Input: What are the treatments for Sudden Cardiac Arrest ?

Output:
Emergency Treatment

Sudden cardiac arrest (SCA) is an emergency. A person having SCA needs to be treated with a defibrillator right away. This device sends an electric shock to the heart. The electric shock can restore a normal rhythm to a heart that's stopped beating.

To work well, defibrillation must be done within minutes of SCA. With every minute that passes, the chances of surviving SCA drop rapidly.

Police, emergency medical technicians, and other first responders usually are trained and equipped to use a defibrillator. Call 911 right away if someone has signs or symptoms of SCA. The sooner you call for help, the sooner lifesaving treatment can begin.

Automated External Defibrillators

Automated external defibrillators (AEDs) are special defibrillators that untrained bystanders can use. These portable devices often are found in public places, such as shopping malls, golf courses, businesses, airports, airplanes, casinos, convention centers, hotels, sports venues, and schools.

AEDs are programmed to give an electric shock if they detect a dangerous arrhythmia, such as ventricular fibrillation. This prevents giving a shock to someone who may have fainted but isn't having SCA.

You should give cardiopulmonary resuscitation (CPR) to a person having SCA until defibrillation can be done.

People who are at risk for SCA may want to consider having an AED at home. A 2008 study by the National Heart, Lung, and Blood Institute and the National Institutes of Health found that AEDs in the home are safe and effective.

Some people feel that placing these devices in homes will save many lives because many SCAs occur at home.Others note that no evidence supports the idea that home-use AEDs save more lives. These people fear that people who have AEDs in their homes will delay calling for help during an emergency. They're also concerned that people who have home-use AEDs will not properly maintain the devices or forget where they are.

When considering a home-use AED, talk with your doctor. He or she can help you decide whether having an AED in your home will benefit you.

Treatment in a Hospital

If you survive SCA, you'll likely be admitted to a hospital for ongoing care and treatment. In the hospital, your medical team will closely watch your heart. They may give you medicines to try to reduce the risk of another SCA.

While in the hospital, your medical team will try to find out what caused your SCA. If you're diagnosed with coronary heart disease, you may havepercutaneous coronary intervention, also known as coronary angioplasty,or coronary artery bypass grafting. These procedures help restore blood flow through narrowed or blocked coronary arteries.

Often, people who have SCA get a device called an implantable cardioverter defibrillator (ICD). This small device is surgically placed under the skin in your chest or abdomen. An ICD uses electric pulses or shocks to help control dangerous arrhythmias. (For more information, go to "How Can Death Due to Sudden Cardiac Arrest Be Prevented?") </s>


Input: How to prevent Sudden Cardiac Arrest ?

Output:
Ways to prevent death due to sudden cardiac arrest (SCA) differ depending on whether:

You've already had SCA

You've never had SCA but are at high risk for the condition

You've never had SCA and have no known risk factors for the condition

For People Who Have Survived Sudden Cardiac Arrest

If you've already had SCA, you're at high risk of having it again. Research shows that an implantable cardioverter defibrillator (ICD) reduces the chances of dying from a second SCA.An ICD is surgically placed under the skin in your chest or abdomen. The device has wires with electrodes on the ends that connect to your heart's chambers. The ICD monitors your heartbeat.

If the ICD detects a dangerous heart rhythm, it gives an electric shock to restore the heart's normal rhythm. Your doctor may give you medicine to limit irregular heartbeats that can trigger the ICD.

Implantable Cardioverter Defibrillator

An ICD isn't the same as a pacemaker. The devices are similar, but they have some differences. Pacemakers give off low-energy electrical pulses. They're often used to treat less dangerous heart rhythms, such as those that occur in the upper chambers of the heart. Most new ICDs work as both pacemakers and ICDs.

For People at High Risk for a First Sudden Cardiac Arrest

If you have severe coronary heart disease (CHD), you're at increased risk for SCA. This is especially true if you've recently had a heart attack.

Your doctor may prescribe a type of medicine called a beta blocker to help lower your risk for SCA. Your doctor also may discuss beginning statin treatment if you have an elevated risk for developing heart disease or having a stroke. Doctors usually prescribe statins for people who have:

Diabetes

Heart disease or had a prior stroke

High LDL cholesterol levels

Your doctor also may prescribe other medications to:

Decrease your chance of having a heart attack or dying suddenly.

Lower blood pressure.

Prevent blood clots, which can lead to heart attack or stroke.

Prevent or delay the need for a procedure or surgery, such as angioplasty or coronary artery bypass grafting.

Reduce your hearts workload and relieve coronary heart disease symptoms.

Take all medicines regularly, as your doctor prescribes. Dont change the amount of your medicine or skip a dose unless your doctor tells you to. You should still follow a heart-healthy lifestyle, even if you take medicines to treat your coronary heart disease.

Other treatments for coronary heart diseasesuch as percutaneous coronary intervention, also known as coronary angioplasty, or coronary artery bypass graftingalso may lower your risk for SCA. Your doctor also may recommend an ICD if youre at high risk for SCA.

For People Who Have No Known Risk Factors for Sudden Cardiac Arrest

CHD seems to be the cause of most SCAs in adults. CHD also is a major risk factor for angina (chest pain or discomfort) and heart attack, and it contributes to other heart problems.

Following a healthy lifestyle can help you lower your risk for CHD, SCA, and other heart problems. A heart-healthy lifestyle includes:

Heart-healthy eating

Maintaining a healthy weight

Managing stress

Physical activity

Quitting smoking

Heart-Healthy Eating

Heart-healthy eating is an important part of a heart-healthy lifestyle. Your doctor may recommend heart-healthy eating, which should include:

Fat-free or low-fat dairy products, such as skim milk

Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week

Fruits, such as apples, bananas, oranges, pears, and prunes

Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans

Vegetables, such as broccoli, cabbage, and carrots

Whole grains, such as oatmeal, brown rice, and corn tortillas

When following a heart-healthy diet, you should avoid eating:

A lot of red meat

Palm and coconut oils

Sugary foods and beverages

Two nutrients in your diet make blood cholesterol levels rise:

Saturated fatfound mostly in foods that come from animals

Trans fat (trans fatty acids)found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats.

Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5percent to 6percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:

If you eat:

Try to eat no more than:

1,200 calories a day

8 grams of saturated fat a day

1,500 calories a day

10 grams of saturated fat a day

1,800 calories a day

12 grams of saturated fat a day

2,000 calories a day

13 grams of saturated fat a day

2,500 calories a day

17 grams of saturated fat a day

Not all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are:

Avocados

Corn, sunflower, and soybean oils

Nuts and seeds, such as walnuts

Olive, canola, peanut, safflower, and sesame oils

Peanut butter

Salmon and trout

Tofu

Sodium

You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and no added salt foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.

Dietary Approaches to Stop Hypertension

Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.

The DASH eating plan is a good heart-healthy eating plan, even for those who dont have high blood pressure. Read more about DASH.

Limiting Alcohol

Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.

Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:

12 ounces of beer

5 ounces of wine

1 ounces of liquor

Maintaining a Healthy Weight

Maintaining a healthy weight is important for overall health and can lower your risk for sudden cardiac arrest. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.

Knowing your body mass index (BMI) helps you find out if youre a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institutes online BMI calculator or talk to your doctor. A BMI:

Below 18.5 is a sign that you are underweight.

Between 18.5 and 24.9 is in the normal range

Between 25.0 and 29.9 is considered overweight

Of 30.0 or higher is considered obese

A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.

Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, youre at a higher risk for heart disease and type2 diabetes. This risk may be higher with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.

If youre overweight or obese, try to lose weight. A loss of just 3percent to 5percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.

Managing Stress

Managing and coping with stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:

A stress management program

Meditation

Physical activity

Relaxation therapy

Talking things out with friends or family

Physical Activity

Regular physical activity can lower your risk for coronary heart disease, sudden cardiac arrest, and other health problems. Everyone should try to participate in moderate-intensity aerobic exercise at least 2hours and 30minutes per week or vigorous aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10minutes at a time spread throughout the week.

Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.

Read more about physical activity at:

Physical Activity and Your Heart

U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans

Quitting Smoking

People who smoke are more likely to have a heart attack than are people who dont smoke. The risk of having a heart attack increases with the number of cigarettes smoked each day. Smoking also raises your risk for stroke and lung diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer.

Quitting smoking can greatly reduce your risk for heart and lung diseases. Ask your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking. Read more about how to quit smoking. </s>


Input: What is (are) Holes in the Heart ?

Output:
Holes in the heart are simple congenital (kon-JEN-ih-tal) heart defects. Congenital heart defects are problems with the heart's structure that are present at birth. These defects change the normal flow of blood through the heart.

The heart has two sides, separated by an inner wall called the septum. With each heartbeat, the right side of the heart receives oxygen-poor blood from the body and pumps it to the lungs. The left side of the heart receives oxygen-rich blood from the lungs and pumps it to the body.

The septum prevents mixing of blood between the two sides of the heart. However, some babies are born with holes in the upper or lower septum.

A hole in the septum between the heart's two upper chambers is called an atrial septal defect (ASD). A hole in the septum between the heart's two lower chambers is called a ventricular septal defect (VSD).

ASDs and VSDs allow blood to pass from the left side of the heart to the right side. Thus, oxygen-rich blood mixes with oxygen-poor blood. As a result, some oxygen-rich blood is pumped to the lungs instead of the body.

Over the past few decades, the diagnosis and treatment of ASDs and VSDs have greatly improved. Children who have simple congenital heart defects can survive to adulthood. They can live normal, active lives because their heart defects close on their own or have been repaired. </s>


Input: What causes Holes in the Heart ?

Output:
Mothers of children who are born with atrial septal defects (ASDs), ventricular septal defects (VSDs), or other heart defects may think they did something wrong during their pregnancies. However, most of the time, doctors don't know why congenital heart defects occur.

Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect is slightly more likely than other people to have a child who has the problem. Very rarely, more than one child in a family is born with a heart defect.

Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. Half of all babies who have Down syndrome have congenital heart defects.

Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.

Scientists continue to search for the causes of congenital heart defects. </s>


Input: What are the symptoms of Holes in the Heart ?

Output:
Atrial Septal Defect

Many babies who are born with atrial septal defects (ASDs) have no signs or symptoms. However, as they grow, these children may be small for their age.

When signs and symptoms do occur, a heart murmur is the most common. A heart murmur is an extra or unusual sound heard during a heartbeat.

Often, a heart murmur is the only sign of an ASD. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs. Doctors can listen to heart murmurs and tell whether they're harmless or signs of heart problems.

If a large ASD isn't repaired, the extra blood flow to the right side of the heart can damage the heart and lungs and cause heart failure. This generally doesn't occur until adulthood. Signs and symptoms of heart failure include:

Fatigue (tiredness)

Tiring easily during physical activity

Shortness of breath

A buildup of blood and fluid in the lungs

Swelling in the ankles, feet, legs, abdomen, and veins in the neck

Ventricular Septal Defect

Babies born with ventricular septal defects (VSDs) usually have heart murmurs. Murmurs may be the first and only sign of a VSD. Heart murmurs often are present right after birth in many infants. However, the murmurs may not be heard until the babies are 6 to 8 weeks old.

Most newborns who have VSDs don't have heart-related symptoms. However, babies who have medium or large VSDs can develop heart failure. Signs and symptoms of heart failure usually occur during the baby's first 2 months of life.

The signs and symptoms of heart failure due to VSD are similar to those listed above for ASD, but they occur in infancy.

A major sign of heart failure in infancy is poor feeding and growth. VSD signs and symptoms are rare after infancy. This is because the defects either decrease in size on their own or they're repaired. </s>


Input: How to diagnose Holes in the Heart ?

Output:
Doctors usually diagnose holes in the heart based on a physical exam and the results from tests and procedures. The exam findings for an atrial septal defect (ASD) often aren't obvious. Thus, the diagnosis sometimes isn't made until later in childhood or even in adulthood.

Ventricular septal defects (VSDs) cause a very distinct heart murmur. Because of this, a diagnosis usually is made in infancy.

Specialists Involved

Doctors who specialize in diagnosing and treating heart problems are called cardiologists. Pediatric cardiologists take care of babies and children who have heart problems. Cardiac surgeons repair heart defects using surgery.

Physical Exam

During a physical exam, your child's doctor will listen to your child's heart and lungs with a stethoscope. The doctor also will look for signs of a heart defect, such as a heart murmur or signs of heart failure.

Diagnostic Tests and Procedures

Your child's doctor may recommend several tests to diagnose an ASD or VSD. These tests also will help the doctor figure out the location and size of the defect.

Echocardiography

Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. The sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen.

Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.

Echo is an important test for both diagnosing a hole in the heart and following the problem over time. Echo can show problems with the heart's structure and how the heart is reacting to the problems. This test will help your child's cardiologist decide whether and when treatment is needed.

EKG (Electrocardiogram)

An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). It also records the strength and timing of electrical signals as they pass through the heart.

An EKG can detect whether one of the heart's chambers is enlarged, which can help diagnose a heart problem.

Chest X Ray

A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart, lungs, and blood vessels.

This test can show whether the heart is enlarged. A chest x ray also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure.

Pulse Oximetry

Pulse oximetry shows the level of oxygen in the blood. A small sensor is attached to a finger or ear. The sensor uses light to estimate how much oxygen is in the blood.

Cardiac Catheterization

During cardiac catheterization (KATH-e-ter-i-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart.

Special dye is injected through the catheter into a blood vessel or one of the heart's chambers. The dye allows the doctor to see the flow of blood through the heart and blood vessels on an x-ray image.

The doctor also can use cardiac catheterization to measure the pressure inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart.

Doctors also use cardiac catheterization to repair some heart defects. For more information, go to "How Are Holes in the Heart Treated?" </s>


Input: What are the treatments for Holes in the Heart ?

Output:
Many holes in the heart don't need treatment, but some do. Those that do often are repaired during infancy or early childhood. Sometimes adults are treated for holes in the heart if problems develop.

The treatment your child receives depends on the type, location, and size of the hole. Other factors include your child's age, size, and general health.

Treating an Atrial Septal Defect

If a child has an atrial septal defect (ASD), routine checkups are done to see whether it closes on its own. About half of all ASDs close on their own over time, and about 20 percent close within the first year of life.

Your child's doctor will let you know how often your child should have checkups. For an ASD, frequent checkups aren't needed.

If an ASD requires treatment, catheter or surgical procedures are used to close the hole. Doctors often decide to close ASDs in children who still have medium- or large-sized holes by the time they're 2 to 5 years old.

Catheter Procedure

Until the early 1990s, surgery was the usual method for closing all ASDs. Now, thanks to medical advances, doctors can use catheter procedures to close secundum ASDs. These are the most common type of ASD.

Before a catheter procedure, your child is given medicine so he or she will sleep and not feel any pain. Then, the doctor inserts a catheter (a thin, flexible tube) into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter.

When the catheter reaches the septum, the device is pushed out of the catheter. The device is placed so that it plugs the hole between the atria. It's secured in place and the catheter is withdrawn from the body.

Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows.

Doctors often use echocardiography (echo), transesophageal (tranz-ih-sof-uh-JEE-ul) echo (TEE), and coronary angiography (an-jee-OG-rah-fee) to guide them in threading the catheter to the heart and closing the defect. TEE is a special type of echo that takes pictures of the heart through the esophagus. The esophagus is the passage leading from the mouth to the stomach.

Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter is inserted. This means that recovery is faster and easier.

The outlook for children having this procedure is excellent. Closures are successful in more than 9 out of 10 patients, with no major leakage. Rarely, a defect is too large for catheter closure and surgery is needed.

Surgery

Open-heart surgery generally is done to repair primum or sinus venosus ASDs. Before the surgery, your child is given medicine so he or she will sleep and not feel any pain.

Then, the cardiac surgeon makes an incision (cut) in the chest to reach the ASD. He or she repairs the defect with a special patch that covers the hole. A heart-lung bypass machine is used during the surgery so the surgeon can open the heart. The machine takes over the heart's pumping action and moves blood away from the heart.

The outlook for children who have ASD surgery is excellent. On average, children spend 3 to 4 days in the hospital before going home. Complications, such as bleeding and infection, are very rare.

In some children, the outer lining of the heart may become inflamed. This condition is called pericarditis (PER-i-kar-DI-tis). The inflammation causes fluid to collect around the heart in the weeks after surgery. Medicine usually can treat this condition.

While in the hospital, your child will be given medicine as needed to reduce pain or anxiety. The doctors and nurses at the hospital will teach you how to care for your child at home.

They will talk about preventing blows to the chest as the incision heals, limiting activity while your child recovers, bathing, scheduling ongoing care, and deciding when your child can go back to his or her regular activities.

Treating a Ventricular Septal Defect

Doctors may choose to monitor children who have ventricular septal defects (VSDs) but no symptoms of heart failure. This means regular checkups and tests to see whether the defect closes on its own or gets smaller.

More than half of VSDs eventually close, usually by the time children are in preschool. Your child's doctor will let you know how often your child needs checkups. Checkups may range from once a month to once every 1 or 2 years.

If treatment for a VSD is required, options include extra nutrition and surgery to close the VSD. Doctors also can use catheter procedures to close some VSDs. They may use this approach if surgery isn't possible or doesn't work. More research is needed to find out the risks and benefits of using catheter procedures to treat VSDs.

Extra Nutrition

Some infants who have VSDs don't grow and develop or gain weight as they should. These infants usually:

Have large VSDs

Are born too early

Tire easily during feeding

Doctors usually recommend extra nutrition or special feedings for these infants. These feedings are high-calorie formulas or breast milk supplements that give babies extra nourishment.

Some infants need tube feeding. A small tube is inserted into the mouth and moved down into the stomach. Food is given through the tube.

Tube feeding can add to or take the place of bottle feeding. This treatment often is short-term because a VSD that causes symptoms will likely require surgery.

Surgery

Most doctors recommend surgery to close large VSDs that are causing symptoms, affecting the aortic valve, or haven't closed by the time children are 1 year old. Surgery may be needed earlier if:

A child doesn't gain weight

Medicines are needed to control the symptoms of heart failure

Rarely, medium-sized VSDs that are causing enlarged heart chambers are treated with surgery after infancy. However, most VSDs that require surgery are repaired in the first year of life. Doctors use open-heart surgery and patches to close VSDs. </s>


Input: What is (are) Congenital Heart Defects ?

Output:
Congenital (kon-JEN-ih-tal) heart defects are problems with the heart's structure that are present at birth. These defects can involve:

The interior walls of the heart

The valves inside the heart

The arteries and veins that carry blood to the heart or the body

Congenital heart defects change the normal flow of blood through the heart.

There are many types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.

Congenital heart defects are the most common type of birth defect. They affect 8 out of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects.

Many of these defects are simple conditions. They need no treatment or are easily fixed. Some babies are born with complex congenital heart defects. These defects require special medical care soon after birth.

The diagnosis and treatment of complex heart defects has greatly improved over the past few decades. As a result, almost all children who have complex heart defects survive to adulthood and can live active, productive lives.

Most people who have complex heart defects continue to need special heart care throughout their lives. They may need to pay special attention to how their condition affects issues such as health insurance, employment, birth control and pregnancy, and other health issues.

In the United States, more than 1 million adults are living with congenital heart defects. </s>


Input: What causes Congenital Heart Defects ?

Output:
If your child has a congenital heart defect, you may think you did something wrong during your pregnancy to cause the problem. However, doctors often don't know why congenital heart defects occur.

Heredity may play a role in some heart defects. For example, a parent who has a congenital heart defect may be more likely than other people to have a child with the defect. Rarely, more than one child in a family is born with a heart defect.

Children who have genetic disorders, such as Down syndrome, often have congenital heart defects. In fact, half of all babies who have Down syndrome have congenital heart defects.

Smoking during pregnancy also has been linked to several congenital heart defects, including septal defects.

Researchers continue to search for the causes of congenital heart defects. </s>


Input: What are the symptoms of Congenital Heart Defects ?

Output:
Many congenital heart defects cause few or no signs and symptoms. A doctor may not even detect signs of a heart defect during a physical exam.

Some heart defects do cause signs and symptoms. They depend on the number, type, and severity of the defects. Severe defects can cause signs and symptoms, usually in newborns. These signs and symptoms may include:

Rapid breathing

Cyanosis (a bluish tint to the skin, lips, and fingernails)

Fatigue (tiredness)

Poor blood circulation

Congenital heart defects don't cause chest pain or other painful symptoms.

Heart defects can cause heart murmurs (extra or unusual sounds heard during a heartbeat). Doctors can hear heart murmurs using a stethoscope. However, not all murmurs are signs of congenital heart defects. Many healthy children have heart murmurs.

Normal growth and development depend on a normal workload for the heart and normal flow of oxygen-rich blood to all parts of the body. Babies who have congenital heart defects may have cyanosis and tire easily while feeding. As a result, they may not gain weight or grow as they should.

Older children who have congenital heart defects may get tired easily or short of breath during physical activity.

Many types of congenital heart defects cause the heart to work harder than it should. With severe defects, this can lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Symptoms of heart failure include:

Shortness of breath or trouble breathing

Fatigue with physical activity

A buildup of blood and fluid in the lungs

Swelling in the ankles, feet, legs, abdomen, and veins in the neck </s>


Input: How to diagnose Congenital Heart Defects ?

Output:
Severe congenital heart defects generally are diagnosed during pregnancy or soon after birth. Less severe defects often aren't diagnosed until children are older.

Minor defects often have no signs or symptoms. Doctors may diagnose them based on results from a physical exam and tests done for another reason.

Specialists Involved

Pediatric cardiologists are doctors who specialize in the care of babies and children who have heart problems. Cardiac surgeons are specialists who repair heart defects using surgery.

Physical Exam

During a physical exam, the doctor will:

Listen to your child's heart and lungs with a stethoscope

Look for signs of a heart defect, such as cyanosis (a bluish tint to the skin, lips, or fingernails), shortness of breath, rapid breathing, delayed growth, or signs of heart failure

Diagnostic Tests

Echocardiography

Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen.

Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.

Echo is an important test for both diagnosing a heart problem and following the problem over time. The test can show problems with the heart's structure and how the heart is reacting to those problems. Echo will help your child's cardiologist decide if and when treatment is needed.

During pregnancy, if your doctor suspects that your baby has a congenital heart defect, fetal echo can be done. This test uses sound waves to create a picture of the baby's heart while the baby is still in the womb.

Fetal echo usually is done at about 18 to 22 weeks of pregnancy. If your child is diagnosed with a congenital heart defect before birth, your doctor can plan treatment before the baby is born.

EKG (Electrocardiogram)

An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through the heart.

An EKG can detect if one of the heart's chambers is enlarged, which can help diagnose a heart problem.

Chest X Ray

A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged. It also can show whether the lungs have extra blood flow or extra fluid, a sign of heart failure.

Pulse Oximetry

For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of how much oxygen is in the blood.

Cardiac Catheterization

During cardiac catheterization (KATH-e-ter-ih-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck. The tube is threaded to the heart.

Special dye is injected through the catheter into a blood vessel or one of the hearts chambers. The dye allows the doctor to see blood flowing through the heart and blood vessels on an x-ray image.

The doctor also can use cardiac catheterization to measure the pressure and oxygen level inside the heart chambers and blood vessels. This can help the doctor figure out whether blood is mixing between the two sides of the heart.

Cardiac catheterization also is used to repair some heart defects. </s>


Input: What are the treatments for Congenital Heart Defects ?

Output:
Although many children who have congenital heart defects don't need treatment, some do. Doctors repair congenital heart defects with catheter procedures or surgery.

Sometimes doctors combine catheter and surgical procedures to repair complex heart defects, which may involve several kinds of defects.

The treatment your child receives depends on the type and severity of his or her heart defect. Other factors include your child's age, size, and general health.

Some children who have complex congenital heart defects may need several catheter or surgical procedures over a period of years, or they may need to take medicines for years.

Catheter Procedures

Catheter procedures are much easier on patients than surgery. They involve only a needle puncture in the skin where the catheter (thin, flexible tube) is inserted into a vein or an artery.

Doctors don't have to surgically open the chest or operate directly on the heart to repair the defect(s). This means that recovery may be easier and quicker.

The use of catheter procedures has increased a lot in the past 20 years. They have become the preferred way to repair many simple heart defects, such as atrial septal defect (ASD) and pulmonary valve stenosis.

For ASD repair, the doctor inserts a catheter into a vein in the groin (upper thigh). He or she threads the tube to the heart's septum. A device made up of two small disks or an umbrella-like device is attached to the catheter.

When the catheter reaches the septum, the device is pushed out of the catheter. The device is placed so that it plugs the hole between the atria. Its secured in place and the catheter is withdrawn from the body.

Within 6 months, normal tissue grows in and over the device. The closure device does not need to be replaced as the child grows.

For pulmonary valve stenosis, the doctor inserts a catheter into a vein and threads it to the hearts pulmonary valve. A tiny balloon at the end of the catheter is quickly inflated to push apart the leaflets, or "doors," of the valve.

Then, the balloon is deflated and the catheter and ballon are withdrawn. This procedure can be used to repair any narrowed valve in the heart.

To help guide the catheter, doctors often use echocardiography (echo), transesophageal (tranz-ih-sof-uh-JEE-ul) echo (TEE), and coronary angiography (an-jee-OG-rah-fee).

TEE is a special type of echo that takes pictures of the heart through the esophagus. The esophagus is the passage leading from the mouth to the stomach. Doctors also use TEE to examine complex heart defects.

Surgery

A child may need open-heart surgery if his or her heart defect can't be fixed using a catheter procedure. Sometimes one surgery can repair the defect completely. If that's not possible, the child may need more surgeries over months or years to fix the problem.

Cardiac surgeons may use open-heart surgery to:

Close holes in the heart with stitches or a patch

Repair or replace heart valves

Widen arteries or openings to heart valves

Repair complex defects, such as problems with the location of blood vessels near the heart or how they are formed

Rarely, babies are born with multiple defects that are too complex to repair. These babies may need heart transplants. In this procedure, the child's heart is replaced with a healthy heart from a deceased child. The heart has been donated by the deceased childs family. </s>


Input: What is (are) Bronchitis ?

Output:
Espaol

Bronchitis (bron-KI-tis) is a condition in which the bronchial tubes become inflamed. These tubes carry air to your lungs. (For more information about the bronchial tubes and airways, go to the Diseases and Conditions Index How the Lungs Work article.)

People who have bronchitis often have a cough that brings up mucus. Mucus is a slimy substance made by the lining of the bronchial tubes. Bronchitis also may cause wheezing (a whistling or squeaky sound when you breathe), chest pain or discomfort, a low fever, and shortness of breath.

Bronchitis

Overview

The two main types of bronchitis are acute (short term) and chronic (ongoing).

Acute Bronchitis

Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed).

Sometimes bacteria cause acute bronchitis.

Acute bronchitis lasts from a few days to 10 days. However, coughing may last for several weeks after the infection is gone.

Several factors increase your risk for acute bronchitis. Examples include exposure to tobacco smoke (including secondhand smoke), dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.

Most cases of acute bronchitis go away within a few days. If you think you have acute bronchitis, see your doctor. He or she will want to rule out other, more serious health conditions that require medical care.

Chronic Bronchitis

Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual.

Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis. </s>


Input: What causes Bronchitis ?

Output:
Acute Bronchitis

Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. Sometimes bacteria can cause the condition.

Certain substances can irritate your lungs and airways and raise your risk for acute bronchitis. For example, inhaling or being exposed to tobacco smoke, dust, fumes, vapors, or air pollution raises your risk for the condition. These lung irritants also can make symptoms worse.

Being exposed to a high level of dust or fumes, such as from an explosion or a big fire, also may lead to acute bronchitis.

Chronic Bronchitis

Repeatedly breathing in fumes that irritate and damage lung and airway tissues causes chronic bronchitis. Smoking is the major cause of the condition.

Breathing in air pollution and dust or fumes from the environment or workplace also can lead to chronic bronchitis.

People who have chronic bronchitis go through periods when symptoms become much worse than usual. During these times, they also may have acute viral or bacterial bronchitis. </s>


Input: Who is at risk for Bronchitis? ?

Output:
Bronchitis is a very common condition. Millions of cases occur every year.

Elderly people, infants, and young children are at higher risk for acute bronchitis than people in other age groups.

People of all ages can develop chronic bronchitis, but it occurs more often in people who are older than 45. Also, many adults who develop chronic bronchitis are smokers. Women are more than twice as likely as men to be diagnosed with chronic bronchitis.

Smoking and having an existing lung disease greatly increase your risk for bronchitis. Contact with dust, chemical fumes, and vapors from certain jobs also increases your risk for the condition. Examples include jobs in coal mining, textile manufacturing, grain handling, and livestock farming.

Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis, especially if you smoke. </s>


Input: What are the symptoms of Bronchitis ?

Output:
Acute Bronchitis

Acute bronchitis caused by an infection usually develops after you already have a cold or the flu. Symptoms of a cold or the flu include sore throat, fatigue (tiredness), fever, body aches, stuffy or runny nose, vomiting, and diarrhea.

The main symptom of acute bronchitis is a persistent cough, which may last 10 to 20 days. The cough may produce clear mucus (a slimy substance). If the mucus is yellow or green, you may have a bacterial infection as well. Even after the infection clears up, you may still have a dry cough for days or weeks.

Other symptoms of acute bronchitis include wheezing (a whistling or squeaky sound when you breathe), low fever, and chest tightness or pain.

If your acute bronchitis is severe, you also may have shortness of breath, especially with physical activity.

Chronic Bronchitis

The signs and symptoms of chronic bronchitis include coughing, wheezing, and chest discomfort. The coughing may produce large amounts of mucus. This type of cough often is called a smoker's cough. </s>


Input: How to diagnose Bronchitis ?

Output:
Your doctor usually will diagnose bronchitis based on your signs and symptoms. He or she may ask questions about your cough, such as how long you've had it, what you're coughing up, and how much you cough.

Your doctor also will likely ask:

About your medical history

Whether you've recently had a cold or the flu

Whether you smoke or spend time around others who smoke

Whether you've been exposed to dust, fumes, vapors, or air pollution

Your doctor will use a stethoscope to listen for wheezing (a whistling or squeaky sound when you breathe) or other abnormal sounds in your lungs. He or she also may:

Look at your mucus to see whether you have a bacterial infection

Test the oxygen levels in your blood using a sensor attached to your fingertip or toe

Recommend a chest x ray, lung function tests, or blood tests </s>


Input: What are the treatments for Bronchitis ?

Output:
The main goals of treating acute and chronic bronchitis are to relieve symptoms and make breathing easier.

If you have acute bronchitis, your doctor may recommend rest, plenty of fluids, and aspirin (for adults) or acetaminophen to treat fever.

Antibiotics usually aren't prescribed for acute bronchitis. This is because they don't work against virusesthe most common cause of acute bronchitis. However, if your doctor thinks you have a bacterial infection, he or she may prescribe antibiotics.

A humidifier or steam can help loosen mucus and relieve wheezing and limited air flow. If your bronchitis causes wheezing, you may need an inhaled medicine to open your airways. You take this medicine using an inhaler. This device allows the medicine to go straight to your lungs.

Your doctor also may prescribe medicines to relieve or reduce your cough and treat your inflamed airways (especially if your cough persists).

If you have chronic bronchitis and also have been diagnosed with COPD (chronic obstructive pulmonary disease), you may need medicines to open your airways and help clear away mucus. These medicines include bronchodilators (inhaled) and steroids (inhaled or pill form).

If you have chronic bronchitis, your doctor may prescribe oxygen therapy. This treatment can help you breathe easier, and it provides your body with needed oxygen.

One of the best ways to treat acute and chronic bronchitis is to remove the source of irritation and damage to your lungs. If you smoke, it's very important to quit.

Talk with your doctor about programs and products that can help you quit smoking. Try to avoid secondhand smoke and other lung irritants, such as dust, fumes, vapors, and air pollution.

For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking. </s>


Input: How to prevent Bronchitis ?

Output:
You can't always prevent acute or chronic bronchitis. However, you can take steps to lower your risk for both conditions. The most important step is to quit smoking or not start smoking.

For more information about how to quit smoking, go to the Diseases and Conditions Index Smoking and Your Heart article and the National Heart, Lung, and Blood Institute's "Your Guide to a Healthy Heart." Although these resources focus on heart health, they include general information about how to quit smoking.

Also, try to avoid other lung irritants, such as secondhand smoke, dust, fumes, vapors, and air pollution. For example, wear a mask over your mouth and nose when you use paint, paint remover, varnish, or other substances with strong fumes. This will help protect your lungs.

Wash your hands often to limit your exposure to germs and bacteria. Your doctor also may advise you to get a yearly flu shot and a pneumonia vaccine. </s>


Input: What is (are) Overweight and Obesity ?

Output:
Espaol

The terms "overweight" and "obesity" refer to body weight thats greater than what is considered healthy for a certain height.

The most useful measure of overweight and obesity is body mass index (BMI). BMI is calculated from your height and weight. For more information about BMI, go to "How Are Overweight and Obesity Diagnosed?"

Overview

Millions of Americans and people worldwide are overweight or obese. Being overweight or obese puts you at risk for many health problems. The more body fat that you have and the more you weigh, the more likely you are to develop:

Coronary heart disease

High blood pressure

Type 2 diabetes

Gallstones

Breathing problems

Certain cancers

Your weight is the result of many factors. These factors include environment, family history and genetics, metabolism (the way your body changes food and oxygen into energy), behavior or habits, and more.

You can't change some factors, such as family history. However, you can change other factors, such as your lifestyle habits.

For example, follow a healthy eating plan and keep your calorie needs in mind. Be physically active and try to limit the amount of time that you're inactive.

Weight-loss medicines and surgery also are options for some people if lifestyle changes aren't enough.

Outlook

Reaching and staying at a healthy weight is a long-term challenge for people who are overweight or obese. But it also is a chance to lower your risk for other serious health problems. With the right treatment and motivation, it's possible to lose weight and lower your long-term disease risk. </s>


Input: What causes Overweight and Obesity ?

Output:
Lack of Energy Balance

A lack of energy balance most often causes overweight and obesity. Energy balance means that your energy IN equals your energy OUT.

Energy IN is the amount of energy or calories you get from food and drinks. Energy OUT is the amount of energy your body uses for things like breathing, digesting, and being physically active.

To maintain a healthy weight, your energy IN and OUT don't have to balance exactly every day. It's the balance over time that helps you maintain a healthy weight.

The same amount of energy IN and energy OUT over time = weight stays the same

More energy IN than energy OUT over time = weight gain

More energy OUT than energy IN over time = weight loss

Overweight and obesity happen over time when you take in more calories than you use.

Other Causes

An Inactive Lifestyle

Many Americans aren't very physically active. One reason for this is that many people spend hours in front of TVs and computers doing work, schoolwork, and leisure activities. In fact, more than 2 hours a day of regular TV viewing time has been linked to overweight and obesity.

Other reasons for not being active include: relying on cars instead of walking, fewer physical demands at work or at home because of modern technology and conveniences, and lack of physical education classes in schools.

People who are inactive are more likely to gain weight because they don't burn the calories that they take in from food and drinks. An inactive lifestyle also raises your risk for coronary heart disease, high blood pressure, diabetes, colon cancer, and other health problems.

Environment

Our environment doesn't support healthy lifestyle habits; in fact, it encourages obesity. Some reasons include:

Lack of neighborhood sidewalks and safe places for recreation. Not having area parks, trails, sidewalks, and affordable gyms makes it hard for people to be physically active.

Work schedules. People often say that they don't have time to be physically active because of long work hours and time spent commuting.

Oversized food portions. Americans are exposed to huge food portions in restaurants, fast food places, gas stations, movie theaters, supermarkets, and even at home. Some of these meals and snacks can feed two or more people. Eating large portions means too much energy IN. Over time, this will cause weight gain if it isn't balanced with physical activity.

Lack of access to healthy foods. Some people don't live in neighborhoods that have supermarkets that sell healthy foods, such as fresh fruits and vegetables. Or, for some people, these healthy foods are too costly.

Food advertising. Americans are surrounded by ads from food companies. Often children are the targets of advertising for high-calorie, high-fat snacks and sugary drinks. The goal of these ads is to sway people to buy these high-calorie foods, and often they do.

Genes and Family History

Studies of identical twins who have been raised apart show that genes have a strong influence on a person's weight. Overweight and obesity tend to run in families. Your chances of being overweight are greater if one or both of your parents are overweight or obese.

Your genes also may affect the amount of fat you store in your body and where on your body you carry the extra fat. Because families also share food and physical activity habits, a link exists between genes and the environment.

Children adopt the habits of their parents. A child who has overweight parents who eat high-calorie foods and are inactive will likely become overweight too. However, if the family adopts healthy food and physical activity habits, the child's chance of being overweight or obese is reduced.

Health Conditions

Some hormone problems may cause overweight and obesity, such as underactive thyroid (hypothyroidism), Cushing's syndrome, and polycystic ovarian syndrome (PCOS).

Underactive thyroid is a condition in which the thyroid gland doesn't make enough thyroid hormone. Lack of thyroid hormone will slow down your metabolism and cause weight gain. You'll also feel tired and weak.

Cushing's syndrome is a condition in which the body's adrenal glands make too much of the hormone cortisol. Cushing's syndrome also can develop if a person takes high doses of certain medicines, such as prednisone, for long periods.

People who have Cushing's syndrome gain weight, have upper-body obesity, a rounded face, fat around the neck, and thin arms and legs.

PCOS is a condition that affects about 510 percent of women of childbearing age. Women who have PCOS often are obese, have excess hair growth, and have reproductive problems and other health issues. These problems are caused by high levels of hormones called androgens.

Medicines

Certain medicines may cause you to gain weight. These medicines include some corticosteroids, antidepressants, and seizure medicines.

These medicines can slow the rate at which your body burns calories, increase your appetite, or cause your body to hold on to extra water. All of these factors can lead to weight gain.

Emotional Factors

Some people eat more than usual when they're bored, angry, or stressed. Over time, overeating will lead to weight gain and may cause overweight or obesity.

Smoking

Some people gain weight when they stop smoking. One reason is that food often tastes and smells better after quitting smoking.

Another reason is because nicotine raises the rate at which your body burns calories, so you burn fewer calories when you stop smoking. However, smoking is a serious health risk, and quitting is more important than possible weight gain.

Age

As you get older, you tend to lose muscle, especially if you're less active. Muscle loss can slow down the rate at which your body burns calories. If you don't reduce your calorie intake as you get older, you may gain weight.

Midlife weight gain in women is mainly due to aging and lifestyle, but menopause also plays a role. Many women gain about 5 pounds during menopause and have more fat around the waist than they did before.

Pregnancy

During pregnancy, women gain weight to support their babies growth and development. After giving birth, some women find it hard to lose the weight. This may lead to overweight or obesity, especially after a few pregnancies.

Lack of Sleep

Research shows that lack of sleep increases the risk of obesity. For example, one study of teenagers showed that with each hour of sleep lost, the odds of becoming obese went up. Lack of sleep increases the risk of obesity in other age groups as well.

People who sleep fewer hours also seem to prefer eating foods that are higher in calories and carbohydrates, which can lead to overeating, weight gain, and obesity.

Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or full (leptin). When you don't get enough sleep, your level of ghrelin goes up and your level of leptin goes down. This makes you feel hungrier than when you're well-rested.

Sleep also affects how your body reacts to insulin, the hormone that controls your blood glucose (sugar) level. Lack of sleep results in a higher than normal blood sugar level, which may increase your risk for diabetes.

For more information, go to the Health Topics Sleep Deprivation and Deficiency article. </s>


Input: Who is at risk for Overweight and Obesity? ?

Output:
Being overweight or obese isn't a cosmetic problem. These conditions greatly raise your risk for other health problems.

Overweight and Obesity-Related Health Problems in Adults

Coronary Heart Disease

As your body mass index rises, so does your risk for coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

Plaque can narrow or block the coronary arteries and reduce blood flow to the heart muscle. This can cause angina (an-JI-nuh or AN-juh-nuh) or a heart attack. (Angina is chest pain or discomfort.)

Obesity also can lead to heart failure. This is a serious condition in which your heart can't pump enough blood to meet your body's needs.

High Blood Pressure

Blood pressure is the force of blood pushing against the walls of the arteries as theheart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Your chances of having high blood pressure are greater if you're overweight or obese.

Stroke

Being overweight or obese can lead to a buildup of plaque in your arteries. Eventually, an area of plaque can rupture, causing a blood clot to form.

If the clot is close to your brain, it can block the flow of blood and oxygen to your brain and cause a stroke. The risk of having a stroke rises as BMI increases.

Type 2 Diabetes

Diabetes is a disease in which the body's blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.

In type 2 diabetes, the body's cells don't use insulin properly. At first, the body reacts by making more insulin. Over time, however, the body can't make enough insulin to control its blood sugar level.

Diabetes is a leading cause of early death, CHD, stroke, kidney disease, and blindness. Most people who have type 2 diabetes are overweight.

Abnormal Blood Fats

If you're overweight or obese, you're at increased risk of having abnormal levels of blood fats. These include high levels of triglycerides and LDL ("bad") cholesterol and low levels of HDL ("good") cholesterol.

Abnormal levels of these blood fats are a risk factor for CHD. For more information about triglycerides and LDL and HDL cholesterol, go to the Health Topics High Blood Cholesterol article.

Metabolic Syndrome

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.

You can develop any one of these risk factors by itself, but they tend to occur together. A diagnosis of metabolic syndrome is made if you have at least three of the following risk factors:

A large waistline. This is called abdominal obesity or "having an apple shape." Having extra fat in the waist area is a greater risk factor for CHD than having extra fat in other parts of the body, such as on the hips.

A higher than normal triglyceride level (or you're on medicine to treat high triglycerides).

A lower than normal HDL cholesterol level (or you're on medicine to treat low HDL cholesterol).

Higher than normal blood pressure (or you're on medicine to treat high blood pressure).

Higher than normal fasting blood sugar (or you're on medicine to treat diabetes).

Cancer

Being overweight or obese raises your risk for colon, breast, endometrial, and gallbladder cancers.

Osteoarthritis

Osteoarthritis is a common joint problem of the knees, hips, and lower back. The condition occurs if the tissue that protects the joints wears away. Extra weight can put more pressure and wear on joints, causing pain.

Sleep Apnea

Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

A person who has sleep apnea may have more fat stored around the neck. This can narrow the airway, making it hard to breathe.

Obesity Hypoventilation Syndrome

Obesity hypoventilation syndrome (OHS) is a breathing disorder that affects some obese people. In OHS, poor breathing results in too much carbon dioxide (hypoventilation) and too little oxygen in the blood (hypoxemia).

OHS can lead to serious health problems and may even cause death.

Reproductive Problems

Obesity can cause menstrual issues and infertility in women.

Gallstones

Gallstones are hard pieces of stone-like material that form in the gallbladder. They're mostly made of cholesterol. Gallstones can cause stomach or back pain.

People who are overweight or obese are at increased risk of having gallstones. Also, being overweight may result in an enlarged gallbladder that doesn't work well.

Overweight and Obesity-Related Health Problems in Children and Teens

Overweight and obesity also increase the health risks for children and teens. Type2 diabetes once was rare in American children, but an increasing number of children are developing the disease.

Also, overweight children are more likely to become overweight or obese as adults, with the same disease risks. </s>


Input: Who is at risk for Overweight and Obesity? ?

Output:
Overweight and obesity affect Americans of all ages, sexes, and racial/ethnic groups. This serious health problem has been growing over the last 30 years.

Adults

According to the National Health and Nutrition Examination Survey (NHANES) 20092010, almost 70 percent of Americans are overweight or obese. The survey also shows differences in overweight and obesity among racial/ethnic groups.

In women, overweight and obesity are highest among non-Hispanic Black women (about 82percent), compared with about 76 percent for Hispanic women and 64 percent for non-Hispanic White women.

In men, overweight and obesity are highest among Hispanic men (about 82percent), compared with about 74 percent for non-Hispanic White men and about 70 percent for non-Hispanic Black men.

Children and Teens

Children also have become heavier. In the past 30 years, obesity has tripled among school-aged children and teens.

According to NHANES 20092010, about 1 in 6 American children ages 219 are obese. The survey also suggests that overweight and obesity are having a greater effect on minority groups, including Blacks and Hispanics. </s>


Input: What are the symptoms of Overweight and Obesity ?

Output:
Weight gain usually happens over time. Most people know when they've gained weight. Some of the signs of overweight or obesity include:

Clothes feeling tight and needing a larger size.

The scale showing that you've gained weight.

Having extra fat around the waist.

A higher than normal body mass index and waist circumference. (For more information, go to "How Are Overweight and Obesity Diagnosed?") </s>


Input: How to diagnose Overweight and Obesity ?

Output:
The most common way to find out whether you're overweight or obese is to figure out your body mass index (BMI). BMI is an estimate of body fat, and it's a good gauge of your risk for diseases that occur with more body fat.

BMI is calculated from your height and weight. You can use the chart below or the National Heart, Lung, and Blood Institute's (NHLBI's) online BMI calculator to figure out your BMI. Or, you health care provider can measure your BMI.

Body Mass Index for Adults

Use this table to learn your BMI. First, find your height on the far left column. Next, move across the row to find your weight. Weight is measured with underwear but no shoes.

Once you've found your weight, move to the very top of that column. This number is your BMI.

This table offers a sample of BMI measurements. If you don't see your height and/or weight listed on this table, go the NHLBI's complete Body Mass Index Table.

What Does Body Mass Index Mean?

Although BMI can be used for most men and women, it does have some limits. It may overestimate body fat in athletes and others who have a muscular build. BMI also may underestimate body fat in older people and others who have lost muscle.

Body Mass Index for Children and Teens

Overweight are obesity are defined differently for children and teens than for adults. Children are still growing, and boys and girls mature at different rates.

BMIs for children and teens compare their heights and weights against growth charts that take age and sex into account. This is called BMI-for-age percentile. A child or teen's BMI-for-age percentile shows how his or her BMI compares with other boys and girls of the same age.

For more information about BMI-for-age and growth charts for children, go to the Centers for Disease Control and Prevention's BMI-for-age calculator.

What Does the BMI-for-Age Percentile Mean?

Waist Circumference

Health care professionals also may take your waist measurement. This helps screen for the possible health risks related to overweight and obesity in adults.

If you have abdominal obesity and most of your fat is around your waist rather than at your hips, you're at increased risk for coronary heart disease and type 2 diabetes. The risk goes up with a waist size that's greater than 35 inches for women or greater than 40inches for men.

You also can measure your waist size. To do so correctly, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.

Specialists Involved

A primary care doctor (or pediatrician for children and teens) will assess your BMI, waist measurement, and overall health risk. If you're overweight or obese, or if you have a large waist size, your doctor should explain the health risks and find out whether you're interested and willing to lose weight.

If you are, you and your doctor can work together to create a treatment plan. The plan may include weight-loss goals and treatment options that are realistic for you.

Your doctor may send you to other health care specialists if you need expert care. These specialists may include:

An endocrinologist if you need to be treated for type 2 diabetes or a hormone problem, such as an underactive thyroid.

A registered dietitian or nutritionist to work with you on ways to change your eating habits.

An exercise physiologist or trainer to figure out your level of fitness and show you how to do physical activities suitable for you.

A bariatric surgeon if weight-loss surgery is an option for you.

A psychiatrist, psychologist, or clinical social worker to help treat depression or stress. </s>


Input: What are the treatments for Overweight and Obesity ?

Output:
Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren't enough.

Set Realistic Goals

Setting realistic weight-loss goals is an important first step to losing weight.

For Adults

Try to lose 5 to 10 percent of your current weight over 6 months. This will lower your risk for coronary heart disease (CHD) and other conditions.

The best way to lose weight is slowly. A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. It also will give you the time to make new, healthy lifestyle changes.

If you've lost 10 percent of your body weight, have kept it off for 6 months, and are still overweight or obese, you may want to consider further weight loss.

For Children and Teens

If your child is overweight or at risk for overweight or obesity, the goal is to maintain his or her current weight and to focus on eating healthy and being physically active. This should be part of a family effort to make lifestyle changes.

If your child is overweight or obese and has a health condition related to overweight or obesity, your doctor may refer you to a pediatric obesity treatment center.

Lifestyle Changes

Lifestyle changes can help you and your family achieve long-term weight-loss success. Example of lifestyle changes include:

Focusing on balancing energy IN (calories from food and drinks) with energy OUT (physical activity)

Following a healthy eating plan

Learning how to adopt healthy lifestyle habits

Over time, these changes will become part of your everyday life.

Calories

Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2pounds a week, adults should cut back their calorie intake by 500 to 1,000calories a day.

In general, having 1,000 to 1,200 calories a day will help most women lose weight safely.

In general, having 1,200 to 1,600 calories a day will help most men lose weight safely. This calorie range also is suitable for women who weigh 165pounds or more or who exercise routinely.

These calorie levels are a guide and may need to be adjusted. If you eat 1,600calories a day but don't lose weight, then you may want to cut back to 1,200calories. If you're hungry on either diet, then you may want to add 100 to 200calories a day.

Very low-calorie diets with fewer than 800 calories a day shouldn't be used unless your doctor is monitoring you.

For overweight children and teens, it's important to slow the rate of weight gain. However, reduced-calorie diets aren't advised unless you talk with a health care provider.

Healthy Eating Plan

A healthy eating plan gives your body the nutrients it needs every day. It has enough calories for good health, but not so many that you gain weight.

A healthy eating plan is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar. Following a healthy eating plan will lower your risk for heart disease and other conditions.

Healthy foods include:

Fat-free and low-fat dairy products, such as low-fat yogurt, cheese, and milk.

Protein foods, such as lean meat, fish, poultry without skin, beans, and peas.

Whole-grain foods, such as whole-wheat bread, oatmeal, and brown rice. Other grain foods include pasta, cereal, bagels, bread, tortillas, couscous, and crackers.

Fruits, which can be fresh, canned, frozen, or dried.

Vegetables, which can be fresh, canned (without salt), frozen, or dried.

Canola and olive oils, and soft margarines made from these oils, are heart healthy. However, you should use them in small amounts because they're high in calories.

You also can include unsalted nuts, like walnuts and almonds, in your diet as long as you limit the amount you eat (nuts also are high in calories).

The National Heart, Lung, and Blood Institute's "Aim for a Healthy Weight" patient booklet provides more information about following a healthy eating plan.

Foods to limit. Foods that are high in saturated and trans fats and cholesterol raise blood cholesterol levels and also might be high in calories. Fats and cholesterol raise your risk for heart disease, so they should be limited.

Saturated fat is found mainly in:

Fatty cuts of meat, such as ground beef, sausage, and processed meats (for example, bologna, hot dogs, and deli meats)

Poultry with the skin

High-fat dairy products like whole-milk cheeses, whole milk, cream, butter, and ice cream

Lard, coconut, and palm oils, which are found in many processed foods

Trans fat is found mainly in:

Foods with partially hydrogenated oils, such as many hard margarines and shortening

Baked products and snack foods, such as crackers, cookies, doughnuts, and breads

Foods fried in hydrogenated shortening, such as french fries and chicken

Cholesterol mainly is found in:

Egg yolks

Organ meats, such as liver

Shrimp

Whole milk or whole-milk products, such as butter, cream, and cheese

Limiting foods and drinks with added sugars, like high-fructose corn syrup, is important. Added sugars will give you extra calories without nutrients like vitamins and minerals. Added sugars are found in many desserts, canned fruit packed in syrup, fruit drinks, and nondiet drinks.

Check the list of ingredients on food packages for added sugars like high-fructose corn syrup. Drinks that contain alcohol also will add calories, so it's a good idea to limit your alcohol intake.

Portion size. A portion is the amount of food that you choose to eat for a meal or snack. It's different from a serving, which is a measured amount of food and is noted on the Nutrition Facts label on food packages.

Anyone who has eaten out lately is likely to notice how big the portions are. In fact, over the past 40 years, portion sizes have grown significantly. These growing portion sizes have changed what we think of as a normal portion.

Cutting back on portion size is a good way to eat fewer calories and balance your energy IN.

Food weight. Studies have shown that we all tend to eat a constant "weight" of food. Ounce for ounce, our food intake is fairly consistent. Knowing this, you can lose weight if you eat foods that are lower in calories and fat for a given amount of food.

For example, replacing a full-fat food product that weighs 2 ounces with a low-fat product that weighs the same helps you cut back on calories. Another helpful practice is to eat foods that contain a lot of water, such as vegetables, fruits, and soups.

Physical Activity

Being physically active and eating fewer calories will help you lose weight and keep weight off over time. Physical activity also will benefit you in other ways. It will:

Lower your risk for heart disease, heart attack, diabetes, and cancers (such as breast, uterine, and colon cancers)

Strengthen your heart and help your lungs work better

Strengthen your muscles and keep your joints in good condition

Slow bone loss

Give you more energy

Help you relax and better cope with stress

Allow you to fall asleep more quickly and sleep more soundly

Give you an enjoyable way to share time with friends and family

The four main types of physical activity are aerobic, muscle-strengthening, bone strengthening, and stretching. You can do physical activity with light, moderate, or vigorous intensity. The level of intensity depends on how hard you have to work to do the activity.

People vary in the amount of physical activity they need to control their weight. Many people can maintain their weight by doing 150 to 300 minutes (2 hours and 30 minutes to 5 hours) of moderate-intensity activity per week, such as brisk walking.

People who want to lose a large amount of weight (more than 5 percent of their body weight) may need to do more than 300 minutes of moderate-intensity activity per week. This also may be true for people who want to keep off weight that they've lost.

You don't have to do the activity all at once. You can break it up into short periods of at least 10 minutes each.

If you have a heart problem or chronic disease, such as heart disease, diabetes, or high blood pressure, talk with your doctor about what types of physical activity are safe for you. You also should talk with your doctor about safe physical activities if you have symptoms such as chest pain or dizziness.

Children should get at least 60 minutes or more of physical activity every day. Most physical activity should be moderate-intensity aerobic activity. Activity should vary and be a good fit for the child's age and physical development.

Many people lead inactive lives and might not be motivated to do more physical activity. When starting a physical activity program, some people may need help and supervision to avoid injury.

If you're obese, or if you haven't been active in the past, start physical activity slowly and build up the intensity a little at a time.

When starting out, one way to be active is to do more everyday activities, such as taking the stairs instead of the elevator and doing household chores and yard work. The next step is to start walking, biking, or swimming at a slow pace, and then build up the amount of time you exercise or the intensity level of the activity.

To lose weight and gain better health, it's important to get moderate-intensity physical activity. Choose activities that you enjoy and that fit into your daily life.

A daily, brisk walk is an easy way to be more active and improve your health. Use a pedometer to count your daily steps and keep track of how much you're walking. Try to increase the number of steps you take each day. Other examples of moderate-intensity physical activity include dancing, gardening, and water aerobics.

For greater health benefits, try to step up your level of activity or the length of time you're active. For example, start walking for 10 to 15 minutes three times a week, and then build up to brisk walking for 60 minutes, 5 days a week.

For more information about physical activity, go to the Department of Health and Human Services "2008 Physical Activity Guidelines for Americans" and the Health Topics Physical Activity and Your Heart article.

Behavioral Changes

Changing your behaviors or habits related to food and physical activity is important for losing weight. The first step is to understand which habits lead you to overeat or have an inactive lifestyle. The next step is to change these habits.

Below are some simple tips to help you adopt healthier habits.

Change your surroundings. You might be more likely to overeat when watching TV, when treats are available at work, or when you're with a certain friend. You also might find it hard to motivate yourself to be physically active. However, you can change these habits.

Instead of watching TV, dance to music in your living room or go for a walk.

Leave the office break room right after you get a cup of coffee.

Bring a change of clothes to work. Head straight to an exercise class on the way home from work.

Put a note on your calendar to remind yourself to take a walk or go to your exercise class.

Keep a record. A record of your food intake and the amount of physical activity that you do each day will help inspire you. You also can keep track of your weight. For example, when the record shows that you've been meeting your physical activity goals, you'll want to keep it up. A record also is an easy way to track how you're doing, especially if you're working with a registered dietitian or nutritionist.

Seek support. Ask for help or encouragement from your friends, family, and health care provider. You can get support in person, through e-mail, or by talking on the phone. You also can join a support group.

Reward success. Reward your success for meeting your weight-loss goals or other achievements with something you would like to do, not with food. Choose rewards that you'll enjoy, such as a movie, music CD, an afternoon off from work, a massage, or personal time.

Weight-Loss Medicines

Weight-loss medicines approved by the Food and Drug Administration (FDA) might be an option for some people.

If you're not successful at losing 1 pound a week after 6months of using lifestyle changes, medicines may help. You should only use medicines as part of a program that includes diet, physical activity, and behavioral changes.

Weight-loss medicines might be suitable for adults who are obese (a BMI of 30 or greater). People who have BMIs of 27 or greater, and who are at risk for heart disease and other health conditions, also may benefit from weight-loss medicines.

Sibutramine (Meridia)

As of October 2010, the weight-loss medicine sibutramine (Meridia) was taken off the market in the United States. Research showed that the medicine may raise the risk of heart attack and stroke.

Orlistat (Xenical and Alli)

Orlistat (Xenical) causes a weight loss between 5 and 10 pounds, although some people lose more weight. Most of the weight loss occurs within the first 6 months of taking the medicine.

People taking Xenical need regular checkups with their doctors, especially during the first year of taking the medicine. During checkups, your doctor will check your weight, blood pressure, and pulse and may recommend other tests. He or she also will talk with you about any medicine side effects and answer your questions.

The FDA also has approved Alli, an over-the-counter (OTC) weight-loss aid for adults. Alli is the lower dose form of orlistat. Alli is meant to be used along with a reduced-calorie, low-fat diet and physical activity. In studies, most people taking Alli lost 5 to 10pounds over 6 months.

Both Xenical and Alli reduce the absorption of fats, fat calories, and vitamins A, D, E, and K to promote weight loss. Both medicines also can cause mild side effects, such as oily and loose stools.

Although rare, some reports of liver disease have occurred with the use of orlistat. More research is needed to find out whether the medicine plays a role in causing liver disease. Talk with your doctor if youre considering using Xenical or Alli to lose weight. He or she can discuss the risks and benefits with you.

You also should talk with your doctor before starting orlistat if youre taking blood-thinning medicines or being treated for diabetes or thyroid disease. Also, ask your doctor whether you should take a multivitamin due to the possible loss of some vitamins.

Lorcaserin Hydrochloride (Belviq) and Qsymia

In July 2012, the FDA approved two new medicines for chronic (ongoing) weight management. Lorcaserin hydrochloride (Belviq) and Qsymia are approved for adults who have a BMI of 30 or greater. (Qsymia is a combination of two FDA-approved medicines: phentermine and topiramate.)

These medicines also are approved for adults with a BMI of 27 or greater who have at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high blood cholesterol.

Both medicines are meant to be used along with a reduced-calorie diet and physical activity.

Other Medicines

Some prescription medicines are used for weight loss, but aren't FDA-approved for treating obesity. They include:

Medicines to treat depression. Some medicines for depression cause an initial weight loss and then a regain of weight while taking the medicine.

Medicines to treat seizures. Two medicines used for seizures, topiramate and zonisamide, have been shown to cause weight loss. These medicines are being studied to see whether they will be useful in treating obesity.

Medicines to treat diabetes. Metformin may cause small amounts of weight loss in people who have obesity and diabetes. It's not known how this medicine causes weight loss, but it has been shown to reduce hunger and food intake.

Over-the-Counter Products

Some OTC products claim to promote weight loss. The FDA doesn't regulate these products because they're considered dietary supplements, not medicines.

However, many of these products have serious side effects and generally aren't recommended. Some of these OTC products include:

Ephedra (also called ma huang). Ephedra comes from plants and has been sold as a dietary supplement. The active ingredient in the plant is called ephedrine. Ephedra can cause short-term weight loss, but it also has serious side effects. It causes high blood pressure and stresses the heart. In 2004, the FDA banned the sale of dietary supplements containing ephedra in the United States.

Chromium. This is a mineral that's sold as a dietary supplement to reduce body fat. While studies haven't found any weight-loss benefit from chromium, there are few serious side effects from taking it.

Diuretics and herbal laxatives. These products cause you to lose water weight, not fat. They also can lower your body's potassium levels, which may cause heart and muscle problems.

Hoodia. Hoodia is a cactus that's native to Africa. It's sold in pill form as an appetite suppressant. However, no firm evidence shows that hoodia works. No large-scale research has been done on humans to show whether hoodia is effective or safe.

Weight-Loss Surgery

Weight-loss surgery might be an option for people who have extreme obesity (BMI of 40 or more) when other treatments have failed.

Weight-loss surgery also is an option for people who have a BMI of 35 or more and life-threatening conditions, such as:

Severe sleep apnea (a condition in which you have one or more pauses in breathing or shallow breaths while you sleep)

Obesity-related cardiomyopathy (KAR-de-o-mi-OP-ah-thee; diseases of the heart muscle)

Severe type 2 diabetes

Types of Weight-Loss Surgery

Two common weight-loss surgeries include banded gastroplasty and Roux-en-Y gastric bypass. For gastroplasty, a band or staples are used to create a small pouch at the top of your stomach. This surgery limits the amount of food and liquids the stomach can hold.

For gastric bypass, a small stomach pouch is created with a bypass around part of the small intestine where most of the calories you eat are absorbed. This surgery limits food intake and reduces the calories your body absorbs.

Weight-loss surgery can improve your health and weight. However, the surgery can be risky, depending on your overall health. Gastroplasty has few long-term side effects, but you must limit your food intake dramatically.

Gastric bypass has more side effects. They include nausea (feeling sick to your stomach), bloating, diarrhea, and faintness. These side effects are all part of a condition called dumping syndrome. After gastric bypass, you may need multivitamins and minerals to prevent nutrient deficiencies.

Lifelong medical followup is needed after both surgeries. Your doctor also may recommend a program both before and after surgery to help you with diet, physical activity, and coping skills.

If you think you would benefit from weight-loss surgery, talk with your doctor. Ask whether you're a candidate for the surgery and discuss the risks, benefits, and what to expect.

Weight-Loss Maintenance

Maintaining your weight loss over time can be a challenge. For adults, weight loss is a success if you lose at least 10 percent of your initial weight and you don't regain more than 6 or 7 pounds in 2 years. You also must keep a lower waist circumference (at least 2 inches lower than your waist circumference before you lost weight).

After 6 months of keeping off the weight, you can think about losing more if:

You've already lost 5 to 10 percent of your body weight

You're still overweight or obese

The key to losing more weight or maintaining your weight loss is to continue with lifestyle changes. Adopt these changes as a new way of life.

If you want to lose more weight, you may need to eat fewer calories and increase your activity level. For example, if you eat 1,600 calories a day but don't lose weight, you may want to cut back to 1,200 calories. It's also important to make physical activity part of your normal daily routine. </s>


Input: How to prevent Overweight and Obesity ?

Output:
Following a healthy lifestyle can help you prevent overweight and obesity. Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make healthy choices, such as following a healthy diet and being physically active.

Make following a healthy lifestyle a family goal. For example:

Follow a healthy eating plan. Make healthy food choices, keep your calorie needs and your family's calorie needs in mind, and focus on the balance of energy IN and energy OUT.

Focus on portion size. Watch the portion sizes in fast food and other restaurants. The portions served often are enough for two or three people. Children's portion sizes should be smaller than those for adults. Cutting back on portion size will help you balance energy IN and energy OUT.

Be active. Make personal and family time active. Find activities that everyone will enjoy. For example, go for a brisk walk, bike or rollerblade, or train together for a walk or run.

Reduce screen time. Limit the use of TVs, computers, DVDs, and videogames because they limit time for physical activity. Health experts recommend 2hours or less a day of screen time that's not work- or homework-related.

Keep track of your weight, body mass index, and waist circumference. Also, keep track of your children's growth.

Led by the National Heart, Lung, and Blood Institute, four Institutes from the National Institutes of Health have come together to promote We Can!Ways to Enhance Children's Activity & Nutrition.

We Can! is a national education program designed for parents and caregivers to help children 8 to 13 years old maintain a healthy weight. The evidence-based program offers parents and families tips and fun activities to encourage healthy eating, increase physical activity, and reduce time spent being inactive.

Currently, more than 140 community groups around the country are participating in We Can! programs for parents and youth. These community groups include hospitals, health departments, clinics, faith-based organizations, YMCAs, schools, and more.

____________

We Can! is a registered trademark of the U.S. Department of Health and Human Services. </s>


Input: What is (are) Cardiogenic Shock ?

Output:
Cardiogenic (kar-dee-oh-JE-nik) shock is a condition in which a suddenly weakened heart isn't able to pump enough blood to meet the body's needs. The condition is a medical emergency and is fatal if not treated right away.

The most common cause of cardiogenic shock is damage to the heart muscle from a severe heart attack. However, not everyone who has a heart attack has cardiogenic shock. In fact, on average, only about 7 percent of people who have heart attacks develop the condition.

If cardiogenic shock does occur, it's very dangerous. When people die from heart attacks in hospitals, cardiogenic shock is the most common cause of death.

What Is Shock?

The medical term "shock" refers to a state in which not enough blood and oxygen reach important organs in the body, such as the brain and kidneys. Shock causes very low blood pressure and may be life threatening.

Shock can have many causes. Cardiogenic shock is only one type of shock. Other types of shock include hypovolemic (hy-po-vo-LEE-mik) shock and vasodilatory (VAZ-oh-DILE-ah-tor-e) shock.

Hypovolemic shock is a condition in which the heart cant pump enough blood to the body because of severe blood loss.

In vasodilatory shock, the blood vessels suddenly relax. When the blood vessels are too relaxed, blood pressure drops and blood flow becomes very low. Without enough blood pressure, blood and oxygen dont reach the bodys organs.

A bacterial infection in the bloodstream, a severe allergic reaction, or damage to the nervous system (brain and nerves) may cause vasodilatory shock.

When a person is in shock (from any cause), not enough blood and oxygen are reaching the body's organs. If shock lasts more than a few minutes, the lack of oxygen starts to damage the bodys organs. If shock isn't treated quickly, it can cause permanent organ damage or death.

Some of the signs and symptoms of shock include:

Confusion or lack of alertness

Loss of consciousness

A sudden and ongoing rapid heartbeat

Sweating

Pale skin

A weak pulse

Rapid breathing

Decreased or no urine output

Cool hands and feet

If you think that you or someone else is in shock, call 911 right away for emergency treatment. Prompt medical care can save your life and prevent or limit damage to your bodys organs.

Outlook

In the past, almost no one survived cardiogenic shock. Now, about half of the people who go into cardiogenic shock survive. This is because of prompt recognition of symptoms and improved treatments, such as medicines and devices. These treatments can restore blood flow to the heart and help the heart pump better.

In some cases, devices that take over the pumping function of the heart are used. Implanting these devices requires major surgery. </s>


Input: What causes Cardiogenic Shock ?

Output:
Immediate Causes

Cardiogenic shock occurs if the heart suddenly can't pump enough oxygen-rich blood to the body. The most common cause of cardiogenic shock is damage to the heart muscle from a severe heart attack.

This damage prevents the hearts main pumping chamber, the left ventricle (VEN-trih-kul), from working well. As a result, the heart can't pump enough oxygen-rich blood to the rest of the body.

In about 3 percent of cardiogenic shock cases, the hearts lower right chamber, the right ventricle, doesnt work well. This means the heart can't properly pump blood to the lungs, where it picks up oxygen to bring back to the heart and the rest of the body.

Without enough oxygen-rich blood reaching the bodys major organs, many problems can occur. For example:

Cardiogenic shock can cause death if the flow of oxygen-rich blood to the organs isn't restored quickly. This is why emergency medical treatment is required.

If organs don't get enough oxygen-rich blood, they won't work well. Cells in the organs die, and the organs may never work well again.

As some organs stop working, they may cause problems with other bodily functions. This, in turn, can worsen shock. For example:   - If the kidneys aren't working well, the levels of important chemicals in the body change. This may cause the heart and other muscles to become even weaker, limiting blood flow even more.   - If the liver isn't working well, the body stops making proteins that help the blood clot. This can lead to more bleeding if the shock is due to blood loss.

If the kidneys aren't working well, the levels of important chemicals in the body change. This may cause the heart and other muscles to become even weaker, limiting blood flow even more.

If the liver isn't working well, the body stops making proteins that help the blood clot. This can lead to more bleeding if the shock is due to blood loss.

How well the brain, kidneys, and other organs recover will depend on how long a person is in shock. The less time a person is in shock, the less damage will occur to the organs. This is another reason why emergency treatment is so important.

Underlying Causes

The underlying causes of cardiogenic shock are conditions that weaken the heart and prevent it from pumping enough oxygen-rich blood to the body.

Heart Attack

Most heart attacks occur as a result of coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque (plak) narrows or blocks the coronary (heart) arteries.

Plaque reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow.

Conditions Caused by Heart Attack

Heart attacks can cause some serious heart conditions that can lead to cardiogenic shock. One example is ventricular septal rupture. This condition occurs if the wall that separates the ventricles (the hearts two lower chambers) breaks down.

The breakdown happens because cells in the wall have died due to a heart attack. Without the wall to separate them, the ventricles cant pump properly.

Heart attacks also can cause papillary muscle infarction or rupture. This condition occurs if the muscles that help anchor the heart valves stop working or break because a heart attack cuts off their blood supply. If this happens, blood doesn't flow correctly between the hearts chambers. This prevents the heart from pumping properly.

Other Heart Conditions

Serious heart conditions that may occur with or without a heart attack can cause cardiogenic shock. Examples include:

Myocarditis (MI-o-kar-DI-tis). This is inflammation of the heart muscle.

Endocarditis (EN-do-kar-DI-tis). This is an infection of the inner lining of the heart chambers and valves.

Life-threatening arrhythmias (ah-RITH-me-ahs). These are problems with the rate or rhythm of the heartbeat.

Pericardial tamponade (per-ih-KAR-de-al tam-po-NADE). This is too much fluid or blood around the heart. The fluid squeezes the heart muscle so it can't pump properly.

Pulmonary Embolism

Pulmonary embolism (PE) is a sudden blockage in a lung artery. This condition usually is caused by a blood clot that travels to the lung from a vein in the leg. PE can damage your heart and other organs in your body. </s>


Input: Who is at risk for Cardiogenic Shock? ?

Output:
The most common risk factor for cardiogenic shock is having a heart attack. If you've had a heart attack, the following factors can further increase your risk for cardiogenic shock:

Older age

A history of heart attacks or heart failure

Coronary heart disease that affects all of the hearts major blood vessels

High blood pressure

Diabetes

Women who have heart attacks are at higher risk for cardiogenic shock than men who have heart attacks. </s>


Input: What are the symptoms of Cardiogenic Shock ?

Output:
A lack of oxygen-rich blood reaching the brain, kidneys, skin, and other parts of the body causes the signs and symptoms of cardiogenic shock.

Some of the typical signs and symptoms of shock usually include at least two or more of the following:

Confusion or lack of alertness

Loss of consciousness

A sudden and ongoing rapid heartbeat

Sweating

Pale skin

A weak pulse

Rapid breathing

Decreased or no urine output

Cool hands and feet

Any of these alone is unlikely to be a sign or symptom of shock.

If you or someone else is having these signs and symptoms, call 911 right away for emergency treatment. Prompt medical care can save your life and prevent or limit organ damage. </s>