and lean forward.

You also may feel the need to bend over or hold your chest to breathe more comfortably.

Other pericarditis symptoms include:

• Pain in your back, neck or left shoulder.
• Trouble breathing when you lie down.
• A dry cough.
• Palpitations (feeling like your heart is racing or beating irregularly).
• Anxiety or fatigue.
• Fever.
• Swelling of your legs, feet and ankles in severe cases.

Swelling in your feet, legs and ankles or shortness of breath every time you exert yourself may be a symptom of constrictive pericarditis. This is a severe type of pericarditis where the pericardium gets hard and/or thick. When this happens, the heart muscle can’t expand, which keeps your heart from working as it should. Your heart can become compressed, which makes blood back up into your lungs, abdomen and legs, leading to swelling and causing symptoms of congestive heart failure. You can also develop an abnormal heart rhythm.

If you have any symptoms of acute pericarditis, call your doctor right away. If you feel your symptoms are a medical emergency, call 911 right away to get treatment at the nearest hospital.

What causes pericarditis?

In up to 90% of cases, the cause of pericarditis is unknown. This is called idiopathic pericarditis.

There are many causes of pericarditis:

• A complication of a viral infection, most often a gastrointestinal virus, causes viral pericarditis.
• A bacterial infection, including tuberculosis, causes bacterial pericarditis.
• A fungal infection causes fungal pericarditis.
• An infection from a parasite causes parasitic pericarditis.
• Some autoimmune diseases, such as lupus, rheumatoid arthritis and scleroderma, can cause pericarditis.
• Injury to the chest, such as after a car accident, causes traumatic pericarditis.
• Kidney failure causes uremic pericarditis.
• Tumors like lymphoma causes malignant pericarditis.
• Genetic diseases such as Familial Mediterranean Fever (FMF).
• Medications that suppress the immune system (This is rare).

Your risk of pericarditis is higher after:

• A heart attack.
• Open heart surgery (postpericardiotomy syndrome).
• Radiation therapy.
• Percutaneous treatment, such as cardiac catheterization or radiofrequency ablation (RFA).

In these cases, it’s likely that the inflammation of the pericardium is an error in the body’s response to the procedure or condition. It can sometimes take several weeks for symptoms of pericarditis to develop after bypass surgery. Talk to your surgeon if you’re concerned about this.

How is pericarditis diagnosed?

Sharp pain in your chest and back of the shoulders that feel better when you sit up and lean forward, and chest pain with breathing are two major clues that you may have pericarditis and not a heart attack. Your healthcare provider will talk to you about your symptoms and medical history (such as whether you’ve recently been sick) and review your history of heart conditions, surgery and other health problems that could put you at a higher risk of pericarditis.

Your provider will listen to your heart. The rubbing of your pericardium’s inflamed lining causes a rubbing or creaking sound called the “pericardial rub.” They’ll be able to hear it best when you lean forward, hold your breath and breathe out. Depending on how bad the inflammation is, your provider may also hear crackles in your lungs, which are signs of fluid in the space around your lungs or extra fluid in your pericardium.

What tests will be done to diagnose pericarditis?

Healthcare providers use a variety of ways to check for pericarditis and any complications, such as pericardial effusion or constrictive pericarditis. You may need one or more tests, such as:

• Chest X-ray to see the size of your heart and any fluid in your lungs.
• Electrocardiogram (ECG or EKG) to look for changes in your heart rhythm. In about half of all people with pericarditis, providers see some characteristic changes to a normal heart rhythm. Some people don’t have any changes. If they do, they may be temporary.
• Echocardiogram (echo) to see how well your heart is working and check for fluid (a pericardial effusion) around your heart. An echo will show the classic signs of constrictive pericarditis, including a stiff or thick pericardium that constricts your heart’s normal movement.
• Cardiac MRI to check for extra fluid in your pericardium, pericardial inflammation or thickening, or compression of your heart. Your provider will give you a contrast agent called gadolinium during this highly specialized test.
• CT scan to look for calcium in the pericardium, fluid, inflammation, tumors and disease of the areas around your heart. Your provider uses iodine dye during the test to get more information about the inflammation. This is an important test for patients who may need surgery for constrictive pericarditis.
• Cardiac catheterization to get information about the filling pressures in your heart. This test can confirm a diagnosis of constrictive pericarditis.
• Blood tests can help your provider make sure you’re not having a heart attack, see how well your heart is working, test the fluid in the pericardium and help find the cause of pericarditis. If you have pericarditis, it is common for your sedimentation rate (ESR) and ultra-sensitive C reactive protein levels (markers of inflammation) to be higher than normal. You may need other tests to check for autoimmune diseases like lupus and rheumatoid arthritis.

How is pericarditis treated?

Most times, people with pericarditis only need medications for pericarditis treatment, depending on the suspected cause. However, if you have a fluid buildup in your pericardium, you might need to have the fluid drained. If you have constrictive pericarditis, you may need surgery.

Medications for pericarditis

Treatment for acute pericarditis may include medication for pain and inflammation, such as ibuprofen or high-dose aspirin. Depending on the cause of your pericarditis, you may need an antibiotic or antifungal medication.

If you have severe symptoms that last longer than two weeks, or they clear up and then return, your healthcare provider may also prescribe an anti-inflammatory drug called colchicine (Colcrys® or Gloperba®). Colchicine can help control the inflammation and prevent pericarditis from returning weeks or even months later. Your provider may also prescribe a steroid medicine called prednisone, especially if you have kidney disease that makes it difficult for you to take ibuprofen and colchicine.

If you need to take large doses of ibuprofen, your provider may prescribe medications to ease gastrointestinal (stomach and digestive) symptoms. If you take large doses of nonsteroidal anti-inflammatory drugs (NSAIDs), you’ll need frequent follow-up appointments to look for changes in your kidney and liver function.

If you have chronic or recurrent pericarditis, you may need to take NSAIDs or colchicine for several years, even if you feel well. A diuretic (“water pill”) usually helps get rid of the extra fluid constrictive pericarditis causes. If you develop a heart rhythm problem, your provider will talk to you about treatment.

Your provider may also talk to you about treatment with steroids or other medications, such as azathioprine (Azasan® or Imuran®), IV human immunoglobulins or anakinra or rilonacept.

If your pericarditis is caused by an infection, your provider will prescribe specific medicines to treat that infection. If your pericarditis is caused by cancer, the most effective treatment is to treat the cancer.

Procedures and surgeries for pericarditis

When fluid builds up in the space between the pericardium, it can cause a condition called pericardial effusion. If the fluid builds up quickly, it can cause cardiac tamponade, a severe compression of the heart that impairs its ability to function. Cardiac tamponade is a medical emergency that requires prompt diagnosis and treatment.

This sudden buildup of fluid in between the layers of the pericardium keeps your heart from working like it should and can cause your blood pressure to drop. Because cardiac tamponade is life-threatening, your provider needs to drain the fluid immediately.

If fluid builds up in your pericardium (pericardial effusion) and compresses your heart, you may need a procedure called pericardiocentesis. Your provider uses a long, thin tube called a catheter to drain the extra fluid. Echocardiography or a CT scan helps guide the catheter and a needle to your pericardium.

If your provider can’t drain the fluid with a needle, they’ll perform a minimally invasive surgical procedure called a pericardial window. They’ll make an opening in the pericardium through a small chest incision to drain fluid from your pericardium.

If you have constrictive pericarditis, you may need to have some of your pericardium removed. This surgery is called a pericardiectomy. Surgeons perform this on people who develop scar tissue in their pericardium. It’s not normally for people who have active inflammation and chest pain from pericarditis.

Surgery isn’t usually used as a treatment for people with pericarditis that keeps coming back because inflammation makes healing after surgery difficult, but your provider may talk to you about it if other treatments aren’t successful.

How long does it take to recover from this treatment?

You should respond to treatment within a week, but you could be taking medicine for two weeks. Recovery from surgery takes longer. It can take weeks or months for a full recovery from pericarditis.

How can I reduce my risk?

Although you can’t prevent acute pericarditis, getting quick treatment and sticking with it can help you reduce your risk of getting it again. You should also follow your provider’s recommendations about when to start exercising again, as brisk exercise can worsen active pericarditis.

What can I expect if I have this condition?

You’ll need to take it easy while recovering from pericarditis. After you recover from pericarditis, you should be able to return to your normal activities without any reason for concern. Don’t return to vigorous exercise until your provider clears you. Your healthcare provider will talk to you about what to expect.

How long does pericarditis last?

Acute pericarditis lasts less than four to six weeks. Incessant pericarditis lasts longer than that but shorter than three months. Chronic pericarditis lasts more than three months. About 15% to 30% of people with pericarditis have repeat (or recurrent) episodes of pericarditis that come and go for many years.

Outlook for this condition

The outlook is very good for people with acute pericarditis who receive treatment. Most people make a full recovery. If you have a mild case, it may get better with rest. Without treatment, some people can end up with chronic pericarditis.

If bacteria or tuberculosis caused your pericarditis, you may have up to a 30% risk of constrictive pericarditis. Cardiac tamponade, a complication of pericarditis, is more likely to happen when cancer or infection causes your pericarditis.

How do I take care of myself?

It’s important to keep taking the medicines your healthcare provider prescribed and to keep all follow-up appointments you have with your provider.

When should I see my healthcare provider?

Contact your healthcare provider if you have symptoms of constrictive pericarditis, including:

• Shortness of breath.
• Swelling in your legs and feet.
• Water retention.
• Heart palpitations.
• Severe swelling of your abdomen.

When should I go to the ER?

Although chest pain is a common symptom of pericarditis, it’s also a symptom of a heart attack. Call 911 if you have chest pain because it could be a heart attack.

What questions should I ask my doctor?

• Do you know what caused my pericarditis?
• How long will I need to take medication?
• What are the chances that I’ll get pericarditis again?

A note from QBan Health Care Services

If you get prompt treatment for pericarditis, you’ll most likely make a full recovery. Continuing with your treatment can help you prevent pericarditis from happening again. That’s why it’s important to keep taking prescribed medicines and go to all of your follow-up appointments. Get familiar with the symptoms of pericarditis so you can get quick treatment if it happens again.

Cardiomyopathy refers to conditions that affect your heart muscle. If you have cardiomyopathy, your heart can’t efficiently pump blood to the rest of your body. As a result, you may experience fatigue, shortness of breath or heart palpitations. Cardiomyopathy gets worse over time. Treatment can slow the progression and improve your quality of life.

What is cardiomyopathy?

Cardiomyopathy is a disease that affects your myocardium (heart muscle). Cardiomyopathy can make your heart stiffen, enlarge or thicken and can cause scar tissue. As a result, your heart can’t pump blood effectively to the rest of your body.

In time, your heart can weaken and cardiomyopathy can lead to heart failure. Treatment can help. Some people with cardiomyopathy eventually need a heart transplant.

Types of cardiomyopathy

Types of cardiomyopathy include:

• Dilated cardiomyopathy.
• Hypertrophic cardiomyopathy.
• Ischemic cardiomyopathy.
• Arrhythmogenic right ventricular dysplasia (ARVD).
• Restrictive cardiomyopathy.
• Transthyretin amyloidosis cardiomyopathy (ATTR-CM).
• Broken heart syndrome (stress-induced or takotsubo cardiomyopathy).
• Chemotherapy-induced cardiomyopathy.
• Alcohol-induced cardiomyopathy.
• Left ventricular non-compaction (LVNC).
• Peripartum cardiomyopathy.

How common is cardiomyopathy?

Cardiomyopathy can affect anyone of any age, sex or race. The most common inherited cardiomyopathy, hypertrophic, affects about 1 in 500 people in the world. Other genetic types occur in 1 in 2,000 or 2,500 people.

What are the symptoms?

Cardiomyopathy symptoms include:

• Fatigue.
• Heart palpitations.
• Chest pain.
• Arrhythmia.
• Shortness of breath (dyspnea).
• Swelling (edema) in your legs or ankles.
• Syncope (fainting).

Some people have no symptoms of cardiomyopathy and don’t need treatment. Others experience symptoms as their disease progresses.

What causes cardiomyopathy?

Causes of cardiomyopathy include genes you get from your parents. Researchers have found thousands of genetic mutations that cause cardiomyopathies.

Other cardiomyopathy causes include:

• Coronary artery disease.
• Autoimmune diseases, such as connective tissue diseases.
• Infections that affect your heart muscle.
• Heart inflammation.
• Diabetes.
• Thyroid disease.
• Muscular dystrophy.
• High cholesterol diseases.
• Sarcoidosis.
• Amyloidosis.
• Hemochromatosis.

Sometimes, experts don’t know the cause of a person’s cardiomyopathy.

What are the risk factors for cardiomyopathy?

Cardiomyopathy risk factors — some of which you can’t change — include:

• History of heart failure, cardiomyopathy or sudden cardiac arrest in your family.
• Personal history of heart attacks.
• Long-term use of cocaine or alcohol.
• Pregnancy.
• A highly stressful experience, such as the loss of a loved one.
• Radiation or chemotherapy to treat cancer.
• A body mass index (BMI) higher than 30.

What are the complications of cardiomyopathy?

As cardiomyopathy worsens, you may develop other heart problems, such as:

• Arrhythmias (irregular heartbeats).
• Heart failure.
• Stroke.
• Heart valve disease.
• Cardiac arrest.
• Cardiogenic shock.

How is cardiomyopathy diagnosed?

Your healthcare provider will ask about your medical history and that of your family. They’ll also do a physical exam.

If they suspect you have a heart condition, they’ll refer you to a cardiologist (heart specialist). A cardiologist performs a full assessment that may include a range of diagnostic tests.

What tests will be done to diagnose cardiomyopathy?

Tests to diagnose cardiomyopathy may include:

• Ambulatory monitoring.
• Blood tests.
• Chest X-ray.
• Cardiac CT.
• Heart MRI.
• Echocardiogram.
• Electrocardiogram (EKG).
• Exercise stress test.
• Cardiac catheterization.
• Myocardial biopsy.

How is cardiomyopathy treated?

Cardiomyopathy treatments don’t cure the condition. However, they can help you manage your symptoms and slow down the disease’s progression. Your healthcare provider may recommend lifestyle changes, medications, devices or procedures. They’ll decide your treatment based on which type of cardiomyopathy you have and how advanced it is.

Lifestyle changes

Changing how you live day-to-day can strengthen your heart. Ways to do this include:

• Eating food with low fat and salt.
• Staying at a weight that’s healthy for you.
• Getting regular exercise.
• Getting the amount of sleep you need.
• Reducing your stress level.
• Avoiding the use of tobacco products.
• Avoiding alcohol.

Medications

Depending on the cause, specific case, your cardiomyopathy and any other underlying medical conditions, certain medications can improve your blood flow and manage your symptoms.

Your cardiologist may prescribe:

• Antihypertensives.
• Blood thinners (anticoagulants).
• Antiarrhythmics.
• Medications to lower cholesterol.
• Aldosterone antagonists.
• Corticosteroids.

Devices to correct arrhythmias

Devices a provider puts into your body can treat irregular heart rhythms. These devices monitor your heartbeat. They send electrical impulses to your heart when an arrhythmia starts. You may receive one of these devices:

• Pacemakers.
• Implantable cardioverter defibrillators (ICDs).

Devices to improve blood flow

Some devices help your heart pump blood more efficiently. You may receive one of these devices:

• Cardiac resynchronization therapy (CRT).
• Left ventricular assist device (LVAD).

Procedures

If you have severe symptoms or underlying heart conditions, your provider may recommend a procedure. Some of these involve surgery. Providers usually only recommend open-heart surgery or a heart transplant when all other treatments have failed to bring relief. Most people with cardiomyopathy don’t need the procedures below.

Rarely used procedures may include:

• Septal myectomy.
• Heart transplant.
• Alcohol septal ablation.
• Catheter ablation.

How can I lower my risk of cardiomyopathy?

You can take action to reduce your risk of conditions that could lead to cardiomyopathy.

Some of these actions include:

• Managing your blood pressure.
• Keeping your cholesterol within healthy ranges.
• Getting regular exercise.
• Avoiding tobacco products, alcohol and cocaine.
• Managing underlying conditions such as sleep apnea or diabetes.
• Scheduling regular checkups with a healthcare provider.
• Taking all medications as prescribed.

You can’t prevent congenital (inherited) types of cardiomyopathy, but you can let relatives know that you have cardiomyopathy. Your relatives can talk to their providers to see if they’re at risk for it or have it. Early diagnosis helps people make a plan for managing cardiomyopathy.

What can I expect if I have cardiomyopathy?

Cardiomyopathy is a serious condition. Without treatment, it can be life-threatening. It’s also a progressive condition, meaning it usually worsens over time.

Cardiomyopathy treatment can improve your outlook. If you have cardiomyopathy, seek treatment from a cardiologist (heart specialist). Medication, procedures or other treatments can increase your quality of life and help you live longer.

How long cardiomyopathy lasts

The length of time that you have cardiomyopathy depends on the type you have. The severity of your condition matters, too. Takotsubo cardiomyopathy is usually temporary and doesn’t last long. Cardiomyopathy from alcohol may only last a few months. You may be able to reverse cardiomyopathy from chemotherapy.

For other types, you’ll need to manage your symptoms for the rest of your life. Many people don’t have major problems from their cardiomyopathy, but some do.

Outlook for cardiomyopathy

There’s no cure for cardiomyopathy. However, you can manage the condition or slow its progression. Many people who make healthy lifestyle choices and seek medical treatment can live a high quality of life with cardiomyopathy. Taking the proper medications can drastically alter and improve the prognosis of cardiomyopathy. Many people can live normal and healthy lives with the right treatment.

How do I take care of myself?

Lifestyle choices can affect how quickly cardiomyopathy progresses. To manage symptoms and increase your heart health, your provider may recommend:

• Achieving and maintaining an ideal weight for your height and age.
• Eating a heart-healthy diet, including reducing your sodium intake.
• Exercising regularly.
• Limiting alcohol intake.
• Managing and reducing stress.
• Quitting smoking.

When should I see my healthcare provider?

You’ll need regular checkups to monitor your heart’s health. Also, you may need regular blood tests or other tests that tell your provider how well your heart is doing. Contact your provider if you have:

• New symptoms.
• Worse symptoms.
• Side effects from medications.
• Trouble with your device.

When should I go to the ER?

Get emergency medical care if you have:

• Chest pain.
• Heart palpitations.
• Fainting.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What’s the most likely cause of my cardiomyopathy?
• What treatments do you recommend?
• What lifestyle changes should I make to improve my heart health?
• Is there a support group nearby or online that I can join?

A note from QBan Health Care Services

It’s normal to have concerns about a cardiomyopathy diagnosis. But healthcare providers can offer many treatments to improve your quality of life and help you live longer. Ask your provider how often you need checkups with them. Going to regular appointments with your provider will help them monitor your condition and see how well treatments are working for you.

Have you ever had to get an X-ray, MRI, or other medical scan? Do you know what these tests involve? Or what they can do?

Medical scans help doctors diagnose everything from head trauma to foot pain. There are many different types of imaging technologies. Each works differently.

Some types of imaging tests use radiation. Others use sound waves, radio waves, or magnets. Learning about how medical scans work can help you feel more comfortable if you or a loved one needs one. It can also help you to know what to ask about before getting an imaging test.

Radiation in Medical Scans

Radiation can be dangerous, but it can also save lives. How can that be? Harnessed properly, radiation can help diagnose and even treat disease. So when you’re faced with a medical test that uses radiation, don’t let fear get in your way. Learn about the risks and benefits, and know what questions to ask. If medical radiation is really needed, take steps to ensure that it’s done as safely as possible.

Radiation, simply put, is the transfer of energy through space. The energy may be in the form of invisible particles or waves. Radiation is all around us—and has been throughout our evolution—so our bodies are designed to deal with the low levels we’re exposed to every day. Excess radiation, however, can damage tissues and lead to serious problems.

Why is radiation used in medicine? Radiation allows radiologists and other physicians to see internal parts of the body that they aren’t able to see directly with their eyes or through other physical examination measures.

Techniques like x-rays and CT scans send controlled amounts of radiation through the body and create images based on what comes through the other side. Another imaging method called nuclear medicine uses compounds that emit radiation, which can then be detected outside the body. Injected or swallowed, these compounds can target a specific area and reveal internal problems. Or they can be used to track how well internal organs are working.

With these advanced imaging tools, doctors can detect disease early, when it’s easier to treat. As a result, use of medical radiation has been rising. But with these benefits come some risks.

One of the main risks of being exposed to radiation is the possibility of developing a cancer. Cancer takes years to develop, so it’s nearly impossible to tell exactly what causes any given cancer. As a result, it’s hard for researchers to gauge exactly how much risk a given amount of radiation poses.

Children’s growing bodies are even more susceptible to radiation damage than those of adults. Children have a long lifetime ahead. Any damage caused by radiation has a longer period of time to show itself.

In 2012, a worrisome report linked childhood CT scans to 2 types of cancer later in life: leukemia and brain cancer. The NIH-funded study looked at more than 175,000 children and young adults. Depending on the radiation dose, those who’d received 2 or more scans had a small boost in cancer risk. Because these cancers are rare, the benefits of CT scans likely outweigh the risks, the researchers concluded. Still, they suggest that doctors consider alternatives to CT scans or use the lowest possible radiation doses.

Strangely enough, radiation can also be used to treat cancer. Focused doses of high-energy radiation can kill cancer cells and shrink tumors. Medical imaging tests, in contrast, use much lower doses.

The fundamental thing to understand is that these procedures all deliver a generally low amount of dose. In some cases, depending on your disease, it’s potentially riskier to not get the scan or nuclear medicine procedure than to get it.

If a doctor recommends a test that uses radiation, ask about its risks and benefits. If the test is truly needed, do some research into the imaging facilities. Find one that monitors the doses they’re giving patients and takes pride in low doses.

X-Rays

The first revolution in seeing into the body came with X-rays. They have been used in the clinic for more than 120 years.

X-rays are still used every day because they can do a lot. They’re useful for looking at bones and finding problems in certain types of tissues, like pneumonia in the lungs.

X-ray imaging works by passing an energy beam through a part of your body. Your bones or other body parts will block some of the X-ray beams from passing through. That makes their shapes appear on the detectors used to capture the beams. The detector turns the X-rays into a digital image for a radiologist to look at.

X-ray beams use radiation. Radiation is energy that’s released as invisible particles or waves. Being exposed to very large amounts of radiation can damage cells and tissues. It may also increase your risk of developing cancer.

But modern X-ray tests use a very small dose of radiation. People are naturally exposed to radiation from many sources, such as the sky, rocks, and soil.

A chest X-ray gives you similar amounts of radiation as you’d get in a plane flight across the Atlantic Ocean.

CT Scans

CT scans also use X-ray beams. But the beams rotate around your entire body to create a 3D picture. These images contain more information than a regular X-ray. The scan can be done in less than a minute. That makes it especially useful in places like the emergency department. There, doctors need to know immediately if a patient has a life-threatening condition.

Because CT scans use more X-ray beams than a normal X-ray, they often deliver a higher dose of radiation. But medical specialists have ways to calculate the smallest radiation dose needed.

The medical specialists tailor the dose to the patient’s size, and they tailor it to the reason for the exam. For example, a CT scan of the chest needs less radiation than a CT scan of the stomach area.

While lower doses of radiation would likely further lower risk, the standard doses are already quite low. That’s important for people to know, because some patients who really need a CT scan are afraid to get it.

Fear can sometimes keep someone from getting a scan that could help improve their health, or even save their life. Current CT doses are in a range where it’s not possible to even prove a risk exists. They’re that low.

MRI

MRI works in a very different way. It doesn’t use X-rays. Instead, it uses strong magnets and radio waves to affect atoms in the water molecules within your body’s tissues. When the radio waves are turned off, the atoms release energy that’s detected by the MRI machine.

Atoms in different tissue types go back to normal at different speeds and release different amounts of energy. MRI software uses this information to create 3D pictures of the different tissue types.

MRI is most helpful when you want to look at diseases that involve soft tissue, such as muscles, tendons, and blood vessels.

MRI can provide information about how the body is functioning in real time. For example, we can measure how much blood is flowing in the vessels. That can help doctors find small blockages or defects in the heart.

Because MRI doesn’t use X-rays, doctors would like to use it more in children. But MRI machines require you to lie motionless for a long time.

It can be difficult for children to hold still. If needed, general anesthesia can help get kids through the test. It makes them unconscious and unable to move. It’s typically very safe, but comes with some risks.

To help reduce the use of anesthesia, medical specialists have created a flexible, blanket-like version of MRI hardware to use with children. They coupled it with new methods for faster scanning. The soft blanket-like coil sits closely on top of the patient, providing a comforting environment. “It’s helping some kids get though exams without anesthesia.

Ultrasound

Another commonly used imaging method is called ultrasound. It is a noninvasive test that sends sound waves into the body. Different types of tissue reflect sound waves differently. These differences can be picked up by an ultrasound machine and turned into a picture or video. Ultrasound is helpful for looking at the heart and other internal organs, other soft tissues such as blood vessels, or a developing baby.

Ultrasound enables healthcare providers to “see” details of soft tissues inside your body without making any incisions (cuts). And unlike X-rays, ultrasound doesn’t use radiation.

Although most people associate ultrasound with pregnancy, healthcare providers use ultrasound for many different situations and to look at several different parts of the inside of your body.

Other Scans

Doctors also use tests called nuclear imaging. These tests use a tiny amount of a radioactive substance, or “tracer.” Most tracers are injected into the body, but some are inhaled or swallowed. The tracers inside the body release radiation that can be measured by a detector outside the body. The type of tracer differs depending on what the doctors want to see.

A positron emission tomography (PET) scan, for example, often uses a radioactive sugar to diagnose cancer. When cancer cells take up the radioactive sugar, they can be seen with the PET scanner.

Scientists are working to develop new types of tracers to detect different conditions, such as infections hiding deep in the body. They’re also continuing to explore other ways to make medical scans faster and deliver less radiation.

A Note from QBan Health Care Services

Medical scans are very useful and generally safe imaging tests that healthcare providers use for a variety of reasons. If you need a medical scan and are worried about the exam or have questions about it, don’t be afraid to ask your healthcare provider. Talk to them about any concerns you have, including all options for testing and the benefits and risks of each. They’re available to help and support you.

Congenital heart disease (CHD) is a defect in the heart’s structure that’s present at birth. It can be detected before birth, soon after birth or anytime throughout life. There are many kinds of CHD. Symptoms and treatment depend on the type of defect and its severity. A person with CHD should see a cardiologist regularly throughout life.

What is congenital heart disease?

Congenital heart disease (CHD) is a defect or problem with the heart’s structure that’s present at birth, such as:

• A hole in the heart wall.
• Issues with the blood vessels (too many or too few, blood flowing too slowly, to the wrong place or in the wrong direction).
• Problems with the heart valves.

Some cases of CHD are simple and may not cause any symptoms, but others can be life-threatening and require treatment.

Heart defects may be detected early (before a baby is born or shortly afterward). But sometimes, CHD isn’t diagnosed until childhood, adolescence or adulthood.

How common are congenital heart defects?

CHD is the most common type of birth defect, affecting 8 to 9 per 1,000 live births.

What are the types of congenital heart defects?

There are two main groups of CHD: cyanotic congenital heart disease and acyanotic congenital heart disease.

Cyanotic (low oxygen in the blood) congenital heart disease

Cyanotic congenital heart disease involves heart defects that reduce the amount of oxygen delivered to the rest of the body. This is sometimes called a critical congenital heart defect. Babies born with cyanotic congenital heart disease usually have low levels of oxygen and need surgery. Examples include:

• Left heart obstructive lesions: This type of defect reduces blood flow between the heart and the rest of the body (systemic blood flow). Examples include hypoplastic left heart syndrome (when the heart is too small on the left side) and interrupted aortic arch (aorta is incomplete).
• Right heart obstructive lesions: This type of defect reduces blood flow between the heart and lungs (pulmonary blood flow). Examples include tetralogy of Fallot (a group of four defects), pulmonary atresia and tricuspid atresia (valves don’t develop correctly).
• Mixing lesions: With this type of defect, the body mixes systemic and pulmonary blood flow. One example is transposition of the great arteries when the two main arteries leaving the heart are reversed. Another is truncus arteriosus, when the heart has only one main artery, instead of two, to carry blood to the body.

Acyanotic (blood oxygen level is acceptable) congenital heart disease

Acyanotic congenital heart disease involves a defect that causes blood to pump through the body abnormally. For example:

• Hole in the heart: One of the heart’s walls can have an abnormal opening. Depending on the location of the hole, this may be called atrial septal defect, atrioventricular canal, patent ductus arteriosus or ventricular septal defect.
• Problem with the aorta: The aorta is the main artery that carries blood away from your heart to the rest of the body. It can be too narrow (aortic coarctation). Or the aortic valve (which opens and closes to regulate blood flow) may be restricted in opening and or a more common defect with only two flaps instead of three (called bicuspid aortic valve).
• Problem with the pulmonary artery: The pulmonary artery carries blood from the right side of the heart to the lungs to get oxygen. If this artery is too narrow, it’s called pulmonary artery stenosis.

What are the symptoms of congenital heart disease?

Symptoms may start as soon as a baby is born or may not appear until later in life. They can include:

• Cyanosis (blueish skin, lips or nails).
• Excessive sleepiness.
• Fast breathing or trouble breathing.
• Fatigue (extreme tiredness).
• Getting unusually tired or out of breath during exercise.
• Heart murmur (a swishing sound made by the heart that may indicate abnormal blood flow).
• Poor blood circulation.
• Weak pulse or pounding heartbeat.

The signs and symptoms vary widely, depending on:

• Age.
• The number of heart defects (a person can be born with more than one defect).
• The severity of the condition.
• Type of defect.

What causes congenital heart disease?

CHD happens when the fetal heart doesn’t develop correctly in the uterus. Scientists don’t fully understand why that happens, but it may be related to:

• Abnormal chromosomes or genetics.
• Drinking or smoking during pregnancy (or significant environmental exposures such as secondhand smoke).
• Illnesses in the mother during pregnancy (diabetes, drug use, phenylketonuria or viral infection).

How is congenital heart disease diagnosed?

Sometimes a heart defect is found before a baby is born. If your healthcare provider finds anything unusual during a routine prenatal ultrasound, you and the fetus may need further testing. For example, a fetal echocardiogram uses sound waves to create pictures of the fetal heart.

Other heart defects are found soon after a baby is born. For example, cyanotic CHD is often detected by pulse oximetry. The simple, painless test uses sensors on the fingers or toes to find out if oxygen levels are too low. Sometimes, congenital heart disease isn’t diagnosed until later in life.

Tests that can help diagnose CHD in newborns, children or adults include:

• Physical exam: During an exam, a healthcare provider will listen to the heart for any abnormal sounds.
• Chest X-ray: A chest X-ray takes pictures of the inside of your chest to reveal any structural abnormalities.
• Electrocardiogram: Electrocardiogram (EKG or ECG) measures the electrical activity of your heart.
• Echocardiogram: An echocardiogram (echo) uses ultrasound to create images of the heart’s valves and chambers.
• Heart catheterization: A healthcare provider can tell how well your heart is pumping and circulating blood by performing a heart catheterization. It’s also called cardiac catheterization or coronary angiography.
• Magnetic resonance imaging (MRI): MRI for heart disease can create detailed pictures of your heart.

How is CHD treated?

Some cases of CHD may heal themselves. Others may remain but don’t require any treatment while others must be treated soon after birth.

Anyone with a heart defect should see a heart specialist (cardiologist) regularly throughout their life. Be sure the cardiologist has training and expertise in congenital heart defects.

Treatment for CHD may involve:

• Catheter procedure to place a plug into the defect.
• Medications to help your heart work more efficiently or to manage blood pressure.
• Nonsurgical procedure to close a defect using a closing device.
• Oxygen therapy, which provides higher levels of oxygen than normal room air would.
• Prostaglandin E1, which relaxes smooth heart muscle and can keep open the ductus arteriosus (a blood vessel normally closed after birth) helping provide needed circulation.
• Surgery to repair a defect, open up blood flow or redirect blood. In severe cases, a heart transplant may be necessary.

Does adult congenital heart disease (ACHD) require special treatment?

Adults with congenital heart disease may develop certain health problems later in life. They can limit your ability to perform everyday tasks and shorten your life span. Examples include:

• Arrhythmia: Arrhythmia is an abnormal heart rhythm. It can occur when there is a problem with the heart’s structure or scar tissue from an earlier surgery.
• Endocarditis: Endocarditis is an infection in the heart. Taking antibiotics if indicated for a specific defect before dental and surgical procedures can help prevent heart infection.
• Heart failure: In heart failure, the heart can no longer pump adequately for proper blood circulation to fulfill the body’s needs. It’s sometimes called congestive heart failure.
• Hypertension: Hypertension (high blood pressure) occurs when pumping blood puts too much pressure on blood vessel walls.
• Pregnancy complications: Women with ACHD may have an increased risk of pregnancy complications, including arrhythmia, heart failure and stroke.
• Pulmonary hypertension: Pulmonary hypertension is high blood pressure in the lung’s arteries. It can lead to heart failure.
• Stroke: A stroke occurs when a blood vessel in the brain becomes blocked or bursts. This blockage or rupture cuts off blood supply to the brain.
• Sudden cardiac death: Sudden cardiac death is a sudden loss of heart function. It’s caused by sudden cardiac arrest. This life-threatening condition occurs when the heart’s electrical system malfunctions, most commonly causing a dangerously fast heartbeat.
• Valve dysfunction: If the heart’s valves aren’t working correctly, blood may be restricted or back up into the heart chambers causing overload or the heart to work harder than it should.

It’s important to see a cardiologist regularly to monitor your heart and prevent or treat complications. Treatment will depend on the type of heart defect you have and how it’s affecting you personally.

How can I reduce the risk of a heart defect?

Scientists don’t have all the answers yet as to what causes heart defects other than random gene mutations. But, there are things that place you at higher risk (smoking, alcohol, certain medications, etc.) and these should be avoided during pregnancy. There are otherwise no proven strategies to prevent CHD.

You should follow your healthcare provider’s instructions during pregnancy, including:

• Don’t use recreational drugs.
• Get all recommended screening tests during pregnancy to detect problems as early as possible.
• Manage any health conditions, such as diabetes and phenylketonuria.
• Stop smoking and avoid secondhand smoke.
• Avoid alcohol.

What is the outlook?

The outlook for people with congenital heart disease depends on the type of defect and its severity. Although serious cases can be life-threatening, many people with CHD live long, relatively normal and fulfilling lives. Decades ago, only 10% of children with CHD survived into adulthood. Advances in diagnosis and treatment now help about 90% survive.

How do I take care of myself with adult congenital heart disease?

To keep your heart as healthy as possible and prevent complications of ACHD:

• Eat a well-balanced, nutritious diet of heart-healthy foods.
• Exercise regularly (but only with your cardiologist’s approval).
• Maintain a healthy weight.
• See a cardiologist regularly throughout your life to monitor and manage ACHD and detect any complications.
• Tell all of your healthcare providers about the heart defect, all medications you take and what surgeries you’ve had.
• Understand the specific type of heart defect you have and what the possible complications are.
• If you plan to become pregnant, talk to your cardiologist, obstetrician and primary care doctor well in advance. They will help you understand and manage the risks throughout your pregnancy.

A note from QBan Health Care Services

Congenital heart disease is a defect in the heart’s structure that’s present at birth. It can be detected before a baby is born, soon after birth, or any time during childhood or adulthood. If you or your baby have a heart defect, it’s important to see a cardiologist who specializes in CHD. You should visit the cardiologist regularly throughout life to monitor the condition and keep the heart as healthy as possible.