Atrial Fibrillation Is Common In Mitral Stenosis And Mitral Regurgitation

Atrial Fibrillation

Awareness of one’s own heartbeats is known as Palpitation. Valve disorders can present with various types of rhythm disturbances. Extra beats (Premature atrial / Ventricular Contractions) are quite common. Atrial Fibrillation is common in Mitral Stenosis and Mitral Regurgitation.

Atrial fibrillation (AF) is an abnormal rhythm where atrial contractions are ineffective and rapid and ventricular contractions are irregular. Often presented as palpitation. In valvular diseases this condition is caused by atrial dilatation and commonly found in Mitral disease.

Atrial fibrillation causes blood to stagnate in atria and can cause clots in the atria. This can lead to Thrombo-Embolism (Migration of small clots into the circulation causing occlusion of arteries) It can embolize to legs or abdomen. When it happens in the brain circulation, the result is a stroke! So AF is a serious condition which needs to be treated. Patient has to be on Anticoagulant medications (Blood thinning agents to prevent clots) until AF is reverted.

Aortic Trauma

Aortic Trauma

Aorta can be injured in variety of accidents or trauma. A piercing or penetrating injury by a sharp object can directly injure the aorta in the thorax or abdomen. These injuries are often instantly fatal due to severe bleeding.

More commonly aorta is injured in blunt trauma especially in high velocity deceleration accidents. Typically the person is thrown from a speeding bike and comes crashing. The relatively fixed part of aorta (close to the position of ligamentum arteriosum) takes the brunt of impact.

So commonest site of injury in these injuries is opposite the left subclavian artery. Aorta may be sustain partial tear of intima and/or media or a complete tear. The complete tear is a devastating injury accounting for heavy mortality- 20% of victims die before reaching medical facility. Untreated another 10% die every hour following injury. Needless to say, this is a true surgical emergency.

Sometimes the extensive traumatic dissection can cause malperfusion of the visceral vessels or intercostals. Bleeding into the chest can severe enough to cause hypotension and shock.

What About Long Term Lifestyle Modification?

Lifestyle Modification

Yes, this is a very important aspect of long term prevention especially in case of Coronary artery disease, as we all know, Coronary Artery Disease is caused by Atherosclerosis.
 
Atherosclerosis has multi-factorial causation. Some of these risk factors are modifiable whereas some are non-modifiable. Success in keeping CAD away is in manipulating these modifiable risk factors effectively.

• Stop Smoking and tobacco use completely
• Control of Diabetes, Hypertension and Cholesterol
• Regular physical activity (Walk 3 kilometers in 30 minutes daily)
• Reduce weight if obese (to ideal BMI)
• Take medications regularly (Do not stop antiplatelets and statins without doctor’s permission)
• Regular follow up checks.

How Wounds Heal After Heart Operation?

Heart Surgery

Body has a natural reparative process for healing wounds. Generally wounds take about 6-8 weeks to heal completely. Bones may take a little longer. The new tissues will need some time to get used to the stress and strain of activities of daily life. This process is called the remodeling. It is natural to experience some discomfort during healing and remodeling stages.

How Are These Wounds Stitched And Are There Any Stitches To Be Removed? 

The surgical wounds are stitched using special needles and suturing threads. Some materials are biodegradable or self absorbing. They need not be removed. Some need to be removed after the necessary period (like silk and nylon).

Generally all the wounds of heart operation are repaired using self absorbing stitch materials. These can not be seen outside and need not be removed. Small wounds are sometimes repaired using silk or nylon sutures. These are usually removed just before discharge.