Input: What are the treatments for Bronchopulmonary Dysplasia ?

Output:
Preventive Measures

If your doctor thinks you're going to give birth too early, he or she may give you injections of a corticosteroid medicine.

The medicine can speed up surfactant production in your baby. Surfactant is a liquid that coats the inside of the lungs. It helps keep the lungs open so your infant can breathe in air once he or she is born.

Corticosteroids also can help your baby's lungs, brain, and kidneys develop more quickly while he or she is in the womb.

Premature babies who have very low birth weights also might be given corticosteroids within the first few days of birth. Doctors sometimes prescribe inhaled nitric oxide shortly after birth for babies who have very low birth weights. This treatment can help improve the babies' lung function.

These preventive measures may help reduce infants' risk of respiratory distress syndrome (RDS), which can lead to BPD.

Treatment for Respiratory Distress Syndrome

The goals of treating infants who have RDS include:

Reducing further injury to the lungs

Providing nutrition and other support to help the lungs grow and recover

Preventing lung infections by giving antibiotics

Treatment of RDS usually begins as soon as an infant is born, sometimes in the delivery room. Most infants who have signs of RDS are quickly moved to a neonatal intensive care unit (NICU). They receive around-the-clock treatment from health care professionals who specialize in treating premature infants.

Treatments for RDS include surfactant replacement therapy, breathing support with nasal continuous positive airway pressure (NCPAP) or a ventilator, oxygen therapy (oxygen given through nasal prongs, a mask, or a breathing tube), and medicines to treat fluid buildup in the lungs.

For more information about RDS treatments, go to the Health Topics Respiratory Distress Syndrome article.

Treatment for Bronchopulmonary Dysplasia

Treatment in the NICU is designed to limit stress on infants and meet their basic needs of warmth, nutrition, and protection. Once doctors diagnose BPD, some or all of the treatments used for RDS will continue in the NICU.

Such treatment usually includes:

Using radiant warmers or incubators to keep infants warm and reduce the risk of infection.

Ongoing monitoring of blood pressure, heart rate, breathing, and temperature through sensors taped to the babies' bodies.

Using sensors on fingers or toes to check the amount of oxygen in the infants' blood.

Giving fluids and nutrients through needles or tubes inserted into the infants' veins. This helps prevent malnutrition and promotes growth. Nutrition is vital to the growth and development of the lungs. Later, babies may be given breast milk or infant formula through feeding tubes that are passed through their noses or mouths and into their throats.

Checking fluid intake to make sure that fluid doesn't build up in the babies' lungs.

As BPD improves, babies are slowly weaned off NCPAP or ventilators until they can breathe on their own. These infants will likely need oxygen therapy for some time.

If your infant has moderate or severe BPD, echocardiography might be done every few weeks to months to check his or her pulmonary artery pressure.

If your child needs long-term ventilator support, he or she will likely get a tracheostomy (TRA-ke-OS-toe-me). A tracheostomy is a surgically made hole. It goes through the front of the neck and into the trachea (TRA-ke-ah), or windpipe. Your child's doctor will put the breathing tube from the ventilator through the hole.

Using a tracheostomy instead of an endotracheal (en-do-TRA-ke-al) tube has some advantages. (An endotracheal tube is a breathing tube inserted through the nose or mouth and into the windpipe.)

Long-term use of an endotracheal tube can damage the trachea. This damage may need to be corrected with surgery later. A tracheostomy can allow your baby to interact more with you and the NICU staff, start talking, and develop other skills.

While your baby is in the NICU, he or she also may need physical therapy. Physical therapy can help strengthen your child's muscles and clear mucus out of his or her lungs.

Infants who have BPD may spend several weeks or months in the hospital. This allows them to get the care they need.

Before your baby goes home, learn as much as you can about your child's condition and how it's treated. Your baby may continue to have some breathing symptoms after he or she leaves the hospital.

Your child will likely continue on all or some of the treatments that were started at the hospital, including:

Medicines, such as bronchodilators, steroids, and diuretics.

Oxygen therapy or breathing support from NCPAP or a ventilator.

Extra nutrition and calories, which may be given through a feeding tube.

Preventive treatment with a medicine called palivizumab for severe respiratory syncytial virus (RSV). This common virus leads to mild, cold-like symptoms in adults and older, healthy children. However, in infantsespecially those in high-risk groupsRSV can lead to severe breathing problems.

Your child also should have regular checkups with and timely vaccinations from a pediatrician. This is a doctor who specializes in treating children. If your child needs oxygen therapy or a ventilator at home, a pulmonary specialist might be involved in his or her care.

Seek out support from family, friends, and hospital staff. Ask the case manager or social worker at the hospital about what you'll need after your baby leaves the hospital.

The doctors and nurses can assist with questions about your infant's care. Also, you may want to ask whether your community has a support group for parents of premature infants. </s>


Input: How to prevent Bronchopulmonary Dysplasia ?

Output:
Taking steps to ensure a healthy pregnancy might prevent your infant from being born before his or her lungs have fully developed. These steps include:

Seeing your doctor regularly during your pregnancy

Following a healthy diet

Not smoking and avoiding tobacco smoke, alcohol, and illegal drugs

Controlling any ongoing medical conditions you have

Preventing infection

If your doctor thinks that you're going to give birth too early, he or she may give you injections of a corticosteroid medicine.

The medicine can speed up surfactant production in your baby. Surfactant is a liquid that coats the inside of the lungs. It helps keep them open so your infant can breathe in air once he or she is born.

Usually, within about 24 hours of your taking this medicine, the baby's lungs start making enough surfactant. This will reduce the infant's risk of respiratory distress syndrome (RDS), which can lead to bronchopulmonary dysplasia (BPD).

Corticosteroids also can help your baby's lungs, brain, and kidneys develop more quickly while he or she is in the womb.

If your baby does develop RDS, it will probably be fairly mild. If the RDS isn't mild, BPD will likely develop. </s>


Input: What is (are) Cardiomyopathy ?

Output:
Cardiomyopathy refers to diseases of the heart muscle. These diseases have many causes, signs and symptoms, and treatments.

In cardiomyopathy, the heart muscle becomes enlarged, thick, or rigid. In rare cases, the muscle tissue in the heart is replaced with scar tissue.

As cardiomyopathy worsens, the heart becomes weaker. It's less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure or irregular heartbeats called arrhythmias. In turn, heart failure can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen.

The weakening of the heart also can cause other complications, such as heart valve problems.

Overview

The types of cardiomyopathy are:

Hypertrophic cardiomyopathy

Dilated cardiomyopathy

Restrictive cardiomyopathy

Arrhythmogenic right ventricular dysplasia

Unclassified cardiomyopathy

Cardiomyopathy can be acquired or inherited. "Acquired" means you aren't born with the disease, but you develop it due to another disease, condition, or factor. "Inherited" means your parents passed the gene for the disease on to you. Many times, the cause of cardiomyopathy isn't known.

Cardiomyopathy can affect people of all ages. However, people in certain age groups are more likely to have certain types of cardiomyopathy. This article focuses on cardiomyopathy in adults.

Outlook

Some people who have cardiomyopathy have no signs or symptoms and need no treatment. For other people, the disease develops quickly, symptoms are severe, and serious complications occur.

Treatments for cardiomyopathy include lifestyle changes, medicines, surgery, implanted devices to correct arrhythmias, and a nonsurgical procedure. These treatments can control symptoms, reduce complications, and stop the disease from getting worse. </s>


Input: What causes Cardiomyopathy ?

Output:
Cardiomyopathy can be acquired or inherited. Acquired means you arent born with the disease, but you develop it due to another disease, condition, or factor.

Inherited means your parents passed the gene for the disease on to you. Researchers continue to look for the genetic links to cardiomyopathy and to explore how these links cause or contribute to the various types of the disease.

Many times, the cause of cardiomyopathy isnt known. This often is the case when the disease occurs in children.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy usually is inherited. Its caused by a mutation or change in some of the genes in heart muscle proteins. Hypertrophic cardiomyopathy also can develop over time because of high blood pressure, aging, or other diseases, such as diabetes or thyroid disease. Sometimes the cause of the disease isnt known.

Dilated Cardiomyopathy

The cause of dilated cardiomyopathy often isnt known. About one-third of the people who have dilated cardiomyopathy inherit it from their parents.

Certain diseases, conditions, and substances also can cause the disease, such as:

Alcohol, especially if you also have a poor diet

Certain toxins, such as poisons and heavy metals

Complications during the last months of pregnancy

Coronary heart disease, heart attack, high blood pressure, diabetes, thyroid disease, viral hepatitis, and HIV

Illegal drugs, such as cocaine and amphetamines, and some medicines used to treat cancer

Infections, especially viral infections that inflame the heart muscle

Restrictive Cardiomyopathy

Certain diseases, conditions, and factors can cause restrictive cardiomyopathy, including:

Amyloidosis: A disease in which abnormal proteins build up in the bodys organs, including the heart

Connective tissue disorders

Hemochromatosis: A disease in which too much iron builds up in the body. The extra iron is toxic to the body and can damage the organs, including the heart.

Sarcoidosis: A disease that causes inflammation and can affect various organs in the body. Researchers believe that an abnormal immune response may cause sarcoidosis. This abnormal response causes tiny lumps of cells to form in the bodys organs, including the heart.

Some cancer treatments, such as radiation and chemotherapy

Arrhythmogenic Right Ventricular Dysplasia

Researchers think that arrhythmogenic right ventricular dysplasia is an inherited disease. </s>


Input: Who is at risk for Cardiomyopathy? ?

Output:
People of all ages and races can have cardiomyopathy. However, certain types of the disease are more common in certain groups.

Dilated cardiomyopathy is more common in African Americans than Whites. This type of the disease also is more common in men than women.

Teens and young adults are more likely than older people to have arrhythmogenic right ventricular dysplasia, although it's rare in both groups.

Major Risk Factors

Certain diseases, conditions, or factors can raise your risk for cardiomyopathy. Major risk factors include:

A family history of cardiomyopathy, heart failure, or sudden cardiac arrest (SCA)

A disease or condition that can lead to cardiomyopathy, such as coronary heart disease, heart attack, or a viral infection that inflames the heart muscle

Diabetes or other metabolic diseases, or severe obesity

Diseases that can damage the heart, such as hemochromatosis, sarcoidosis, or amyloidosis

Long-term alcoholism

Long-term high blood pressure

Some people who have cardiomyopathy never have signs or symptoms. Thus, it's important to identify people who may be at high risk for the disease. This can help prevent future problems, such as serious arrhythmias (irregular heartbeats) or SCA. </s>


Input: What are the symptoms of Cardiomyopathy ?

Output:
Some people who have cardiomyopathy never have signs or symptoms. Others don't have signs or symptoms in the early stages of the disease.

As cardiomyopathy worsens and the heart weakens, signs and symptoms of heart failure usually occur. These signs and symptoms include:

Shortness of breath or trouble breathing, especially with physical exertion

Fatigue (tiredness)

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

Other signs and symptoms may include dizziness; light-headedness; fainting during physical activity; arrhythmias (irregular heartbeats); chest pain, especially after physical exertion or heavy meals; and heart murmurs. (Heart murmurs are extra or unusual sounds heard during a heartbeat.) </s>


Input: How to diagnose Cardiomyopathy ?

Output:
Your doctor will diagnose cardiomyopathy based on your medical and family histories, a physical exam, and the results from tests and procedures.

Specialists Involved

Often, a cardiologist or pediatric cardiologist diagnoses and treats cardiomyopathy. A cardiologist specializes in diagnosing and treating heart diseases. A pediatric cardiologist is a cardiologist who treats children.

Medical and Family Histories

Your doctor will want to learn about your medical history. He or she will want to know what signs and symptoms you have and how long you've had them.

Your doctor also will want to know whether anyone in your family has had cardiomyopathy, heart failure, or sudden cardiac arrest.

Physical Exam

Your doctor will use a stethoscope to listen to your heart and lungs for sounds that may suggest cardiomyopathy. These sounds may even suggest a certain type of the disease.

For example, the loudness, timing, and location of a heart murmur may suggest obstructive hypertrophic cardiomyopathy. A "crackling" sound in the lungs may be a sign of heart failure. (Heart failure often develops in the later stages of cardiomyopathy.)

Physical signs also help your doctor diagnose cardiomyopathy. Swelling of the ankles, feet, legs, abdomen, or veins in your neck suggests fluid buildup, a sign of heart failure.

Your doctor may notice signs and symptoms of cardiomyopathy during a routine exam. For example, he or she may hear a heart murmur, or you may have abnormal test results.

Diagnostic Tests

Your doctor may recommend one or more of the following tests to diagnose cardiomyopathy.

Blood Tests

During a blood test, a small amount of blood is taken from your body. It's often drawn from a vein in your arm using a needle. The procedure usually is quick and easy, although it may cause some short-term discomfort.

Blood tests give your doctor information about your heart and help rule out other conditions.

Chest X Ray

A chest x ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. This test can show whether your heart is enlarged. A chest x ray also can show whether fluid is building up in your lungs.

EKG (Electrocardiogram)

An EKG is a simple 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 each part of the heart.

This test is used to detect and study many heart problems, such as heart attacks, arrhythmias (irregular heartbeats), and heart failure. EKG results also can suggest other disorders that affect heart function.

A standard EKG only records the heartbeat for a few seconds. It won't detect problems that don't happen during the test.

To diagnose heart problems that come and go, your doctor may have you wear a portable EKG monitor. The two most common types of portable EKGs are Holter and event monitors.

Holter and Event Monitors

Holter and event monitors are small, portable devices. They record your heart's electrical activity while you do your normal daily activities. A Holter monitor records the heart's electrical activity for a full 24- or 48-hour period.

An event monitor records your heart's electrical activity only at certain times while you're wearing it. For many event monitors, you push a button to start the monitor when you feel symptoms. Other event monitors start automatically when they sense abnormal heart rhythms.

Echocardiography

Echocardiography (echo) is a test that uses sound waves to create a moving picture of your heart. The picture shows how well your heart is working and its size and shape.

There are several types of echo, including stress echo. This test is done as part of a stress test (see below). Stress echo can show whether you have decreased blood flow to your heart, a sign of coronary heart disease.

Another type of echo is transesophageal (tranz-ih-sof-uh-JEE-ul) echo, or TEE. TEE provides a view of the back of the heart.

For this test, a sound wave wand is put on the end of a special tube. The tube is gently passed down your throat and into your esophagus (the passage leading from your mouth to your stomach). Because this passage is right behind the heart, TEE can create detailed pictures of the heart's structures.

Before TEE, you're given medicine to help you relax, and your throat is sprayed with numbing medicine.

Stress Test

Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (or are given medicine if you're unable to exercise) to make your heart work hard and beat fast while heart tests are done.

These tests may include nuclear heart scanning, echo, and positron emission tomography (PET) scanning of the heart.

Diagnostic Procedures

You may have one or more medical procedures to confirm a diagnosis or to prepare for surgery (if surgery is planned). These procedures may include cardiac catheterization (KATH-e-ter-i-ZA-shun), coronary angiography (an-jee-OG-ra-fee), or myocardial (mi-o-KAR-de-al) biopsy.

Cardiac Catheterization

This procedure checks the pressure and blood flow in your heart's chambers. The procedure also allows your doctor to collect blood samples and look at your heart's arteries using x-ray imaging.

During cardiac catheterization, a long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck and threaded to your heart. This allows your doctor to study the inside of your arteries for blockages.

Coronary Angiography

This procedure often is done with cardiac catheterization. During the procedure, dye that can be seen on an x ray is injected into your coronary arteries. The dye lets your doctor study blood flow through your heart and blood vessels.

Dye also may be injected into your heart chambers. This allows your doctor to study the pumping function of your heart.

Myocardial Biopsy

For this procedure, your doctor removes a piece of your heart muscle. This can be done during cardiac catheterization. The heart muscle is studied under a microscope to see whether changes in cells have occurred. These changes may suggest cardiomyopathy.

Myocardial biopsy is useful for diagnosing some types of cardiomyopathy.

Genetic Testing

Some types of cardiomyopathy run in families. Thus, your doctor may suggest genetic testing to look for the disease in your parents, brothers and sisters, or other family members.

Genetic testing can show how the disease runs in families. It also can find out the chances of parents passing the genes for the disease on to their children.

Genetic testing also may be useful if your doctor thinks you have cardiomyopathy, but you don't yet have signs or symptoms. If the test shows you have the disease, your doctor can start treatment early, when it may work best. </s>


Input: What are the treatments for Cardiomyopathy ?

Output:
People who have cardiomyopathy but no signs or symptoms may not need treatment. Sometimes, dilated cardiomyopathy that comes on suddenly may go away on its own. For other people who have cardiomyopathy, treatment is needed. Treatment depends on the type of cardiomyopathy you have, the severity of your symptoms and complications, and your age and overall health. Treatments may include:

Heart-healthy lifestyle changes

Medicines

Nonsurgical procedure

Surgery and implanted devices

The main goals of treating cardiomyopathy include:

Controlling signs and symptoms so that you can live as normally as possible

Managing any conditions that cause or contribute to the disease

Reducing complications and the risk of sudden cardiac arrest

Stopping the disease from getting worse

Heart-Healthy Lifestyle Changes

Your doctor may suggest lifestyle changes to manage a condition thats causing your cardiomyopathy including:

Heart-healthy eating

Maintaining a healthy weight

Managing stress

Physical activity

Quitting smoking

Heart-Healthy Eating

Your doctor may recommend heart-healthy eating, which should include:

Fat-free or low-fat dairy products, such as fat-free 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 5 percent 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:

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

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 2,300 milligrams 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.

Alcohol

Talk to your doctor about how much alcohol you drink. Too much alcohol canraise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain. Your doctor may recommend that you reduce the amount of alcohol you drinkor stop drinking alcohol.

Maintaining a Healthy Weight

Maintaining a healthy weight is important for overall health and can lower your risk for coronary heart disease. 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 (NHLBI) onlineBMI calculatoror 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 and 29.9 is considered overweight.

Of 30 or more 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 type 2 diabetes. This risk may be high 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, visitAssessing Your Weight and Health Risk.

If youre overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.

Managing Stress

Research shows that the most commonly reported trigger for a heart attack is an emotionally upsetting eventparticularly one involving anger. Also, some of the ways people cope with stresssuch as drinking, smoking, or overeatingarent healthy.

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

Routine physical activity can lower many risk factors for coronary heart disease, including LDL (bad) cholesterol, high blood pressure, and excess weight. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. HDL is the good cholesterol that helps prevent coronary heart disease.

Everyone should try to participate in moderate intensity aerobic exercise at least 2hours and 30minutes per week, or vigorous intensity aerobic exercise for 1hour and 15minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats fasterand you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.

Read more about physical activity at:

Physical Activity and Your Heart

U.S. Department of Health and Human Services 2008 Physical Activity Guidelines forAmericans

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.

Quitting Smoking

If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. 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 quitting smoking at Smoking and Your Heart.

Medicines

Many medicines are used to treat cardiomyopathy. Your doctor may prescribe medicines to:

Balance electrolytes in your body. Electrolytes are minerals that help maintain fluid levels and acid-base balance in the body. They also help muscle and nerve tissues work properly. Abnormal electrolyte levels may be a sign of dehydration (lack of fluid in your body), heart failure, high blood pressure, or other disorders. Aldosterone blockers are an example of a medicine used to balance electrolytes.

Keep your heart beating with a normal rhythm. These medicines, called antiarrhythmics, help prevent arrhythmias.

Lower your blood pressure. ACE inhibitors, angiotensin II receptor blockers, beta blockers, and calcium channel blockers are examples of medicines that lower blood pressure.

Prevent blood clots from forming. Anticoagulants, or blood thinners, are an example of a medicine that prevents blood clots. Blood thinners often are used to prevent blood clots from forming in people who have dilated cardiomyopathy.

Reduce inflammation. Corticosteroids are an example of a medicine used to reduce inflammation.

Remove excess sodium from your body. Diuretics, or water pills, are an example of medicines that help remove excess sodium from the body, which reduces the amount of fluid in your blood.

Slow your heart rate. Beta blockers, calcium channel blockers, and digoxin are examples of medicines that slow the heart rate. Beta blockers and calcium channel blockers also are used to lower blood pressure.

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.

Surgery and Implanted Devices

Doctors use several types of surgery to treat cardiomyopathy, including septal myectomy, surgically implanted devices, and heart transplant.

Septal Myectomy

Septal myectomy is open-heart surgery and is used to treat people who have hypertrophic cardiomyopathy and severe symptoms. This surgery generally is used for younger patients and for people whose medicines arent working well.

A surgeon removes part of the thickened septum thats bulging into the left ventricle. This improves blood flow through the heart and out to the body. The removed tissue doesnt grow back. If needed, the surgeon also can repair or replace the mitral valve at the same time. Septal myectomy often is successful and allows you to return to a normal life with nosymptoms.

Surgically Implanted Devices

Surgeons can place several types of devices in the heart to improve function and symptoms, including:

Cardiac resynchronization therapy (CRT) device. A CRT device coordinates contractions between the hearts left and right ventricles.

Implantable cardioverter defibrillator(ICD). An ICD helps control life-threatening arrhythmias that may lead tosudden cardiac arrest. This small device is implanted in the chest or abdomen and connected to the heart with wires. If an ICD senses a dangerous change in heart rhythm, it will send an electric shock to the heart to restore a normal heartbeat.

Left ventricular assist device (LVAD). This device helps the heart pump blood to the body. An LVAD can be used as a long-term therapy or as a short-term treatment for people who are waiting for a heart transplant.

Pacemaker. This small device is placed under the skin of your chest or abdomen to help control arrhythmias. The device uses electrical pulses to prompt the heart to beat at a normal rate.

Heart Transplant

For this surgery, a surgeon replaces a persons diseased heart with a healthy heart from a deceased donor. A heart transplant is a last resort treatment for people who have end-stage heart failure. End-stage means the condition has become so severe that all treatments, other than heart transplant, have failed. For more information about this treatment, go to the Heart Transplant Health Topic.

Nonsurgical Procedure

Doctors may use a nonsurgical procedure called alcohol septal ablation to treat cardiomyopathy. During this procedure, the doctor injects ethanol (a type of alcohol) through a tube into the small artery that supplies blood to the thickened area of heart muscle. The alcohol kills cells, and the thickened tissue shrinks to a more normal size. This procedure allows blood to flow freely through the ventricle, which improves symptoms. </s>


Input: How to prevent Cardiomyopathy ?

Output:
You can't prevent inherited types of cardiomyopathy. However, you can take steps to lower your risk for diseases or conditions that may lead to or complicate cardiomyopathy. Examples includecoronary heart disease,high blood pressure, andheart attack.

Your doctor may advise you to make heart-healthy lifestyle changes, such as:

Avoiding the use of alcohol and illegal drugs

Getting enough sleep and rest

Heart-healthy eating

Physicalactivity

Quitting smoking

Managing stress

Your cardiomyopathy may be due to an underlying disease or condition. If you treat that condition early enough, you may be able to prevent cardiomyopathy complications. For example, to control high blood pressure,high blood cholesterol, and diabetes:

Follow your doctors advice about lifestyle changes.

Get regular checkups with your doctor.

Take all of your medicines as your doctor prescribes. </s>


Input: What is (are) Aplastic Anemia ?

Output:
Aplastic anemia (a-PLAS-tik uh-NEE-me-uh) is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. Bone marrow is a sponge-like tissue inside the bones. It makes stem cells that develop into red blood cells, white blood cells, and platelets (PLATE-lets).

Red blood cells carry oxygen to all parts of your body. They also carry carbon dioxide (a waste product) to your lungs to be exhaled. White blood cells help your body fight infections. Platelets are blood cell fragments that stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.

It's normal for blood cells to die. The lifespan of red blood cells is about 120 days. White blood cells live less than a day. Platelets live about 6 days. As a result, your bone marrow must constantly make new blood cells.

If your bone marrow can't make enough new blood cells, many health problems can occur. These problems include irregular heartbeats called arrhythmias (ah-RITH-me-ahs), an enlarged heart, heart failure, infections, and bleeding. Severe aplastic anemia can even cause death.

Overview

Aplastic anemia is a type of anemia. The term "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). This iron-rich protein helps carry oxygen to your body.

In people who have aplastic anemia, the body doesn't make enough red blood cells, white blood cells, and platelets. This is because the bone marrow's stem cells are damaged. (Aplastic anemia also is called bone marrow failure.)

Many diseases, conditions, and factors can damage the stem cells. These conditions can be acquired or inherited. "Acquired" means you aren't born with the condition, but you develop it. "Inherited" means your parents passed the gene for the condition on to you.

In many people who have aplastic anemia, the cause is unknown.

Outlook

Aplastic anemia is a rare but serious disorder. It can develop suddenly or slowly. The disorder tends to get worse over time, unless its cause is found and treated. Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and medicines.

With prompt and proper care, many people who have aplastic anemia can be successfully treated. Blood and marrow stem cell transplants may offer a cure for some people who have aplastic anemia. </s>


Input: What causes Aplastic Anemia ?

Output:
Damage to the bone marrow's stem cells causes aplastic anemia. When stem cells are damaged, they don't grow into healthy blood cells.

The cause of the damage can be acquired or inherited. "Acquired" means you aren't born with the condition, but you develop it. "Inherited" means your parents passed the gene for the condition on to you.

Acquired aplastic anemia is more common, and sometimes it's only temporary. Inherited aplastic anemia is rare.

In many people who have aplastic anemia, the cause is unknown. Some research suggests that stem cell damage may occur because the body's immune system attacks its own cells by mistake.

Acquired Causes

Many diseases, conditions, and factors can cause aplastic anemia, including:

Toxins, such as pesticides, arsenic, and benzene.

Radiation and chemotherapy (treatments for cancer).

Medicines, such as chloramphenicol (an antibiotic rarely used in the United States).

Infectious diseases, such as hepatitis, Epstein-Barr virus, cytomegalovirus (si-to-MEG-ah-lo-VI-rus), parvovirus B19, and HIV.

Autoimmune disorders, such as lupus and rheumatoid arthritis.

Pregnancy. (Aplastic anemia that occurs during pregnancy often goes away after delivery.)

Sometimes, cancer from another part of the body can spread to the bone and cause aplastic anemia.

Inherited Causes

Certain inherited conditions can damage the stem cells and lead to aplastic anemia. Examples include Fanconi anemia, Shwachman-Diamond syndrome, dyskeratosis (DIS-ker-ah-TO-sis) congenita, and Diamond-Blackfan anemia. </s>


Input: Who is at risk for Aplastic Anemia? ?

Output:
Aplastic anemia is a rare but serious blood disorder. People of all ages can develop aplastic anemia. However, it's most common in adolescents, young adults, and the elderly. Men and women are equally likely to have it.

The disorder is two to three times more common in Asian countries.

Your risk of aplastic anemia is higher if you:

Have been exposed to toxins

Have taken certain medicines or had radiation or chemotherapy (treatments for cancer)

Have certain infectious diseases, autoimmune disorders, or inherited conditions

For more information, go to "What Causes Aplastic Anemia?" </s>


Input: What are the symptoms of Aplastic Anemia ?

Output:
Lower than normal numbers of red blood cells, white blood cells, and platelets cause most of the signs and symptoms of aplastic anemia.

Signs and Symptoms of Low Blood Cell Counts

Red Blood Cells

The most common symptom of a low red blood cell count is fatigue (tiredness). A lack of hemoglobin in the blood causes fatigue. Hemoglobin is an iron-rich protein in red blood cells. It helps carry oxygen to the body.

A low red blood cell count also can cause shortness of breath; dizziness, especially when standing up; headaches; coldness in your hands or feet; pale skin; and chest pain.

If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to move the reduced amount of oxygen in your blood. This can lead to arrhythmias (irregular heartbeats), a heart murmur, an enlarged heart, or even heart failure.

White Blood Cells

White blood cells help fight infections. Signs and symptoms of a low white blood cell count include fevers, frequent infections that can be severe, and flu-like illnesses that linger.

Platelets

Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding. People who have low platelet counts tend to bruise and bleed easily, and the bleeding may be hard to stop.

Common types of bleeding associated with a low platelet count include nosebleeds, bleeding gums, pinpoint red spots on the skin, and blood in the stool. Women also may have heavy menstrual bleeding.

Other Signs and Symptoms

Aplastic anemia can cause signs and symptoms that aren't directly related to low blood cell counts. Examples include nausea (feeling sick to your stomach) and skin rashes.

Paroxysmal Nocturnal Hemoglobinuria

Some people who have aplastic anemia have a condition called paroxysmal (par-ok-SIZ-mal) nocturnal hemoglobinuria (HE-mo-glo-bi-NOO-re-ah), or PNH. This is a red blood cell disorder. Most people who have PNH don't have any signs or symptoms.

If symptoms do occur, they may include:

Shortness of breath

Swelling or pain in the abdomen or swelling in the legs caused by blood clots

Blood in the urine

Headaches

Jaundice (a yellowish color of the skin or whites of the eyes)

In people who have aplastic anemia and PNH, either condition can develop first. </s>


Input: How to diagnose Aplastic Anemia ?

Output:
Your doctor will diagnose aplastic anemia based on your medical and family histories, a physical exam, and test results.

Once your doctor knows the cause and severity of the condition, he or she can create a treatment plan for you.

Specialists Involved

If your primary care doctor thinks you have aplastic anemia, he or she may refer you to a hematologist. A hematologist is a doctor who specializes in treating blood diseases and disorders.

Medical and Family Histories

Your doctor may ask questions about your medical history, such as whether:

You've had anemia or a condition that can cause anemia

You have shortness of breath, dizziness, headaches, or other signs and symptoms of anemia

You've been exposed to certain toxins or medicines

You've had radiation or chemotherapy (treatments for cancer)

You've had infections or signs of infections, such as fever

You bruise or bleed easily

Your doctor also may ask whether any of your family members have had anemia or other blood disorders.

Physical Exam

Your doctor will do a physical exam to check for signs of aplastic anemia. He or she will try to find out how severe the disorder is and what's causing it.

The exam may include checking for pale or yellowish skin and signs of bleeding or infection. Your doctor may listen to your heart and lungs for abnormal heartbeats and breathing sounds. He or she also may feel your abdomen to check the size of your liver and feel your legs for swelling.

Diagnostic Tests

Many tests are used to diagnose aplastic anemia. These tests help:

Confirm a diagnosis of aplastic anemia, look for its cause, and find out how severe it is

Rule out other conditions that may cause similar symptoms

Check for paroxysmal nocturnal hemoglobinuria (PNH)

Complete Blood Count

Often, the first test used to diagnose aplastic anemia is a complete blood count (CBC). The CBC measures many parts of your blood.

This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is an iron-rich protein in red blood cells. It carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.

The normal range of these levels varies in certain racial and ethnic populations. Your doctor can explain your test results to you.

The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of aplastic anemia, an infection, or another condition.

Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. The results may be a clue as to the cause of your anemia.

Reticulocyte Count

A reticulocyte (re-TIK-u-lo-site) count measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. People who have aplastic anemia have low reticulocyte levels.

Bone Marrow Tests

Bone marrow tests show whether your bone marrow is healthy and making enough blood cells. The two bone marrow tests are aspiration (as-pi-RA-shun) and biopsy.

Bone marrow aspiration may be done to find out if and why your bone marrow isn't making enough blood cells. For this test, your doctor removes a small amount of bone marrow fluid through a needle. The sample is looked at under a microscope to check for faulty cells.

A bone marrow biopsy may be done at the same time as an aspiration or afterward. For this test, your doctor removes a small amount of bone marrow tissue through a needle.

The tissue is checked for the number and types of cells in the bone marrow. In aplastic anemia, the bone marrow has a lower than normal number of all three types of blood cells.

Other Tests

Other conditions can cause symptoms similar to those of aplastic anemia. Thus, other tests may be needed to rule out those conditions. These tests may include:

X ray, computed tomography (CT) scan, or an ultrasound imaging test. These tests can show enlarged lymph nodes in your abdomen. Enlarged lymph nodes may be a sign of blood cancer. Doctors also may use these tests to look at the kidneys and the bones in the arms and hands, which are sometimes abnormal in young people who have Fanconi anemia. This type of anemia can lead to aplastic anemia.

Chest x ray. This test creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray may be used to rule out infections.

Liver tests and viral studies. These tests are used to check for liver diseases and viruses.

Tests that check vitamin B12 and folate levels in the blood. These tests can help rule out anemia caused by vitamin deficiency.

Your doctor also may recommend blood tests for PNH and to check your immune system for proteins called antibodies. (Antibodies in the immune system that attack your bone marrow cells may cause aplastic anemia.) </s>


Input: What are the treatments for Aplastic Anemia ?

Output:
Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and medicines. These treatments can prevent or limit complications, relieve symptoms, and improve quality of life.

Blood and marrow stem cell transplants may cure the disorder in some people who are eligible for a transplant. Removing a known cause of aplastic anemia, such as exposure to a toxin, also may cure the condition.

Who Needs Treatment

People who have mild or moderate aplastic anemia may not need treatment as long as the condition doesn't get worse. People who have severe aplastic anemia need medical treatment right away to prevent complications.

People who have very severe aplastic anemia need emergency medical care in a hospital. Very severe aplastic anemia can be fatal if it's not treated right away.

Blood Transfusions

Blood transfusions can help keep blood cell counts at acceptable levels. A blood transfusion is a common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels.

Transfusions require careful matching of donated blood with the recipient's blood.

Blood transfusions help relieve the symptoms of aplastic anemia, but they're not a permanent treatment.

Blood and Marrow Stem Cell Transplants

A blood and marrow stem cell transplant replaces damaged stem cells with healthy ones from another person (a donor).

During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein in your chest. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.

Blood and marrow stem cell transplants may cure aplastic anemia in people who can have this type of treatment. The transplant works best in children and young adults with severe aplastic anemia who are in good health and who have matched donors.

Older people may be less able to handle the treatments needed to prepare the body for the transplant. They're also more likely to have complications after the transplant.

If you have aplastic anemia, talk with your doctor about whether a blood and marrow stem cell transplant is an option for you.

Medicines

If you have aplastic anemia, your doctor may prescribe medicines to:

Stimulate your bone marrow

Suppress your immune system

Prevent and treat infections

Medicines To Stimulate Bone Marrow

Man-made versions of substances that occur naturally in the body can stimulate the bone marrow to make more blood cells. Examples of these types of medicines include erythropoietin and colony-stimulating factors.

These medicines have some risks. You and your doctor will work together to decide whether the benefits of these medicines outweigh the risks. If this treatment works well, it can help you avoid the need for blood transfusions.

Medicines To Suppress the Immune System

Research suggests that aplastic anemia may sometimes occur because the body's immune system attacks its own cells by mistake. For this reason, your doctor may prescribe medicines to suppress your immune system.

These medicines allow your bone marrow to start making blood cells again. They also may help you avoid the need for blood transfusions.

Medicines that suppress the immune system don't cure aplastic anemia. However, they can relieve its symptoms and reduce complications. These medicines often are used for people who can't have blood and marrow stem cell transplants or who are waiting for transplants.

Three medicinesoften given togethercan suppress the body's immune system. They are antithymocyte globulin (ATG), cyclosporine, and methylprednisolone.

It may take a few months to notice the effects of these medicines. Most often, as blood cell counts rise, symptoms lessen. Blood cell counts in people who respond well to these medicines usually don't reach normal levels. However, the blood cell counts often are high enough to allow people to do their normal activities.

People who have aplastic anemia may need long-term treatment with these medicines.

Medicines that suppress the immune system can have side effects. They also may increase the risk of developing leukemia (lu-KE-me-ah) or myelodysplasia (MI-e-lo-dis-PLA-ze-ah; MDS). Leukemia is a cancer of the blood cells. MDS is a condition in which the bone marrow makes too many faulty blood cells.

Medicines To Prevent and Treat Infections

If you have aplastic anemia, you might be at risk for infections due to low white blood cell counts. Your doctor may prescribe antibiotic and antiviral medicines to prevent and treat infections. </s>


Input: What is (are) Iron-Deficiency Anemia ?

Output:
Espaol

Iron-deficiency anemia is a common, easily treated condition that occurs if you don't have enough iron in your body. Low iron levels usually are due to blood loss, poor diet, or an inability to absorb enough iron from food.

Overview

Iron-deficiency anemia is a common type of anemia. The term "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. Red blood cells carry oxygen and remove carbon dioxide (a waste product) from your body.

Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). Hemoglobin is an iron-rich protein that carries oxygen from the lungs to the rest of the body.

Iron-deficiency anemia usually develops over time if your body doesn't have enough iron to build healthy red blood cells. Without enough iron, your body starts using the iron it has stored. Soon, the stored iron gets used up.

After the stored iron is gone, your body makes fewer red blood cells. The red blood cells it does make have less hemoglobin than normal.

Iron-deficiency anemia can cause fatigue (tiredness), shortness of breath, chest pain, and other symptoms. Severe iron-deficiency anemia can lead to heart problems, infections, problems with growth and development in children, and other complications.

Infants and young children and women are the two groups at highest risk for iron-deficiency anemia.

Outlook

Doctors usually can successfully treat iron-deficiency anemia. Treatment will depend on the cause and severity of the condition. Treatments may include dietary changes, medicines, and surgery.

Severe iron-deficiency anemia may require treatment in a hospital, blood transfusions, iron injections, or intravenous iron therapy. </s>


Input: What causes Iron-Deficiency Anemia ?

Output:
Not having enough iron in your body causes iron-deficiency anemia. Lack of iron usually is due to blood loss, poor diet, or an inability to absorb enough iron from food.

Blood Loss

When you lose blood, you lose iron. If you don't have enough iron stored in your body to make up for the lost iron, you'll develop iron-deficiency anemia.

In women, long or heavy menstrual periods or bleeding fibroids in the uterus may cause low iron levels. Blood loss that occurs during childbirth is another cause of low iron levels in women.

Internal bleeding (bleeding inside the body) also may lead to iron-deficiency anemia. This type of blood loss isn't always obvious, and it may occur slowly. Some causes of internal bleeding are:

A bleeding ulcer, colon polyp, or colon cancer

Regular use of aspirin or other pain medicines, such as nonsteroidal anti-inflammatory drugs (for example, ibuprofen and naproxen)

Urinary tract bleeding

Blood loss from severe injuries, surgery, or frequent blood drawings also can cause iron-deficiency anemia.

Poor Diet

The best sources of iron are meat, poultry, fish, and iron-fortified foods (foods that have iron added). If you don't eat these foods regularly, or if you don't take an iron supplement, you're more likely to develop iron-deficiency anemia.

Vegetarian diets can provide enough iron if you eat the right foods. For example, good nonmeat sources of iron include iron-fortified breads and cereals, beans, tofu, dried fruits, and spinach and other dark green leafy vegetables.

During some stages of life, such as pregnancy and childhood, it may be hard to get enough iron in your diet. This is because your need for iron increases during these times of growth and development.

Inability To Absorb Enough Iron

Even if you have enough iron in your diet, your body may not be able to absorb it. This can happen if you have intestinal surgery (such as gastric bypass) or a disease of the intestine (such as Crohn's disease or celiac disease).

Prescription medicines that reduce acid in the stomach also can interfere with iron absorption. </s>


Input: Who is at risk for Iron-Deficiency Anemia? ?

Output:
Infants and Young Children

Infants and young children need a lot of iron to grow and develop. The iron that full-term infants have stored in their bodies is used up in the first 4 to 6 months of life.

Premature and low-birth-weight babies (weighing less than 5.5 pounds) are at even greater risk for iron-deficiency anemia. These babies don't have as much iron stored in their bodies as larger, full-term infants.

Iron-fortified baby food or iron supplements, when used properly, can help prevent iron-deficiency anemia in infants and young children. Talk with your child's doctor about your child's diet.

Young children who drink a lot of cow's milk may be at risk for iron-deficiency anemia. Milk is low in iron, and too much milk may take the place of iron-rich foods in the diet. Too much milk also may prevent children's bodies from absorbing iron from other foods.

Children who have lead in their blood also may be at risk for iron-deficiency anemia. Lead can interfere with the body's ability to make hemoglobin. Lead may get into the body from breathing in lead dust, eating lead in paint or soil, or drinking water that contains lead.

Teens

Teens are at risk for iron-deficiency anemia if they're underweight or have chronic (ongoing) illnesses. Teenage girls who have heavy periods also are at increased risk for the condition.

Women

Women of childbearing age are at higher risk for iron-deficiency anemia because of blood loss during their monthly periods. About 1 in 5 women of childbearing age has iron-deficiency anemia.

Pregnant women also are at higher risk for the condition because they need twice as much iron as usual. The extra iron is needed for increased blood volume and for the fetus' growth.

About half of all pregnant women develop iron-deficiency anemia. The condition can increase a pregnant woman's risk for a premature or low-birth-weight baby.

Adults Who Have Internal Bleeding

Adults who have internal bleeding, such as intestinal bleeding, can develop iron-deficiency anemia due to blood loss. Certain conditions, such as colon cancer and bleeding ulcers, can cause blood loss. Some medicines, such as aspirin, also can cause internal bleeding.

Other At-Risk Groups

People who get kidney dialysis treatment may develop iron-deficiency anemia. This is because blood is lost during dialysis. Also, the kidneys are no longer able to make enough of a hormone that the body needs to produce red blood cells.

People who have gastric bypass surgery also may develop iron-deficiency anemia. This type of surgery can prevent the body from absorbing enough iron.

Certain eating patterns or habits may put you at higher risk for iron-deficiency anemia. This can happen if you:

Follow a diet that excludes meat and fish, which are the best sources of iron. However, vegetarian diets can provide enough iron if you eat the right foods. For example, good nonmeat sources of iron include iron-fortified breads and cereals, beans, tofu, dried fruits, and spinach and other dark green leafy vegetables.

Eat poorly because of money, social, health, or other problems.

Follow a very low-fat diet over a long time. Some higher fat foods, like meat, are the best sources of iron.

Follow a high-fiber diet. Large amounts of fiber can slow the absorption of iron. </s>


Input: What are the symptoms of Iron-Deficiency Anemia ?

Output:
The signs and symptoms of iron-deficiency anemia depend on its severity. Mild to moderate iron-deficiency anemia may have no signs or symptoms.

When signs and symptoms do occur, they can range from mild to severe. Many of the signs and symptoms of iron-deficiency anemia apply to all types of anemia.

Signs and Symptoms of Anemia

The most common symptom of all types of anemia is fatigue (tiredness). Fatigue occurs because your body doesn't have enough red blood cells to carry oxygen to its many parts.

Also, the red blood cells your body makes have less hemoglobin than normal. Hemoglobin is an iron-rich protein in red blood cells. It helps red blood cells carry oxygen from the lungs to the rest of the body.

Anemia also can cause shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, chest pain, weakness, and fatigue (tiredness).

If you don't have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. This can lead to irregular heartbeats called arrhythmias (ah-RITH-me-ahs), a heart murmur, an enlarged heart, or even heart failure.

In infants and young children, signs of anemia include poor appetite, slowed growth and development, and behavioral problems.

Signs and Symptoms of Iron Deficiency

Signs and symptoms of iron deficiency may include brittle nails, swelling or soreness of the tongue, cracks in the sides of the mouth, an enlarged spleen, and frequent infections.

People who have iron-deficiency anemia may have an unusual craving for nonfood items, such as ice, dirt, paint, or starch. This craving is called pica (PI-ka or PE-ka).

Some people who have iron-deficiency anemia develop restless legs syndrome (RLS). RLS is a disorder that causes a strong urge to move the legs. This urge to move often occurs with strange and unpleasant feelings in the legs. People who have RLS often have a hard time sleeping.

Iron-deficiency anemia can put children at greater risk for lead poisoning and infections.

Some signs and symptoms of iron-deficiency anemia are related to the condition's causes. For example, a sign of intestinal bleeding is bright red blood in the stools or black, tarry-looking stools.

Very heavy menstrual bleeding, long periods, or other vaginal bleeding may suggest that a woman is at risk for iron-deficiency anemia. </s>


Input: How to diagnose Iron-Deficiency Anemia ?

Output:
Your doctor will diagnose iron-deficiency anemia based on your medical history, a physical exam, and the results from tests and procedures.

Once your doctor knows the cause and severity of the condition, he or she can create a treatment plan for you.

Mild to moderate iron-deficiency anemia may have no signs or symptoms. Thus, you may not know you have it unless your doctor discovers it from a screening test or while checking for other problems.

Specialists Involved

Primary care doctors often diagnose and treat iron-deficiency anemia. These doctors include pediatricians, family doctors, gynecologists/obstetricians, and internal medicine specialists.

A hematologist (a blood disease specialist), a gastroenterologist (a digestive system specialist), and other specialists also may help treat iron-deficiency anemia.

Medical History

Your doctor will ask about your signs and symptoms and any past problems you've had with anemia or low iron. He or she also may ask about your diet and whether you're taking any medicines.

If you're a woman, your doctor may ask whether you might be pregnant.

Physical Exam

Your doctor will do a physical exam to look for signs of iron-deficiency anemia. He or she may:

Look at your skin, gums, and nail beds to see whether they're pale

Listen to your heart for rapid or irregular heartbeats

Listen to your lungs for rapid or uneven breathing

Feel your abdomen to check the size of your liver and spleen

Do a pelvic and rectal exam to check for internal bleeding

Diagnostic Tests and Procedures

Many tests and procedures are used to diagnose iron-deficiency anemia. They can help confirm a diagnosis, look for a cause, and find out how severe the condition is.

Complete Blood Count

Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many parts of your blood.

This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.

The normal range of these levels varies in certain racial and ethnic populations. Your doctor can explain your test results to you.

The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of infection, a blood disorder, or another condition.

Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. The results may be a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal.

Other Blood Tests

If the CBC results confirm you have anemia, you may need other blood tests to find out what's causing the condition, how severe it is, and the best way to treat it.

Reticulocyte count. This test measures the number of reticulocytes (re-TIK-u-lo-sites) in your blood. Reticulocytes are young, immature red blood cells. Over time, reticulocytes become mature red blood cells that carry oxygen throughout your body.

A reticulocyte count shows whether your bone marrow is making red blood cells at the correct rate.

Peripheral smear. For this test, a sample of your blood is examined under a microscope. If you have iron-deficiency anemia, your red blood cells will look smaller and paler than normal.

Tests to measure iron levels. These tests can show how much iron has been used from your body's stored iron. Tests to measure iron levels include:

Serum iron. This test measures the amount of iron in your blood. The level of iron in your blood may be normal even if the total amount of iron in your body is low. For this reason, other iron tests also are done.

Serum ferritin. Ferritin is a protein that helps store iron in your body. A measure of this protein helps your doctor find out how much of your body's stored iron has been used.

Transferrin level, or total iron-binding capacity. Transferrin is a protein that carries iron in your blood. Total iron-binding capacity measures how much of the transferrin in your blood isn't carrying iron. If you have iron-deficiency anemia, you'll have a high level of transferrin that has no iron.

Other tests. Your doctor also may recommend tests to check your hormone levels, especially your thyroid hormone. You also may have a blood test for a chemical called erythrocyte protoporphyrin. This chemical is a building block for hemoglobin.

Children also may be tested for the level of lead in their blood. Lead can make it hard for the body to produce hemoglobin.

Tests and Procedures for Gastrointestinal Blood Loss

To check whether internal bleeding is causing your iron-deficiency anemia, your doctor may suggest a fecal occult blood test. This test looks for blood in the stools and can detect bleeding in the intestines.

If the test finds blood, you may have other tests and procedures to find the exact spot of the bleeding. These tests and procedures may look for bleeding in the stomach, upper intestines, colon, or pelvic organs. </s>


Input: What are the treatments for Iron-Deficiency Anemia ?

Output:
Treatment for iron-deficiency anemia will depend on its cause and severity. Treatments may include dietary changes and supplements, medicines, and surgery.

Severe iron-deficiency anemia may require a blood transfusion, iron injections, or intravenous (IV) iron therapy. Treatment may need to be done in a hospital.

The goals of treating iron-deficiency anemia are to treat its underlying cause and restore normal levels of red blood cells, hemoglobin, and iron.

Dietary Changes and Supplements

Iron

You may need iron supplements to build up your iron levels as quickly as possible. Iron supplements can correct low iron levels within months. Supplements come in pill form or in drops for children.

Large amounts of iron can be harmful, so take iron supplements only as your doctor prescribes. Keep iron supplements out of reach from children. This will prevent them from taking an overdose of iron.

Iron supplements can cause side effects, such as dark stools, stomach irritation, and heartburn. Iron also can cause constipation, so your doctor may suggest that you use a stool softener.

Your doctor may advise you to eat more foods that are rich in iron. The best source of iron is red meat, especially beef and liver. Chicken, turkey, pork, fish, and shellfish also are good sources of iron.

The body tends to absorb iron from meat better than iron from nonmeat foods. However, some nonmeat foods also can help you raise your iron levels. Examples of nonmeat foods that are good sources of iron include:

Iron-fortified breads and cereals

Peas; lentils; white, red, and baked beans; soybeans; and chickpeas

Tofu

Dried fruits, such as prunes, raisins, and apricots

Spinach and other dark green leafy vegetables

Prune juice

The Nutrition Facts labels on packaged foods will show how much iron the items contain. The amount is given as a percentage of the total amount of iron you need every day.

Vitamin C

Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Citrus fruits include oranges, grapefruits, tangerines, and similar fruits. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.

If you're taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. Grapefruit can affect the strength of a few medicines and how well they work.

Other fruits rich in vitamin C include kiwi fruit, strawberries, and cantaloupes.

Vegetables rich in vitamin C include broccoli, peppers, Brussels sprouts, tomatoes, cabbage, potatoes, and leafy green vegetables like turnip greens and spinach.

Treatment To Stop Bleeding

If blood loss is causing iron-deficiency anemia, treatment will depend on the cause of the bleeding. For example, if you have a bleeding ulcer, your doctor may prescribe antibiotics and other medicines to treat the ulcer.

If a polyp or cancerous tumor in your intestine is causing bleeding, you may need surgery to remove the growth.

If you have heavy menstrual flow, your doctor may prescribe birth control pills to help reduce your monthly blood flow. In some cases, surgery may be advised.

Treatments for Severe Iron-Deficiency Anemia

Blood Transfusion

If your iron-deficiency anemia is severe, you may get a transfusion of red blood cells. A blood transfusion is a safe, common procedure in which blood is given to you through an IV line in one of your blood vessels. A transfusion requires careful matching of donated blood with the recipient's blood.

A transfusion of red blood cells will treat your anemia right away. The red blood cells also give a source of iron that your body can reuse. However, a blood transfusion is only a short-term treatment. Your doctor will need to find and treat the cause of your anemia.

Blood transfusions are usually reserved for people whose anemia puts them at a higher risk for heart problems or other severe health issues.

For more information, go to the Health Topics Blood Transfusion article.

Iron Therapy

If you have severe anemia, your doctor may recommend iron therapy. For this treatment, iron is injected into a muscle or an IV line in one of your blood vessels.

IV iron therapy presents some safety concerns. It must be done in a hospital or clinic by experienced staff. Iron therapy usually is given to people who need iron long-term but can't take iron supplements by mouth. This therapy also is given to people who need immediate treatment for iron-deficiency anemia. </s>


Input: How to prevent Iron-Deficiency Anemia ?

Output:
Eating a well-balanced diet that includes iron-rich foods may help you prevent iron-deficiency anemia.

Taking iron supplements also may lower your risk for the condition if you're not able to get enough iron from food. Large amounts of iron can be harmful, so take iron supplements only as your doctor prescribes.

For more information about diet and supplements, go to "How Is Iron-Deficiency Anemia Treated?"

Infants and young children and women are the two groups at highest risk for iron-deficiency anemia. Special measures can help prevent the condition in these groups.

Infants and Young Children

A baby's diet can affect his or her risk for iron-deficiency anemia. For example, cow's milk is low in iron. For this and other reasons, cow's milk isn't recommended for babies in their first year. After the first year, you may need to limit the amount of cow's milk your baby drinks.

Also, babies need more iron as they grow and begin to eat solid foods. Talk with your child's doctor about a healthy diet and food choices that will help your child get enough iron.

Your child's doctor may recommend iron drops. However, giving a child too much iron can be harmful. Follow the doctor's instructions and keep iron supplements and vitamins away from children. Asking for child-proof packages for supplements can help prevent overdosing in children.

Because recent research supports concerns that iron deficiency during infancy and childhood can have long-lasting, negative effects on brain health, the American Academy of Pediatrics recommends testing all infants for anemia at 1 year of age.

Women and Girls

Women of childbearing age may be tested for iron-deficiency anemia, especially if they have:

A history of iron-deficiency anemia

Heavy blood loss during their monthly periods

Other risk factors for iron-deficiency anemia

The Centers for Disease Control and Prevention (CDC) has developed guidelines for who should be screened for iron deficiency, and how often:

Girls aged 12 to 18 and women of childbearing age who are not pregnant: Every 5 to 10 years.

Women who have risk factors for iron deficiency: Once a year.

Pregnant women: At the first prenatal visit.

For pregnant women, medical care during pregnancy usually includes screening for anemia. Also, your doctor may prescribe iron supplements or advise you to eat more iron-rich foods.This not only will help you avoid iron-deficiency anemia, but also may lower your risk of having a low-birth-weight baby. </s>


Input: What is (are) Antiphospholipid Antibody Syndrome ?

Output:
Antiphospholipid (AN-te-fos-fo-LIP-id) antibody syndrome (APS) is an autoimmune disorder. Autoimmune disorders occur if the body's immune system makes antibodies that attack and damage tissues or cells.

Antibodies are a type of protein. They usually help defend the body against infections. In APS, however, the body makes antibodies that mistakenly attack phospholipidsa type of fat.

Phospholipids are found in all living cells and cell membranes, including blood cells and the lining of blood vessels.

When antibodies attack phospholipids, cells are damaged. This damage causes blood clots to form in the body's arteries and veins. (These are the vessels that carry blood to your heart and body.)

Usually, blood clotting is a normal bodily process. Blood clots help seal small cuts or breaks on blood vessel walls. This prevents you from losing too much blood. In APS, however, too much blood clotting can block blood flow and damage the body's organs.

Overview

Some people have APS antibodies, but don't ever have signs or symptoms of the disorder. Having APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.

APS can lead to many health problems, such as stroke, heart attack, kidney damage, deep vein thrombosis (throm-BO-sis), and pulmonary embolism (PULL-mun-ary EM-bo-lizm).

APS also can cause pregnancy-related problems, such as multiple miscarriages, a miscarriage late in pregnancy, or a premature birth due to eclampsia (ek-LAMP-se-ah). (Eclampsia, which follows preeclampsia, is a serious condition that causes seizures in pregnant women.)

Very rarely, some people who have APS develop many blood clots within weeks or months. This condition is called catastrophic antiphospholipid syndrome (CAPS).

People who have APS also are at higher risk for thrombocytopenia (THROM-bo-si-to-PE-ne-ah). This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets (PLATE-lets). Antibodies destroy the platelets, or theyre used up during the clotting process. Mild to serious bleeding can occur with thrombocytopenia.

APS can be fatal. Death may occur as a result of large blood clots or blood clots in the heart, lungs, or brain.

Outlook

APS can affect people of any age. However, it's more common in women and people who have other autoimmune or rheumatic (ru-MAT-ik) disorders, such as lupus. ("Rheumatic" refers to disorders that affect the joints, bones, or muscles.)

APS has no cure, but medicines can help prevent its complications. Medicines are used to stop blood clots from forming. They also are used to keep existing clots from getting larger. Treatment for APS is long term.

If you have APS and another autoimmune disorder, it's important to control that condition as well. When the other condition is controlled, APS may cause fewer problems. </s>


Input: What causes Antiphospholipid Antibody Syndrome ?

Output:
Antiphospholipid antibody syndrome (APS) occurs if the body's immune system makes antibodies (proteins) that attack phospholipids.

Phospholipids are a type of fat found in all living cells and cell membranes, including blood cells and the lining of blood vessels. What causes the immune system to make antibodies against phospholipids isn't known.

APS causes unwanted blood clots to form in the body's arteries and veins. Usually, blood clotting is a normal bodily process. It helps seal small cuts or breaks on blood vessel walls. This prevents you from losing too much blood. In APS, however, too much blood clotting can block blood flow and damage the body's organs.

Researchers don't know why APS antibodies cause blood clots to form. Some believe that the antibodies damage or affect the inner lining of the blood vessels, which causes blood clots to form. Others believe that the immune system makes antibodies in response to blood clots damaging the blood vessels. </s>


Input: Who is at risk for Antiphospholipid Antibody Syndrome? ?

Output:
Antiphospholipid antibody syndrome (APS) can affect people of any age. The disorder is more common in women than men, but it affects both sexes.

APS also is more common in people who have other autoimmune or rheumatic disorders, such as lupus. ("Rheumatic" refers to disorders that affect the joints, bones, or muscles.)

About 10 percent of all people who have lupus also have APS. About half of all people who have APS also have another autoimmune or rheumatic disorder.

Some people have APS antibodies, but don't ever have signs or symptoms of the disorder. The mere presence of APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.

However, people who have APS antibodies but no signs or symptoms are at risk of developing APS. Health problems, other than autoimmune disorders, that can trigger blood clots include:

Smoking

Prolonged bed rest

Pregnancy and the postpartum period

Birth control pills and hormone therapy

Cancer and kidney disease </s>


Input: What are the symptoms of Antiphospholipid Antibody Syndrome ?

Output:
The signs and symptoms of antiphospholipid antibody syndrome (APS) are related to abnormal blood clotting. The outcome of a blood clot depends on its size and location.

Blood clots can form in, or travel to, the arteries or veins in the brain, heart, kidneys, lungs, and limbs. Clots can reduce or block blood flow. This can damage the body's organs and may cause death.

Major Signs and Symptoms

Major signs and symptoms of blood clots include:

Chest pain and shortness of breath

Pain, redness, warmth, and swelling in the limbs

Ongoing headaches

Speech changes

Upper body discomfort in the arms, back, neck, and jaw

Nausea (feeling sick to your stomach)

Blood clots can lead to stroke, heart attack, kidney damage, deep vein thrombosis, and pulmonary embolism.

Pregnant women who have APS can have successful pregnancies. However, they're at higher risk for miscarriages, stillbirths, and other pregnancy-related problems, such as preeclampsia (pre-e-KLAMP-se-ah).

Preeclampsia is high blood pressure that occurs during pregnancy. This condition may progress to eclampsia. Eclampsia is a serious condition that causes seizures in pregnant women.

Some people who have APS may develop thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets.

Mild to serious bleeding causes the main signs and symptoms of thrombocytopenia. Bleeding can occur inside the body (internal bleeding) or underneath or from the skin (external bleeding).

Other Signs and Symptoms

Other signs and symptoms of APS include chronic (ongoing) headaches, memory loss, and heart valve problems. Some people who have APS also get a lacy-looking red rash on their wrists and knees. </s>


Input: How to diagnose Antiphospholipid Antibody Syndrome ?

Output:
Your doctor will diagnose antiphospholipid antibody syndrome (APS) based on your medical history and the results from blood tests.

Specialists Involved

A hematologist often is involved in the care of people who have APS. This is a doctor who specializes in diagnosing and treating blood diseases and disorders.

You may have APS and another autoimmune disorder, such as lupus. If so, a doctor who specializes in that disorder also may provide treatment.

Many autoimmune disorders that occur with APS also affect the joints, bones, or muscles. Rheumatologists specialize in treating these types of disorders.

Medical History

Some people have APS antibodies but no signs or symptoms of the disorder. Having APS antibodies doesn't mean that you have APS. To be diagnosed with APS, you must have APS antibodies and a history of health problems related to the disorder.

APS can lead to many health problems, including stroke, heart attack, kidney damage, deep vein thrombosis, and pulmonary embolism.

APS also can cause pregnancy-related problems, such as multiple miscarriages, a miscarriage late in pregnancy, or a premature birth due to eclampsia. (Eclampsia, which follows preeclampsia, is a serious condition that causes seizures in pregnant women.)

Blood Tests

Your doctor can use blood tests to confirm a diagnosis of APS. These tests check your blood for any of the three APS antibodies: anticardiolipin, beta-2 glycoprotein I (2GPI), and lupus anticoagulant.

The term "anticoagulant" (AN-te-ko-AG-u-lant) refers to a substance that prevents blood clotting. It may seem odd that one of the APS antibodies is called lupus anticoagulant. The reason for this is because the antibody slows clotting in lab tests. However, in the human body, it increases the risk of blood clotting.

To test for APS antibodies, a small blood sample is taken. It's often drawn from a vein in your arm using a needle. The procedure usually is quick and easy, but it may cause some short-term discomfort and a slight bruise.

You may need a second blood test to confirm positive results. This is because a single positive test can result from a short-term infection. The second blood test often is done 12 weeks or more after the first one. </s>


Input: What are the treatments for Antiphospholipid Antibody Syndrome ?

Output:
Antiphospholipid antibody syndrome (APS) has no cure. However, medicines can help prevent complications. The goals of treatment are to prevent blood clots from forming and keep existing clots from getting larger.

You may have APS and another autoimmune disorder, such as lupus. If so, it's important to control that condition as well. When the other condition is controlled, APS may cause fewer problems.

Research is ongoing for new ways to treat APS.

Medicines

Anticoagulants, or "blood thinners," are used to stop blood clots from forming. They also may keep existing blood clots from getting larger. These medicines are taken as either a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).

Warfarin and heparin are two blood thinners used to treat APS. Warfarin is given in pill form. (Coumadin is a common brand name for warfarin.) Heparin is given as an injection or through an IV tube. There are different types of heparin. Your doctor will discuss the options with you.

Your doctor may treat you with both heparin and warfarin at the same time. Heparin acts quickly. Warfarin takes 2 to 3 days before it starts to work. Once the warfarin starts to work, the heparin is stopped.

Aspirin also thins the blood and helps prevent blood clots. Sometimes aspirin is used with warfarin. Other times, aspirin might be used alone.

Blood thinners don't prevent APS. They simply reduce the risk of further blood clotting. Treatment with these medicines is long term. Discuss all treatment options with your doctor.

Side Effects

The most common side effect of blood thinners is bleeding. This happens if the medicine thins your blood too much. This side effect can be life threatening.

Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually need regular blood tests, called PT and PTT tests, to check how well their blood is clotting.

These tests also show whether you're taking the right amount of medicine. Your doctor will check to make sure that you're taking enough medicine to prevent clots, but not so much that it causes bleeding.

Talk with your doctor about the warning signs of internal bleeding and when to seek emergency care. (For more information, go to "Living With Antiphospholipid Antibody Syndrome.")

Treatment During Pregnancy

Pregnant women who have APS can have successful pregnancies. With proper treatment, these women are more likely to carry their babies to term.

Pregnant women who have APS usually are treated with heparin or heparin and low-dose aspirin. Warfarin is not used as a treatment during pregnancy because it can harm the fetus.

Babies whose mothers have APS are at higher risk for slowed growth while in the womb. If you're pregnant and have APS, you may need to have extra ultrasound tests (sonograms) to check your babys growth. An ultrasound test uses sound waves to look at the growing fetus.

Treatment for Other Medical Conditions

People who have APS are at increased risk for thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets. Platelets help the blood clot.

If you have APS, you'll need regular complete blood counts (a type of blood test) to count the number of platelets in your blood.

Thrombocytopenia is treated with medicines and medical procedures. For more information, go to the Health Topics Thrombocytopenia article.

If you have other health problems, such as heart disease or diabetes, work with your doctor to manage them. </s>


Input: What is (are) Marfan Syndrome ?

Output:
Marfan syndrome is a condition in which your body's connective tissue is abnormal. Connective tissue helps support all parts of your body. It also helps control how your body grows and develops.

Marfan syndrome most often affects the connective tissue of the heart and blood vessels, eyes, bones, lungs, and covering of the spinal cord. Because the condition affects many parts of the body, it can cause many complications. Sometimes the complications are life threatening.

Overview

Marfan syndrome is a genetic disorder. A mutation, or change, in the gene that controls how the body makes fibrillin causes Marfan syndrome. Fibrillin is a protein that plays a major role in your body's connective tissue.

Most people who have Marfan syndrome inherit it from their parents. If you have Marfan syndrome, you have a 50 percent chance of passing the altered gene to each of your children.

In about 1 in 4 cases, the mutation that causes Marfan syndrome is not inherited. Thus, the affected person is the first in his or her family to have the condition.

Marfan syndrome often affects the long bones of the body. This can lead to signs, or traits, such as:

A tall, thin build.

Long arms, legs, fingers, and toes and flexible joints.

A spine that curves to one side. This condition is called scoliosis (sko-le-O-sis).

A chest that sinks in or sticks out. These conditions are called pectus excavatum (eks-ka-VA-tum) and pectus carinatum (ka-ri-NA-tum), respectively.

Teeth that are too crowded.

Flat feet.

Marfan syndrome traits vary from person to person, even in the same family. Some people who have the condition have many traits, while others have few.

The most serious complications of Marfan syndrome involve the heart and blood vessels. Marfan syndrome can affect the aorta, the main blood vessel that supplies oxygen-rich blood to the body. In Marfan syndrome, the aorta can stretch and grow weak. This condition is called aortic dilation (di-LA-shun) or aortic aneurysm (AN-u-rism).

If the aorta stretches and grows weak, it may tear or burst and leak blood. This condition is called aortic dissection. It's very serious and can lead to severe heart problems or even death.

Marfan syndrome has no cure, but treatments can help delay or prevent complications. Treatments include medicines, surgery, and other therapies. Limiting certain activities, or changing how you do them, may help reduce the risks to the aorta, eyes, and joints.

The type of treatment you receive depends on how the condition is affecting your body.

Outlook

About 1 out of every 5,000 people in the United States has Marfan syndrome. Men, women, children, and people of all races can have the condition.

Advances have been made in the early diagnosis and treatment of Marfan syndrome. It's now possible for people who have the condition to live longer and enjoy a good quality of life. Many people who have Marfan syndrome and are properly diagnosed and treated may live an average lifespan.

Researchers continue to study the condition and look for better treatments. </s>


Input: What causes Marfan Syndrome ?

Output:
Marfan syndrome is a genetic disorder. A mutation, or change, in the gene that controls how the body makes fibrillin causes Marfan syndrome. Fibrillin is a protein that plays a major role in your body's connective tissue.

Most people who have Marfan syndrome inherit it from their parents. If you have the condition, you have a 50 percent chance of passing the altered gene to each of your children.

Sometimes Marfan syndrome isn't inherited. The mutation in the fibrillin gene occurs in the egg or sperm cells. If a child is conceived, the altered gene may be passed on to the child. The risk of that child's brothers or sisters having Marfan syndrome is low. </s>


Input: Who is at risk for Marfan Syndrome? ?

Output:
People at highest risk for Marfan syndrome are those who have a family history of the condition. If you have Marfan syndrome, you have a 50 percent chance of passing the altered gene to each of your children.

Marfan syndrome affects about 1 out of every 5,000 people in the United States. Men, women, and children, and people of all races, can have the condition. </s>


Input: What are the symptoms of Marfan Syndrome ?

Output:
Marfan syndrome can affect many parts of the body. As a result, the signs and symptoms of the disorder vary from person to person, even in the same family.

Marfan complications also vary, depending on how the condition affects your body. Marfan syndrome most often affects the connective tissue of the heart, eyes, bones, lungs, and covering of the spinal cord. This can cause many complications, some of which are life threatening.

Marfan Traits

Marfan syndrome often affects the long bones of the body. This can lead to signs, or traits, such as:

A tall, thin build.

Long arms, legs, fingers, and toes and flexible joints.

A spine that curves to one side. This condition is called scoliosis.

A chest that sinks in or sticks out. These conditions are called pectus excavatum and pectus carinatum, respectively.

Teeth that are too crowded.

Flat feet.

Stretch marks on the skin also are a common trait in people who have Marfan syndrome. Stretch marks usually appear on the lower back, buttocks, shoulders, breasts, thighs, and abdomen.

Not everyone who has these traits has Marfan syndrome. Some of these traits also are signs of other connective tissue disorders.

Complications of Marfan Syndrome

Heart and Blood Vessel Complications

The most serious complications of Marfan syndrome involve the heart and blood vessels.

Marfan syndrome can affect the aorta, the main blood vessel that supplies oxygen-rich blood to the body. In Marfan syndrome, the aorta can stretch and grow weak. This condition is called aortic dilation or aortic aneurysm.

If the aorta stretches and grows weak, it may tear and leak blood. This condition, called aortic dissection, can lead to severe heart problems or even death.

Aortic dissection can cause severe pain in either the front or back of the chest or abdomen. The pain can travel upward or downward. If you have symptoms of aortic dissection, call 911.

Marfan syndrome also can cause problems with the heart's mitral (MI-trul) valve. This valve controls blood flow between the upper and lower chambers on the left side of the heart. Marfan syndrome can lead to mitral valve prolapse (MVP).

MVP is a condition in which the flaps of the mitral valve are floppy and don't close tightly. MVP can cause shortness of breath, palpitations (pal-pi-TA-shuns), chest pain, and other symptoms.

If you have MVP, your doctor may hear a heart murmur if he or she listens to your heart with a stethoscope. A heart murmur is an extra or unusual sound heard during the heartbeat.

Eye Complications

Marfan syndrome can cause many eye problems. A common problem in Marfan syndrome is a dislocated lens in one or both of the eyes. In this condition, the lens (the part of the eye that helps focus light) shifts up, down, or to the side. This can affect your eyesight. A dislocated lens often is the first sign that someone has Marfan syndrome.

Other eye complications of Marfan syndrome include nearsightedness, early glaucoma (high pressure in the fluid in the eyes), and early cataracts (clouding of an eye's lens). A detached retina also can occur.

Nervous System Complications

Fluid surrounds your brain and spinal cord. A substance called dura covers the fluid. In Marfan syndrome, the dura can stretch and grow weak.

This condition, called dural ectasia (ek-TA-ze-ah), can occur in people who have Marfan syndrome as they grow older. Eventually, the bones of the spine may wear away.

Symptoms of this condition are lower back pain, abdominal pain, headache, and numbness in the legs.

Lung Complications

Marfan syndrome can cause sudden pneumothorax (noo-mo-THOR-aks), or collapsed lung. In this condition, air or gas builds up in the space between the lungs and chest wall. If enough air or gas builds up, a lung can collapse.

The most common symptoms of a collapsed lung are sudden pain in one side of the lung and shortness of breath.

Conditions such as scoliosis (a curved spine) and pectus excavatum (a chest that sinks in) can prevent the lungs from expanding fully. This can cause breathing problems. Marfan syndrome also can cause changes in the lung tissue, and it can lead to early emphysema (em-fi-SE-ma).

Marfan syndrome also has been linked to sleep apnea. In people who have Marfan syndrome, the shape of the face, oral cavity, or teeth may increase the risk of sleep apnea. Sleep apnea causes one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. </s>


Input: How to diagnose Marfan Syndrome ?

Output:
Your doctor will diagnose Marfan syndrome based on your medical and family histories, a physical exam, and test results. He or she also will consult a set of guidelines called Ghent criteria, which are used to diagnose Marfan syndrome.

Marfan syndrome can be hard to diagnose. This is because its signs, or traits, are the same as or similar to the signs of other connective tissue disorders.

If you're diagnosed with Marfan syndrome, all of your first-degree relatives (for example, parents, siblings, and children) also should be checked for the disorder. This is because, even in families, the outward traits of Marfan syndrome may vary quite a bit.

Specialists Involved

Your family doctor or another type of doctor, such as an orthopedist (bone specialist), may notice certain traits that suggest Marfan syndrome.

If so, your doctor will likely refer you to a geneticist or cardiologist. A geneticist is hereditary disease expert. A cardiologist is a heart specialist. These two types of specialists often have the most experience working with people who have Marfan syndrome.

A geneticist will ask for medical information about you and your family. He or she will examine you and perhaps other members of your family. The geneticist also will coordinate your visits with other doctors, including a cardiologist, an ophthalmologist (eye specialist), and an orthopedist.

After reviewing the medical findings, the geneticist will determine whether you have Marfan syndrome.

Medical and Family Histories

Your doctor will ask about your medical history and your family's medical history. For example, your doctor may ask whether:

You've had heart disease, eye problems, or problems with your spine. These complications are common in people who have Marfan syndrome.

You have shortness of breath, palpitations, or chest pain. These are common symptoms of heart or lung problems linked to Marfan syndrome.

Any of your family members have Marfan syndrome, have died from heart problems, or have died suddenly.

Physical Exam

During the physical exam, your doctor will look for Marfan syndrome traits. For example, he or she may check the curve of your spine and the shape of your feet. Your doctor also will listen to your heart and lungs with a stethoscope.

Diagnostic Tests

Your doctor may recommend one or more of the following tests to help diagnose Marfan syndrome.

Echocardiography

Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, is a painless test that uses sound waves to create pictures of your heart and blood vessels.

This test shows the size and shape of your heart and the diameter of your aorta or other blood vessels. (The aorta is the main artery that carries oxygen-rich blood to your body.) Echo also shows how well your heart's chambers and valves are working.

For people who have Marfan syndrome, echo mainly is used to check the heart's valves and aorta.

Magnetic Resonance Imaging and Computed Tomography Scans

Magnetic resonance imaging (MRI) is a test that uses radio waves and magnets to create detailed pictures of your organs and tissues. Computed tomography (CT) uses an x-ray machine to take clear, detailed pictures of your organs.

MRI and CT scans are used to check your heart valves and aorta. These scans also are used to check for dural ectasia, a nervous system complication of Marfan syndrome.

Slit-Lamp Exam

For this test, an ophthalmologist (eye specialist) will use a microscope with a light to check your eyes. A slit-lamp exam can find out whether you have a dislocated lens, cataracts, or a detached retina.

Genetic Testing

In general, genetic testing involves blood tests to detect changes in genes. However, because many different genetic changes can cause Marfan syndrome, no single blood test can diagnose the condition.

Ghent Criteria

Because no single test can diagnose Marfan syndrome, doctors use a set of guidelines called Ghent criteria to help diagnose the condition. The Ghent criteria are divided into major criteria and minor criteria. Sometimes genetic testing is part of this evaluation.

Major criteria include traits that are common in people who have Marfan syndrome. Minor criteria include traits that are common in many people. Doctors use a scoring system based on the number and type of Ghent criteria present to diagnose Marfan syndrome.

Talk with your doctor about which traits you have and your likelihood of having Marfan syndrome. </s>