heart and blood vessels

What is heart rate variability, and how do you improve it?

June 27th, 2020 by The Hello Doctor Team

Heart rate variability refers to differences in time between each heartbeat. For example, if your heart rate is 60 beats per minute, it’s not necessarily beating once every second. Within that minute there may be 0.9 seconds between two beats, and 1.15 seconds between two others. The greater this variability is, the more “prepared” your body is to perform at an optimal level.

Heart rate vs. heart rate variability?

Heart rate (HR)

Heart rate is measured in beats per minute and refers to the average number of the beats in a given time period.

For example, a 60 beats per minute HR could mean 1 beat per second or it could mean an average of 1 beat every 0.5s, 1.5s, 0.5s, 1.5s, etc.

Generally, a low HR is measured during rest, while a high HR is associated with movement, exercise and sometimes stress.

Heart rate variability (HRV), on the other hand, measures the specific changes in time between consecutive heartbeats.

The time between beats is measured in milliseconds (ms) and is called an “R-R interval” or “inter-beat interval (IBI).

Why should you check heart rate variability?

Checking your heart rate variability is a great way to identify how well your autonomic nervous system is functioning.

When you’re in a fight-or-flight mode, or feeling very stressed, the variation between heartbeats is usually low. But if you’re in a more relaxed state, the variation between beats is higher.

The healthier the autonomic nervous system, the faster you’re able to switch mechanisms, showing more resilience and flexibility, especially to stress. A higher HRV is associated with improved cardiovascular fitness and resilience to stress, whereas a low HRV has been linked to anxiety, heart disease and an increased risk of early death.

Your HRV may also help give an idea of your lifestyle habits. Your HRV changes as you incorporate exercise, mindfulness, meditation and sleep into your life. This is a great way to not only track how your nervous system reacts to the environment, but also to your emotions, thoughts, and feelings.

How to improve heart rate variability

Stay hydrated: The more hydrated you are, the easier it is for your blood to circulate and carry oxygen and nutrients to your body.

Avoid alcohol: One night of drinking may negatively affect your HRV for up to five days.

Eat clean: Poor nutrition has a negative effect on HRV

Quality sleep: The quality and consistency of your sleep is important. Going to bed and waking up at similar times every day is beneficial.

Auto-regulation: Adopting a consistent schedule for your body especially with sleep and eating is helpful. Your body operates more efficiently when it knows what’s coming.

References:

Is your dizziness caused by cardiomyopathy?

January 27th, 2020 by Content Editor

Cardiomyopathy is a disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body.

It affects those of all ages and develops either because of genetics or an underlying condition.

Factors that can increase your risk of cardiomyopathy include:

A family history of heart failure and sudden cardiac arrest
Long-term high blood pressure
Past heart attacks
Coronary artery disease or an infection in the heart
Obesity
Long-term alcohol abuse
Drug use
Certain chemotherapy drugs and radiation therapy for cancer
Diabetes, an under- or overactive thyroid gland, or a disorder that causes the body to store excess iron (hemochromatosis)

In some cases, the cause of cardiomyopathy isn’t known. This is often the case when the disease develops in children.

Other types of the disease are called “unclassified cardiomyopathy.” Another type is “stress-induced cardiomyopathy,” also known as broken heart syndrome.

Symptoms

There may be no symptoms in the early stages of cardiomyopathy. However, as the condition advances, the following signs usually appear:

Breathlessness
Swelling of the legs, ankles and feet
Bloating of the abdomen due to fluid build-up
Coughing while lying down
Fatigue
Rapid, pounding or fluttering heartbeats
Dizziness, light-headedness and fainting
Chest discomfort or pressure

Symptoms tend to get worse unless treated. In some people, the condition worsens quickly; in others, it is a gradual process.

Treating cardiomyopathy

Treatment is aimed at the cause of heart failure. Once you have been diagnosed, the main goals are to improve cardiac function, reduce symptoms and to help prevent complications.

Your doctor will also recommend lifestyle changes that reduce your symptoms and improve your quality of life.

When to see a doctor

Because some types of cardiomyopathy can be hereditary, your doctor might advise that your family members be checked too.

See your doctor if you have one or more signs associated with cardiomyopathy, like severe difficulty breathing, fainting or chest pain that lasts for more than a few minutes.

In many cases, you can’t prevent cardiomyopathy, but let your doctor know if you have a family history of the condition.

You can help reduce your chances of cardiomyopathy and other types of heart disease with a heart-healthy lifestyle that includes:

Controlling high blood pressure, high cholesterol and diabetes
Avoiding the use of alcohol or drugs
Eating a heart-healthy diet
Being regularly active
Getting enough sleep
Reducing stress

Teaser: Make heart-healthy choices

References:

Are your potassium levels off?

January 27th, 2020 by Content Editor

Potassium, just like other minerals play an integral part in how your body functions. Unfortunately, your body can’t produce potassium on its own, so it must come from your diet.

Potassium is also known as an electrolyte. Electrolytes assist your body with essential functions, including:

Digestion
Blood pressure
Muscle contractions
Nerve impulses
Maintaining water balance
Heart rhythm
pH balance

Taking in too much or too little potassium could lead to serious health problems. A potassium deficiency is called hypokalaemia and an overload is known as hyperkalaemia.

Hypokalaemia

Potassium deficiency is often caused by an underlying condition. Common ones could include:

Magnesium deficiency
Regularly using penicillin-based antibiotics
Kidney disease
Vomiting, diarrhoea and excessive sweating

Symptoms of hypokalaemia vary depending on the severity of the deficiency. If it’s temporary, you may not have any symptoms. For example, you could experience a temporary potassium deficiency after a workout. Once you eat and drink enough water, it should stabilise.

Symptoms of hypokalaemia include:

Muscle spasms or cramping
Irregular heartbeat
Extreme fatigue
Weakness
Constipation
Nausea and vomiting

Treating hypokalaemia

A potassium deficiency is usually diagnosed with a blood test. If your doctor finds that you have hypokalaemia, potassium supplements are usually the first line of treatment.
If your kidneys are healthy, then supplements would usually be effective. For a severe potassium deficiency, you may need IV treatment (delivers fluid medication directly into a vein).
If there’s too much sodium in your body, you may also be given diuretics (water pills which help you urinate) to help balance out the electrolyte levels.

Hyperkalaemia

Too much potassium in the body is rare, particularly if you eat a balanced diet. The most common symptom of too much potassium, is an abnormal heartbeat.

Some of the risk factors for hyperkalaemia include:

Kidney disease
Too much exercise
Chemotherapy
Taking too many potassium supplements
Diabetes
Severe burns

If you have mild hyperkalaemia, your doctor may prescribe medication that will give your body a potassium boost.

Severe cases require more treatment and could involve kidney dialysis to remove excess potassium. This procedure is usually used in cases of kidney failure. Insulin or glucose may also be recommended. These help to transport potassium from the blood to your cells for removal.

The final word on potassium

If you don’t have any of the risk factors for hypokalaemia or hyperkalaemia, then changes in body potassium shouldn’t be a concern. Having healthy kidneys should also be enough to regulate your potassium levels.

If you have any conditions that could affect your potassium levels they should be monitored. Talk to your doctor if you suspect a deficiency or overdose, along with any unusual symptoms.

References:

What is atrial fibrillation?

May 13th, 2019 by Content Editor

Does your heart beat so fast that it feels like it’s banging against your chest wall; especially if you’re carrying stuff or bending down?

You may have atrial fibrillation.

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat. Changes in your heart rhythm lead to stroke, blood clots, heart failure and other heart-related complications.

According to the AME Medical Journal, there has been an increase in the global prevalence of atrial fibrillation in all regions of the world. In the European Union, it is estimated that AFib will increase from eight million adults over 55 years in 2010, to 17 million by 2060.

The rhythm of the heartbeat

Usually, your heart contracts and relaxes to a regular beat. With atrial fibrillation, the upper chambers of the heart (the atria) beat irregularly to move blood into the ventricles (the cavity or chamber that can be filled with fluid).

When this happens, the lower chambers don’t fill completely and therefore can’t pump enough blood to the lungs and body. This can result in fatigue or dizziness, heart palpitations or chest pain. Blood may also pool in the heart, which can increase your risk of having a stroke or other complications.

Symptoms 

Now and then, people with AFib have no symptoms and their condition is only detectable from a physical exam. Others may experience symptoms such as:

Rapid and irregular heartbeat.
General fatigue.
Dizziness.
Weakness.
Shortness of breath and anxiety.
Fluttering or “thumping” in the chest.
Faintness or confusion.
Fatigue when exercising.
Sweating.
Chest pain or pressure.

Diagnosis 

To diagnose atrial fibrillation, your doctor may check for symptoms, ask for your medical history, and do a physical exam. In addition, you may have tests like:

Blood tests: This will help check thyroid problems or other substances in your blood that could lead to atrial fibrillation.

Stress test: This involves running tests on your heart while you’re exercising.

Chest X-ray: X-ray images will help your doctor see the condition of your lungs and heart.

Treatment

The general goal to treat AFib is to:

Reset the rhythm or control the rate.
Prevent blood clots.
Decrease the risk of strokes.

With the help of your doctor, you’ll be able choose the most appropriate option. This will depend on whether you have other problems with your heart and if you’re able to take medication that can control your heart rhythm. In some cases, you may need more invasive treatment, like medical procedures using catheters or surgery.

With some people, an underlying condition like a thyroid disorder may trigger atrial fibrillation. Treating the condition causing atrial fibrillation may help relieve your heart rhythm problems.

Prevention 

It’s important to live a heart-healthy lifestyle to reduce your risk of heart disease and prevent atrial fibrillation.   This includes:

Eating a heart-healthy diet.
Avoiding smoking.
Exercising more often.
Limiting or avoiding caffeine and alcohol.
Reducing stress (intense stress and anger can cause heart rhythm problems).
Using over-the-counter medications with caution, as some cold and cough medications have stimulants that may trigger a rapid heartbeat.
Maintaining a healthy weight.

References:

Could your swelling be from lymphedema?

May 12th, 2019 by Content Editor

Your lymphatic system is an arrangement of channels and glands that run through your body. The main function of the lymphatic system is to remove excess liquid from your body and assist in fighting infection.

Lymphedema is a long-term condition where excess fluids in your tissues cause swelling in your arms and legs. It develops when your lymphatic system doesn’t work properly.
There are two main types of lymphedema: primary and secondary lymphedema.

Primary lymphedema occurs when the lymphatic system is underdeveloped. It is mainly causedby faulty genes and can happen at any age. Secondary lymphedema occurs when the lymphatic system is damaged in some way. This damage can be from an injury, inflammation in the limbs (arms and legs), lack of limb movement and/or problems with drainage within the lymphatic system.

Symptoms 

The main symptom of lymphedema is swelling in the limbs or another part of the body. The swelling usually comes and goes but may get worse over time.

Other common symptoms include:

Skin infections.
Fluid leaking through the skin.
Hard, tight skin.
Folds in the skin.
Difficulty with movement.
A heavy or achy feeling.
Wart-like growths on the skin.
Restricted range of motion.

Diagnosis

Swelling is a common symptom, so your doctor will first try to rule out other potential culprits, such as a blood clot or infection. If you have recently had surgery or lymphatic treatment, lymphedema may be diagnosed based on your other symptoms.

If there’s no obvious cause for lymphedema, then imaging tests might be done. This includes an MRI scan, a CT scan or a Doppler ultrasound scan.

Treatment

There’s no cure for lymphedema, but there are ways to manage your symptoms. You can do this by using techniques that minimise fluid build-up. Common ways to achieve this include wearing compression garments, exercising regularly, massage therapy and following a healthy diet and lifestyle.

Complex decongestive therapy (CDT) is the usual treatment for lymphedema. Initial therapy is intensive, with daily sessions to drain fluid, followed by a maintenance programme. Maintenance is made up of four parts: remedial exercise, skincare, manual lymphatic drainage (MLD) and multilayer lymphedema bandaging.

Remedial exercises are light exercises that help with moving the lymph fluid out of your limbs.
Skincare is vital because good skincare lowers your risk of skin infections.
MLD is where a lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where the fluid can be drained. The therapist also teaches you how to give yourself this kind of massage.
Lastly, multilayer lymphedema bandaging is where the muscles surrounding your lymph vessels and nodes are bandaged. This helps fluid to move through your lymphatic system.

See your doctor immediately if:

There’s persistent swelling in your arm or leg.
You’re already diagnosed with lymphedema and there’s a sudden increase in the size of the affected limb.

Reduce the risk of lymphedema by lowering your risk of infection:

Avoid wearing tight-fitting clothes.
Don’t take long, hot showers or baths.
Don’t walk barefoot outside.
Look for changes or breaks in your skin.
Stay moisturised by applying lotion and drinking enough water.
Use gloves when gardening and keep your nails short.

References: 

Why do women get cold more easily than men?

April 8th, 2019 by The Hello Doctor Team

There’s a reason why men are always draping their coats over women’s shoulders in movies, and often in real life. And no, it’s not (just) in the name of romance. Turns out that on average, women are more sensitive to the cold than men are.

One of the main ways your body regulates temperature is through the blood vessels. When you feel hot, the blood vessels in your skin dilate (get wider) to release heat through your skin. When you feel cold, your blood vessels contract (get narrower) to retain heat. A person’s regular body temperature is 37 degrees, but it can go up or down by a degree during the day.

Men and women are generally able to keep a constant, safe core (internal) temperature, despite fluctuating external temperatures. However, even though our core temperatures are the same, the temperature of our skin may differ, and this is where the differences between men and women come in.

A study published in The Lancet found that women’s hand temperatures are approximately three degrees lower than men. The common reasons: differences in size, weight and body proportions. Together, these all affect the way we’re able to retain heat.

The colder, fairer sex

Women have more body fat

Although you’d think extra kilos would keep you toasty, for women, that’s not always the case. Fat helps protect your organs, but it can also restrict blood flow. This brings on the chills. Women also have less muscle mass and lose heat faster from their skin than men because they’re naturally smaller.

Women have slower metabolic rates

Your metabolism is the rate at which your body can burn fuel, and a man’s metabolic rate is about 23% higher than a woman’s. For women, this is a downer for two reasons. One, this means women gain weight more easily than men because they can’t burn food as fast. And two, a woman’s body is often colder because the longer it takes fuel to burn, the less heat it can create to keep you warm.

Women have “lady problems”

Besides the painful side-effects that come with menstruation, like cramps and headaches, a woman’s temperature is also affected at that time of the month. Their body temperature fluctuates due to increasing and decreasing hormone levels. This means women feel chillier or warmer at different times during the month. Due to its effects on hormones, birth control can also trigger changes in body temperature.

Good to know

Feeling cold is usually harmless, but if you’re frosty all the time to the point of discomfort, it could be related to another condition. Some other signs that may be clues to a cold-related condition include:

constant chills
you sweat more or less than usual.
your nails turn blue or dark.
you feel colder than normal quite often.
your skin is brittle or very dry.

If this is you, why not chat to one of our doctors, so you can get the right treatment to help warm up those joints.

References:

Sauna: the hot new therapy for a healthy heart

March 24th, 2019 by The Hello Doctor Team

Age is an uncontrollable risk factor for cardiovascular heart disease, unlike risk factors like smoking, drinking alcohol and a lack of exercise.

Now, new studies have shown that a sauna a few times a week could help stave off heart health problems in older people, even amongst those who are at a higher risk of cardiovascular disease.

Heat for heart health

In a 15-year study of approximately 1 600 men and women aged between 53 and 74 in Finland, it was found that just 181 people succumbed to heart-related illnesses. The study concluded that the more saunas the individuals in the group took, the lower their risk of heart disease.

The sauna is a cultural institution in Finland but is rapidly gaining popularity worldwide. Unlike other types of sauna, like the hot, humid Turkish sauna, the Finnish version is very hot and dry. These saunas are wood-lined rooms heated by stones on a stove. An occasional splash of water over the stones produces steam in an internal temperature of around 100°C.

It’s the heat that seems to be key in the sauna’s benefit to heart health. In one study, participants’ pulse rates increased by 30%, causing the heart to pump almost twice the volume of blood it would normally do at rest. This increase in heart rate is similar to what would occur during moderate intensity exercise.

Other studies have shown that sauna therapy is associated with a reduction in high blood pressure and a lower risk of stroke and cognitive decline, again supporting the concept of improved heart health.

Get the best out of sauna therapy

Evidence suggests that the frequency of using a sauna is closely linked to the risk of heart disease. People who used the sauna more than four times a week, and those who sauna-bathed for more than 45 minutes a week showed a significant reduction in their risk of fatal cardiovascular disease-related events. Furthermore, those people who exercised regularly and used a sauna had a significantly lower risk of dying from heart disease than people who didn’t exercise regularly and used a sauna.

There were some underlying factors that could have improved the study outcomes:

Sauna baths are inherently relaxing, so lowering stress levels could be an additional factor to consider.
Sauna baths are also accessible across the board to all Finns, so the socioeconomic risk factor – poverty – associated with cardiovascular disease did not apply.

Sauna safety

Dashing off immediately to the sauna might seem tempting, but it’s always best to check with your doctor before you start any sort of activity that affects your heart. If you’re already fit, there should be no problem, but some conditions may exempt you from sauna therapy. If you have fluctuating blood pressure, abnormal heart rhythms, unstable angina and advanced heart failure or heart valve disease, sauna therapy may not be for you.

If you can and do sauna, here are some tips to help make the most of the experience:

Don’t drink alcohol before, after or during your sauna
Keep to a reasonable time limit: 15 to 20 minutes is enough.
Don’t cool down too fast. This puts your circulatory system under considerable stress.
Stay hydrated: quench your thirst with a few glasses of water after each sauna.
Try to sauna at least four times a week, or for 45 minutes a week.
Listen to your body. If you aren’t feeling well, skip the sauna.

References:

Home remedies for heart palpitations

March 20th, 2019 by The Hello Doctor Team

Does your heart feel like it’s flip-flopping? Racing or fluttering? If so, it’s possible you could have heart palpitations. Heart palpitations are sensations that feel like your heart is beating really fast or pounding in your chest. Palpitations can also be felt in your throat, chest and neck.

These feelings are commonly triggered by stress, certain medications, exercise, caffeine, low blood sugar and dehydration. Although it’s rare, it can also stem from medical conditions like thyroid problems, heart failure, abnormal heart rhythms and anaemia.

Heart palpitations not caused by a medical condition are harmless and usually resolve on their own. Here are some home remedies to relieve the symptoms.

Wind things down

Stress has different effects on the body and heart palpitations can make things worse. Learn how to relax with meditation or yoga. These techniques have a good reputation for reducing palpitations and calming you down. Do a mix of different relaxation methods throughout the week.

You can try:

Deep breathing. Sit or lay flat in a comfortable position. Place a hand on your stomach just below your ribs and the other on your chest. Now, take a deep breath through your nose and allow your belly to push your hand away. Breathe out through pursed lips. Repeat two to three times.
Try writing down how you feel once a day before bed. Journaling helps you manage stressful experiences in a healthy way. It also gives you an emotional release and allows you to work through whatever is worrying you.
Working out keeps your physical health in check, and helps you to de-stress. Aim for at least 30 minutes of exercise every day to give yourself a boost.

Trigger your vagus nerve

The vagus nerve is connected to the heart and helps control your heart rate. Stimulating it can help reduce palpitations. Activate it by coughing, placing a cold, damp cloth on your face for a few seconds, taking a cold shower and splashing cold water on your face. (It may be best to talk to your doctor before trying this method.)

Balance your electrolytes

Electrolytes are found in your body and are helpful in transferring electrical signals. The signals help regulate your heart rate. Boost your electrolytes with foods that contain salt, magnesium, potassium and calcium. Bananas, potatoes, avocados and spinach are rich in potassium. Get your fix of magnesium and calcium from dark leafy greens, nuts and fish. Don’t worry about adding in extra salt.

Drink up

When your body becomes dehydrated, it must work harder to circulate blood. This causes heart palpitations. Signs that you need to drink more water include feeling thirsty, a dry mouth, a racing heart, a headache, dizziness and dry skin.

Good to know

Although heart palpitations are usually harmless, see your doctor if you experience them often. If someone in your family has heart disease, you should also be checking in with your doctor regularly. If you get heart palpitations with symptoms like chest pain, severe dizziness, fainting or pain, get to a doctor immediately.

References

Heart palpitations : when should you worry?

July 16th, 2018 by The Hello Doctor Team

If you’ve ever felt like your heart has skipped a beat, fluttered or flip-flopped, then you’ve experienced heart palpitations. Heart palpitations are the feelings of a fast-beating, pounding heart. Exercise, stress, certain medications, and medical conditions may trigger them.

Although heart palpitations can be scary or worrying, they aren’t usually harmful and are seldom caused by a condition. You’d usually feel heart palpitations in the throat and neck, as well as the chest. The beats can be more than 100 per minute and you can feel them when you’re active or relaxing.

In some cases, along with additional symptoms, heart palpitations can be a sign of a condition called atrial fibrillation.

What is atrial fibrillation?

When your heart beats, its muscular walls contract so it can force blood out and around the body. It then relaxes and fills with blood again, repeating the process. With atrial fibrillation, the heart’s upper chambers (atria) contract randomly and often too fast for the heart muscles to relax properly between contractions.

Due to this, the heart can’t carry out its processes efficiently. Atrial fibrillation happens when abnormal electrical impulses are sent into the atria. This becomes overwhelming for your heart and the heart’s natural pacemaker can no longer control your heart’s rhythm. So, you end up with an irregular pulse rate.

Atrial fibrillation can be occasional, persistent, permanent or long-standing and persistent (lasts for more than 12 months). It’s estimated that globally, 34 million people have been diagnosed with atrial fibrillation.

Common symptoms usually include:

Heart palpitations
Weakness
Reduced ability to exercise
Fatigue
Light-headedness
Dizziness
Confusion
Shortness of breath
Chest pain

Causes

Any abnormalities or damage to the heart’s structure can result in atrial fibrillation. Common conditions that may contribute to atrial fibrillation include high blood pressure, heart attacks, coronary artery disease, lung diseases, viral infections, previous heart surgery, and improper functioning of the heart’s natural pacemaker. Risk factors include being older than 65, excessive alcohol intake, family history and a chronic condition like asthma and diabetes.

Prevention

It’s important to live a healthy lifestyle to reduce the risk of atrial fibrillation.

Eat a heart-healthy diet.
Exercise regularly
If you smoke, quit now. Keep your weight steady without major fluctuations.
Limit or avoid caffeine and alcohol.
Find ways to reduce stress, as intense stress and anger can cause heart rhythm problems.
Use over-the-counter medications with caution, as some may trigger symptoms of atrial fibrillation.

Treatment

Medication to control atrial fibrillation.
Electric shock treatment (cardioversion).
Having a pacemaker fitted.

When to see your doctor

For any symptoms of atrial fibrillation, talk to your doctor. If he suspects atrial fibrillation, he will run tests to examine your symptoms. This is usually an electrocardiogram which helps assess if you may have any other heart disorders. If you have chest pain, go to the hospital or call emergency services immediately. Chest pain could signal a heart attack. A sudden change in your heartbeat, as well as an irregular heartbeat is cause for concern, too.