Medical literacy with Reuben Zulu

Heart Palpitations.

Heart Palpitations refers to a state where one feels like the heart is racing or being aware of his own or her own heart beat.

There are different causes of heart palpitations and the following are some of them.

1) Anxiety and Panic : When one is anxious or under panic, the hearts races very fast due to the release of hormones such as the adrenaline which increases the heart rate.

2) Stimulant Drugs: Stimulant drugs increases the function of the central nervous system. Stimulant drugs include: caffeine containing drinks, coffee,tea, ni****ne, co***ne, methamphetamines and other energy drinks.

3) Certain Medication like Sulbutamol ( ventoline) can increase the heart rate because of the effects on the heart beta receptors
Cough mixtures that contain pseudoephedrine can also increase the heart rate leading to palpitations.

4) Anaemia: When the blood levels are low, the heart starts to beat fast so that it can maintain the oxygen supply to all parts of the body. When the blood levels are too low, it causes palpitations.

5) Heavy systemic infection causing fever. Hypovolemic shock in the early stages.

6) Heart associated problems.

7) Other drugs like alcohol, to***co can also cause heart palpitations.

When you experience heart palpitations, it is important to know the triggers.
Managing the cause of the palpitations is the definitive management.

Cyanosis

This is another important signs that tells us that the body is not receiving adequate oxygen.

When one has a condition such as asthma, severe pneumonia or any condition that interferes with the breathing or blood circulation, it can lead to the build up of carbon dioxide in blood or high concentration of deoxygenated blood.Blood that is rich in oxygen is bright red, but blood that is rich in Carbon dioxide appears bluish.
The bluish discoloration is what we see as cyanosis.

Cyanosis can be in the peripherals ( the far or extremities of the body such as toes, hands and fingers) or central cyanosis which is seen on the lips or tongue.

Central cyanosis indicates a very serious underlying problem with breathing or blood circulation.

Shunting: When the body is not receiving adequate oxygen, it starts to prioritise the most important body parts such as the brain and the heart while leaving the less important body parts like the peripherals ( fingers, skin and toes ) without oxygen or flow of blood.

We should also know that body parts start to die if they are deprived of blood that is rich in oxygen.

When the extremities are cold it may be an indicator that shunting is taking place and efforts to restore the normal circulation and breathing should be put in place.

In line with cyanosis, we will also talk about the blue Baby syndrome. ( A blue Baby)

Jaundice

Jaundice is the yellowish discoloration of the skin, sclera and mucus membranes due to the accumulation of bilirubin.

Bilirubin is produced from the breakdown of the red blood cells.

Bilirubin is removed from the body through urine and feaces. But when it accumulates, it causes jaundice.

Jaundice can be due to :

1) Increased or rapid breakdown of red blood cells
- Rapid destruction can be due to an abnormal shape in the red blood cells as seen in sickle cell disease.
- an infection affecting the red blood cells such as malaria, bacterial infection ( sepsis).

2) Problem with the Liver.
- bilirubin is processed from the liver after the breakdown of red blood cells.
- if the liver is having a problem, the processing of bilirubin is affected and it begins to build up causing jaundice
- problems that affects the liver include: paracetamol overdose, chronic alcohol use, hepatitis, liver cirrhosis, liver Cancer

3) problems after the liver.
- After the liver, bilirubin has to move through the bile tract so that it goes where it is supposed to be removed through urine and feaces.
- In some cases, there can be an obstruction in the bile tract by cancer, gallstones, worms or chronic pancreatitis.

In the next post, we will be looking at Cyanosis.

We continue looking at our topic on pallor, jaundice and cyanosis.

1) Pallor: paleness, it is sign of anaemia.
• Anaemia is a condition where the red blood cells are few or abnormal such that the transportation of oxygen is affected.
•Anaemia can be due to the following:

a) Prolonged bleeding: prolonged me**es, minimal bleeding from the gastro intestinal tract ( bleeding from stomach ulcers, heamorrhoids)

b) Due to nutritional deficiency ( deficiency in iron and folate)

c) Due to chronic illness like chronic kidney disease, cancers, HIV and autoimmune diseases

d) Due to bone marrow suppression: The red blood cells are produced in the bone marrows, so if the bone marrows are suppressed by things like medications ( chemotherapy, chloramphenicol, septrine, carbamazepine) , leukemia ( cancer of the bone marrows) and viral infections ,the production of red blood cells can be affected.

e) It can be due to acute loss of blood through massive hemorrhage ( bleeding).

f) Due to the rapid destruction of red blood cells as seen in sickle cell disease, malaria and sepsis.
The rapid destruction can be due to an infection affecting the red blood cells or abnormality in the red blood cells shape.

Pallor can be checked on the palms, conjunctiva, nail beds and lips.
When we notice this sign (pallor), we should seek medical attention so that the blood tests are done to confirm the anaemia and also to find the cause of the anaemia.

We don't manage anaemia by just taking supplements but also addressing the root cause of the anaemia.

In the next post we will talk about Jaundice.

Yesterday we were talking about a rare condition didelphys uterus ( double uterus).

Today we are going to share with you two rare conditions.

1) Dextrocardia: This is a condition where the heart of an individual points to the right side of the chest instead of the usual left side.

2) Situs Inversus : This is another rare condition where the internal body organs ( from the chest and Abdomen) are aligned in a different order than what we call the usual.
Example, the heart is on the left side of the chest while the liver and appendix are on the right side of the abdomen, in Situs Inversus, the liver and appendix are on the left side of the abdomen while the heart is on the right side of the chest.

These things may seem confusing and impossible but they do exist.

Did you know that it is possible for someone to carry or have two pregnancies at the same time? The pregnancies can have two or more fetus that are of different gestational age and with different genetic information?

Well it is possible if the mother has didelphys uterus.

A didelphys uterus is a type of anomaly of the uterus, where one has two separate uteruses.

Each uterus functions independently and it can support the implantation and growth of a fertilised egg making it possible for one to have babies in each uterus

It is sounds complicated and confusing right?
It is a rare condition but it is there and aside this condition, there is a bicornuate uterus which is also an anomaly of the uterus.

Hypertensive disorders in pregnancy.

- We are fresh from commemorating the world hypertension Day and it can be a serious error if we don't talk about hypertensive disorders in pregnancy.
- Being pregnant comes with its own challenges and changes in the body which can increase the chances of having abnormalities such as raised BP, sugar , severe vomiting among other conditions.
- When we talk about hypertensive disorders in pregnancy, we need to understand what they are.
- Hypertension is a sustained elevated blood pressure of more 140/90 mmHg that is taken atleast on three different occasions.
- Hypertensive disorders are a major complication in most pregnancies and the can increase the chances of mortality on a mother and child.
- Hypertensive disorders in pregnancy include the following

1) Chronic Hypertension
2) Pre eclampsia
3) Eclampsia
4) Gestational Hypertension
5) Chronic Hypertension with superimposed Preeclampsia.

For more information about the five types of Hypertensive disorders in pregnancy, videos will be posted on medical literacy with Reuben Zulu.