Category: Health

CONGESTIVE HEART FAILURE

Congestive heart failure is a long-term condition that happens when your heart can’t pump blood well enough to give your body a normal supply. Blood and fluids collect in your lungs and legs over time. Medications and other treatments help manage symptoms like swelling. Congestive heart failure is life-limiting for many.

What is congestive heart failure?

Congestive heart failure, or heart failure, is a long-term condition in which your heart can’t pump blood well enough to meet your body’s needs. Your heart is still working. But because it can’t handle the amount of blood it should, blood builds up in other parts of your body. Most of the time, it collects in your lungs, legs and feet.

Think of it like a shipping department that can’t keep up with getting all the shipments where they need to go. The shipping department is always running behind and things pile up. When things pile up, they cause issues.

Types of congestive heart failure

Types of congestive heart failure include:

How common is congestive heart failure?

More than 6 million people in the United States have congestive heart failure. It’s the leading cause of hospitalization in people older than 65.

What are the congestive heart failure symptoms?

Congestive heart failure symptoms include:

Sometimes, you may have mild symptoms of congestive heart failure or none at all. This doesn’t mean you don’t have heart failure anymore. Symptoms of heart failure can range from mild to severe and may come and go.

Unfortunately, congestive heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.

What causes congestive heart failure?

Causes of congestive heart failure include:

Left-sided heart failure is the most common cause of right-sided heart failure. When your left ventricle isn’t working correctly, it allows blood to back up. At some point, this backup affects your right ventricle. Other causes include certain lung problems and issues in other organs.

What are the risk factors for congestive heart failure?

Risk factors for congestive heart failure include:

  • Being older than 65.
  • Using tobacco products, cocaine or alcohol.
  • Having an inactive (sedentary) lifestyle.
  • Eating foods that have a lot of salt and fat.
  • Having high blood pressure.
  • Having coronary artery disease.
  • Having a heart attack.
  • Having a family history of congestive heart failure.

What are the complications of congestive heart failure?

Some of the complications from congestive heart failure include:

  • Irregular heartbeat.
  • Sudden cardiac arrest.
  • Heart valve problems.
  • A collection of fluid in your lungs.
  • Pulmonary hypertension.
  • Kidney damage.
  • Liver damage.
  • Malnutrition.

How is congestive heart failure diagnosed?

Your healthcare provider will ask you about your symptoms and medical history. They may ask you about:

  • Other health conditions you have.
  • A family history of heart disease or sudden death.
  • Your use of tobacco products.
  • How much alcohol you drink.
  • Any history of chemotherapy and/or radiation.
  • The medications you take.

You’ll also have a physical exam. Your provider will look for signs of congestive heart failure and diseases that may have made your heart muscle weak or stiff.

What are the four stages of congestive heart failure?

Heart failure is a chronic condition that gets worse with time. There are four heart failure stages (Stages A, B, C and D). They range from having a high risk of developing heart failure to having advanced heart failure.

Stage A

Stage A (pre-heart failure) means you’re at a high risk of developing heart failure because you have a family history of congestive heart failure or you have one or more of these medical conditions:

Stage B

Stage B (pre-heart failure) means your left ventricle isn’t working well and/or is structurally abnormal but you’ve never had symptoms of heart failure.

Stage C

People with Stage C heart failure have a congestive heart failure diagnosis and currently have or previously had signs and symptoms of the condition.

Stage D and reduced EF (ejection fraction)

People who have Stage D HFrEF (heart failure with reduced ejection fraction) have advanced symptoms that don’t get better with treatment. This is the final stage of heart failure.

What tests will be done to diagnose congestive heart failure?

Common tests to identify congestive heart failure, its stage and its cause include:

How is congestive heart failure treated?

Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle changes are part of every heart failure treatment plan. Your healthcare provider will talk to you about the best treatment plan for you.

There’s no cure for heart failure. As congestive heart failure gets worse, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. Since you can’t move backward through the heart failure stages, the goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.

Stage A treatment

Treatment for people with Stage A heart failure includes:

Stage B treatment

Treatment for people with Stage B heart failure includes:

  • Treatments for Stage A.
  • Angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) if your EF is 40% or lower.
  • Beta-blocker if you’ve had a heart attack and your EF is 40% or lower (if you aren’t already taking one).
  • Aldosterone antagonist if you’ve had a heart attack or if you have an EF of 35% or less.
  • Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease (valve repair or replacement) or congenital heart disease.

Stage C treatment

Treatment for people with Stage C HFrEF includes:

  • Treatments from Stages A and B.
  • Beta-blocker.
  • Aldosterone antagonist.
  • Sodium-glucose transport 2 inhibitors (SGLT2i).
  • Hydralazine/nitrate combination if other treatments don’t stop your symptoms and you’re African American.
  • Medications that slow your heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms.
  • A diuretic (“water pill”) if symptoms continue.
  • Restriction of sodium (salt) in your diet.
  • Weight tracking every day. Tell your healthcare provider if you gain or lose more than 4 pounds.
  • Possible fluid restriction.
  • Possible cardiac resynchronization therapy (biventricular pacemaker).
  • Possible implantable cardiac defibrillator (ICD) therapy.

If the treatment improves or stops your symptoms, you still need to continue treatment to slow the progression to Stage D.

Stage D treatment

Treatment for people who have Stage D heart failure includes treatments for Stages A, B and C. In addition, it includes evaluation for more advanced treatment options, including:

Stages C and D with preserved EF

Treatment for people with Stage C and Stage D heart failure and preserved EF (HFpEF) includes:

  • Treatments for Stages A and B.
  • Medications for the treatment of medical conditions that can cause heart failure or make it worse, such as atrial fibrillation, high blood pressure, diabetes, obesity, coronary artery disease, chronic lung disease, high cholesterol and kidney disease.
  • Diuretic (“water pill”) to reduce or relieve symptoms.

It’s very important for you to manage your other health conditions, such as:

Some conditions have signs and symptoms similar to congestive heart failure. If you have new or worsening nonurgent symptoms, tell your healthcare provider.

Complications/side effects of the treatment

Complications of congestive heart failure treatments may include:

  • Hypotension.
  • Kidney failure.
  • Infections from frequent hospital visits that involve central IVs.

How can I lower my risk of congestive heart failure?

Although you can’t change some risk factors like age, family history or race, you can change your lifestyle to give yourself the best chance of preventing heart failure. Things you can do include:

  • Staying at a weight that’s healthy for you.
  • Eating foods that are good for your heart.
  • Exercising regularly.
  • Managing your stress.
  • Stopping the use of tobacco products.
  • Not drinking alcohol.
  • Not using recreational drugs.
  • Taking care of other medical conditions you have that can increase your risk.

What can I expect if I have congestive heart failure?

With the right care, congestive heart failure won’t stop you from doing the things you enjoy. Your prognosis, or outlook for the future, will depend on:

  • How well your heart muscle is working.
  • Your symptoms.
  • How well you respond to your treatment plan.
  • How well you follow your treatment plan.

One study says that people with congestive heart failure have a life span 10 years shorter than those who don’t have heart failure. Another study showed that the survival rates of people with chronic heart failure were:

  • 80% to 90% for one year.
  • 50% to 60% for year five.
  • 30% for 10 years.

A different study found that people who had heart failure had expected life spans ranging from three to 20 years after their hospital stay, depending on various factors like age and assigned sex at birth. It’s important to look at your specific situation when considering your prognosis.

How long congestive heart failure lasts

Congestive heart failure is a chronic, or lifelong, condition. You’ll need to treat it for the rest of your life.

How do I take care of myself?

With the right care and treatment plan, many adults still enjoy life even though congestive heart failure limits their activities.

You can care for yourself by:

  • Taking your medications.
  • Being active.
  • Following a low-sodium diet.
  • Tracking and reporting new or worsening symptoms to your provider.
  • Keeping regular follow-up appointments with your provider.

Congestive heart failure is a chronic, long-term illness that can get worse quickly, so it’s a good idea to let your provider and family know your preferences for medical care. You can complete an advance directive or living will to let everyone involved in your care know what you want. A living will details the treatments you want or don’t want to prolong your life. It’s a good idea to prepare a living will while you’re well in case you aren’t able to make these decisions at a later time.

What can’t I eat or drink with congestive heart failure?

People with congestive heart failure may need to limit how much salt and/or fluid they consume each day. Your provider can give you guidelines for this.

When should I see my healthcare provider?

It’s important to let your provider know if you have new symptoms or if your heart failure symptoms get worse. Contact them for new or worsening:

  • Shortness of breath when you’re at rest.
  • Swelling in your legs or belly.
  • Sudden weight gain.
  • Constant tiredness.

When should I go to the ER?

You need emergency treatment when your heart failure suddenly gets worse. Providers call this acute decompensated heart failure. They can give you medicine and oxygen to improve your condition.

What questions should I ask my doctor?

Questions to ask your healthcare provider include:

  • Which stage of congestive heart failure do I have?
  • What’s the best treatment for me at this stage?
  • What kinds of exercise are safe for me to do?
  • Is there a support group for people with congestive heart failure?

A note from QBan Health Care Services

If you have heart failure, you can take steps to improve your heart health. Take your medications, follow a low-sodium diet, stay active, take notice of sudden changes in your weight, keep your follow-up appointments and track your symptoms. If you have questions or concerns about your medications, lifestyle changes or any other part of your treatment plan, talk to your provider. They’re there to help you manage your heart failure.

MYOCARDIAL ISCHEMIA

Myocardial ischemia is a lack of blood flow getting to your heart muscle. That means your heart muscle isn’t getting enough blood to do what it needs to do. Often, the cause is a collection of fat and cholesterol (plaque) that doesn’t let enough blood go through your coronary arteries. Medicines and surgeries can treat myocardial ischemia.

What is myocardial ischemia?

Myocardial ischemia (or cardiac ischemia) means your heart muscle is not getting enough blood (which contains oxygen and nutrients) to work as it should. If this lack of blood from your coronary arteries is severe or goes on for more than a few minutes, it can damage your heart muscle. Then it becomes a myocardial infarction (heart attack).

A heart attack is an emergency. You should call 911 for an ambulance instead of having someone drive you to the hospital.

Who does myocardial ischemia affect?

People who get myocardial ischemia often have:

How common is myocardial ischemia?

Each year, more than 1 million people in the United States die from myocardial infarction (heart attack). This is due to myocardial ischemia, a lack of blood flow and oxygen to your heart muscle.

How does myocardial ischemia affect my body?

Myocardial ischemia makes it difficult to exercise, especially in the cold. As your condition gets worse, you can have symptoms of myocardial ischemia with less and less activity. In time, it can be hard to go up a flight of stairs. Eventually, you can even have symptoms when you’re at rest.

What are the symptoms?

The most common symptom of myocardial ischemia is angina (also called angina pectoris). This is chest pain (similar to indigestion or heartburn) that feels like:

  • Chest discomfort.
  • Heaviness.
  • Tightness.
  • Pressure.
  • Aching.
  • Burning.
  • Numbness.
  • Fullness.
  • Squeezing.

There are two types of angina:

  • Stable angina, which usually stops soon after you rest or take medication to manage it.
  • Unstable angina, which can happen at any time, even when you’re relaxed or sleeping. It may not go away when you take medication.

Other myocardial ischemia symptoms can also include:

  • Pain or discomfort in your upper body, including your arms, left shoulder, back, neck, jaw or stomach.
  • Trouble breathing or feeling short of breath.
  • Sweating or “cold sweat.”
  • Feeling full, indigestion, or a choking feeling (may feel like heartburn).
  • Nausea or vomiting.
  • Feeling lightheaded, dizzy, very weak or anxious.
  • Fast or irregular heartbeat.

If you have angina or any of the symptoms of ischemia listed above that last for more than five minutes, call 911 right away.

It’s possible to have ischemia ─ or even a heart attack ─ and not have any warning signs. This is called silent myocardial ischemia. This is most common in people with diabetes, but it can happen to anyone with heart disease.

What causes myocardial ischemia?

Often, a person has more than one cause of myocardial ischemia.

Causes of myocardial ischemia include:

  • Coronary artery disease. This is a buildup of plaque and cholesterol inside your coronary arteries, which supply blood to your heart muscle. The buildup narrows your artery so much that the oxygen-rich blood your heart needs can’t get through, and your heart muscle becomes starved for oxygen. This causes ischemia and angina. Atherosclerotic plaque causes 70% of fatal heart attacks.
  • Blood clot. When plaque that forms in your narrow coronary artery breaks apart, it can attract a blood clot. When a blood clot settles in a coronary artery that’s already narrow, it can cause a blockage (thrombosis).
  • Coronary artery spasm. This happens when the coronary arteries spasm, which temporarily reduces or cuts off blood supply to your heart.
  • Cocaine use.
  • Coronary artery dissection. This rare condition can keep blood from getting to your heart.

Ischemia is most likely to happen when your heart needs more oxygen and nutrients than it’s getting. It happens when your heart can’t keep up with your body’s increased demand for blood.

Your body needs more blood when you’re:

  • Active/exercising.
  • Eating.
  • Excited.
  • Stressed.
  • Cold.

How is myocardial ischemia diagnosed?

In addition to getting your medical history and doing a physical exam, your healthcare provider may do the following tests:

Your provider may also do blood tests to check for:

  • Proteins and enzymes that only show up in the blood when the heart muscle is damaged.
  • Causes of ischemia.
  • High cholesterol.

How is myocardial ischemia treated?

Myocardial ischemia treatments may include medications or procedures to improve blood flow to your heart muscle. Your treatment for myocardial ischemia depends on the cause of the problem. Your healthcare provider will talk to you about the treatment that’s best for you.

What medications/treatments are used?

Medicines or treatments for myocardial ischemia may include:

Complications/side effects of the treatment

Complications of coronary artery bypass graft may include:

Rarely, some of these complications can happen with angioplasty/ stent placement as well.

How long does it take to recover from this treatment?

After a coronary artery bypass graft, you’ll need to spend about a week in the hospital. After that, you’ll need six to 12 weeks to recover at home.

After angioplasty or stent placement, you’ll probably spend the night in the hospital and go home the next day.

How can I reduce my risk?

Your healthcare provider may recommend medications or lifestyle changes to reduce your risk of myocardial ischemia.

Medicines

Lifestyle changes

  • Get treatment for diabetes.
  • Get treatment for high blood pressure.
  • Get treatment for high cholesterol.
  • Exercise 30 to 60 minutes on most days.
  • Eat less fat and lots of fruits, vegetables and whole grains.
  • Don’t use tobacco products.

What can I expect if I have myocardial ischemia?

It’s common for people with unstable angina to have a heart attack in the next three months. Heart attacks are fatal in the first few hours for up to a third of people who have them.

Most people who get through the first few days after a heart attack recover completely. However, 10% live less than a year after their heart attack.

How long does myocardial ischemia last?

Angina from myocardial ischemia lasts 10 minutes or less in most cases.

How do I take care of myself?

Exercise is very helpful for improving your cardiovascular health. It gets more oxygen to your heart muscle, which helps with symptoms. Healthcare providers recommend getting at least 30 to 60 minutes of exercise five or more days a week.

Other ways to stay healthy include:

  • Keep taking all medicines your provider prescribed for you.
  • Eat a healthy diet.
  • Stay at a healthy weight.
  • Avoid tobacco products.

When should I see my healthcare provider?

Contact your healthcare provider if your medicines aren’t helping you or if the side effects are severe. If you’ve had an angioplasty and stent placement or coronary artery bypass graft, you’ll most likely need to see your provider every six months during the first year after your procedure.

When should I go to the ER?

Call 911 and chew an aspirin if you think you’re having a heart attack. If you have a clot in your coronary artery, aspirin can help make it smaller.

You should also get help immediately if you’ve taken three nitroglycerin doses (one every five minutes) and still have angina.

What questions should I ask my doctor?

  • How often will you need to see me once I start exercising?
  • Will I need to take the medicines you prescribed for the rest of my life?
  • How high is my individual risk of a heart attack?

Is myocardial ischemia the same as angina?

No. Angina (chest pain) is a very common symptom of myocardial ischemia.

Is myocardial ischemia a stroke?

No. Myocardial ischemia is a lack of blood supply to your heart muscle. A stroke affects your brain.

How long can you live with myocardial ischemia?

It depends on many factors, such as:

  • Whether you have a heart attack.
  • How quickly you get diagnosis and treatment.
  • How well you do with following your healthcare provider’s instructions for making lifestyle changes.
  • How well you manage conditions that cause myocardial ischemia (usually atherosclerosis).

A note from QBan Health Care Services

Chest pain from myocardial ischemia is understandably a cause for concern, but a diagnosis and treatment plan can give you peace of mind. Following your healthcare provider’s recommendations will give you the best chance of improving your heart health. Although you may not want to think about it, it’s a good idea to know the warning signs of a heart attack. Having a plan in place in case that happens will help you be prepared to help yourself or a loved one.

ARRHYTHMIA

An arrhythmia is a heart rhythm that isn’t normal. Your heart may be beating too fast when you’re at rest or just not beating in a regular pattern, for example. Arrhythmias range from harmless to serious, with symptoms and without. There are many options to treat arrhythmias, but some don’t need them. The prognosis varies greatly depending on the type.

What is arrhythmia?

An arrhythmia (also called dysrhythmia) is an abnormal heartbeat. Arrhythmias can start in different parts of your heart and they can be too fast, too slow or just irregular.

Normally, your heart beats in an organized, coordinated way. Issues with various parts of your heart — or even the blood your heart pumps — can affect your heart’s normal rhythm. Having a normal heart rhythm matters because your heart supplies your whole body with nutrients and oxygen through the blood it pumps.

How serious is a heart arrhythmia?

Some types of arrhythmia are harmless and don’t require treatment. Others can put you at risk for cardiac arrest. Many are in between these two extremes. A healthcare provider can tell you which type of arrhythmia you have and what kind of treatment you need, if any.

What are the types of arrhythmia?

Healthcare providers describe arrhythmias by where in your heart they start.

  • Supraventricular arrhythmias: These begin in your atria (your heart’s upper chambers). “Supraventricular” means above your ventricles or lower chambers of your heart.
  • Ventricular arrhythmias: These begin in your heart’s ventricles or lower chambers.
  • Bradyarrhythmias and junctional rhythms: These can happen because of issues in your heart’s conduction system, such as the sinoatrial (SA) node, atrioventricular (AV) node or His-Purkinje network.

How common is arrhythmia?

An estimated 1.5% to 5% of people have arrhythmias. However, some people don’t have symptoms, making it difficult to estimate how many people actually have arrhythmias. In the U.S., atrial fibrillation is the most common type of arrhythmia.

What are the warning signs of arrhythmia?

Heart arrhythmia symptoms may include:

A cardiac arrhythmia may be “silent” and not cause any symptoms.

What causes arrhythmia?

Arrhythmia causes include:

What is the main cause of arrhythmia?

Most arrhythmias happen because of an issue with your heart’s arteries, valves or muscles.

What are the risk factors for arrhythmia?

Risk factors for arrhythmia include:

  • Using tobacco products.
  • Drinking alcohol.
  • Consuming drinks and foods that have caffeine.
  • Taking stimulants like cold medicines or herbal supplements.
  • Having high blood pressure.
  • Having a BMI (body mass index) higher than 30.
  • Having high blood sugar.
  • Having sleep apnea.

What are the complications of arrhythmia?

Without treatment, arrhythmias can lead to complications such as:

  • Weakening of your heart muscle (cardiomyopathy).
  • Cardiac arrest.
  • Stroke.

How is an arrhythmia diagnosed?

A healthcare provider can find an irregular heartbeat during an examination by taking your pulse and listening to your heart.

After assessing your symptoms and performing a physical examination, they may order diagnostic tests to help confirm that you have an arrhythmia. This can also help find the cause.

You may also want to see an electrophysiologist — a cardiologist who has additional specialized training in the diagnosis and treatment of heart rhythm disorders.

What tests will be done to diagnose arrhythmia?

Some tests that can check for an irregular heart rhythm and associated diseases include:

  • Electrocardiogram (ECG or EKG).
  • Blood tests to check your electrolyte levels or look for a genetic issue.
  • Ambulatory monitors.
  • Stress test.
  • Echocardiogram.
  • Cardiac catheterization.
  • Electrophysiology study (EPS).
  • Tilt table test.
  • Computed tomography (CT).
  • Heart MRI (magnetic resonance imaging).

How is an arrhythmia treated?

Treatment depends on the type and severity of your arrhythmia. In some cases, no treatment is necessary. Heart arrhythmia treatment options include:

  • Medications.
  • Lifestyle changes.
  • Therapies.
  • Devices.
  • Surgery.

Medications

Many medications can treat arrhythmias. Because everyone is different, you may have to try several medications and doses to find the one that works best for you. Heart arrhythmia treatments include:

  • Antiarrhythmic drugs that convert the arrhythmia to sinus rhythm (normal rhythm) or prevent an arrhythmia.
  • Medicines that control your heart rate.
  • Anticoagulant or antiplatelet therapy drugs (such as warfarin or aspirin) that reduce the risk of blood clots forming.
  • Medications that treat related conditions that may be causing an abnormal heart rhythm.

It’s important to know:

  • The names of your medications.
  • Why you take them.
  • How often and at what times to take them.
  • Side effects of your medications.

Lifestyle changes

Simple changes to the way you live can help with arrhythmias. These changes may include:

  • Managing blood pressure and blood sugar levels.
  • Avoiding tobacco products.
  • Cutting back on alcohol intake.
  • Avoiding caffeine and stimulants.
  • Working toward a healthy weight.

Therapies

In addition to medicine, some people need therapies to treat or eliminate irregular heart rhythms. Your healthcare provider will determine the best treatment for you and discuss the benefits and risks of these therapies with you.

Therapies include:

  • Cardioversion: An electrical impulse synchronizes your heart and allows your normal rhythm to restart.
  • Catheter ablation: A catheter sends high-frequency electrical energy to a small area of tissue inside your heart to “disconnect” the abnormal rhythm’s pathway. Ablation can treat most SVTs, atrial flutter, atrial fibrillation and some atrial and ventricular tachycardias.
  • Pulmonary vein isolation: This type of ablation creates rings of scars to isolate areas that may cause atrial fibrillation. This can help people with frequent, paroxysmal or persistent atrial fibrillation.

Devices

A cardiologist may insert certain devices during a procedure in the electrophysiology lab. Devices to treat a heart arrhythmia include:

  • Permanent pacemaker: This device sends small electrical impulses to your heart muscle to maintain a normal heart rate and keep your heart from beating too slowly.
  • Implantable cardioverter defibrillator (ICD): This device constantly monitors your heart rhythm. When it detects a very fast, abnormal heart rhythm, it delivers energy to your heart muscle to make it beat in a normal rhythm. This device treats ventricular tachycardia and ventricular fibrillation, two life-threatening heart rhythms.
  • Biventricular (B-V) pacemakers and defibrillators (also called cardiac resynchronization therapy or CRT): These devices help to synchronize the contraction of your left ventricle. In addition to the leads that go to the right side of your heart, they have a lead that goes to your left ventricle. People with heart failure and uncoordinated left ventricle contractions may need this.

Surgery

People with arrhythmias may require heart surgery for any of these reasons:

  • To treat heart disease that may be causing the arrhythmia, including valve surgery or coronary artery bypass surgery.
  • A maze procedure can correct atrial fibrillation that doesn’t respond to medications or nonsurgical treatment methods.
  • In some cases, a provider may place biventricular pacemaker leads (tiny wires) on your heart using minimally invasive or surgical techniques.

Complications/side effects of the treatment

Side effects and complications vary depending on the treatment. They may include:

Arrhythmia medication

  • Allergic reactions.
  • Dizziness.
  • Headaches.
  • Bleeding.
  • Upset stomach.

Cardioversion

  • Embolization of blood clots.
  • Skin bruises.
  • Skin rash.

Catheter ablation

  • Bleeding.
  • Blood clots.
  • Stroke.
  • Infection.
  • Injury to a vein or heart tissue.

Pulmonary vein isolation

  • Allergic reaction to dye (if used).
  • Infection.
  • Injury to your heart, esophagus or vein.
  • Stroke.

Devices

  • Device malfunction.
  • Infection.
  • Bleeding.
  • Collapsed lung.

Surgery

  • Bleeding.
  • Infection.
  • Stroke.
  • Heart attack.
  • Need for a pacemaker.

How soon after treatment will I feel better?

It may take a little time to find the right medication and dose that works for your arrhythmia. Depending on the procedure or surgery, recovery afterward can take weeks or months. If you have a procedure like catheter ablation or pulmonary vein isolation, you may still have arrhythmias for several weeks while you’re healing. Your provider can tell you what to expect in your specific situation.

How can I lower my risk of arrhythmia?

Here are some ways to lower your risk of arrhythmia:

  • Stop using tobacco products.
  • Limit your intake of alcohol.
  • Limit or stop using caffeine. Some people are sensitive to caffeine and may notice more symptoms when using caffeinated products (like tea, coffee, colas and some over-the-counter medications).
  • Don’t take stimulants. Beware of stimulants in cough and cold medications and herbal or nutritional supplements. Some of these medications contain ingredients that promote irregular heart rhythms. Read the label and ask your provider what medication would be best for you.
  • Manage high blood pressure.
  • Work toward a weight that’s healthy for you.
  • Manage blood sugar levels.
  • Treat sleep apnea.
  • Avoid activities that appear to trigger an arrhythmia.

What can I expect if I have an arrhythmia?

Depending on the type of cardiac arrhythmia you have, you may have mild or severe symptoms or none at all. You may not need treatment, but some people need medicine or a procedure. With heart arrhythmia treatment, many people can live full lives. Some people with more serious arrhythmias have a cardiac arrest and may or may not survive.

How long arrhythmia lasts

Harmless arrhythmias go away and come back in response to what triggers them. However, people with other types of arrhythmias — especially those that put you at risk for cardiac arrest — need treatment for the rest of their lives.

How do I take care of myself?

If you have a cardiac arrhythmia, you might find it useful to know how to take your pulse. Your pulse is your heart rate, or the number of times your heart beats in 1 minute. Pulse rates vary from person to person. Your pulse is slower when you’re at rest and increases when you exercise. A normal heart rate (at rest) is 60 to 100 beats per minute. If you have a fitness tracker or smartwatch, it can track your heart rate.

You should also make sure that your family and friends know how to recognize your arrhythmia symptoms. It can give you peace of mind if they learn how to start CPR.

What can’t I eat/drink with this condition?

If you have an arrhythmia, you should limit the amount of alcohol and caffeine you consume. Both of these can trigger arrhythmias.

When should I see my healthcare provider?

Your provider will tell you how often you should visit. Call them in between visits if your symptoms become more frequent or severe.

You’ll need to visit your provider for regular follow-up visits to:

  • Make sure your arrhythmia treatments are working.
  • Properly adjust your medications.
  • Evaluate how well any implanted devices are working.
  • Make sure you’re staying healthy and not having other medical issues.

When should I go to the ER?

Get immediate medical care if you have:

  • Trouble breathing.
  • Chest pain.
  • Dizziness.
  • Fainting episodes.

What questions should I ask my doctor?

Questions you may want to ask your provider include:

  • Which type of arrhythmia do I have?
  • Do I need treatment?
  • What’s the best treatment for me?
  • What do I need to do to maintain my device?

A note from QBan Health Care Services

There are many ways for your heartbeat to be irregular. Some of these irregular heartbeats, called arrhythmias, don’t cause symptoms. It’s important to see your healthcare provider if you do notice symptoms like extreme fatigue or heart palpitations. Your provider will help determine the best treatment option for you, but you can also help yourself by making appropriate lifestyle changes.

COLON CANCER

Colon cancer develops from polyps (growths) in your colon’s inner lining. Healthcare providers have screening tests and treatments that detect and remove precancerous polyps. If untreated, colon cancer may spread to other areas of your body. Thanks to these tests, early treatment and new kinds of treatment, fewer people are dying from colon cancer.

What is colon cancer?

Colon (colorectal) cancer starts in your colon (large intestine), the long tube that helps carry digested food to your rectum and out of your body.

Colon cancer develops from certain polyps or growths in the inner lining of your colon. Healthcare providers have screening tests that detect precancerous polyps before they can become cancerous tumors. Colon cancer that’s not detected or treated may spread to other areas of your body. Thanks to screening tests, early treatment and new kinds of treatment, fewer people are dying from colon cancer.

How does this condition affect people?

Your colon wall is made of layers of mucous membrane, tissue and muscle. Colon cancer starts in your mucosa, the innermost lining of your colon. It consists of cells that make and release mucus and other fluids. If these cells mutate or change, they may create a colon polyp.

Over time, colon polyps may become cancerous. (It usually takes about 10 years for cancer to form in a colon polyp.) Left undetected and/or untreated, the cancer works its way through a layer of tissue, muscle and the outer layer of your colon. The colon cancer may also spread to other parts of your body via your lymph nodes or your blood vessels.

Who is affected by colon cancer?

Colon cancer is the third most common cancer diagnosed in people in the U.S. According to the U.S. Centers for Disease Control and Prevention (CDC), men and people assigned male at birth (AMAB) are slightly more likely to develop colon cancer than women and people assigned female at birth (AFAB). Colon cancer affects more people who are Black than people who are members of other ethnic groups or races.

Colon cancer typically affects people age 50 and older. Over the past 15 years, however, the number of people age 20 to 49 with colon cancer has increased by about 1.5% each year. Medical researchers aren’t sure why this is happening.

What are colon cancer symptoms?

You can have colon cancer without having symptoms. If you do have symptoms, you may not be sure if changes in your body are signs of colon cancer. That’s because some colon cancer symptoms are similar to symptoms of less serious conditions. Common symptoms of colon cancer include:

  • Blood on or in your stool (poop): Talk to a healthcare provider if you notice blood in the toilet after you poop or after wiping, or if your poop looks dark or bright red. It’s important to remember blood in poop doesn’t mean you have colon cancer. Other things — from hemorrhoids to anal tears to eating beets — may change your poop’s appearance. But it’s always better to check with a healthcare provider any time you notice blood in or on your stool.
  • Persistent changes in your bowel habits (how you poop): Talk to a healthcare provider if you have persistent constipation and/or diarrhea, or if you feel as if you still need to poop after going to the bathroom.
  • Abdominal (belly) pain: Talk to a healthcare provider if you have belly pain with no known cause, that doesn’t go away or hurts a lot. Many things may cause belly pain, but it’s always best to check with a healthcare provider if you have unusual or frequent belly pain.
  • Bloated stomach: Like belly pain, there are many things that may make you feel bloated. Talk to a healthcare provider if your bloated belly lasts for more than a week, gets worse or you have other symptoms like vomiting or blood in or on your poop.
  • Unexplained weight loss: This is a noticeable drop in your body weight when you’re not trying to lose weight.
  • Vomiting: Talk to a healthcare provider if you’ve been vomiting periodically for no known reason or if you vomit a lot in 24 hours.
  • Fatigue and feeling short of breath: These are symptoms of anemia. Anemia may be a sign of colon cancer.

What causes colon cancer?

Like all types of cancer, colon cancer happens when cells grow and divide uncontrollably. All cells in your body are constantly growing, dividing and dying. That’s how your body remains healthy and working as it should. In colon cancer, cells lining your colon and rectum keep growing and dividing even when they’re supposed to die. These cancerous cells may come from polyps in your colon.

Medical researchers aren’t sure why some people develop precancerous colon polyps that become colon cancer. They do know certain risk factors increase people’s chances of developing precancerous polyps and colon cancer.

Those risk factors include certain medical conditions, including inherited conditions, and lifestyle choices. Having one or more risk factors for colon cancer doesn’t mean you’ll develop the condition. It just means you have increased risk. Understanding risk factors may help you decide if you should talk to a healthcare provider about your risk of developing colon (colorectal) cancer.

Lifestyle choices that are risk factors for colon cancer

  • Smoking: Using tobacco products, including chewing tobacco and e-cigarettes, increases your risk of developing colon cancer.
  • Excessive alcohol use: In general, men and people AMAB should limit beverages containing alcohol to two servings a day. Women and people AFAB should limit beverages containing alcohol to one serving a day. Even light alcohol use can increase your risk of developing cancer.
  • Having obesity: Eating high-fat, high-calorie foods may affect your weight and increase your risk of colon cancer.
  • Having a diet that includes lots of red meat and processed meat: Processed meat includes bacon sausage and lunchmeat. Healthcare providers recommend you limit red meat and processed meat to two servings a week.
  • Not exercising: Any kind of physical activity may reduce your risk of developing colon cancer.

Medical conditions that increase colon cancer risk

  • Inflammatory bowel disease: People who have conditions like chronic ulcerative colitis and Crohn’s colitis, which cause inflammation in their colon lining, may have an increased risk of colon cancer. The risk increases if you have inflammatory bowel disease that lasts more than seven years and affects large parts of your colon.
  • Inherited conditions: Certain conditions like Lynch syndrome and familial adenomatous polyposis may increase your risk of developing colon cancer. Colon cancer may happen if you inherit a gene that causes cancer.
  • A family history of colon and other kinds of cancer: If a close family member has colon cancer, you may have an increased risk of developing the condition. Close family members include your biological parents, siblings and children. Your risk may be higher if any biological family member developed colon cancer before age 45.
  • A family history of polyps: If your parent, sibling or child has an advanced polyp, you may have an increased risk of getting colon cancer. An advanced polyp may be a large polyp. Medical pathologists may characterize a polyp as being advanced if they see certain changes in the polyp when they look at it under a microscope that are signs the polyp may contain cancerous cells.
  • Many polyps: People with numerous colon polyps — including adenomas,  errated polyps  or other types of polyps — often have an increased risk of developing polyps and colon cancer. People may inherit a tendency toward having many colon polyps.

How do healthcare providers diagnose colon cancer?

Healthcare providers use several tests to diagnose colon cancer. Those tests include:

What’s the difference between a screening test and tests that diagnose colon cancer?

A cancer screening test checks for cancer when you don’t have any signs or symptoms of cancer. If your screening test shows abnormalities, a healthcare provider may recommend additional tests.

What are common colon cancer screening tests?

A colonoscopy is the most common screening test for colon cancer. Other tests include:

  • Fecal immunochemical test (FIT): This test detects hidden blood in your poop. Medical pathologists test samples of your poop for blood that you may not see just by looking.
  • Guaiac-based fecal occult blood test (gFOBT): Like the FIT, this test looks for blood in poop that may not be visible.
  • Fecal DNA test: This test looks for signs of genetic mutations and blood products in your poop.
  • Flexible sigmoidoscopy: Healthcare providers use a flexible scope called a sigmoidoscope to see inside your lower colon and rectum.
  • Virtual colonoscopy: A virtual colonoscopy is an X-ray that looks for polyps, tumors and ulcers (sores) in your colon and rectum.

How do healthcare providers stage colon cancer?

Healthcare providers use the TNM cancer staging system developed by the American Joint Committee on Cancer to stage colon cancer.

There are five stages of colon cancer. Three of the four stages have three sub-stages. The colon cancer staging system includes the following:

  • Stage 0: Healthcare providers may refer to this as carcinoma in situ. When they do, they’re talking about abnormal or precancerous cells in your mucosa, the innermost layer of your colon wall.
  • Stage I: Stage I colorectal cancer has grown into the wall of your intestine but hasn’t spread beyond the muscular coat or into close lymph nodes.
  • Stage II: The cancer has spread farther into the wall of your intestine but hasn’t spread to nearby lymph nodes. There are three types of Stage II colon cancer:
  1. Stage IIA: Cancer has spread through most of your colon wall but hasn’t grown into the wall’s outer layer.
  2. Stage IIB: Cancer has spread into the outer layer of your colon wall or through the wall.
  3. Stage IIC: Cancer has spread to a nearby organ.
  • Stage III: In this stage, colon cancer has spread to your lymph nodes. Like Stage II colon cancer, there are three sub-stages of Stage III colon cancer:
  1. Stage IIIA: There’s cancer in the first or second layers of your colon wall and it’s spread to one to four lymph nodes.
  2. Stage IIIB: The cancer affects more layers of your colon wall but only affects one to three lymph nodes. Cancer that affects fewer colon wall layers but has spread to four or more lymph nodes is also a stage IIIB colon cancer.
  3. Stage IIIC: There’s cancer in the outer layer or the next outermost layer of your colon and in four or more lymph nodes. Cancer that’s spread into a nearby organ and one or more lymph nodes is also a stage IIIC colon cancer.
  • Stage IV: Cancer has spread (metastasized) to other areas of your body, such as your liver, lungs or ovaries:
  1. Stage IVA: In this stage, cancer has spread to one organ or to lymph nodes that are farther or more distant from your colon.
  2. Stage IVB: The cancer has moved to more than one distant organ and more lymph nodes.
  3. Stage IVC: Cancer affects distant organs, lymph nodes and abdominal tissue.

How do healthcare providers treat colon cancer?

Surgery is the most common colon cancer treatment. There are different colon cancer surgeries and procedures:

  • Polypectomy: This surgery removes cancerous polyps.
  • Partial colectomy: This is also called colon resection surgery. Surgeons remove the section of your colon that contains a tumor and some surrounding healthy tissue. They’ll reconnect healthy colon sections in a procedure called anastomosis.
  • Surgical resection with colostomy: Like a colectomy, surgeons remove the section of your colon that contains a tumor. In this surgery, however, they can’t connect healthy colon sections. Instead, they do a colostomy. In a colostomy, your bowel is moved to an opening in your abdominal wall so your poop is collected in a bag.
  • Radiofrequency ablation: This procedure uses heat to destroy cancer cells.

Healthcare providers may combine surgery with adjuvant therapy. This is cancer treatment done before or after surgery. They may also use these treatments for colon cancer that has spread or come back. Treatments may include:

  • Chemotherapy: Healthcare providers may use chemotherapy drugs to shrink tumors and ease colon cancer symptoms.
  • Targeted therapy: This treatment targets the genes, proteins and tissues that help colon cancer cells grow and multiply. Healthcare providers often use a type of targeted therapy called monoclonal antibody therapy. This therapy uses lab-created antibodies that attach to specific targets on cancer cells or cells that help cancer cells grow. The antibodies kill the cancer cells.

Can colon cancer be prevented?

You may not be able to prevent colon cancer, but you can reduce your risk of developing the condition by managing risk factors:

  • Avoid tobacco. If you smoke and want help quitting, talk to a healthcare provider about smoking cessation programs.
  • Use moderation when you drink beverages containing alcohol.
  • Maintain a healthy weight.
  • Eat a healthy diet. Add fruit and vegetables to your diet and cut back on red meat processed foods, and high-fat and high-calorie foods. Drinking coffee may lower your risk of developing colon cancer.
  • Keep track of your family medical history.Colon cancer can run in families. Tell your healthcare provider if your biological parents, siblings or children have colon cancer or an advanced polyp or if any of your family has cancer before age 45.
  • Follow colon cancer screening guidelines. Ask your healthcare provider when you should have colon cancer screening. If you have chronic irritable bowel disease or a family history of colon cancer, your healthcare provider may recommend you start screening earlier than age 45.

Can healthcare providers cure colon cancer?

According to U.S. National Cancer Institute (NCI) data, more than 90% of people treated for early-stage colorectal cancer were alive five years after diagnosis. (NCI data doesn’t break out separate survival rates for colon and rectal cancer.)

What are the survival rates for colon cancer?

NCI data shows that overall, 65% of people with colorectal cancer were alive five years after diagnosis. (A survival rate is an estimate based on the experiences of people with specific kinds of cancer.)

Colorectal cancer survival rates vary based on the cancer stage at diagnosis. For example, 73% of people with colorectal cancer that’s spread to nearby tissues, organs or lymph nodes were alive five years after diagnosis. That five-year survival rate drops to 17% if the cancer spreads to a distant organ or lymph node.

A survival rate is an estimate based on outcomes — how long people lived after treatment for a specific type of cancer. In this case, survival rates are based on the experiences of large groups of people who have colorectal cancer, and not just colon cancer. In addition, many things affect colon cancer survival rates. If you have this condition, your healthcare provider is your best resource for information about what you can expect.

I have colon cancer. How do I take care of myself?

Self-care is an important part of living with colon cancer, but everyone’s situation is different. People treated for early-stage colon cancer may become cancer-free. They’re cancer survivors, but they may worry that their colon cancer will come back.

People who have advanced colon cancer have different concerns. They’re also cancer survivors. But for them, living with colon cancer may mean treatment that eases symptoms but doesn’t cure colon cancer. They may benefit from having palliative care. Palliative care helps people manage cancer symptoms and treatment side effects.

When should I see my healthcare provider?

Follow-up colon cancer care varies depending on the cancer stage. For example, people who have surgery for Stage 0 or Stage I colon cancer may have a colonoscopy one year after surgery, another colonoscopy three years after surgery and a third five years after surgery.

Unless the follow-up colonoscopies find signs of cancer, someone with Stage 0 or Stage 1 colon cancer may be able to wait several more years before having another colonoscopy.

People successfully treated for Stage II or Stage III colon cancer will need to see their healthcare provider every three to six months for the first two years after treatment and are typically followed for five years from surgery. They may have tests including colonoscopies, CEA blood tests and imaging tests.

Anyone recovering from colon cancer treatment should contact their healthcare provider if they notice changes that may indicate the cancer has come back or is spreading.

When should I go to the emergency room?

If you’re receiving colon cancer treatment, ask your healthcare provider about symptoms that may be signs you should go to the emergency room. You may need to go to the emergency room if you have:

  • Side effects that are more intense than you expected.
  • A fever higher than 100.4 degrees Fahrenheit (38 degrees Celsius).
  • Chills that don’t go away.
  • Severe abdominal pain.
  • Persistent diarrhea that causes dehydration.

What questions should I ask my doctor?

Most people have heard of colon cancer, which is the third most common cancer diagnosed in the U.S. If you have colon cancer, you probably want to know more about your specific situation. Here are some questions you may want to ask your healthcare provider:

  • What kind of colon cancer do I have?
  • Can you cure this kind of colon cancer?
  • What is the cancer stage?
  • What are effective colon cancer treatments?
  • If I need surgery, what kind of surgery do you recommend?
  • Will I need a colostomy?
  • Will I need other kinds of cancer treatments?
  • What are those treatment side effects?
  • Is a clinical trial an option for me?
  • What is the chance my colon cancer could come back?
  • If you can’t cure the cancer, can you keep it from spreading?
  • If you can’t stop the cancer, should I have palliative care?

A note from QBan Health Care Services

Thanks to more people taking time for colon cancer screening, healthcare providers are able to catch and treat colon cancer before it causes symptoms, much less spreads. Recent survival rate data show that more than 90% of people treated for early-stage colon cancer were alive five years after diagnosis. People with colon cancer also benefit from having newer treatments that target cancer. If you have colon cancer, ask your healthcare provider about newer treatments that may be appropriate for your situation.

THYROID CANCER

Thyroid cancer develops in your thyroid gland, a part of your endocrine system. Your thyroid gland produces hormones that regulate body temperature, heart rate and metabolism. Most thyroid cancers are highly curable. Treatments include surgery, chemotherapy, radiation, hormone therapy and radioiodine therapy.

What is thyroid cancer?

Thyroid cancer develops in your thyroid, a small, butterfly-shaped gland at the base of your neck. This gland produces hormones that regulate your metabolism (how your body uses energy). Thyroid hormones also help control your body temperature, blood pressure and heart rate. Thyroid cancer, a type of endocrine cancer, is generally highly treatable, with an excellent cure rate.

How common is thyroid cancer?

Close to 53,000 Americans receive a thyroid cancer diagnosis every year. Treatments for most thyroid cancers are very successful. Still, about 2,000 people die from the disease every year.

Women and people assigned female at birth (AFAB) are three times more likely to get thyroid cancer compared to men and people assigned male at birth (AMAB). The disease is commonly diagnosed in women and people AFAB in their 40s and 50s and men and people AMAB in their 60s and 70s. Even children can develop the disease.

What are the types of thyroid cancer?

Healthcare providers classify thyroid cancer based on the type of cells from which the cancer grows. Types of thyroid cancer include:

  • Papillary: Up to 80% of all thyroid cancers are papillary. This cancer type grows slowly. Although papillary thyroid cancer often spreads to lymph nodes in your neck, the disease responds very well to treatment. Papillary thyroid cancer is highly curable and rarely fatal.
  • Follicular: Follicular thyroid cancer accounts for up to 15% of thyroid cancer diagnoses. This cancer is more likely to spread to your bones and organs, like your lungs. Metastatic cancer (cancer that spreads) may be more challenging to treat.
  • Medullary: About 2% of thyroid cancers are medullary. A quarter of people with medullary thyroid cancer have a family history of the disease. A faulty gene (genetic mutation) may be to blame.
  • Anaplastic: This aggressive thyroid cancer is the hardest type to treat. It can grow quickly and often spreads into surrounding tissue and other parts of your body. This rare cancer type accounts for about 2% of thyroid cancer diagnoses.

What are the thyroid cancer stages?

Healthcare providers use a staging system to determine if and how far thyroid cancer has spread. Generally, when cancer cells in your thyroid metastasize, they spread to your nearby structures and lymph nodes first. After that, the cancer can spread to distant lymph nodes, organs and bones.

Thyroid cancer stages range from 1 (I) to 4 (IV). In simple terms, the higher the number, the more the cancer has spread. To learn more about cancer staging and how it applies to your specific diagnosis, talk to your healthcare provider.

What are the warning signs of thyroid cancer?

You or your healthcare provider might feel a lump or growth in your neck called a thyroid nodule. Don’t panic if you have a thyroid nodule. Most nodules are benign (not cancer). Only about 3 out of 20 thyroid nodules turn out to be cancerous (malignant).

Other thyroid cancer symptoms include:

What are the signs that thyroid cancer has spread?

If you have thyroid cancer that has spread (metastasized) to other areas of your body, you may experience symptoms such as:

  • Tiredness.
  • Loss of appetite.
  • Nausea and vomiting.
  • Unexpected weight loss.

What causes thyroid cancer?

Experts aren’t sure why some cells become cancerous (malignant) and attack your thyroid. Certain factors, such as radiation exposure, a diet low in iodine and faulty genes can increase risk. Other risk factors include:

  • Enlarged thyroid (goiter).
  • Family history of thyroid disease or thyroid cancer.
  • Thyroiditis (inflammation of your thyroid gland).
  • Gene mutations (changes) that cause endocrine diseases, such as multiple endocrine neoplasia type 2A (MEN2A) or type 2B (MEN2B) syndrome.
  • Low iodine intake.
  • Obesity (high body mass index).
  • Radiation therapy for head and neck cancer, especially during childhood.
  • Exposure to radioactive fallout from nuclear weapons or a power plant accident.

How is thyroid cancer diagnosed?

If you have an enlarged thyroid nodule or other signs of thyroid cancer, your healthcare provider may order one or more of these tests:

  • Blood tests: A thyroid blood test checks hormone levels and gauges whether your thyroid is functioning properly.
  • Biopsy: During a fine-needle aspiration biopsy, your healthcare provider removes cells from your thyroid to test for cancer cells. A sentinel node biopsy can determine if cancer cells have spread to lymph nodes. Your provider may use ultrasound  technology to guide these biopsy procedures.
  • Radioiodine scan: This test can detect thyroid cancer and determine if cancer has spread. You swallow a pill containing a safe amount of radioactive iodine (radioiodine). Over a few hours, your thyroid gland absorbs the iodine. Your healthcare provider uses a special device to measure the amount of radiation in the gland. Areas with less radioactivity need more testing to confirm the presence of cancer.
  • Imaging scans: Radioactive iodine scan, computed tomography (CT) and positron emission tomography (PET) scans can detect thyroid cancer and cancer spread.

How is thyroid cancer managed or treated?

Treatments for thyroid cancer depend on the tumor size and whether the cancer has spread. Treatments include:

  • Surgery: Surgery is the most common treatment for thyroid cancer. Depending on the tumor’s size and location, a surgeon may remove part of your thyroid gland (lobectomy) or all of the gland (thyroidectomy). The surgeon also removes any nearby lymph nodes where cancer cells have spread.
  • Radioiodine therapy: With radioiodine therapy, you swallow a pill or liquid containing a higher dose of radioactive iodine than what’s used in a diagnostic radioiodine scan. The radioiodine shrinks and destroys the diseased thyroid gland along with cancer cells. This treatment is very safe. Your thyroid gland absorbs almost all of the radioiodine and the rest of your body has minimal radiation exposure.
  • Radiation therapy: Radiation kills cancer cells and stops them from growing. External radiation therapy uses a machine to deliver strong beams of energy directly to the tumor site. Internal radiation therapy (brachytherapy) involves placing radioactive seeds in or around the tumor.
  • Chemotherapy: Intravenous or oral chemotherapy drugs kill cancer cells and stops cancer growth. Very few people diagnosed with thyroid cancer will ever need chemotherapy.
  • Hormone therapy: This treatment blocks the release of hormones that can cause cancer to spread or come back.

What are the complications of thyroid cancer?

Thyroid cancer can spread (metastasize) to other parts of your body, such as your liver, lungs or bones. Detecting and treating thyroid cancer in the early stages reduces your risk for metastasis.

Thyroid cancer can recur (come back), even after treatment. Because thyroid cancer grows slowly, it could take up to 20 years to come back. Recurrence happens in up to 30% of thyroid cancer cases.

Overall, thyroid cancer prognosis (outlook) is positive. But it’s important to know that after thyroid surgery or treatments, your body still needs thyroid hormones to function. You’ll need thyroid replacement hormone therapy for life. Synthetic thyroid hormones, such as levothyroxine (Synthroid®), take over for the thyroid hormones that your body no longer naturally produces.

How does thyroid cancer affect pregnancy?

Thyroid cancer is the second most common cancer diagnosed in people who are pregnant (breast cancer is first). Approximately 10% of thyroid cancers develop during pregnancy or within the first year after childbirth. Experts believe fluctuating hormone levels during pregnancy may trigger the cancer.

If you receive a thyroid cancer diagnosis during pregnancy, your healthcare provider can discuss treatment options. Depending on the cancer type and severity, your provider may recommend delaying treatment until after you deliver your baby. If treatment can’t wait, most people can safely undergo surgery to remove the cancerous gland. You shouldn’t have radioactive diagnostic tests or treatments when you’re pregnant or breastfeeding (chestfeeding).

How long does it take to recover from thyroid cancer treatment?

Recovery depends on several factors, including your age, the size and stage of your thyroid tumor, and what type of treatment you received. Talk to your healthcare provider about what to expect during and after your thyroid cancer treatment.

Can I prevent thyroid cancer?

Many people develop thyroid cancer for no known reason, so prevention isn’t really possible. But if you know you’re at risk for thyroid cancer, you may be able to take these steps:

  • Preventive (prophylactic) surgery: Genetic tests can determine if you carry an altered gene (a mutation) that increases your risk for medullary thyroid cancer or multiple endocrine neoplasia. If you have the faulty gene, you may opt to have preventive (prophylactic) surgery to remove your thyroid gland before cancer develops.
  • Potassium iodide: If you’ve had radiation exposure during a nuclear disaster, such as the 2011 incident at Fukushima, Japan, taking potassium iodide within 24 hours of exposure can lower your risk of eventually getting thyroid cancer. Potassium iodide (Pima®) blocks your thyroid gland from absorbing too much radioiodine. As a result, your gland stays healthy.

What’s the thyroid cancer survival rate?

Eight out of 10 people who have thyroid cancer develop the papillary type. Papillary thyroid cancer has a five-year survival rate of almost 100% when the cancer is in their gland (localized). Even when the cancer spreads (metastasizes), the survival rate is close to 80%. This rate means that, on average, you’re about 80% as likely to live for at least five years after diagnosis as someone who doesn’t have metastatic papillary thyroid cancer.

Five-year survival rates for other thyroid cancer types include:

  • Follicular: Close to 100% for localized; around 63% for metastasized.
  • Medullary: Close to 100% for localized; around 40% for metastasized.
  • Anaplastic: Close to 31% for localized; 4% for metastasized.

Is thyroid cancer curable?

Yes, most thyroid cancers are curable with treatment, especially if the cancer cells haven’t spread to distant parts of your body. If treatment doesn’t fully cure thyroid cancer, your healthcare provider can design a treatment plan to destroy as much of the tumor as possible and prevent it from growing back or spreading.

When should I see my healthcare provider?

You should call your healthcare provider if you have thyroid cancer and you experience:

  • Lump in your neck.
  • Rapid heart rate.
  • Unexplained weight loss or gain.
  • Extreme fatigue.

What questions should I ask my doctor?

If you have thyroid cancer, you may want to ask your healthcare provider:

  • Why did I get thyroid cancer?
  • What type of thyroid cancer do I have?
  • Has the cancer spread outside of my thyroid gland?
  • What’s the best treatment for this type of thyroid cancer?
  • What are the treatment risks and side effects?
  • Will I need thyroid replacement hormone therapy?
  • Is my family at risk for developing this type of thyroid cancer? If so, should we get genetic tests?
  • Can I get thyroid cancer again?
  • Am I at risk for other types of cancer?
  • What type of follow-up care do I need after treatment?
  • Should I look out for signs of complications?

A note from QBan Health Care Services

Receiving a cancer diagnosis is unsettling, regardless of the type. Fortunately, most thyroid cancers respond extremely well to treatment. Your healthcare provider can discuss the best treatment option for the type of thyroid cancer you have. After treatment, you may need to take synthetic thyroid hormones for life. These hormones support vital body functions. They usually don’t cause any significant side effects, but you’ll have regular checkups to monitor your health.

CHRONIC VENOUS INSUFFICIENCY

Chronic venous insufficiency (CVI) happens when your leg veins become damaged and can’t work as they should. Normally, valves in your leg veins keep blood flowing back up to your heart. But CVI damages those valves, causing blood to pool in your legs. This increases pressure in your leg veins and causes symptoms like swelling and ulcers.

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is a form of venous disease that occurs when veins in your legs are damaged. As a result, these veins can’t manage blood flow as well as they should, and it’s harder for blood in your legs to return to your heart. CVI causes blood to pool in your leg veins, leading to high pressure in those veins.

CVI can happen due to damage in any of your leg veins. These include your:

  • Deep veins, which are large veins deep in your body that run through your muscle.
  • Superficial veins, which are close to your skin’s surface.
  • Perforating veins, which connect your deep and superficial veins.

CVI may cause mild symptoms at first. But over time, this condition may interfere with your quality of life and lead to serious complications.

Chronic venous insufficiency vs. post-thrombotic syndrome

Both terms refer to the same problem of damaged leg veins. Post-thrombotic syndrome is chronic venous insufficiency caused by deep vein thrombosis (DVT). DVT is a blood clot in a deep vein in your leg. “Post-thrombotic” means after a blood clot (which is also called a “thrombus”). After the blood clot is gone, it can leave scar tissue that damages your vein.

About 20% to 50% of people who’ve had DVT develop post-thrombotic syndrome, usually within one to two years.

How common is chronic venous insufficiency?

Venous disease in general is very common. For example, varicose veins affect about 1 in 3 adults. Each year, about 1 in 50 adults with varicose veins go on to develop chronic venous insufficiency.

Chronic venous insufficiency usually affects people over age 50. The risk goes up the older you get.

Overall, chronic venous insufficiency affects about 1 in 20 adults.

How does chronic venous insufficiency affect my body?

Chronic venous insufficiency slows down blood flow from your legs back up to your heart. Without treatment, CVI raises the pressure in your leg veins so much that your tiniest blood vessels (capillaries) burst. When this happens, the skin in that area takes on a reddish-brown color and can easily break open if bumped or scratched.

These burst capillaries can cause:

  • Tissue inflammation in that area.
  • Tissue damage.
  • Venous stasis ulcers. These are open sores on your skin’s surface.

Venous stasis ulcers don’t heal easily, and they can become infected. The infection could spread to nearby tissue. This condition is known as cellulitis, which is dangerous if not treated right away.

What are the signs and symptoms of chronic venous insufficiency?

Chronic venous insufficiency signs and symptoms include:

  • Achy or tired legs.
  • Burning, tingling or “pins and needles” sensation in your legs.
  • Cramping in your legs at night.
  • Discolored skin that looks reddish-brown.
  • Edema (swelling) in your lower legs and ankles, especially after standing a while or at the end of the day.
  • Flaking or itching skin on your legs or feet.
  • Full or heavy feeling in your legs.
  • Leathery-looking skin on your legs.
  • Ulcers (open sores), usually near your ankles. If they’re very painful, they may be infected.
  • Varicose veins.

Severe edema in your lower leg can cause scar tissue to develop. This scar tissue traps fluid in your tissues. Your calf may feel large and hard to the touch. When this happens, your skin is more vulnerable to persistent ulcers.

You may not have all of these issues at once. Instead, you may only have one or two. Your signs and symptoms depend on how far your condition has progressed.

What are the stages of chronic venous insufficiency?

The stages of venous disorders range from 0 to 6. “Venous disorders” is a general category for many possible issues with your veins, including CVI. The stages are based on clinical signs, which are things your provider can see or feel when they examine your legs.

Venous disorder stages include:

  • Stage 0: No signs that can be seen or felt. You may feel symptoms like achy or tired legs.
  • Stage 1: Visible blood vessels, including spider veins.
  • Stage 2: Varicose veins at least 3 millimeters wide.
  • Stage 3: Edema (swelling) but no skin changes.
  • Stage 4: Changes to your skin’s color and/or texture.
  • Stage 5: Healed ulcer.
  • Stage 6: Acute (active) ulcer.

You’ll be diagnosed with chronic venous insufficiency if you’re at stage 3 or above. In other words, having varicose veins doesn’t mean you have CVI. But varicose veins are a sign of blood flow problems that could get worse over time. So, it’s important to tell your provider about any new varicose veins you notice.

What causes chronic venous insufficiency?

Chronic venous insufficiency happens when the valves in your leg veins don’t work properly. Your leg veins contain valves that help your blood flow in the correct direction (toward your heart). If a valve becomes damaged, it can’t close properly. Gravity takes over, and blood struggles to flow upward toward your heart. It instead flows backward, a situation known as venous reflux.

Causes of valve malfunction may be congenital, primary or secondary.

  • Congenital causes are malformations in your leg veins that you’re born with. For example, some people are born without valves in their leg veins.
  • Primary causes are any changes to your leg veins that prevent them from working as they should. For example, your vein may get too wide, preventing its valve from closing all the way.
  • Secondary causes are other medical issues that damage your leg veins. Deep vein thrombosis (DVT) is usually the culprit. The thrombus (blood clot) leaves behind scar tissue that damages your valve.

What is the most common cause of chronic venous insufficiency?

Deep vein thrombosis (DVT) is the most common cause of chronic venous insufficiency. The blood clot damages the valve in your leg vein. People with a history of DVT face a higher risk of developing CVI.

How is chronic venous insufficiency diagnosed?

Chronic venous insufficiency is diagnosed through a physical exam and ultrasound imaging. During the physical exam, your provider will:

  • Carefully examine your legs. Your provider will look for clinical signs of CVI, like ulcers or changes in skin color.
  • Perform a vascular ultrasound. This painless test uses sound waves to create an image of your veins. It shows which parts of your veins are damaged.

Your provider will also rule out other medical conditions that could be causing your symptoms. This may involve other tests like an MRI.

Many people with CVI also have peripheral artery disease (PAD). So, your provider may ask questions or run tests to check you for PAD. If you have both CVI and PAD, your provider will advise you on treatment methods and precautions you need to take with compression therapy.

What are the treatments for chronic venous insufficiency?

Treatment for chronic venous sufficiency involves lifestyle changes and compression therapy. If these measures aren’t enough, your provider may recommend a procedure or surgery. The best treatment for you depends on how far your condition has progressed and other medical conditions you have. Your provider will tailor treatment to your individual needs.

The goals of treatment are to:

  • Help your blood flow better in your veins.
  • Help ulcers heal and limit their chances of coming back.
  • Improve your skin’s appearance.
  • Reduce pain and swelling.

Lifestyle changes

Usually, providers recommend lifestyle changes as the first method of treatment for CVI. These include:

  • Leg elevation: Lifting your legs above the level of your heart can help reduce pressure in your leg veins. Your provider may suggest you do this for 30 minutes or longer at least three times per day.
  • Exercise: Walking and other forms of exercise can help blood flow better in your leg veins. Each time you take a step, your calf muscle squeezes and helps your veins pump blood back up to your heart. This “calf muscle pump” is known as your “second heart.” It helps blood in your legs defy gravity, and it’s vital for your circulation. So, making your calf muscles stronger can help improve your blood flow. Your provider may also recommend foot and ankle flexing exercises.
  • Weight management: Extra weight can put pressure on your veins and damage the valves. Ask your provider what a healthy weight is for you. Work with your provider to come up with a healthy and manageable plan for achieving that weight.

Compression therapy

Providers commonly recommend compression therapy for treating CVI. Compression therapy helps ease swelling and discomfort in your legs.

There are many types of compression bandages and stockings. Some offer more compression than others. Very tight stockings require a prescription.

Some stockings are “graduated,” meaning they’re tighter down by your ankles and less tight further up your leg. It’s essential that you follow your provider’s guidance on the type of compression you need and when to use it.

Many people with CVI struggle to wear compression stockings over the long term. But compression therapy is very important to help your veins work better and ease your symptoms. If you struggle with compression therapy, talk with your provider. You may need a different type of stocking. Or, your provider may offer advice to make the treatment plan more doable for you.

If stockings don’t help, your provider may suggest intermittent pneumatic compression (IPC). IPC devices are inflatable sleeves you wear on your legs that help blood flow through your veins.

People who have peripheral artery disease (PAD) need to be careful with compression therapy. Your provider may caution you not to use it at all depending on the extent of your PAD. Closely follow your provider’s instructions.

Medications

Medications used to treat CVI include:

  • Antibiotics to clear skin infections or ulcers caused by CVI. These medications don’t treat the underlying disease.
  • Anticoagulants, or “blood thinners,” to treat blood clots and prevent future blood clots from forming.
  • Medicated wrap known as an Unna boot. This wrap combines multilayer compression with a zinc oxide gel-based wound cover that forms a semi-rigid bandage.

Nonsurgical treatment

Nonsurgical treatments for CVI include:

  • Sclerotherapy: Your provider injects a foam or liquid solution into your spider vein or varicose vein. This causes the vein to collapse or disappear.
  • Endovenous thermal ablation: This technique targets large veins. It uses a laser or high-frequency radio waves to create intense heat. This heat closes up the diseased vein but leaves it in place so there’s minimal bleeding or bruising.

Surgical treatment

Surgical treatments for CVI include:

  • Ligation and stripping: These two procedures are often performed together. For vein ligation, your provider cuts and ties off the problem veins. Stripping is the surgical removal of larger veins through two small incisions.
  • Microincision/ambulatory phlebectomy: This is a minimally invasive procedure. It targets varicose veins near your skin’s surface. Your provider makes small incisions or needle punctures over your veins. Then, they use a phlebectomy hook to remove the problem veins.
  • Subfascial Endoscopic Perforator Surgery (SEPS): This is a minimally invasive procedure. It targets your perforating veins above your ankle. Your provider uses a clip to block off damaged veins so blood doesn’t flow through them. SEPS helps ulcers heal and also helps prevent them from coming back.
  • Vein bypass: This is similar to heart bypass surgery, just in a different location. Your provider takes part of a healthy vein from somewhere else in your body and uses it to reroute blood around your damaged vein. Providers only use this method in severe cases when no other treatment is effective.

What are the risk factors for chronic venous insufficiency?

If you have risk factors for CVI, you’re more likely than other people to develop the disease. Risk factors include:

  • History of deep vein thrombosis (most important).
  • Varicose veins or a family history of varicose veins.
  • Obesity.
  • Pregnancy.
  • Not getting enough physical activity.
  • Smoking and tobacco use.
  • Sitting or standing for long periods of time.
  • Sleeping in a chair or recliner.
  • May-Thurner syndrome.
  • Being female or designated female at birth (DFAB).
  • Being over age 50.

How can I prevent chronic venous insufficiency?

Sometimes, CVI can’t be prevented. But you can lower your risk of CVI and other vein problems by making some lifestyle changes. These include:

  • Avoid smoking and tobacco use.
  • Avoid wearing restrictive clothing like tight girdles or belts.
  • Don’t sit or stand for too long at a time. Get up and move around as often as you can.
  • Eat a heart-healthy diet. This includes reducing your sodium (salt) intake.
  • Exercise regularly.
  • Keep a healthy weight.

If you’ve had DVT, your provider may recommend anticoagulants.

What can I expect if I have chronic venous insufficiency?

CVI usually isn’t life-threatening and doesn’t result in amputation. But it’s a progressive disease that can cause discomfort, pain and reduced quality of life. Treatment can help manage your symptoms and give you a better quality of life.

Venous ulcers are difficult to treat, and they may return even after treatment. It’s important to keep all your medical appointments and closely follow your provider’s guidance.

Can chronic venous insufficiency be reversed?

Treatment can’t reverse the damage to your vein valves. But it can reverse your symptoms so that you feel better and have a better quality of life. Some procedures and surgeries can target and remove the damaged veins so that blood doesn’t flow through them anymore.

Similarly, chronic venous insufficiency can’t be cured. But you can manage the condition with lifestyle changes and other treatments your provider recommends.

How do I take care of myself with chronic venous insufficiency?

Your provider will tell you how to manage CVI at home. Some general tips include:

  • Avoid long periods of standing or sitting. On long car or plane rides, flex and extend your legs, feet and ankles about 10 times every 30 minutes. This helps your blood flow through your leg veins. If you have to stand for a while, take breaks often to sit down and elevate your feet.
  • Check your skin. Each time you shower, check your skin. If you notice any changes, like new ulcers, call your provider.
  • Elevate your legs. When sitting or lying down, elevate your legs above the level of your heart.
  • Exercise on a regular basis. Walking is especially helpful for your leg veins.
  • Manage your weight. Keep a weight that’s healthy for you. Talk with your provider about what that weight is.
  • Practice good skin hygiene. Wash and moisturize your skin every day. Ask your provider what kind of moisturizer is best for your skin. Keeping your skin moisturized will help prevent flaking and cracks, which could become infected. Your provider may also recommend creams to reduce itching, protect your skin or prevent fungal infections.
  • Wear compression stockings if your provider recommends them. This is one of the best ways to manage CVI. There are many different types, so follow your provider’s guidance on which type is best for you. Also, ask your provider how best to wash and care for your stockings.

When should I see my healthcare provider?

See your provider if you have any risk factors for chronic venous insufficiency. Your provider can assess your risk factors and help you lower them.

If you have CVI, keep all your medical appointments, and follow your provider’s guidance on when to return.

Call your provider if:

  • You have any questions about your condition.
  • You have new or changing symptoms.
  • Your compression stockings don’t fit right. There shouldn’t be any bunching. Elastic stockings that don’t fit right can make your condition worse by blocking blood flow in the area where they’re bunched up.

When should I go to the ER?

Call your local emergency number right away if you have symptoms of a pulmonary embolism. This is a life-threatening complication of deep vein thrombosis. It needs immediate medical attention.

What questions should I ask my healthcare provider?

There’s a lot to learn about chronic venous insufficiency. Don’t hesitate to ask your provider any question that comes to mind. You may also want to ask:

  • What stage of chronic venous insufficiency am I at?
  • How can I manage CVI at home?
  • How can you help me stick with compression therapy?
  • Do I need a procedure or surgery?
  • What can I do to prevent my CVI from getting worse?

A note from QBan Health Care Services

Vein problems are often more than just a cosmetic concern. Chronic venous insufficiency gets worse over time and can greatly interfere with your quality of life.

If you’ve been dealing with venous disease for a while, you’re probably frustrated and wish it would just go away. Luckily, there’s a lot you can do on your own to manage your symptoms and feel better. But sticking with the program is essential. Talk with your provider about strategies for keeping up a daily treatment plan and making compression therapy doable for you.

TRANSIENT ISCHEMIC ATTACK

Transient ischemic attacks (TIAs) are often incorrectly called “mini-strokes,” but they’re every bit as serious as a true stroke. Having a TIA often means you could have a stroke in the very near future. A TIA is a medical emergency you shouldn’t ignore. More importantly, it’s a chance to get treatment that can prevent a future stroke.

What is a transient ischemic attack?

A transient ischemic attack is like a temporary stroke. It means there’s a temporary (transient) lack of blood flow to part of your brain. Without blood flow, the brain cells malfunction and start to die (ischemia).

Often shortened to TIA, a transient ischemic attack is a medical emergency that’s very similar to an ischemic stroke. The symptoms of the two are the same, but TIA symptoms go away within 24 hours (most go away in minutes).

IMPORTANT: A transient ischemic attack is a medical emergency just like a stroke is. That’s because there’s no way to predict how long a TIA will last, and every minute counts. Seek immediate medical help if you have signs of stroke, including balance issues, vision changes, face and arm drooping, and speech difficulties.

If you or someone you’re with has TIA or stroke symptoms, you should immediately call 911 (or the local emergency services number in your area). Don’t wait to see if the symptoms will subside, and don’t avoid calling if the symptoms get better after a few minutes of resting. A TIA can be the precursor to a stroke, so get medical attention right away!

TIA vs. mini-stroke — which is the correct name?

A common nickname for TIAs is “mini-strokes.” But that’s not an accurate name. A TIA isn’t necessarily “mini” or smaller, and TIAs can easily affect large brain areas. Importantly, a stroke may occur after a TIA, within a matter of minutes, hours or days.

There are also two critical differences between strokes and TIAs. The first is that a TIA stops on its own. A stroke doesn’t, and it needs treatment to stop and reverse the effects. A stroke also leaves behind evidence on a magnetic resonance imaging (MRI) scan. The changes remain even if your symptoms go away.

What are the symptoms of a TIA?

The possible symptoms of a TIA are nearly identical to the possible symptoms of a stroke.

The symptoms of an ischemic stroke can involve one or more of the following:

What causes a TIA?

Transient ischemic attacks and ischemic strokes happen for the same reasons. Those reasons include:

  • Formation of a clot in your brain (thrombosis).
  • A fragment of a clot that formed elsewhere in your body that breaks free and travels through your blood vessels until it gets stuck in your brain (thromboembolism).
  • Small vessel blockage (lacunar stroke).
  • Cryptogenic TIA (the word “cryptogenic” means “hidden origin,” so these are TIAs that happen with an unknown cause).

What are the risk factors for this condition?

Many factors can contribute to a TIA or make one more likely to happen. Risk factors include:

  • High blood pressure (hypertension). This is the most significant of all risk factors for TIA. It’s one of the reasons why managing blood pressure is so essential.
  • Type 2 diabetes.
  • Tobacco use (especially smoking or vaping).
  • Atrial fibrillation (Afib). This irregular heart rhythm (arrhythmia) can cause blood to swirl and pool in one of your heart’s chambers rather than smoothly flow through. That can allow clots to form, and these can then travel through your carotid arteries and into your brain.
  • A history of stroke or TIA. Having a previous stroke or TIA raises the risk of having a TIA.

Other risk factors that can contribute to a TIA include:

  • Heart disease and a previous heart attack (especially a recent one).
  • High cholesterol (hyperlipidemia).
  • Having excess weight or obesity.
  • Nonmedical drug use (including recreational drugs) and alcohol overuse.
  • Age. As people age, their blood vessels become less flexible for several reasons. That can contribute to atherosclerosis, narrowed blood vessels and other concerns that can contribute to a TIA.

What are the complications of a transient ischemic attack?

The main reason that a TIA is a medical emergency is because it’s often a warning that a stroke is possible or even imminent. Up to 20% of people who have a TIA have a stroke within 90 days, and half of those strokes happen within the first two days after a TIA.

How is a transient ischemic attack diagnosed?

A healthcare provider can diagnose a TIA using a combination of methods, including:

  • Medical history. This involves asking you questions about your health history and symptoms.
  • Physical and neurological exam. These help a provider learn more about your symptoms, especially if you’re still experiencing them at the time of the exam.
  • Imaging scans. Healthcare providers can get a computed tomography (CT) scan in only a few minutes. It helps them to quickly see if you’re having a brain bleed or not and, if so, provide treatment immediately. An MRI scan helps your care team tell if you had a stroke or a TIA. If there’s visible damage (even though your symptoms are completely gone), it was a stroke, not a TIA.

Other tests may also be possible, depending on your symptoms and if your healthcare provider suspects another health issue is causing or contributing to the TIA and its symptoms. Your healthcare provider can tell you more about the tests they recommend and why those tests could be helpful.

How is a transient ischemic attack treated?

A TIA, by definition, is a temporary issue. But it indicates that a stroke — which isn’t temporary — could happen. That means treating the condition(s) that caused the TIA can help prevent a stroke.

Healthcare providers often recommend treating these conditions aggressively. That’s because a stroke is a much more serious — and dangerous — condition. Strokes are also often more difficult to treat. It’s also because even with treatment, strokes can cause permanent damage or death.

The most common treatments to prevent a stroke after a TIA include:

  • Medications.
  • Catheter-based procedures.
  • Surgery.

Medications for post-TIA stroke prevention

Many types of medications can help treat the conditions that cause or contribute to a TIA and prevent TIA or stroke from happening in the future. They include:

  • Aspirin. This is one of the most common medications that healthcare providers recommend. It helps prevent stroke by reducing your risk of blood clots. Other alternatives include clopidogrel (Plavix®), ticagrelor (Brilinta®) and Aggrenox (a combination pill of aspirin and dipyridamole).
  • Blood pressure medications. These help reduce pressure strain on your blood vessels from the inside. Common medications for this include calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), diuretics and more.
  • Statins. Statins are cholesterol-lowering medications. They generally reduce low-density lipoprotein (LDL) cholesterol levels in your blood. That’s the cholesterol that can build up inside blood vessels, narrowing them and causing atherosclerosis. Atorvastatin (Lipitor®) and rosuvastatin (Crestor®) are effective and likely the best-known of these medications.
  • Blood thinners. These medications make it harder for your blood to clot, which can lower the risk of a clot forming and getting stuck in a blood vessel in your brain. These include anticoagulants like warfarin (Coumadin®), apixaban (Eliquis®), rivaroxaban (Xarelto®) or dabigatran (Pradaxa®). These medications are often recommended if you have atrial fibrillation or blood clots in your heart.

Catheter-based procedures

“Endovascular procedures” is the blanket term for all procedures that use thin, tube-like devices threaded into your blood vessels through very small incisions in your skin. Endovascular means “inside a blood vessel,” and these procedures treat problems from the inside without full surgery.

These usually involve your carotid arteries, the main vessels that carry blood from your heart to your brain. Narrowing (stenosis) in your carotid arteries can lead to a TIA or a stroke.

Some examples of endovascular procedures that can help prevent a stroke after a TIA include:

  • Endovascular thrombectomy. This is a procedure to remove the blood clot. It opens up the artery, restoring blood flow to your brain.
  • Stenting. This involves placing a stent, a mesh scaffold-like device, inside a blood vessel. The stent helps hold open narrowed blood vessel sections so blood can flow through.
  • Angioplasty. This involves a catheter with a balloon attachment at its tip. Inflating the balloon can widen narrowed arteries.

Endarterectomy

When catheter-based procedures aren’t possible, surgery may be an option to widen blood vessels. That can prevent another TIA or stroke. An example of a surgery like this is carotid endarterectomy to clean up the plaque and create a wider space for blood to flow through into your brain.

Procedures for other conditions that can contribute to a TIA

Other procedures are also possible, depending on what conditions you have. For example, your cardiovascular or cerebrovascular care team may determine that your TIA or stroke is due to conditions like patent foramen ovale (PFO), a hole in the wall that separates the lower two chambers of your heart. PFO can allow blood clots to travel to your brain. Your provider may recommend closing the hole to reduce the odds of having a stroke.

Can a transient ischemic attack be prevented?

Sometimes, but not always. Many TIAs happen for preventable reasons. But a TIA can also happen for unpredictable or unexpected reasons.

You can do many things to reduce your risk of having an ischemic stroke. While this doesn’t mean you can prevent a stroke, it can lower your risk. Actions you can take include:

  • See a primary care provider yearly for a checkup (this can detect symptomless concerns like high blood pressure and Type 2 diabetes sooner).
  • Reach and maintain a weight that’s healthy for you.
  • Manage what you eat (your primary care provider can guide you on this).
  • Stop using tobacco products (or don’t start using them in the first place).
  • Use alcohol only in moderation and avoid nonmedical drug use.
  • Take prescription medications exactly as instructed.
  • Manage any chronic conditions you have (such as high blood pressure, Type 2 diabetes and high cholesterol).

What can I expect if I have a transient ischemic attack?

Having a TIA is like having a temporary stroke. If they happen while you’re active, the symptoms may stop or lessen if you rest because you don’t feel well. However, the symptoms can return quickly once you resume whatever you were doing.

Because a TIA and a stroke have the same possible symptoms, you should always call 911 (or your local emergency services number) immediately. There’s no way to tell if what you’re experiencing is a stroke or a TIA while it’s happening.

How long do transient ischemic attacks last?

How long TIAs last can vary. By definition, TIAs last less than 24 hours. But it’s rare for a TIA to last even that long. Most TIAs last for only minutes.

What’s the outlook for transient ischemic attack?

The outlook for a TIA depends strongly on what’s causing it and what you do about it. Without treatment, your stroke risk within the next 90 days — especially the first two days after the TIA — can be very high.

The outlook is best when you get immediate emergency medical care. Healthcare providers can make sure that what you had was a TIA and not a stroke, and they can find out what’s causing or contributing to your TIA. That can also determine how to treat the underlying issue and what you can do to prevent further issues.

How do I take care of myself after a TIA?

Once you receive care, it’s essential for you to follow your healthcare provider’s guidance. The closer you follow it, the better the odds that you won’t have another TIA or stroke. Because TIAs can happen for different reasons, what you should do to take care of yourself may vary.

In general, the same actions or precautions that prevent TIAs or lower your risk of having one are also what you should do after you have a TIA. Your healthcare provider can also guide you specifically on what you can and should do.

When should I see my healthcare provider?

After emergency treatment for a TIA, you should see a provider for follow-up care. They can recommend a schedule for follow-up visits as needed and help you monitor for any changes in symptoms and how well treatment is working.

When should I go to the emergency room?

You should immediately call 911 (or your local emergency services number) and go to the nearest emergency room if you have any stroke-like symptoms. If you previously had a TIA, you should call 911 (or your local emergency number) and go to the nearest ER if any of the symptoms return.

Several other conditions are possible if you recently had a TIA. You should get emergency care if you experience symptoms of any of the following conditions:

What questions should I ask my doctor?

  • Did I have a TIA or a stroke?
  • What were the underlying causes or factors that contributed to my TIA?
  • What kind of changes can or should I make to prevent another TIA or a stroke?
  • What treatments are available to prevent another TIA or a stroke?
  • What are the possible side effects of medications or treatments that I should watch for?
  • What are the symptoms that mean I need to go to the ER?

How common are transient ischemic attacks?

TIAs are very common. Experts estimate there are about 500,000 per year. However, there’s evidence that estimate is too low. The reasons for that include:

  • TIAs are temporary. People may not realize what they’re experiencing. If the symptoms go away quickly, they may not go to the hospital or get medical attention.
  • TIAs don’t leave behind evidence. Imaging scans can’t detect a TIA after it ends. If there are visible changes left behind, it was a stroke, not a TIA.
  • TIAs often precede strokes. People may have a stroke shortly after a TIA, but not realize what the TIA was.
  • There are many TIA mimics. Many conditions can cause stroke-like symptoms but aren’t actually strokes. By the time a person gets to the hospital, it may not be possible to tell what caused their symptoms.

A note from QBan Health Care Services

A transient ischemic attack (TIA) can happen suddenly and be gone in minutes, leaving behind confusion and worry. If you experience stroke symptoms that only last minutes, don’t ignore them! They’re still a sign that you need medical attention right away.

A TIA greatly increases your risk of having a stroke in the next 90 days, and half of the strokes that do follow a TIA happen within the next two days. Getting immediate care can help you avoid a much more serious stroke, potentially saving your life and preventing permanent damage and loss of abilities.

CAROTID ARTERY ANEURYSM

A carotid artery aneurysm is a bulge in one of the arteries supplying blood to your brain and nearby structures. Atherosclerosis is a common cause. Some people have no symptoms, but others have facial swelling, hoarseness or a throbbing lump they can feel in their neck. A carotid artery aneurysm may lead to a TIA (mini stroke) or stroke.

What is a carotid artery aneurysm?

A carotid artery aneurysm is a bulge in one of your carotid arteries. These arteries supply blood to your brain, head, face and neck. You have a common carotid artery on each side of your upper chest. As it travels up your neck, each common carotid artery divides into two branches. These are your internal carotid artery and external carotid artery. Aneurysms may affect any of your carotid arteries. But they usually develop in one of your internal carotid arteries.

An aneurysm happens when part of an artery wall weakens. As the aneurysm grows bigger, your artery wall grows thinner. There’s an increased risk that the aneurysm will burst. You can compare this to a balloon filling up with air. As the balloon gets bigger, its walls get thinner and may pop. So, the larger an aneurysm grows, the more dangerous it can be.

How serious is a carotid artery aneurysm?

Carotid artery aneurysms affect blood vessels that send blood to your brain. These aneurysms may be small and cause no complications. But blood clots can sometimes form in the aneurysm and block blood flow to your brain. This can lead to a transient ischemic attack (TIA) (mini stroke) or ischemic stroke. Large aneurysms may rupture (burst), leading to a hemorrhagic stroke and life-threatening bleeding.

What is a true vs. false carotid artery aneurysm?

Like other aneurysms, carotid artery aneurysms can be either true or false. These are medical terms that describe how the bulge forms in your artery. A true carotid artery aneurysm affects all three layers of your artery wall. These three layers (intima, media and adventitia) all bulge outward and form the aneurysm’s wall. Atherosclerosis is the most common cause of a true aneurysm.

A false carotid artery aneurysm is also called a pseudoaneurysm. A pseudoaneurysm only affects one or two layers of your artery wall. It usually looks like a round sac that sticks out of your artery on a narrow “neck.” Trauma, infection and complications from medical procedures are typical causes of a pseudoaneurysm.

Both true and false aneurysms can lead to complications and may require treatment.

Who do carotid artery aneurysms affect?

Carotid artery aneurysms can affect adults of any age and, rarely, children. But they usually affect people in their 50s or 60s.

Are carotid artery aneurysms common?

Carotid artery aneurysms are rare. Fewer than 1 in 100 aneurysms are carotid artery aneurysms.

What are the symptoms of a carotid artery aneurysm?

Some people with carotid artery aneurysms have no symptoms. Of those who do, symptoms of a transient ischemic attack (TIA) or stroke are most common. A TIA is also called a “mini stroke,” and it may be a warning sign that a stroke may happen in the next few days or weeks. Both TIAs and strokes happen when blood flow to your brain is interrupted.

TIAs and strokes are medical emergencies that need immediate care. Call 911 or your local emergency number if you have any of the following symptoms:

  • Difficulty seeing from one or both eyes.
  • Difficulty walking.
  • Dizziness, loss of coordination or feeling off-balance.
  • Numbness or weakness in your face, arms or legs, especially on one side of your body.
  • Sudden, severe headache.
  • Trouble speaking or understanding others’ speech. Your speech may be slurred or confused.

You may not be able to call 911 if you’re experiencing severe symptoms. So, it’s important to educate your loved ones about TIA and stroke symptoms so they know when to call for help. If you live alone, it’s a good idea to get a medical alert system that requires simply pushing a button to seek help.

Aside from TIAs and strokes, the aneurysm may cause you to feel other symptoms if it puts pressure on nearby structures. If the aneurysm presses on veins or nerves in your neck or head, you may experience:

Call your healthcare provider if you have any of these symptoms.

What causes carotid artery aneurysms?

There are many possible causes of carotid artery aneurysms, including:

What are the risk factors for carotid artery aneurysms?

Carotid artery aneurysms happen when your artery’s walls become weak. Many factors can raise your risk of weakened arterial walls, including:

How is a carotid artery aneurysm diagnosed?

Healthcare providers diagnose carotid artery aneurysms through:

  • A physical exam. This includes using a stethoscope to hear blood flow through your carotid artery. A whooshing sound (carotid bruit) is sometimes a sign of a carotid artery aneurysm.
  • Family history. Your provider will ask about medical conditions that have affected your biological family. People with a family history of aneurysms often face a higher risk.
  • Medical history. Your provider will learn about your medical history and associated conditions. This helps your provider identify possible causes of an aneurysm.
  • Imaging tests. Imaging tests show what’s happening inside of your carotid artery and the surrounding areas. They confirm the diagnosis of a carotid artery aneurysm and help your provider determine the best treatment.

Sometimes, providers diagnose aneurysms after suspecting a person has one. Other times, they diagnose them through imaging tests done for other reasons. This is called an incidental diagnosis.

What tests diagnose carotid artery aneurysms?

Imaging tests that diagnose carotid artery aneurysms include:

Your provider may also recommend:

  • Brain imaging to check blood flow through your brain and look for additional aneurysms.
  • Genetic testing to check for underlying genetic conditions.
  • Imaging tests to check your aorta or other arteries for additional aneurysms.

What is the treatment for carotid artery aneurysms?

Carotid artery aneurysm treatment includes:

  • Surveillance.
  • Open surgery.
  • Endovascular stent grafting.

The goals of treatment are to reduce symptoms and lower your risk of complications. You may need surgical or endovascular repair if you face a high risk of complications like aneurysm rupture or stroke. Your surgeon takes into account many factors to determine your risk, including:

  • Aneurysm size.
  • How quickly the aneurysm is growing.
  • Whether or not you have symptoms.

Surveillance

Also called “watchful waiting,” surveillance means your provider monitors your aneurysm. You’ll have imaging testing (ultrasound, CT or MRI scans) every six to 12 months. Your provider will look for any changes. This is often an option for small aneurysms that aren’t causing any symptoms.

If you have high blood pressure, your provider may prescribe blood pressure medication. This can help lower pressure on the aneurysm. Your provider may also prescribe a cholesterol-lowering medication.

Open surgery

Surgical repair is the traditional treatment method. Your surgeon removes the damaged part of your carotid artery. Then, they create a new path for your blood to flow from the normal artery below the aneurysm to the normal artery above it. This is called bypass grafting.

Your surgeon may use part of a blood vessel taken from somewhere else in your body to create the new blood vessel (graft). Or they may use an artificial material like GORE-TEX®.

Endovascular stent grafting

Endovascular repair is a less invasive option compared to open surgery. You may be eligible for endovascular stent grafting depending on the size of the aneurysm and its location in your carotid artery.

Endovascular means that surgery is performed inside of your artery using long, thin tubes (catheters). Your surgeon makes a small puncture in an artery in your groin. Then, they use catheters to guide a stent graft through your blood vessels until it reaches the aneurysm site. Under X-ray guidance, your surgeon positions the graft in the area of the aneurysm. They expand the graft inside of your artery, where metallic hooks hold it in place. The graft functions as a new path for your blood to flow.

Which treatment is right for me?

Your healthcare provider will tailor treatment to your situation and needs. Before any procedure or surgery, your provider will talk with you about its benefits, risks and side effects. Your provider will also give you detailed guidelines for your preparation and recovery.

How can I reduce my risk of a carotid artery aneurysm?

Some risk factors (like biological family history) are out of your control. But you can take some steps to keep your arteries healthy and lower your risk of an aneurysm. These include:

  • Don’t smoke, vape or use tobacco products. Ask your provider for resources to help you quit.
  • Eat a heart-healthy diet low in saturated fat, sodium and sugar.
  • Exercise regularly, according to your healthcare provider’s guidance.
  • Limit your alcohol intake.
  • Manage risk factors like high blood pressure.
  • Take your medications as prescribed.
  • Visit your provider for yearly check-ups and keep all of your follow-up appointments.

What can I expect if I have a carotid artery aneurysm?

The outlook for people with carotid artery aneurysms can vary widely. Some people have a small aneurysm that their provider monitors for many years. Others have an aneurysm that grows quickly and needs treatment. Surgeries and endovascular procedures can treat your aneurysm but carry some risks. Talk with your provider about your condition and what you can expect going forward.

How do I take care of myself?

Follow your healthcare provider’s guidance on lifestyle changes that can help you manage your condition. Also, ask your provider about any activity restrictions. You may need to avoid some activities that cause you to overexert yourself.

When should I see my healthcare provider?

Your provider will tell you how often you need to come in for appointments or testing. Be sure to go to all of your appointments.

Call your provider if you have:

  • New or changing symptoms.
  • Side effects from any of your medications.
  • Any questions or concerns about your aneurysm or your treatment plan.

When should I go to the emergency room?

Call 911 or your local emergency number immediately if you have symptoms of a:

What questions should I ask my doctor?

If you’ve been diagnosed with a carotid artery aneurysm, you probably have many questions. But you might not know where to start. Some questions to begin the conversation include:

  • Where’s the aneurysm located? Is it in my neck or skull?
  • How big is the aneurysm?
  • Will I need treatment? If so, when?
  • What are my treatment options?
  • What are the benefits and risks of each treatment option?
  • What can I expect as I recover?
  • What lifestyle changes should I make?
  • Do I have any activity restrictions?
  • Do I need additional testing? If so, how often?

What is the difference between an extracranial carotid artery aneurysm and an intracranial carotid artery aneurysm?

Both terms refer to an aneurysm that affects one of your carotid arteries. But they each describe a different location for where the aneurysm forms. Extracranial means the aneurysm is outside of your skull, in your neck. Intracranial means the aneurysm is within your skull.

Researchers use these two terms because your internal carotid artery travels both outside and within your skull. So, it’s helpful to take a closer look at this artery’s path.

Anatomy of your internal carotid artery

Your internal carotid arteries (one on each side of your neck) branch from your common carotid arteries in your neck. They then travel straight upward through your neck until they reach the base of your skull. This extracranial part of each internal carotid artery is called the C1 or cervical segment. “Cervical” in this context means something related to your neck.

Each internal carotid artery then passes through an opening in your skull called the carotid canal. This is the dividing point between the extracranial and intracranial parts of your artery. After this point, your internal carotid artery is within your skull (intracranial). It continues on a winding path to join up with other blood vessels in your brain. Scientists further divide the intracranial part into six segments:

  • C2: Petrous segment.
  • C3: Lacerum segment.
  • C4: Cavernous segment.
  • C5: Clinoid segment.
  • C6: Ophthalmic segment.
  • C7: Communicating segment.

There’s no need to memorize these terms, but knowing this anatomy can help you talk with your provider about your condition. Your provider may say you have an aneurysm in your “left internal carotid artery, cervical segment.” This refers to the internal carotid artery on the left side of your body, but specifically, a segment outside of your skull.

Ask your provider about any terms you don’t understand. They can help you understand what’s going on inside of your body and where it’s happening.

A note from QBan Health Care Services

Learning you have an aneurysm can feel frightening. You might wonder what caused this to happen and whether your daily life will change. You might also fear complications. But thanks to imaging technologies and treatments, many people can go on with life as normal.

If you’ve been diagnosed with a carotid artery aneurysm, talk with your healthcare provider about next steps for treatment. They may recommend a period of surveillance (keeping an eye on the aneurysm) if the aneurysm is small. Be sure to keep all of your appointments for imaging and follow-ups. And let your provider know if you have any questions or concerns along the way.

AORTIC ANEURYSM

An aortic aneurysm is a bulge in the wall of your aorta, the main artery from your heart. Aortic aneurysms form in a weak area in your artery wall. They may rupture (burst) or split (dissect), which can cause life-threatening internal bleeding or block the flow of blood from your heart to various organs.

What is an aortic aneurysm?

Your aorta is the largest artery in your body. It carries blood and oxygen from your heart to other parts of your body. It’s shaped like a curved candy cane. Your ascending aorta leads up from your heart. Your descending aorta travels back down into your abdomen (belly).

An aneurysm can develop in any artery. An aortic aneurysm develops when there’s a weakness in the wall of your aorta. The pressure of blood pumping through the artery causes a balloon-like bulge in the weak area of your aorta. This bulge is called an aortic aneurysm.

What are the different types?

There are two different types of aortic aneurysms. They affect different parts of your body:

  • Abdominal aortic aneurysm (AAA): An abdominal aortic aneurysm develops in the “handle” of your aorta that points down.
  • Thoracic aortic aneurysm (TAA): A thoracic aortic aneurysm (heart aneurysm) occurs in the section that’s shaped like an upside-down U at the top of your aorta. In people with Marfan syndrome (a connective tissue disorder), a TAA may occur in the ascending aorta.

How common are they?

Abdominal aortic aneurysms are 4 to 6 times more common in men and people assigned male at birth than women and people assigned female at birth. They affect only about 1% of men aged 55 to 64. They become more common with every decade of age. The likelihood increases by up to 4% every 10 years of life.

Abdominal aortic aneurysms occur more frequently than thoracic aortic aneurysms. This may be because the wall of your thoracic aorta is thicker and stronger than the wall of your abdominal aorta.

What are the risk factors for aortic aneurysm?

Both your family history and your lifestyle can play a role in your risk of developing an aortic aneurysm. Aortic aneurysms occur most often in people who:

  • Smoke.
  • Are over age 65.
  • Were assigned male at birth.
  • Have a family history of aortic aneurysms.
  • Have high blood pressure (hypertension).

What causes aortic aneurysm?

The causes of an aortic aneurysm are often unknown, but can include:

What are the symptoms of an aortic aneurysm?

In many cases, people don’t know they have an aortic aneurysm. An aneurysm often doesn’t cause any symptoms until it ruptures (bursts).

If an aneurysm ruptures, it’s a medical emergency that requires immediate treatment. Call 911 if you or someone you are with has a ruptured aneurysm.

Symptoms of a ruptured aneurysm come on suddenly and can include:

Finding an aortic aneurysm before it ruptures offers your best chance of recovery. As an aortic aneurysm grows, you might notice symptoms including:

  • Difficulty breathing or shortness of breath.
  • Feeling full even after a small meal.
  • Pain wherever the aneurysm is growing (could be in your neck, back, chest or abdomen).
  • Painful or difficult swallowing.
  • Swelling of your arms, neck or face.

What are the complications of an aortic aneurysm?

If an aortic aneurysm ruptures, it causes internal bleeding. Depending on the location of the aneurysm, a rupture can be very dangerous — even life-threatening. With immediate treatment, many people can recover from a ruptured aneurysm.

A growing aortic aneurysm can also lead to a tear (aortic dissection) in your artery wall. A dissection allows blood to leak in between the walls of your artery. This causes a narrowing of your artery. The narrowed artery reduces or blocks blood flow from your heart to other areas. The pressure of blood building up in your artery walls can also cause the aneurysm to rupture.

How is aortic aneurysm diagnosed?

Many aneurysms develop without causing symptoms. Providers often discover these aneurysms during a routine checkup or screening.

If you’re at high risk of developing an aortic aneurysm — or have any aneurysm symptoms — your provider will do imaging tests. Imaging tests that can find and help diagnose an aortic aneurysm include:

How is an unruptured aortic aneurysm treated?

If you have an unruptured aortic aneurysm, your provider will monitor your condition closely. If you have risk factors for developing an aortic aneurysm, your provider may also recommend regular screenings.

Treatment aims to prevent the aneurysm from growing large enough to tear the artery or burst. For smaller, unruptured aneurysms, your provider may prescribe medications to improve blood flow, lower blood pressure or manage cholesterol. All can help slow aneurysm growth and reduce pressure on the artery wall.

What are the types of aortic aneurysm surgery?

Large aneurysms at risk of dissecting or rupturing may require surgery. Your provider might use one of these types of surgical procedures to treat an aortic aneurysm:

  • Open aneurysm repair: Your provider removes the aneurysm and sews a graft (a section of specialized tubing) in place to repair the artery. Open aneurysm repair surgery may also be necessary if an aneurysm bursts.
  • Endovascular aneurysm repair (EVAR): Endovascular surgery is a minimally invasive procedure to fix aortic aneurysms. During the procedure, your provider uses a catheter (thin tube) to insert a graft to reinforce or repair the artery. This procedure is also called thoracic endovascular aneurysm repair (TEVAR) or fenestrated endovascular aneurysm repair (FEVAR).

What can I expect after aortic aneurysm surgery?

Recovery after aneurysm surgery takes a month or longer. Your provider will continue to monitor you for changes to the aneurysm, growth or complications. Most people have positive outcomes after surgery.

All surgery has risks. Possible complications after surgery include:

  • Leaking blood around the graft (called endoleak).
  • Movement of the graft away from where it was placed.
  • Formation of blood clots.
  • Infection.

Can I prevent an aortic aneurysm?

Having high blood pressure, high cholesterol or using tobacco products increases your risk of developing an aortic aneurysm. You can reduce your risk by maintaining a healthy lifestyle. This includes:

What is the prognosis (outlook) for people with an aortic aneurysm?

With careful monitoring and treatment, your provider can help you manage an aortic aneurysm. Ideally, your healthcare team can identify and care for an aortic aneurysm before it ruptures.

If an aortic aneurysm ruptures, seek medical care immediately. Without prompt treatment, a ruptured aortic aneurysm can be fatal. Both open and endovascular surgery can successfully treat a ruptured aortic aneurysm.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • Loss of consciousness (syncope, fainting or passing out).
  • Low blood pressure.
  • Rapid heart rate.
  • Sudden, severe pain in your chest, abdomen or back.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

  • Am I at risk of developing an aortic aneurysm?
  • How will I know if I have an aortic aneurysm?
  • What steps can I take to prevent an aortic aneurysm from dissecting or rupturing?
  • What lifestyle changes will help reduce my risk of an aortic aneurysm?

A note from QBan Health Care Services

Taking steps to improve your heart health can help prevent aortic aneurysms from developing or getting worse. Talk to your doctor about lifestyle changes you can make. If you’re at risk for an aortic aneurysm, be sure to get regular screenings. Finding and treating an aneurysm early greatly reduces the risk of rupture or other complications.

VASCULAR DISEASE

Vascular disease (vasculopathy) affects the blood vessels that carry oxygen and nutrients throughout your body and remove waste from your tissues. Common vascular problems happen because plaque (made of fat and cholesterol) slows down or blocks blood flow inside your arteries or veins. Lifestyle changes often help, but some people need medication or surgery.

What is vascular disease?

Vascular disease includes any condition that affects your circulatory system, or system of blood vessels. This ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.

Blood vessels are elastic-like tubes that carry blood to every part of your body. Blood vessels include:

  • Arteries that carry blood away from your heart.
  • Veins that return blood back to your heart.
  • Capillaries, your tiniest blood vessels, which link your small veins and arteries, deliver oxygen and nutrients to your tissues and take away their waste.

Types of Vascular Disease

Some vascular diseases affect your arteries, while others occur in your veins. They can also happen only in specific parts of your body.

Peripheral artery disease

Like the blood vessels of your heart (coronary arteries), your peripheral arteries (blood vessels outside your heart) also may develop atherosclerosis, the buildup of plaque (fat and cholesterol deposits), inside them. Over time, the buildup narrows the artery. Eventually, the narrowed artery causes less blood to flow, which may lead to ischemia, or inadequate blood flow to your body’s tissue. Types of peripheral arterial disease include:

  • Peripheral artery disease: A blockage in your legs. Total loss of circulation can lead to gangrene and loss of a limb.
  • Intestinal ischemic syndrome: A blockage in the blood vessels leading to your gastrointestinal system.
  • Renal artery disease: A blockage in your renal arteries can cause renal artery disease and kidney failure.
  • Popliteal Entrapment Syndrome: A rare vascular disease that affects the legs of some young athletes. The muscle and tendons near the knee compress the popliteal artery, restricting blood flow to the lower leg and possibly damaging the artery.
  • Raynaud’s Phenomenon: Consists of spasms of the small arteries of your fingers, and sometimes toes, from exposure to cold or stress.
  • Buerger’s Disease: Most commonly affects the small and medium-sized arteries, veins and nerves. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of your arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to your fingers, hands, toes and feet. With severe blockages, the tissue may die (gangrene), making it necessary to amputate affected fingers and toes. Superficial vein inflammation and symptoms of Raynaud’s can occur as well.

Carotid artery issues

These happen in the two main carotid arteries in your neck.

  • Carotid artery disease: A blockage or narrowing in the arteries supplying your brain. This can lead to a transient ischemic attack (TIA) or stroke.
  • Carotid artery dissection: Begins as a tear in one layer of your artery wall. Blood leaks through this tear and spreads between the wall layers.
  • Carotid body tumors: Growths within the nervous tissue around your carotid artery.
  • Carotid artery aneurysm: A bulge in your artery wall that weakens the wall and may cause a rupture.

Venous disease

Veins are flexible, hollow tubes with flaps inside, called valves. When your muscles contract, these one-way valves open, and blood moves through your veins. When your muscles relax, the valves close, keeping blood flowing in one direction through your veins.

If the valves inside your veins become damaged, the valves may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves inside the damaged vein(s) will not be able to hold the blood. This can cause pooling of blood or swelling in your veins. The veins bulge and look like ropes under the skin. The blood begins to move more slowly through your veins and may stick to the sides of your vessel walls. Symptoms include heaviness, aching, swelling, throbbing or itching. Blood clots can form.

  • Varicose veins: Bulging, swollen, purple, ropy veins, seen just under your skin. Damaged valves within the veins cause this.
  • Spider veins: Small red or purple bursts on your knees, calves, or thighs. Swollen capillaries (small blood vessels) cause this.
  • Klippel-Trenaunay syndrome (KTS): A rare congenital (present at birth) vascular disorder.
  • May-Thurner syndrome (MTS): Your right iliac artery compresses your left iliac vein, which increases the risk of deep vein thrombosis (DVT) in your left extremity.
  • Thoracic outlet syndrome (TOS): A group of disorders that happen with compression, injury or irritation of the nerves and/or blood vessels (arteries and veins) in your lower neck, armpit and upper chest area.
  • Chronic venous insufficiency (CVI): A condition that happens when the venous wall and/or valves in your leg veins are not working effectively, making it difficult for blood to return to your heart from your legs.

Blood clots

A clot forms when clotting factors in your blood make it coagulate or become a solid, jelly-like mass. When a blood clot forms inside a blood vessel (a thrombus), it can come loose and travel through your bloodstream, causing a deep vein thrombosis, pulmonary embolism, heart attack or stroke.

Blood clots in your arteries can increase the risk for stroke, heart attack, severe leg pain, difficulty walking or even the loss of a limb.

  • Hypercoagulable states or blood clotting disorders: Conditions that put people at increased risk for developing blood clots because they make blood more likely to form blood clots (hypercoagulable) in the arteries and veins. You can inherit these conditions (congenital, occurring at birth) or acquire them. These disorders include high levels of factors in your blood that cause blood to clot (fibrinogen, factor 8, prothrombin) or not enough natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S). The most aggressive disorders include circulating antiphospholipid antibodies, which can cause clots in both arteries and veins.
  • Deep vein thrombosis (DVT): A blood clot occurring in a deep vein.
  • Pulmonary embolism: A blood clot that breaks loose from a vein and travels to your lungs.
  • Axillo-subclavian vein thrombosis, also called Paget-Schroetter Syndrome: Most common vascular condition to affect young, competitive athletes. The condition develops when your collarbone (clavicle), first rib or the surrounding muscle compresses a vein in your armpit (axilla) or in front of your shoulder (the subclavian vein). This increases your risk of blood clots.
  • Superficial thrombophlebitis: A blood clot in a vein just under your skin.

Aortic aneurysm

An aneurysm is an abnormal bulge in a blood vessel wall. Aneurysms can form in any blood vessel, but they occur most commonly in the aorta (aortic aneurysm) which is the main blood vessel leaving the heart:

Fibromuscular dysplasia (FMD)

Fibromuscular dysplasia (FMD): A rare medical condition in which people have abnormal cellular growth in the walls of their medium and large arteries. This can cause the arteries with abnormal growth to look beaded and become narrow. This can cause issues with the arteries, including aneurysms and dissection.

Lymphedema

The lymphatic system includes an extensive network of lymph vessels and lymph nodes that helps coordinate your immune system’s function to protect your body from foreign substances. Lymphedema, an abnormal buildup of fluid, develops when lymph vessels or lymph nodes are missing, impaired, damaged or removed.

  • Primary lymphedema (rare): Some people are born without certain lymph vessels or have abnormalities in them.
  • Secondary lymphedema: Happens as a result of a blockage or interruption that alters the lymphatic system. Causes of this include: infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (DVT), radiation or other cancer treatment.

Vasculitis

Your blood vessels can get inflamed because of a medicine, an infection or an unknown cause. This can make it hard for blood to travel through your blood vessels. This is sometimes associated with rheumatological conditions or connective tissue disease. Vasculitis can also cause an aneurysm.

Who does vasculopathy affect?

Some people are born with vascular diseases they inherit from their parents. In these cases, such as blood clotting disorders, they start dealing with this issue at a younger age. However, many vascular diseases develop over time because of an accumulation of plaque (fat and cholesterol) in the arteries, such as peripheral artery disease or carotid artery disease. Atherosclerosis, the hardening of the arteries, can start when you’re a teen and cause problems in middle age or later.

How common is vascular disease?

Vascular diseases are very common in America, partly because so many people weigh too much and have diabetes. The most common vascular diseases include peripheral artery disease (PAD) and carotid artery disease.

What are the vascular disease symptoms?

Symptoms vary depending on the type of vascular disease.

Peripheral artery disease symptoms

  • Peripheral artery disease: Leg pain or cramps with activity but improve with rest; changes in skin color; sores or ulcers and tired legs.
  • Intestinal ischemic (or mesenteric ischemia) syndrome: Severe stomach pain, nausea, throwing up, diarrhea, food fear and weight loss.
  • Renal artery disease: Uncontrolled hypertension (high blood pressure), congestive heart failure and abnormal kidney function.
  • Popliteal entrapment syndrome: Leg and foot cramps, numbness, tingling, discoloration.
  • Raynaud’s phenomenon: Fingers and toes that look red, blue or white, throbbing, tingling, redness.
  • Buerger’s disease: Pain in your arms, hands, legs and feet, even at rest. Blue or pale fingers or toes.

Symptoms of carotid artery issues

  • Carotid artery disease: Usually no symptoms until having a stroke or transient ischemic attack (TIA or mini-stroke). Symptoms of these include trouble with vision or speech, confusion and difficulty with memory.
  • Carotid artery dissection: Headache, neck pain and eye or facial pain.
  • Carotid body tumors: Palpitations, high blood pressure, sweating and headaches.
  • Carotid artery aneurysm: Stroke or transient ischemic attack (TIA or mini-stroke).

Venous disease symptoms

  • Varicose veins and spider veins: Swelling, pain, blue or red veins visible on legs.
  • Klippel-Trenaunay syndrome (KTS): Pain or heaviness in your leg or arm.
  • May-Thurner syndrome (MTS): Swelling, tenderness, pain in your leg, red or discolored skin.
  • Thoracic outlet syndrome (TOS): Neck, arm and shoulder pain, tingling and numbness in your arm or hand.
  • Chronic venous insufficiency (CVI): Leg cramps, heavy or achy legs, swelling or pain in your legs.

Blood clots

  • Blood clotting disorders: Deep vein thrombosis, pulmonary embolism.
  • Deep vein thrombosis (DVT): Pain, swelling, warmth in your leg, red skin.
  • Pulmonary embolism: Coughing up blood, chest pain, shortness of breath.
  • Axillo-subclavian vein thrombosis: Swelling, heaviness or pain in your arm or hand, skin that looks blue.
  • Superficial thrombophlebitis: Inflammation, pain, warmth around your vein, red skin.

Aortic aneurysm symptoms

  • Thoracic aortic aneurysm: Chest pain, fast heart rate, trouble swallowing, swollen neck.
  • Abdominal aortic aneurysm: Abdominal or back pain, dizziness, nausea and throwing up, fast heart rate (if the aneurysm ruptures).

Fibromuscular Dysplasia (FMD) symptoms

Fibromuscular dysplasia (FMD): Neck pain, vision changes, high blood pressure, dizziness, hearing a “whooshing sensation” or hearing your heartbeat in your ears.

Lymphedema symptoms

Swelling, most often in your arms or legs.

Vasculitis symptoms

Not feeling well, fever, swelling.

What causes vascular disease?

For some vascular problems, the cause isn’t known. Vascular disease causes include:

How is vascular disease diagnosed?

Your healthcare provider will want to do a physical exam and get your medical history, as well as a history of which diseases are in your family. It helps your healthcare provider look for vascular disease when you take your shoes and socks off before they examine you.

Depending on the type of vascular disease your provider suspects, they may do blood tests and imaging.

What tests will be done to diagnose vasculopathy?

Many vascular diseases involve clots or blockages in blood vessels. To diagnose these, your healthcare provider needs to be able to see inside your blood vessels using imaging methods that include:

How is vascular disease treated?

Eating healthier and exercising more can help with many vascular diseases. For others, you may need to take medicine or have a surgical procedure. Vascular disease treatments vary depending on the condition.

Peripheral artery disease treatment

  • Peripheral artery disease: Diet, exercise, medicine, surgery.
  • Intestinal ischemic syndrome: Pain medicine, clot-busting drugs, surgical removal of blood clot. Angioplasty, stenting or bypass surgery for chronic cases.
  • Renal artery disease: Low-salt, heart-healthy diet. High blood pressure medicine, statins.
  • Popliteal entrapment syndrome: Surgery to release the popliteal artery.
  • Raynaud’s phenomenon: Keep hands and feet warm. Take medicine that helps blood vessels stay open (dilated).
  • Buerger’s disease: Quit tobacco products. Warm up fingers and toes. Take medicine (vasodilators) to open blood vessels.

Treatment of carotid artery issues

  • Carotid artery disease: Healthier diet. Blood thinners and cholesterol-lowering medicine. Plaque removal (carotid endarterectomy). Angioplasty and stenting to keep the artery open.
  • Carotid artery dissection: Antiplatelets, anticoagulants, stenting.
  • Carotid body tumors: Surgical removal of the tumor.
  • Carotid artery aneurysm: Antihypertensives, cholesterol-lowering medicine, clot-busting medicine. Bypass or stent-graft surgery.

Venous disease treatment

  • Varicose veins and spider veins: Removal using heat, saltwater or laser therapy.
  • Klippel-Trenaunay syndrome (KTS): Same treatment as varicose veins.
  • May-Thurner syndrome (MTS): Same as for deep vein thrombosis.
  • Thoracic outlet syndrome (TOS): Physical therapy, medicine.
  • Chronic venous insufficiency (CVI): Move legs frequently and wear compression stockings. Vein treatment with saltwater, laser or removal through an incision.

Blood clot treatment

  • Blood clotting disorders: Same as for deep vein thrombosis and pulmonary embolism.
  • Deep vein thrombosis (DVT): Elevate your legs. Take blood thinners and medicines for pain.
  • Pulmonary embolism: Blood thinners and thrombolytics. Procedure to remove the clot.
  • Axillo-subclavian vein thrombosis: Thrombolytics, blood thinners. Removal of the clot.
  • Superficial thrombophlebitis: Raise your affected limb above your heart. Use a warm compress. Put on support stockings. Have the vein surgically removed.

Aortic aneurysm treatment

  • Thoracic aortic aneurysm: Surgery to put in a fabric graft or a stent. This can be a major surgery depending on the location and surgical method.
  • Abdominal aortic aneurysm: Surgery to put in a graft. An endovascular repair is less invasive.

Fibromuscular Dysplasia (FMD)

  • Blood thinners, medicine for pain.
  • Angioplasty. Surgery to prevent an artery rupture.

Lymphedema

  • Let your arm rest above your heart level while you lie down for 45 minutes twice daily.
  • Wear a compression sleeve.
  • Use your affected limb for daily tasks.
  • Visit a specialized lymphedema clinic if your healthcare provider recommends it.

Vasculitis

  • Your provider may prescribe medications like steroids.

Complications/side effects of the treatment

Any medicine can have side effects, but the benefits of medicines usually make them worth taking. Side effects often go away. If they don’t, you can ask your healthcare provider to switch you to a different drug.

When considering a procedure or surgery, talk to your provider about the risks and benefits. What’s right for your neighbor may not be the right treatment for you.

How can I reduce my risk of vascular disease?

You can’t do anything about your age, family history or genetics, but you can:

  • Manage your diabetes, high cholesterol and high blood pressure.
  • Exercise regularly.
  • Eat healthier foods.
  • Move around once an hour if you have to sit or stand for hours.
  • Stay at a healthy weight.
  • Reduce your stress level.
  • Avoid tobacco products.

What can I expect if I have vasculopathy?

Vascular disease can be a lifelong problem. Once your healthcare provider knows you have plaque accumulations in your blood vessels, they’ll want you to make some changes to how you live. These changes, such as exercising, not using tobacco products and choosing healthier foods, are things you’ll need to keep doing for years to come. You may also need to take medicines to decrease your risk of a heart attack or stroke.

Outlook for this condition

The outlook for many vascular conditions is good if your healthcare provider catches the problem early. Many vascular issues get harder to treat as they get worse. Some vascular conditions, such as carotid artery dissection, abdominal aortic aneurysm and pulmonary embolism, can be life-threatening.

How do I take care of myself?

In addition to the things mentioned above, you’ll also want to keep taking medicines your healthcare provider prescribes and keep going to your regular checkups.

When should I see my healthcare provider?

Contact your provider if anything changes with your vascular issue or if you have a problem with the medication they prescribed.

When should I go to the ER?

Call 911 if you have:

  • Confusion or dizziness.
  • Slurred speech.
  • A droop on one side of your face.
  • Severe chest pain.
  • Severe abdominal pain.
  • Loss of vision.
  • Weakness in an arm or leg.

What questions should I ask my doctor?

  • What’s the best treatment for my specific situation?
  • Is there anything else I should be doing to take care of my vascular condition?
  • Are there related conditions I should watch for with this vascular issue?

A note from QBan Health Care Services

With vascular disease, the best thing you can do is stay vigilant. Don’t skip any medical checkups or medicine doses. Because some vascular issues run in families, sharing health information with your family can help them prevent and be on the lookout for vascular disease. Encourage your family to get their blood pressure and cholesterol checked since high levels put them at risk for vascular diseases.