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AISC Team D2 6

Answer this question truthfully ### Question: What are the Symptoms of Lyme Disease? ### Response: It's important to know the symptoms of Lyme disease and to seek medical help if you think have Lyme disease. Early signs and symptoms (3 to 30 days after tick bite): The first symptom is usually a red rash at the site of tick bite, which may look like a bullseye, but not all people with Lyme disease have a rash. The rash is called erythema chronicum migrans or erythema migrans (EM). EM occurs in approximately 70 to 80 percent of infected persons. EM begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days). EM expands gradually over a period of days reaching up to 12 inches or more (30 cm) across. EM may feel warm to the touch but is rarely itchy or painful. Sometimes, EM clears as it enlarges, resulting in a target or bullseye appearance. EM may appear on any area of the body but is usually present on areas including the axilla, inguinal region, popliteal fossa, or along belt line. The rash may or may not be associated with flu-like symptoms including: Fever and/or chills Headache Body aches Joint aches Stiff neck Fatigue Classic Lyme disease rash - Source: CDC.gov Late Signs and Symptoms (days to months after tick bite): Severe headaches and neck stiffness Multiple erythema migrans rashes on other areas of the body. Arthritis with severe joint pain and swelling, particularly of the knees and other large joints. Facial palsy (loss of muscle tone or droop on one or both sides of the face). Intermittent pain in tendons, muscles, joints, and bones. Heart palpitations or an irregular heart beat (Lyme carditis). Episodes of dizziness or shortness of breath. Inflammation of the brain and spinal cord. Nerve pain. Shooting pains, numbness, or tingling in the hands or feet. Problems with short-term memory. Notes Fever and other flu-like symptoms may occur in the absence of rash. A small bump or redness at the site of a tick bite that occurs immediately and resembles a mosquito bite, is common. This irritation generally goes away in 1-2 days and is not a sign of Lyme disease. A rash with a very similar appearance to EM occurs with Southern Tick-associated Rash Illness (STARI), but is not Lyme disease. Ticks can spread other organisms that may cause a different type of rash. What Causes Lyme disease? Lyme disease is caused by a bacterial infection you get from bite of an infected tick. The majority of Lyme disease in North America is caused by bite of black-legged tick, or deer tick (Ixodes scapularis). Other ticks that transmit Lyme disease are the sheep tick, castor bean tick, or European castor bean tick (Ixodes ricinus) in the Europe, the Western black legged tick (Ixodes pacificus) in the Pacific region of North America, and the taiga tick (Ixodes persulactus) in Europe, Central and Northern Asia, China, and Japan. Only 20% of individuals infected with Lyme disease by the deer tick are aware of having had any tick bite. I. scapularis, the primary vector of Lyme disease in Eastern North America - Source: Gross L (2006) A New View on Lyme Disease: Rodents Hold the Key to Annual Risk. PLoS Biol 4(6): e182. https://doi.org/10.1371/journal.pbio.0040182

Answer this question truthfully ### Question: Who is at highest risk for Lyme disease ? ### Response: Individuals who spend time outdoors and/or have pets that go outdoors in endemic regions are at risk for tick-borne disease. Exposure to ticks: Individuals with frequent exposure to dogs and who reside near wooded areas or areas with high grass may also be at increased risk of tick-borne infection. Individuals with outdoor occupations and who work outside with bare or exposed skin are at a high risk of contracting Lyme disease. Failing to remove a tick as soon as you see it on your skin (the longer a tick is attached to your skin, the greater your risk of developing Lyme disease) also increases risk of developing Lyme disease. Endemic Regions: About 95% of all reported cases are confined to 14 states including Connecticut, Delaware, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. Any individual traveling or living within these five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central is at a heightened risk of exposure to Lyme disease. Seasonal Variation: The majority of Lyme disease cases are reported during the summer months of May to August. Case incidence increases in May, peaks in June and July, and tapers off in August. Rarer forms of Transmission: Cases of blood transfusion and organ transplantation have been recorded as methods of transmission but transmission through this avenue is rare.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Lyme disease ? ### Response: You should seek medical care if: You are bitten by a tick. You have a rash similar to erythema migrans (even if you do not remember getting bitten by a tick). After removal of a tick with the proper procedure.

Answer this question truthfully ### Question: Where to find Medical Care for Lyme Disease? ### Response: Medical care for Lyme disease can be found here.

Answer this question truthfully ### Question: What to expect if I have Lyme disease (Outlook/Prognosis)? ### Response: For early cases, prompt treatment is usually curative. However, the severity and treatment of Lyme disease may be complicated due to: Late diagnosis Failure of antibiotic treatment Coinfection with other tick-borne diseases including Ehrlichiosis and Babesiosis Immune suppression in the patient Some patients with Lyme disease have fatigue, joint and/or muscle pain, and neurocognitive symptoms persisting for years despite antibiotic treatment. Patients with late stage Lyme disease have been shown to experience a level of physical disability similar to that seen in congestive heart failure. Though rare, Lyme disease can be fatal.

Answer this question truthfully ### Question: What are the symptoms of Malignant hypertension? ### Response: Blurred vision Change in mental status Anxiety Confusion Decreased alertness, decreased ability to concentrate Fatigue Restlessness Sleepiness, stupor, lethargy Chest pain (feeling of crushing or pressure) Cough Headache Nausea or vomiting Numbness of the arms, legs, face, or other areas Reduced urine Seizure Shortness of breath Weakness of the arms, legs, face, or other areas

Answer this question truthfully ### Question: What causes Malignant hypertension? ### Response: The disorder affects about 1% of people with high blood pressure, including both children and adults. It is more common in younger adults, especially African-American men. It also occurs in people with: Collagen vascular disorders Kidney problems Toxemia of pregnancy You are at high risk for malignant hypertension if you have had: Kidney failure Renal hypertension caused by renal artery stenosis

Answer this question truthfully ### Question: When to seek urgent medical care when I have Malignant hypertension ? ### Response: Go to the emergency room or call your local emergency number (such as 911) if you have symptoms of malignant hypertension. This is an emergency condition and it can be life-threatening. Call your health care provider if you know you have poorly controlled high blood pressure.

Answer this question truthfully ### Question: What to expect if I have Malignant hypertension (Outlook/Prognosis)? ### Response: Many body systems are at serious risk from the extreme rise in blood pressure. Many organs, including the brain, eyes, blood vessels, heart, and kidneys may be damaged. The blood vessels of the kidney are very likely to be damaged by pressure. Kidney failure may develop, which may be permanent and need dialysis (kidney machine). If treated right away, malignant hypertension can often be controlled without causing permanent problems. If it is not treated right away, complications may be severe and life-threatening.

Answer this question truthfully ### Question: What are the symptoms of Mediastinitis? ### Response: Chest pain Chills Coughing up blood Fever Malaise Shortness of breath

Answer this question truthfully ### Question: What causes Mediastinitis? ### Response: Mediastinitis may occur suddenly (acute) or may develop slowly and get worse over time (chronic). Most cases occur in patients who have had open chest surgery. Less than 5 percent of patients develop mediastinitis after having chest surgery. Patients may have a tear in their esophagus that causes mediastinitis. Causes of the tear include: A procedure such as endoscopy Forceful or constant vomiting Trauma Other causes of mediastinitis include: Cancer Histoplasmosis Radiation Sarcoidosis Tuberculosis

Answer this question truthfully ### Question: Who is at risk for Mediastinitis? ### Response: Risk factors include: Problems in the upper gastrointestinal tract Recent chest surgery or endoscopy Weak immune system

Answer this question truthfully ### Question: When to seek urgent medical care when I have Mediastinitis ? ### Response: Contact your health care provider if you have had open chest surgery and develop: Chest pain Chills Drainage from the wound Fever Shortness of breath If you have tuberculosis, histoplasmosis, or sarcoidosis and develop any of these symptoms, contact your health care provider right away.

Answer this question truthfully ### Question: What to expect if I have Mediastinitis (Outlook/Prognosis)? ### Response: How well a person does depends on the cause of the mediastinitis. Mediastinitis after open chest surgery is very serious. There is a significant risk of dying from the condition.

Answer this question truthfully ### Question: What are the symptoms of Metabolic syndrome? ### Response: Extra weight around your waist (central or abdominal obesity).

Answer this question truthfully ### Question: What causes Metabolic syndrome? ### Response: Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity. The two most important risk factors for metabolic syndrome are: Extra weight around the middle and upper parts of the body (central obesity). The body may be described as "apple-shaped." Insulin resistance, in which the body cannot use insulin effectively. Insulin is needed to help control the amount of sugar in the body. As a result, blood sugar and fat levels rise. Other risk factors include: Aging Genes that make you more likely to develop this condition Hormone changes Lack of exercise People who have metabolic syndrome often have two other problems that can either cause the condition or make it worse: Excess blood clotting Low levels of inflammation throughout the body

Answer this question truthfully ### Question: Who is at highest risk for Metabolic syndrome ? ### Response: Patients who are obese and have family history are at increased risks.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Metabolic syndrome ? ### Response: Call your health care provider if you have signs or symptoms of this condition.

Answer this question truthfully ### Question: What to expect if I have Metabolic syndrome (Outlook/Prognosis)? ### Response: People with metabolic syndrome have an increased long-term risk for developing cardiovascular disease and type 2 diabetes.

Answer this question truthfully ### Question: What are the symptoms of Mitral regurgitation? ### Response: Symptoms for acute mitral regurgitation include chest pain unrelated to coronary artery disease or heart attack, cough, rapid breathing, shortness of breath that increases when lying flat (orthopnea), and sensation of feeling the heart beat (palpitations). These symptoms may start suddenly. For chronic mitral regurgitation there are often no symptoms. When symptoms do occur, they often develop gradually and may include cough, fatigue, exhaustion, and light-headedness, palpitations (related to atrial fibrillation), shortness of breath during activity and when lying down, and excessive urination at night.

Answer this question truthfully ### Question: What causes Mitral regurgitation? ### Response: Regurgitation means leaking from a valve that doesn't close all the way. It is caused by diseases that weaken or damage the valve or its supporting structures. Mitral regurgitation becomes chronic when the condition persists rather than occurring for only a short time period. Chronic mitral regurgitation should be distinguished from acute mitral regurgitation. In acute mitral regurgitation, the mitral valve doesn't close all the way and blood flows backward into the left upper heart chamber (atrium). This leads to a decrease in blood flow to the rest of the body. As a result, the heart may try to pump harder. Acute mitral regurgitation may be caused by dysfunction or injury to the valve following a heart attack or infection of the heart valve (infective endocarditis). These conditions may rupture the valve or surrounding structures, leaving an opening for blood to move backwards. Mitral valve prolapse is a relatively common cause of chronic mitral regurgitation. About one-third of all cases of chronic mitral regurgitation are caused by rheumatic heart disease, a complication of untreated strep throat that is becoming less common. Congenital (present from birth) mitral regurgitation is rare if it is not part of a more complex heart defect or syndrome. Chronic mitral regurgitation can also be caused by: Atherosclerosis Endocarditis Heart tumors High blood pressure Marfan syndrome Swelling of the left lower heart chamber Untreated syphilis (rare) Risk factors include an individual or family history of any of the disorders mentioned above and use of fenfluramine or dexfenfluramine (appetite suppressants banned by the FDA) for 4 or more months.

Answer this question truthfully ### Question: Who is at highest risk for Mitral regurgitation ? ### Response: Persons who already have cardiac disease, sustained trauma to the chest area, have congenital heart abnormalities, or have had endocarditis or rheumatic fever are at risk for mitral regurgitation.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Mitral regurgitation ? ### Response: Call your health care provider if you have symptoms of mitral valve regurgitation, or if symptoms worsen or do not improve with treatment. Call your health care provider if you are being treated for this condition and develop signs of infection, which include: Chills Fever General ill feeling Headache Muscle aches

Answer this question truthfully ### Question: What to expect if I have Mitral regurgitation (Outlook/Prognosis)? ### Response: How well a patient does depends on the cause and severity of the valve leakage. Milder forms may become a chronic condition. Acute mitral regurgitation can rarely be controlled with medications. Surgery is usually needed to repair or replace the mitral valve. Abnormal heart rhythms associated with acute mitral regurgitation can sometimes be deadly.

Answer this question truthfully ### Question: What are the symptoms of Mitral stenosis? ### Response: Among adults there may be no symptoms at all. Symptoms may appear or get worse with exercise or any activity that raises the heart rate. Symptoms may include: Chest discomfort: Patients may feel tight, crushing, pressure, squeezing, constricting, increasing with activity and decreasing with rest. The pain may radiate to the arm, neck, jaw, or other areas. Cough, possibly hemoptysis. Difficulty breathing during or after exercise or when lying flat. Fatigue. Frequent respiratory infections such as bronchitis. Palpitations. Swelling of feet or ankles. Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible. Among infants and children, symptoms may be present from birth (congenital), and almost always develop within the first 2 years of life. Symptoms include: Bluish discoloration of the skin or mucus membranes (cyanosis). Poor growth. Shortness of breath.

Answer this question truthfully ### Question: What causes Mitral stenosis? ### Response: Clinical data has suggested that the development of mitral stenosis is related to several factors: A history of rheumatic fever and recurrent strep infections. The valve problems develop 5 - 10 years after the rheumatic fever. Rheumatic fever is becoming rare in the United States, so mitral stenosis is also less common. Radiation treatment involving the chest. Medications such as ergot preparations used for migraines. Rarely, there maybe calcium deposits forming around the mitral valve and cause mitral stenosis in adults. Children may be born with mitral stenosis (congenital) or other birth defects involving the heart that cause mitral stenosis. Often, there are other heart defects present, along with the mitral stenosis. Mitral stenosis may run in families.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Mitral stenosis ? ### Response: Call your health care provider if you have symptoms of mitral stenosis. Call your health care provider if your symptoms do not improve with treatment, or if new symptoms appear. If you experience either of the following symptoms, you should seek urgent medical care as soon as possible: Hemoptysis. Difficulty breathing when lying flat; may wake up with difficulty breathing. Palpitation.

Answer this question truthfully ### Question: What to expect if I have Mitral stenosis (Outlook/Prognosis)? ### Response: The outcome varies widely. The disorder may be mild, without symptoms, or may be more severe and eventually disabling, this depends on: The severity of mitral stenosis, such as mitral valve area. Heart function With/without complications such as atrial fibrillation, atrial flutter, blood clots to the brain, intestines, kidneys, or other areas, heart failure, pulmonary edema, pulmonary hypertension, etc. Whether or not the mitral valve can be repaired or replaced by surgery. Complications may be severe or life threatening. Mitral stenosis is usually controllable with treatment and improved with valvuloplasty or surgery.

Answer this question truthfully ### Question: What are the symptoms of Mitral valve prolapse? ### Response: Many patients with mitral valve prolapse do not have symptoms. The group of symptoms found in patients with mitral valve prolapse is called mitral valve prolapse syndrome and includes: Sensation of feeling the heart beat (palpitations) Chest pain (not caused by coronary artery disease or a heart attack) Difficulty breathing after activity Fatigue Cough Shortness of breath when lying flat (orthopnea) Note: There may be no symptoms, or symptoms may develop slowly

Answer this question truthfully ### Question: What causes Mitral valve prolapse? ### Response: The mitral valve helps blood on the left side of the heart flow in one direction. It closes to keep blood from moving backwards when the heart beats (contracts). Mitral valve prolapse is the term used when the valve does not close properly. It can be caused by many different things. In most cases, it is harmless and patients usually do not know they have the problem. As much as 10% of the population has some minor, insignificant form of mitral valve prolapse, but it does not generally affect their lifestyle. In a small number of cases, the prolapse can cause blood to leak backwards. This is called mitral regurgitation. Mitral valves that are structurally abnormal can raise the risk for bacterial infection. Some forms of mitral valve prolapse seem to be passed down through families (inherited). Mitral valve prolapse has been associated with Graves disease. Mitral valve prolapse often affects thin women who may have minor chest wall deformities, scoliosis, or other disorders. Mitral valve prolapse is associated with some connective tissue disorders, especially Marfan syndrome. Other conditions include: Ehlers-Danlos syndrome Osteogenesis imperfecta Polycystic kidney disease

Answer this question truthfully ### Question: How is Mitral valve surgery (minimally invasive) done? ### Response: Before your surgery you will receive general anesthesia. This will make you unconscious and unable to feel pain. There are several different ways to perform minimally invasive mitral valve surgery. Your heart surgeon may make a 2-inch to 3-inch-long cut in the right part of your chest near the sternum (breastbone). Muscles in the area will be divided so your surgeon can reach the heart. A small cut is made in the left side of your heart so the surgeon can repair or replace the mitral valve. In endoscopic surgery, your surgeon makes one to four small holes in your chest. Then your surgeon uses special instruments and a camera to do the surgery. For robotically-assisted valve surgery, the surgeon makes two to four tiny cuts (about ½ to ¾ inch) in your chest. The surgeon uses a special computer to control robotic arms during the surgery. The surgeon sees a three-dimensional view of the heart and mitral valve on the computer. This method is very precise. You may or may not need to be on a heart lung machine for these types of surgery, but if not, your heart rate will be slowed by medicine or a mechanical device. If your surgeon can repair your mitral valve, you may have: Ring annuloplasty -- The surgeon repairs the ring-like part around the valve by sewing a ring of metal, cloth, or tissue around the valve. Valve repair -- The surgeon trims, shapes, or rebuilds one or both of the leaflets of the valve. The leaflets are flaps that open and close the valve. If your mitral valve is too damaged, you will need a new valve. This is called valve replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two main types of new valves: Mechanical -- made of man-made materials, such as titanium, or ceramic. These valves last the longest, but you will need to take blood thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life. Biological -- made of human or animal tissue. These valves last 10 - 12 years, but you may not need to take blood thinners for life. The surgery may take 2 -4 hours. This surgery can also be done through a groin artery, with no cuts on your chest. The doctor sends a catheter (flexible tube) with a balloon attached on the end. The balloon stretches the opening of the valve. This procedure is called percutaneous valvuloplasty.

Answer this question truthfully ### Question: Who needs Mitral valve surgery (minimally invasive)? ### Response: You may need surgery if your mitral valve does not work properly because: You have mitral regurgitation -- a mitral valve that does not close all the way and allows blood to leak back into the left atria. You have mitral stenosis -- a mitral valve that does not open fully and restricts blood flow. Your valve has developed an infection (infectious endocarditis) You have severe mitral valve prolapse that is not controlled with medications. Minimally invasive surgery may be done for these reasons: Changes in your mitral valve are causing major heart symptoms, such as chest pain (angina), shortness of breath, fainting spells (syncope), or heart failure. Tests show that the changes in your mitral valve are beginning to seriously affect your heart function. Your heart valve has been damaged by infection (endocarditis). A minimally invasive procedure has many benefits. There is less pain, blood loss, and risk of infection. You will also recover faster than you would from open heart surgery. Percutaneous valvoplasty is a procedure that is only done in people who are too sick to have anesthesia. The results of this procedure are not long lasting.

Answer this question truthfully ### Question: Where to find centers that perform Mitral valve surgery (minimally invasive)? ### Response: Directions to Hospitals Performing Mitral valve surgery - minimally invasive

Answer this question truthfully ### Question: What are the risks of Mitral valve surgery (minimally invasive)? ### Response: Risks for any surgery are: Blood clots in the legs that may travel to the lungs. Blood loss. Breathing problems. Infection, including in the lungs, kidneys, bladder, chest, or heart valves. Reactions to medicines. Minimally invasive surgery techniques have far fewer risks than open surgery. Possible risks from minimally invasive valve surgery are: Damage to other organs, nerves, or bones. Heart attack, stroke, or death. Infection of the new valve. Irregular heartbeat that must be treated with medicines or a pacemaker. Kidney failure. Poor healing of the wounds.

Answer this question truthfully ### Question: What to expect before Mitral valve surgery (minimally invasive)? ### Response: Always tell your doctor or nurse: If you are or could be pregnant What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon about how you and your family members can donate blood. For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. Some of them are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). If you are taking warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs. Prepare your house for when you get home from the hospital. The day before your surgery, shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest two or three times with this soap. You also may be asked to take an antibiotic to guard against infection. During the days before your surgery: Ask your doctor which drugs you should still take on the day of your surgery. If you smoke, you must stop. Ask your doctor for help. Always let your doctor know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery. On the day of the surgery: You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the drugs your doctor told you to take with a small sip of water. Your doctor or nurse will tell you when to arrive at the hospital.

Answer this question truthfully ### Question: What to expect after Mitral valve surgery (minimally invasive)? ### Response: Expect to spend 3 - 5 days in the hospital after surgery. You will wake up in the intensive care unit (ICU) and recover there for 1 or 2 days. Nurses will closely watch monitors that show information about your vital signs (pulse, temperature, and breathing). Two to three tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 - 3 days after surgery. You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV, in a vein) lines to get fluids. You will go from the ICU to a regular hospital room. Your nurses and doctors will continue to monitor your heart and vital signs until you are stable enough to go home. You will receive pain medicine for pain in your chest. Your nurse will help you slowly resume some activity. You may begin a program to make your heart and body stronger. A temporary pacemaker may be placed in your heart if your heart rate becomes too slow after surgery.

Answer this question truthfully ### Question: How is Mitral valve surgery (open) done? ### Response: Before your surgery, you will receive general anesthesia. This will make you asleep and pain-free during the entire procedure. Your surgeon will make a 10-inch-long cut in the middle of your chest. Next, your surgeon will separate your breastbone to be able to see your heart. Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped. A small cut is made in the left side of your heart so your surgeon can repair or replace the mitral valve. If your surgeon can repair your mitral valve, you may have: Ring annuloplasty -- The surgeon repairs the ring-like part around the valve by sewing a ring of metal, cloth, or tissue around the valve. Valve repair -- The surgeon trims, shapes, or rebuilds one or more of the three leaflets of the valve. The leaflets are flaps that open and close the valve. If your mitral valve is too damaged, you will need a new valve. This is called valve replacement surgery. Your surgeon will remove your mitral valve and sew a new one into place. There are two types of mitral valves: Mechanical -- made of man-made (synthetic) materials, such as a metal like titanium. These valves last the longest, but you will need to take blood thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life. Biological -- made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life. Once the new or repaired valve is working, your surgeon will: Close your heart and take you off the heart-lung machine. Place catheters (tubes) around your heart to drain fluids that build up. Close your breastbone with stainless steel wires. It will take about 6 weeks for the bone to heal. The wires will stay inside your body. You may have a temporary pacemaker connected to your heart until your natural heart rhythm returns. Your surgeon may also perform coronary artery bypass surgery at the same time, if needed. This surgery may take 3 - 6 hours.

Answer this question truthfully ### Question: Who needs Mitral valve surgery (open)? ### Response: You may need surgery if your mitral valve does not work properly. A mitral valve that does not close all the way will allow blood to leak back into the left atria. This is called mitral regurgitation. A mitral valve that does not open fully will restrict blood flow. This is called mitral stenosis. A valve defect that you have had since birth is called mitral valve prolapse. You may need open heart surgery for these reasons: Changes in your mitral valve are causing major heart symptoms, such as angina (chest pain), shortness of breath, fainting spells (syncope), or heart failure. Tests show that the changes in your mitral valve are beginning to seriously affect your heart function. Your doctor may want to replace or repair your mitral valve at the same time as you are having open-heart surgery for another reason. Your heart valve has been damaged by endocarditis (infection of the heart valve). You have received a new heart valve in the past, and it is not working well, or you have other problems such as blood clots, infection, or bleeding.

Answer this question truthfully ### Question: Where to find centers that perform Mitral valve surgery (open)? ### Response: Directions to Hospitals Performing Mitral valve surgery - open

Answer this question truthfully ### Question: What are the risks of Mitral valve surgery (open)? ### Response: Risks for any surgery are: Blood clots in the legs that may travel to the lungs. Blood loss. Breathing problems. Infection, including in the lungs, kidneys, bladder, chest, or heart valves. Reactions to medicines. Possible risks from having open-heart surgery are: Heart attack or stroke. Heart rhythm problems. Infection in the cut, which is more likely to happen in people who are obese, have diabetes, or have already had this surgery. Memory loss and loss of mental clarity, or "fuzzy thinking." Post-pericardiotomy syndrome, which is a low-grade fever and chest pain. This could last for up to 6 months.

Answer this question truthfully ### Question: What to expect before Mitral valve surgery (open)? ### Response: Always tell your doctor or nurse: If you are or could be pregnant. What drugs you are taking, supplements, or herbs you bought without a prescription. You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon how you and your family members can donate blood (autologous donation). For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery. Some of these drugs are aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). If you are taking warfarin (Coumadin) or clopidogrel (Plavix), talk with your surgeon before stopping or changing how you take these drugs. Prepare your house for when you get home from the hospital. The day before your surgery, shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest two or three times with this soap. You also may be asked to take an antibiotic to guard against infection. During the days before your surgery: Ask your doctor which drugs you should still take on the day of your surgery. If you smoke, you must stop. Ask your doctor for help. Always let your doctor know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery. On the day of the surgery: You will usually be asked not to drink or eat anything after midnight the night before your surgery. This includes chewing gum and using breath mints. Rinse your mouth with water if it feels dry, but be careful not to swallow. Take the drugs your doctor told you to take with a small sip of water. Your doctor or nurse will tell you when to arrive at the hospital.

Answer this question truthfully ### Question: What to expect after Mitral valve surgery (open)? ### Response: Expect to spend 4 to 7 days in the hospital after surgery. You will wake up in the intensive care unit (ICU) and recover there for 1 or 2 days. Two to three tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 to 3 days after surgery. You may have a flexible tube (catheter) in your bladder to drain urine. You may also have intravenous (IV, in the vein) lines to get fluids. Nurses will closely watch monitors that show information about your vital signs (pulse, temperature, and breathing). You will be moved to a regular hospital room from the ICU. Your nurses and doctors will continue to monitor your heart and vital signs until you are stable enough to go home. You will receive pain medicine to control pain around your surgical cut. Your nurse will help you slowly resume some activity. You will be asked to begin a physical therapy program to make your heart and body stronger.

Answer this question truthfully ### Question: What are the symptoms of Myocarditis? ### Response: There may be no symptoms. Symptoms may be similar to the flu. If symptoms occur, they may include: A racing heartbeat Chest pain that may resemble a heart attack Fatigue Fever and other signs of a flu -like infection including headache, muscle aches, sore throat, diarrhea, or a rash Joint pain or swelling Leg swelling Shortness of breath Other symptoms that may occur with this disease: Fainting, often related to irregular heart rhythms Low urine output

Answer this question truthfully ### Question: What causes Myocarditis? ### Response: Myocarditis is an uncommon disorder that is usually caused by viral, bacterial, or fungal infections that reach the heart. Viral infections: Coxsackie B, Cytomegalovirus, Hepatitis C, Herpes, HIV, Parvovirus Bacterial infections: Chlamydia, Mycoplasma, Streptococcus, Treponema Fungal infections: Aspergillus, Candida, Coccidioides, Cryptococcus, Histoplasma When you have an infection, your immune system produces special cells that release chemicals to fight off disease. If the infection affects your heart, the disease-fighting cells enter the heart. However, the chemicals produced by an immune response can damage the heart muscle. As a result, the heart can become thick, swollen, and weak. This leads to symptoms of heart failure. Other causes of myocarditis may include: Allergic reactions to certain medications or toxins (alcohol, cocaine, certain chemotherapy drugs, heavy metals, and catecholamines) Being around certain chemicals Certain diseases that cause inflammation throughout the body (rheumatoid arthritis, sarcoidosis)

Answer this question truthfully ### Question: When to seek urgent medical care when I have Myocarditis ? ### Response: Call your health care provider if you have symptoms of myocarditis, especially after a recent infection. Seek immediate medical help if you have severe symptoms or have been diagnosed with myocarditis and have increased: Chest pain Difficulty breathing Swelling of your extremities

Answer this question truthfully ### Question: What to expect if I have Myocarditis (Outlook/Prognosis)? ### Response: How well you do depends on the cause of the problem and your overall health. The outlook varies. Some people may recover completely. Others may have permanent heart failure.

Answer this question truthfully ### Question: What are the symptoms of Noonan syndrome? ### Response: Symptoms of Noonan syndrome may include: Physical Appearance: Abnormally shaped or low-set ears Downward slanting eyes Wide-set eyes Extra fold of skin on the inner part of the eye (epicanthal folds) Drooping eyelids (ptosis) Short stature Sinking in or protruding out of the breast bone Short or webbed neck Scoliosis Excess skin on the back of the neck Small penis Undescended testicles Developmental: Mental retardation Motor problems Speech and language problems Delayed onset of puberty

Answer this question truthfully ### Question: What are the causes of Noonan syndrome? ### Response: Noonan syndrome is caused by the genetic inheritance of several abnormal genes from one or both parents.

Answer this question truthfully ### Question: Who is at highest risk for Noonan syndrome ? ### Response: Individuals at highest risk are those who have parents or family members with Noonan syndrome or abnormal/mutated genes associated with Noonan syndrome.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Noonan syndrome ? ### Response: Contact your doctor if you feel your infant has symptoms of Noonan syndrome.

Answer this question truthfully ### Question: What to expect if I have Noonan syndrome (Outlook/Prognosis)? ### Response: The prognosis for individuals with Noonan syndrome is typically good. However, it will vary from individual to individual depending on the extent of the abnormalities and types of symptoms present. Talk to your doctor to get a more specific prognosis for your child's condition.

Answer this question truthfully ### Question: What causes Obesity ? ### Response: Taking in more calories than you burn can lead to obesity because the body stores unused calories as fat. Obesity can be caused by: Eating more food than your body can use Drinking too much alcohol Not getting enough exercise Many obese people who lose large amounts of weight and gain it back think it is their fault. They blame themselves for not having the willpower to keep the weight off. Many people regain more weight than they lost. Other factors that affect weight include: The way we eat when we are children can affect the way we eat as adults. The way we eat over many years becomes a habit. It affects what we eat, when we eat, and how much we eat. We are surrounded by things that make it easy to overeat and hard to stay active: Many people do not have time to plan and make healthy meals. More people today work desk jobs compared to more active jobs in the past. People with less free time have less time to exercise. The term "eating disorder" means a group of medical conditions that have an unhealthy focus on eating, dieting, losing or gaining weight, and body image. A person may be obese, follow an unhealthy diet, and have an eating disorder all at the same time. Sometimes, medical problems or treatments cause weight gain, including: Underactive thyroid gland hypothyroidism Medicines such as birth control pills, antidepressants, and antipsychotics Other things that can cause weight gain are: Quitting smoking. Most people who quit smoking gain 4 - 10 pounds in the first 6 months after quitting. Some people gain as much as 25 - 30 pounds. Stress, anxiety, feeling sad, or not sleeping well For women: Menopause -- women may gain 12-15 pounds during menopause Not losing the weight they gained during pregnancy

Answer this question truthfully ### Question: What causes Oliguria? ### Response: Dehydration due to vomiting, diarrhea, or fever, with a lack of adequate fluid intake. Total urinary tract obstruction, such as from an enlarged prostate. Severe infection or any other medical condition leading to shock. Use of certain medications such as anticholinergics, methotrexate, and diuretics.

Answer this question truthfully ### Question: Who is at highest risk for Oliguria ? ### Response: Patient having any of the conditions mentioned in the causes are at risk of oliguria.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Oliguria ? ### Response: Contact your health care provider if you have: A noticeable and consistent decrease in urine output. Vomiting, diarrhea, or high fever and are unable to replace fluids by mouth. A decrease in urine output associated with dizziness, lightheadedness, or rapid pulse.

Answer this question truthfully ### Question: What to expect if I have Oliguria (Outlook/Prognosis)? ### Response: Prognosis depends on the cause of oliguria.

Answer this question truthfully ### Question: What causes Breathing difficulty - lying down? ### Response: Chronic obstructive pulmonary disease (COPD) Cor pulmonale Heart failure Obesity (does not directly cause difficulty breathing while lying down but often aggravates other conditions that lead to it) Panic disorder Sleep apnea Snoring

Answer this question truthfully ### Question: When to seek urgent medical care when I have Orthopnea ? ### Response: If you have any unexplained difficulty in breathing while lying down, call for an appointment with your health care provider.

Answer this question truthfully ### Question: When could I drive after i underwent Pacemaker insertion discharge instructions ? ### Response: You should not drive after the procedure without asking your doctor when you could do that. This is different for everyone.

Answer this question truthfully ### Question: What medications should I take after Pacemaker insertion discharge instructions ? ### Response: Ask your doctor whether you should go back to taking the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.

Answer this question truthfully ### Question: Should I take any OTC pain medications? ### Response: You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.

Answer this question truthfully ### Question: What precautions should I take? ### Response: Most machines and devices will not interfere with your pacemaker. But some with strong magnetic fields may. Always ask your doctor or nurse about any specific device that you need to avoid. Do not put a magnet near your pacemaker. Most appliances in your home are safe to be around. This includes your refrigerator, washer, dryer, toaster, blender, computers and fax machines, hair dryer, stove, CD player, remote controls, and microwave. You should keep several devices at least 12 inches away from the site where the pacemaker is placed under your skin. These include: Battery powered cordless tools (such as screwdrivers and drills). Plug-in power tools (such as drills and table saws). Electric lawn mowers and leaf blowers. Slot machines. Stereo speakers. Tell all health care providers that you have a pacemaker before any tests are done. Some medical equipment may interfere with your pacemaker. Stay away from large motors, generators, and equipment. Do not lean over the open hood of a car that is running. Also stay away from: Radio transmitters and high-voltage power lines. Products that use magnetic therapy, such as some mattresses, pillows, and massagers. Large electrical or gasoline powered appliances. If you have a cell phone: Do not put it in a pocket on the same side of your body as your pacemaker. When using your cell phone, hold it to your ear on the opposite side of your body. Be careful around metal detectors and security wands. Handheld security wands may interfere with your pacemaker. Show your wallet card and ask to be hand searched. Most security gates at airports and stores are okay. But do not stand near these devices for long periods. Your pacemaker may set off alarms. After any operation, have your doctor check your pacemaker.

Answer this question truthfully ### Question: When may I resume my regular activities? ### Response: Do not use your arm on the side where your pacemaker is inserted to lift, push or pull anything weighing more than five pounds, at least for the first 6 weeks. You may do the daily activities like face washing, hair combing, tooth brushing. You should avoid swimming, playing golf or playing tennis after the procedure.

Answer this question truthfully ### Question: When can I go back to work after Pacemaker insertion discharge instructions ? ### Response: It depends on the type of your work. You can ask your doctor when you can go back to work.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Pacemaker insertion discharge instructions ? ### Response: Call your doctor if: Your wound looks infected (redness, increased drainage, swelling, painful). You are having the symptoms you had before the pacemaker was implanted. You feel dizzy or short of breath. You have chest pain. You have hiccups that do not go away. You were unconscious for a moment.

Answer this question truthfully ### Question: What are the symptoms of Palpitation? ### Response: Normally the heart beats 60 - 100 times per minute. In people who exercise routinely or take medications that slow the heart, the rate may drop below 55 beats per minute. If your heart rate is fast (over 100 beats per minute), this is called tachycardia. A slow heart rate is called bradycardia. An occasional extra heartbeat is known as extrasystole. Palpitations are usually not serious. However, it depends on whether or not the sensations represent an abnormal heart rhythm (arrhythmia). The following conditions make you more likely to have an abnormal heart rhythm: Known heart disease at the time the palpitations begin Significant risk factors for heart disease An abnormal heart valve An electrolyte abnormality in your blood (for example, a low potassium level)

Answer this question truthfully ### Question: What causes Palpitation? ### Response: Heart palpitations can be caused by: Anemia Anxiety, stress, fear Caffeine Certain medications, including those used to treat thyroid disease, asthma, high blood pressure, or heart problems Cocaine Diet pills Exercise Fever Hyperventilation Low levels of oxygen in your blood Heart valve disease, including mitral valve prolapse Nicotine Overactive thyroid

Answer this question truthfully ### Question: When to seek urgent medical care when I have Palpitation ? ### Response: Call 911 if: You lose and regain consciousness. Someone with you loses consciousness. You have shortness of breath, chest pain, unusual sweating, dizziness, or lightheadedness. Call your doctor right away if: You feel frequent extra heartbeats (more than 6 per minute or coming in groups of 3 or more). You have risk factors for heart disease, such as high cholesterol, diabetes, or high blood pressure. You have new or different heart palpitations. Your pulse is more than 100 beats per minute (without exercise, anxiety, or fever).

Answer this question truthfully ### Question: What are the symptoms of Patent ductus arteriosus? ### Response: Infants with patent ductus arteriosus may have symptoms such as: Bounding pulse Fast breathing Poor feeding habits Shortness of breath Sweating while feeding Fatigue Poor growth Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Answer this question truthfully ### Question: Who is at highest risk for Patent ductus arteriosus ? ### Response: Like many congenital heart disease, the cause of patent ductus arteriosus is not clear. Clinical studies suggest that the genetic and environmental factors both play an important role during the pregnancy. Genetic disorders such as Down syndrome Pregnant woman had German measles during pregnancy

Answer this question truthfully ### Question: When to seek urgent medical care when I have Patent ductus arteriosus ? ### Response: Call your health care provider if your baby has patent ductus arteriosus and symptoms do not improve with treatment, or if new symptoms appear. If your baby experiences either of the following symptoms, seeking urgent medical care as soon as possible: Shortnesss of breath Hemoptysis

Answer this question truthfully ### Question: What to expect if I have Patent ductus arteriosus (Outlook/Prognosis)? ### Response: Prognosis of patent ductus arteriosus varies widely. It depends on: The size of patent ductus arteriosus Whether the patient has been treated with closure medicines. Whether surgery has been done. Whether the patient with complications or not, such as heart failure, problems with lung development, or infective endocarditis.

Answer this question truthfully ### Question: What are the symptoms of Patent foramen ovale? ### Response: Infants with a patent foramen ovale and no other heart defects usually do not have symptoms.

Answer this question truthfully ### Question: What causes Patent foramen ovale? ### Response: While a fetus grows in the uterus, its lungs are not functional. The foramen ovale allows blood to bypass the lungs so it does not cause issues in the fetus. The opening is supposed to close soon after birth, but sometimes it does not. In about 1 out of 4 people, the opening never closes. If it does not, it is called a patent foramen ovale (PFO). The cause of a patent foramen ovale is unknown.

Answer this question truthfully ### Question: Who is at highest risk for Patent foramen ovale ? ### Response: There are no known risk factors.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Patent foramen ovale ? ### Response: Mostly patent foramen ovale stays asymptomatic. In case of development of weakness of any part of body (stroke), seek urgent care.

Answer this question truthfully ### Question: What to expect if I have Patent foramen ovale (Outlook/Prognosis)? ### Response: The infant will have normal health in the absence of other heart defects.

Answer this question truthfully ### Question: What causes Pedal edema? ### Response: Foot, leg, and ankle swelling is common with the following situations: Being overweight Blood clot in the leg Increased age Leg infection Veins in the legs that cannot properly pump blood back to the heart Injury or surgery involving the leg, ankle, or foot can cause swelling. Swelling may also occur after pelvic surgery, especially for cancer. Long airplane flights or car rides, as well as standing for long periods of time, often lead to some swelling in the feet and ankles. Swelling may occur in women who take estrogen or during parts of the menstrual cycle. Most women have some swelling during pregnancy. More severe swelling during pregnancy may be a sign of preeclampsia (also called toxemia), a serious condition that includes high blood pressure and swelling. Swollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body. Certain medications may also cause your legs to swell: Antidepressants, including MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (such as nortriptyline, desipramine, and amitriptyline) Blood pressure medicines called calcium channel blockers (such as nifedipine, amlodipine, diltiazem, felodipine, and verapamil) Hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone Steroids.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Pedal edema ? ### Response: Call 911 if: You feel short of breath. You have chest pain, especially if it feels like pressure or tightness. Call your doctor right away if: You have heart disease or kidney disease and the swelling gets worse. You have a history of liver disease and now have swelling in your legs or abdomen. Your swollen foot or leg is red or warm to the touch. You have a fever. You are pregnant and have more than just mild swelling or have a sudden increase in swelling. Also call your doctor if self-care measures do not help or swelling gets worse.

Answer this question truthfully ### Question: Who needs Percutaneous coronary intervention? ### Response: Percutaneous coronary intervention is used to restore blood flow to the heart when the coronary (heart) arteries have become narrowed or blocked because of coronary heart disease (CHD). Percutaneous coronary intervention is one of a number of treatments for CHD. Other treatments include medicines and coronary artery bypass grafting (CABG). Your doctor will consider many factors when deciding what treatment or combination of treatments to recommend. Compared with CABG, some advantages of percutaneous coronary intervention are that it: Doesn't require an incision (cut) Doesn't require general anesthesia (that is, you won't be temporarily put to sleep during the procedure) Has a shorter recovery time Percutaneous coronary intervention also is used as an emergency procedure during a heart attack. As plaque builds up in the coronary arteries, it can rupture. This can cause a blood clot to form on the plaque's surface and block blood flow. The lack of oxygen-rich blood to the heart can damage the heart muscle. Quickly opening a blockage lessens the damage during a heart attack by restoring blood flow to the heart muscle. Percutaneous coronary intervention usually is the fastest way to open a blocked artery and is the best approach during a heart attack. A disadvantage of percutaneous coronary intervention, when compared with CABG, is that the artery more frequently renarrows over time. However, the risk of this happening is lower when stents are used, especially stents coated with medicines (drug-eluting stents). Stents are small mesh tubes that support the inner artery wall. They reduce the chance of the artery becoming narrowed or blocked again. Some stents are coated with medicines that are slowly and continuously released into the artery. The medicines help prevent the artery from becoming blocked again. However, stents aren't without risks. In some cases, blood clots can form in stents and cause a heart attack. Your doctor will talk to you about your treatment options and which procedure is best for you.

Answer this question truthfully ### Question: How is Percutaneous coronary intervention performed? ### Response: Before the percutaneous coronary intervention procedure begins, you will be given some pain medicine. You may also be given blood thinning medicines to prevent a blood clot from forming. You will lie on a padded table. Your doctor will insert a flexible tube (catheter) through a surgical cut into an artery. Sometimes the catheter will be placed in your arm or wrist. You will be awake during the procedure. The doctor will use live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctor see any blockages in the blood vessels that lead to your heart. A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart. A wire mesh tube (stent) may then be placed in this blocked area. The stent is inserted along with the balloon catheter. It expands when the balloon is inflated. The stent is left there to help keep the artery open. The stent may be coated with a drug (called a drug-eluting stent). This type of stent may lower the chance of the artery closing back up in the future. However, drug-eluting stents are slightly more likely to close in the short-term. Currently, they are only used for certain patients.

Answer this question truthfully ### Question: Why is the procedure performed? ### Response: Arteries can become narrowed or blocked by deposits called plaque. Plaque is made up of fat and cholesterol that builds up on the inside of the artery walls. This condition is called atherosclerosis. Percutaneous coronary intervention may be used to treat: Blockage in a coronary artery during or after a heart attack Blockage of one or more coronary arteries that puts you at risk for a heart attack Persistent chest pain (angina) that medicines do not control Not every blockage can be treated with percutaneous coronary intervention. Some patients who have several blockages or blockages in certain locations may need coronary bypass surgery.

Answer this question truthfully ### Question: Where to find centers that do Percutaneous coronary intervention? ### Response: Directions to Hospitals Performing Percutaneous coronary intervention

Answer this question truthfully ### Question: What are the risks of Percutaneous coronary intervention and stent placement? ### Response: Percutaneous coronary intervention is a common medical procedure. Serious complications don't occur often. However, they can happen no matter how careful your doctor is or how well he or she does the procedure. Serious complications include: Bleeding from the blood vessel where the catheters were inserted. Blood vessel damage from the catheters. An allergic reaction to the dye given during the percutaneous coronary intervention. An arrhythmia (irregular heartbeat). The need for emergency coronary bypass surgery during the procedure (2–4 percent of people). This may occur if an artery closes down instead of opening up. Damage to the kidneys caused by the dye used. Heart attack (3–5 percent of people). Stroke (less than 1 percent of people). Sometimes chest pain can occur during percutaneous coronary intervention because the balloon briefly blocks blood supply to the heart. As with any procedure involving the heart, complications can sometimes, though rarely, cause death. Less than 2 percent of people die during percutaneous coronary intervention. Complications from stents include: After percutaneous coronary intervention, the treated coronary artery can become narrowed or blocked again, often within 6 months of percutaneous coronary intervention. This is called restenosis. Studies suggest that there's a higher risk of blood clots forming in medicine-coated stents compared to bare metal stents. However, no conclusive evidence shows that these stents increase the chances of having a heart attack or dying, if used as recommended. The risk of complications is higher in: People aged 75 and older People who have kidney disease or diabetes Women People who have poor pumping function in their hearts People who have extensive heart disease and blockages in their coronary (heart) arteries

Answer this question truthfully ### Question: What to expect before Percutaneous coronary intervention? ### Response: Cardiologists do coronary angioplasties at hospitals. Cardiologists are doctors who specialize in diagnosing and treating heart diseases and conditions. If your percutaneous coronary intervention isn't done as an emergency treatment, you'll meet with your cardiologist before the procedure. He or she will go over your medical history (including the medicines you take), do a physical exam, and talk to you about the procedure. Your doctor also may recommend some routine tests, such as blood tests, an EKG (electrocardiogram), and a chest x ray. Once the percutaneous coronary intervention is scheduled, your doctor will advise you: When to begin fasting (not eating or drinking) before the procedure. Often you have to stop eating and drinking by midnight the night before the procedure. What medicines you should and shouldn't take on the day of the percutaneous coronary intervention. When to arrive at the hospital and where to go. Even though percutaneous coronary intervention takes only 1 to 2 hours, you'll likely need to stay in the hospital overnight or longer. Your doctor may advise you not to drive for a certain amount of time after the procedure, so you may have to arrange for a ride home.

Answer this question truthfully ### Question: What to expect after Percutaneous coronary intervention? ### Response: After percutaneous coronary intervention, you'll be moved to a special care unit. You'll stay there for a few hours or overnight. You must lie still for a few hours to allow the blood vessel in your arm or groin (upper thigh) to seal completely. While you recover, nurses will check your heart rate and blood pressure. They also will check your arm or groin for bleeding. After a few hours, you'll be able to walk with help. The place where the catheters (tubes) were inserted may feel sore or tender for about a week. Going Home: Most people go home the day after the procedure. When your doctor thinks you're ready to leave the hospital, you'll get instructions to follow at home, such as: How much activity or exercise you can do. When you should follow up with your doctor. What medicines you should take. What you should look for daily when checking for signs of infection around the area where the tube was inserted. Signs of infection may include redness, swelling, or drainage. When you should call your doctor. For example, you may need to call if you have shortness of breath; a fever; or signs of infection, pain, or bleeding where the tubes were inserted. When you should call 9–1–1 (for example, if you have any chest pain). Your doctor will prescribe medicine to prevent blood clots from forming after the procedure such as aspirin and clopidogrel (Plavix) or prasugrel (Efient). Taking your medicine as directed is very important. If you got a stent during percutaneous coronary intervention, the medicine reduces the risk that blood clots will form in the stent. Blood clots in the stent can block blood flow and cause a heart attack. DO NOT STOP TAKING THEM WITHOUT TALKING TO YOUR DOCTOR FIRST. Stopping these medications too soon can be life-threatening. Recovery and Recuperation: Most people recover from percutaneous coronary intervention and return to work about 1 week after leaving the hospital. Your doctor will want to check your progress after you leave the hospital. During the follow-up visit, your doctor will examine you, make changes to your medicines (if needed), do any necessary tests, and check your overall recovery. Use this time to ask questions you may have about activities, medicines, or lifestyle changes, or to talk about any other issues that concern you. Lifestyle Changes: Although percutaneous coronary intervention can reduce the symptoms of coronary heart disease (CHD), it isn't a cure for CHD or the risk factors that led to it. Making healthy lifestyle changes can help treat CHD and maintain the good results from percutaneous coronary intervention. Talk with your doctor about your risk factors for CHD and the lifestyle changes you'll need to make. For some people, these changes may be the only treatment needed. Lifestyle changes may include changing your diet, quitting smoking, doing physical activity regularly, losing weight or maintaining a healthy weight, and reducing stress. You also should take all of your medicines exactly as your doctor prescribes.

Answer this question truthfully ### Question: What are the symptoms of Pericarditis? ### Response: Chest pain is almost always present, which is caused by the inflamed pericardium rubbing against the heart. The pain: May be felt in the neck, shoulder, back, or abdomen. Often increases with deep breathing and lying flat, and may increase with coughing and swallowing. Patients may often feel better sitting up and leaning forward. Can be a sharp, stabbing pleuritic type pain (pleuritis). Fever, chills, or sweating if the condition is caused by an infection. Ankle, feet, and leg swelling (occasionally if there is a constriction of the heart filling in a condition known as constrictive pericarditis). Anxiety Breathing difficulty when lying down (orthopnea) Dry cough Fatigue

Answer this question truthfully ### Question: What causes Pericarditis? ### Response: The cause of pericarditis is often unknown or unproven, but is often the result of an infection such as: Viral infections that cause a chest cold or pneumonia, such as the echovirus or coxsackie virus (which are common in children), as well as influenza Infections with bacteria (much less common) Some fungal infections (even more rare) In addition, pericarditis may be seen with diseases such as: Cancer (including leukemia) Disorders in which the immune system attacks healthy body tissue by mistake HIV infection and AIDS Underactive thyroid gland Kidney failure Rheumatic fever Tuberculosis (TB) Other causes include: Heart attack Heart surgery or trauma to the chest, esophagus, or heart Certain medications, such as procainamide, hydralazine, phenytoin, isoniazid, and some drugs used to treat cancer or suppress the immune system Swelling or inflammation of the heart muscle Radiation therapy to the chest

Answer this question truthfully ### Question: Who is at highest risk for Pericarditis ? ### Response: Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Pericarditis ? ### Response: Pericarditis can be potentially life threatening and one should seek medical care when suffering from symptoms of pericarditis. Severe chest pain, fainting, palpitations and high grade fever may be signs of a build up of fluids within the pericardium, which is referred to as a cardiac tamponade. A cardiac tamponade is a condition in which the heart cannot expand to accept blood.

Answer this question truthfully ### Question: What to expect if I have Pericarditis (Outlook/Prognosis)? ### Response: Pericarditis can range from mild cases that get better on their own to life-threatening cases. The condition can be complicated by fluid buildup around the heart and poor heart function. The outcome is good if the disorder is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic if symptoms or episodes continue. Scarring and thickening of the sac-like covering of the heart muscle may occur in severe cases. This is called constrictive pericarditis, and it can cause long-term problems similar to those of heart failure.

Answer this question truthfully ### Question: When could I drive after i underwent Peripheral angioplasty discharge instructions ? ### Response: You should not drive for 48 hours after the procedure.

Answer this question truthfully ### Question: What medications should I take after Peripheral angioplasty discharge instructions ? ### Response: Aspirin every day. Ask your doctor about the dose you should take. Plavix (clopidogrel) may be used in addition to Aspirin to decrease the risk of a blood clot forming in the artery. You will be given a list of all medicines you should take once you are at home. Ask your doctor whether you should go back to take the medications you were on before the procedure. Be sure your doctor knows about everything you are taking.

Answer this question truthfully ### Question: Should I take any OTC pain medications? ### Response: You may take acetaminophen (Tylenol) every six hours as needed for pain in the area where the catheter was placed. Please be sure you are not taking more than one product containing acetaminophen, and do not take more Tylenol than what is recommended on the label.

Answer this question truthfully ### Question: When may I resume my regular activities? ### Response: You may resume your regular activities one week after the procedure. Avoid lifting, pushing, or pulling anything heavier than 10 pounds in the first week after the procedure. Also avoid any exercise that causes you to hold your breath and bear down with your abdominal muscles.

Answer this question truthfully ### Question: When could I bathe or swim? ### Response: Usually after one week, when the puncture site is healed. This usually takes about a week. You may shower on the day after the procedure after removing the Band-Aid over your puncture site.

Answer this question truthfully ### Question: When can I go back to work after Peripheral angioplasty discharge instructions ? ### Response: It depends on the type of your work. you can ask your doctor when you can go back to work.

Answer this question truthfully ### Question: When to seek urgent medical care when I have Peripheral angioplasty discharge instructions ? ### Response: Call your doctor or nurse if: There is swelling at the catheter site. There is bleeding at the catheter insertion site that does not stop when pressure is applied. Your leg below where the catheter was inserted changes color or becomes cool to the touch, pale, or numb. The small incision from your catheter becomes red or painful, or yellow or green discharge is draining from it. Your legs are swelling. You have chest pain or shortness of breath that does not go away with rest. You have dizziness, fainting, or you are very tired. You are coughing up blood or yellow or green mucus. You have chills or a fever over 101 °F. You develop weakness in your body or are unable to get out of bed.

Answer this question truthfully ### Question: What are the symptoms of Peripheral arterial disease? ### Response: The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise and go away after several minutes of rest. At first, these symptoms may appear only when you walk uphill, walk faster, or walk for longer distances. Slowly, these symptoms come on more quickly and with less exercise. Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may look pale. When peripheral artery disease becomes severe, you may have: Impotence Pain and cramps at night Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful Pain that is worse when you raise the leg and improves when you dangle your legs over the side of the bed Skin that looks dark and blue Sores that do not heal

Answer this question truthfully ### Question: What causes Peripheral arterial disease? ### Response: Peripheral artery disease is caused by arteriosclerosis, or "hardening of the arteries." This problem occurs when fatty material (plaque) builds up on the walls of your arteries. This causes the arteries to become narrower. The walls of the arteries also become stiffer and cannot widen (dilate) to allow greater blood flow when needed. As a result, when the muscles of your legs are working harder (such as during exercise or walking) they cannot get enough blood and oxygen. Eventually, there may not be enough blood and oxygen, even when the muscles are resting. Peripheral artery disease is a common disorder that usually affects men over age 50.