Pericardial Effusion – the fluid around the heart, is a clinical problem that is caused when an unusual accumulation of that fluid takes place in the pericardial cavity. A condition when there occurs some inflammation in the sac, then those inflammations of the sac are termed as pericarditis. This condition of pericarditis gives rise to an effusion. The quantity of fluid production increases with an increase of this inflammation. One of the main cause of this inflammation to occur is found to be the presence of viral infections in the body.
Every heart has a sac around it which forms a very important part of the cardio system. This sac is known as the pericardium. The main function of this sac is to protect and shield our heart from other body structures which normally surrounds the heart. Further, this sac has a very small amount of fluid present in them that is evenly spread across the entire heart. In case the fluid present within the sac accumulates abnormally or it exceeds the normal levels, then that situation generally leads to this problem of pericardial effusion.
The fluid around the heart is spread across as a thin layer, evenly throughout the heart. This fluid that surrounds the heart is known as a pericardial fluid. Normally, a very small amount of this accumulated fluid is present inside the sac. Basically, this fluid acts and serves as a lubricating agent or as a lubricant for the proper functioning of the heart. It allows the heart to pump and function properly. It also allows it to turn, stretch and perform with minimal friction.
Most of the times, pericardial effusions are not so dangerous, but at times it may make the heart perform low and work poorly. The sac around your heart, called as pericardium, is a tough covering, although a thin lined layer. Whenever the heart beats, it tends to slide along within it smoothly and easily in normal conditions. A small amount of clear pericardial fluid is already present in between the two layers of the sac which helps in the movement of the heart inside the sac layers. Generally, 15 to 50 ml of the fluid amount is considered to be a normal level for the pericardial fluid. However, a 100m ml of fluid is or 2-3 tablespoons of fluid is normally considered as a small amount of fluid. And a very high accumulation of fluid refers to normally more than 2 litres present inside the same sac, thus causing an inflammation.
The pericardial cavity has a very limited space for storing any fluid or materials inside it. And this is one the major reasons why the higher amount of fluid accumulation in the cavity starts emitting a pressure on the heart and thus affecting the overall heart functions to perform negatively.
An unbalanced equilibrium of the production and absorption of the pericardial fluid which gives a way for entering of the fluid into the pericardial cavity leads to the condition of pericardial effusion. The pericardial fluid is pale yellow in colour. This fluid helps is responsible for balancing the equilibrium of the frictions between the heart functions and movements. Now, if you will ask if the fluid around the heart is dangerous or not, then certainly the answer would be that it may be yes and it may also be no. This certainly depends on the level and type of the medical issue and concerns associated with this problem.
It is recommended that you immediately refer to your doctor as soon as you feel that your chest pain is lasting for some duration, or more than minutes. Similarly, seek a doctor help if you face any problem in the breathing like if f you feel difficulty in breathing or find it painful to breathe. Also, if you anytime tend to faint due to any unexplained reasons then that is also another call when you may plan an emergency and seek for medical help immediately because it may be due to pericardial effusion.
Pericardial Effusion Treatment | Fluid Around Heart Diagnosis:
- Treatment of pericardial effusion depends on the associated cause and severity of the problem.
- Ultrasound scans are done to assess the pericardial effusion. That ultrasound of the heart is medically known as the echocardiogram. An echocardiogram helps in quantifying the amount of fluid that is present around the heart.
- CT scans also help in determining the fluid levels. Pericardial effusion can mostly be detected through a CT scan, and it can determine the quantity of excess fluid surrounding the heart.
- An echocardiogram is more effective most of the time as compared to CT scans because echocardiogram tells us how the effusion is actually upsetting and affecting the heart and its regular functions.
- Pericardial effusion may get even worse if you try to breathe deeply or if you take deep breaths.
- However, you will feel much better if you lean your body forward.
- In some cases, few pericardial effusions remain small in size and don’t enlarge. In this case, treatment may not be required.
- Smaller pericardial effusion which doesn’t generally tend to show any form of symptom or signs of the effusion is normally due to some known reasons and cause, and therefore require no special treatment as such.
- However, if the infections are serious or when the inflammations are high, or when the fluid accumulations are large, or any type of impairments exist in the heart, then it needs to be treated wisely and effectively.
- Taking prescribed medications may also help to recover the cause. It all depends on case to case basis and depends on the cause of the root problem. However, it is one option as well. Medications are also prescribed in most of the cases.
- All extra fluids need to be drained by the surgeon, a specialist, or your doctor.
- The drainage tube in some cases may have to be left intact for few days.
- Draining of the fluid may most probably be done by the help of a needle that will be inserted from the walls of your chest and inserted deep into your pericardial space.
- In few of the cases, drainage of fluids may also require surgical methods. The process of surgical drainage is done by making a window by cutting through the pericardium.
The excess fluid that gets drained out is generally not a big in quantity, and many times patients may get surprised to see that such a minute quantity of that fluid had caused such a big and life-threatening problem to the person. However, it is actually true that balancing and maintaining the desired levels of the fluid quantity limit is very important.
The presence of pericardial effusion in your heart tends to normally put some amount of pressure in your heart, thereby affecting the functioning of the heart. Left untreated, the condition of pericardial effusion may even lead to severe problems which may be very dangerous and sorrowful. It may lead to a complete failure of your or may even take away the life and lead to death. It may be due to a result of the poor or improper circulation of blood and an insufficient supply of the required oxygen into your body. It may at times be life-threatening and therefore there is a need to take proper safety and precautions by seeking medical help and be attentive whenever you face any medical urgency.
It is a fact that many of the effusions are not so harmful, but still, at times it may tend to harm the functioning of your heart. Obviously, there are reasons why inflammations and effusion occur or why fluid gets accumulated in your cardiac parts. Problems may be raised if the accumulation of fluid exceeds the desired limit, which also affects the overall blood supply of the body.
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The very first thing that could come to your mind when you have a chest pain is a Heart attack! The position & the location of the heart also adds to the fear of a heart attack. Apparently, that may not be the only reason. Often there are many factors associated with chest pain. Certainly, chain pain is not something that could be ignored. Chest pain may be due to many reasons like problems in the rib cage, lungs, or even nerves. Whatever be the reason it requires immediate attention.
The chest pain develops anywhere from your neck to the upper abdomen. Chest pain may be sharp, dull, tight squeezing, burning or aching depending upon its cause.
Causes of Chest Pain:
- Anxiety: Anxiety & stress can often cause chest pain. Chest pain on the left side or in the middle of the chest is mainly due to anxiety. It may cause heaviness, discomfort & even increase the heartbeat rate most of the times. These disorders are usually dealt with medications & therapy. Once anxiety is dealt with then the chest pain will be resolved.
- Costochondritis: This is the condition when there is an inflammation around the cartileges surrounding the ribs and this might eventually cause pain on the left side of the chest. This condition may arise due to various reasons such as an excessive cough, vomiting, hitting the chest in a car accident, muscle pulling, or even vigorous exercises. The person is advised to take proper rest and give it some time so that heals on its own.
- Intercostal neuralgia: This is referred to as the nerve damage near the chest area. It may be caused due to damage to the rib cage or surgery to the rib cage.
- Bronchitis: Any viruses, bacteria or even harmful pollutants such as smoke, fumes, harmful toxins from chimneys or industrial cleaning may cause bronchitis. It is accompanied by a dry cough, tiredness, and vomiting that may contain blood. It also results in shortness of breath or fever. The pain is worsened by coughing. Treatment varies depending on the underlying cause.
- Pleuritis: it is an irritation of the lining of the chest or lungs. When the irritation is mostly in the left lung the pain is felt more on the left side.
- Pulmonary embolism: it is more likely to occur in persons who have been immobile for days after surgery or may occur even as a complication of cancer. It is a serious condition wherein the blood clot in any part of the body travels through the bloodstream and gets stuck in the lungs. It causes difficulty in breathing and also increases the heart rate. It requires immediate medical attention. Failure to do so can be life-threatening.
- Rib fracture: It may be due to the accident and can cause discomfort in breathing, pain while bending or twisting or a pressure in the chest or rib area. This may be often mistaken for a heart attack.
- Angina pectoris: it is a condition where there is a block in the arteries that supply the heart muscles. The chest pain is due to inadequate flow f blood to the heart and is often accompanied by nausea, sweating, tiredness and a feeling of heaviness in the chest. The discomfort arises in the left shoulder or arm and runs downward.
- Aortic dissection: when there is a tear in the large blood vessel coming from the heart it results in a condition known as aortic dissection. Blood rush through the tear and layers of the heart begin to separate. The pain, in this case, is very severe and feels like a tearing. It is often associated with fainting and is a very rare case that presents in the form of chest pain.
Coronary Artery Disease(CAD):
When there is any block in the blood vessels, the supply of blood & oxygen to the heart is highly reduced results in a condition known as coronary artery disease. This can cause pain in the heart muscle but does not cause any permanent damage to the heart. The chest pain, in this case, is referred to as angina and spreads to the left shoulder, arm, back & jaw.
- Myocardial infarction: Even in this case the blood flow to the heart is reduced due to blockages in the blood vessels. The pain, in this case, is even more severe & can cause severe damage to the heart.2.
- Myocarditis: it does not cause any blockage but the symptoms are similar to those of heart attack. The chest pain is often associated with fever, heart muscle inflammation, increased heart rate & difficulty in breathing.
- Pericarditis: this is the inflammation or infection of the sac around the heart. The pain experienced is sharp & steady and is along the upper neck & shoulder. The pain also causes difficulty in breathing & consuming food.
- Hypertrophic cardiomyopathy: it is a genetic disease that causes the heart muscles to grow abnormally thick. It might turn life-threatening when the heart muscles turn unusually thick as it makes it harder for the heart to pump blood. The chest pain is often accompanied by shortness of breath.
- Mitral valve prolapse: when one of the heart valves fail to close properly it results in a medical condition called as mitral valve prolapse. Chest pain, palpitation, & tiredness are often associated with this condition.
Other problems that might cause chest pain:
- A hiatal hernia: this happens when the upper abdomen pushes into the lower chest after consumption. This causes heartburn or chest pain. You may experience severe pain when you lie down.
- Pancreatitis: you will have redness if you have got pain in the lower chest. You may experience severe pain when you lie down.
- Gallbladder: if at all you develop a chest pain after a fatty meal in the right lower chest area or right upper side of the abdomen then the chest pain is probably due to the problem in the abdomen.
When should I seek a medical help at the hospital?
Generally, as we have already mentioned, chest pain could be a symptom that an individual must not ever ignore. The explanation is that although most times it’s from a benign cause, you cannot tell whether or not it’s being caused by a critical downside on your own. This is why you ought to get it consult with a Doctor. Generally aches that you simply suppose might not mean something serious can be early warning signs of one thing terribly dangerous.
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Angina is a type of chest pain that results due to the decrease in the blood flow to the heart. When there is decreased blood flow to the heart, it means that heart is lacking sufficient oxygen. Emotional stress or physical activities are the main causes of the pain. Angina Pectoris also called as stable angina is the most common type of Angina. Stable angina is predictable which means you can actually track the pattern of the chest when you feel the pain. On the other hand, unstable angina is another type of angina which occurs suddenly and gets worse over time.
Though stable angina is less serious condition both types of angina are the symptom of underlying heart disease.
What Causes Stable Angina?
Stable Angina is a condition when the heart does not receive sufficient oxygen supply. There are many factors that can possibly reduce the oxygen supply to the heart. Some of them are:
- Emotional stress and physical activity
- Narrowing of arteries
- Accumulation of plaque (Cholesterol, fat, etc) in the artery walls
- Blood clots in arteries
What are the Risks Factors of Stable Angina?
The risk factors associated with Stable Angina include:
- Overweight or obese
- Medical history of Heart disease
- Diabetic patients
- People with High Cholesterol or High Blood Pressure
- Lack of physical activities
Unhealthy diets, vigorous workouts and extreme cold and hot weathers can also stimulate stable angina in some cases.
What are the Symptoms of Stable Angina?
The pain that occurs during the stable angina is referred to as pressure or fullness in the center of the chest. The pain may be like a heavy weight resting on your chest or a mild squeezing of the chest. The pain slowly spreads from the chest to neck, arms and shoulders.
One may notice the following symptoms while suffering from stable angina:
The symptoms usually last for 15 minutes whereas in the case of unstable angina the pain is more severe and continuous.
How is Stable Angina Diagnosed?
Your doctor will run through your medical history and perform some tests such as ECG and angiography. These tests help to diagnose the proper functioning of the heart and if the arteries are blocked. You will also be asked to perform a stress test while which your heart rhythm and breathing will be measured. This helps to find out if physical activity triggers angina. A blood test will also be taken to measure cholesterol and C-reactive protein levels (CRP). High CRP levels can also increase the risk of heart diseases.
How is Stable Angina treated?
Treatment for stable angina includes changes in lifestyle, medication, and surgery.
Lifestyle changes: Certain lifestyle changes can help prevent future stable angina. These changes include regular exercising, eating a healthy diet consisting of whole grains, fruits, and vegetables, nuts, etc. One should also quit smoking. These changes will help in the long run and reduce the risk of diabetes, cholesterol, and high blood pressure.
Medication: nitroglycerine is usually prescribed which relieves pain associated with stable angina. You will also have to take other medications to stabilize your blood pressure, diabetes, and cholesterol levels.
Surgery: Angioplasty is often recommended to treat stable angina. The blocked arteries can be surgically treated using surgery. Angioplasty involves a balloon which is inserted into the arteries and inflated to a required size. A stent is placed to keep the blocked artery open.
The condition often improves with medications. In addition to this, adapting yourself to lifestyle changes will reduce the chances of future stable angina.
You can even call or book an appointment with doctors on our website to ask your queries or have a free consultation.
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Heart attack or myocardial infarction usually occurs when the smooth flow of blood to the heart is blocked, by a build-up of fat. When the flow of blood is blocked the tissues lose oxygen and dies.Heart attack also happens to women and can be identified through certain symptoms.
Symptoms of Heart Attack:
Unusual fatigue can be one of the signs of heart attacks. Some women feel tired, at times even if they’ve been sitting still for a while. One must pay attention to fatigue and should watch out if it’s new or dramatic.
- Does simple activity like walking to the bathroom make you feel exhausted?
- Do you experience sleep disturbances even if you’re dead tired?
- Do you feel completely worn out after your regular exercise routine.
2. Stomach pain:
Most of the time people mistake stomach pain with flu, stomach ulcer, heartburn.
- Stomach pain can also cause in the middle of the upper abdomen.
- The pain in the upper abdomen can be more like discomfort or heaviness rather than stabbing pain. It can also occur with or without pain.
- The pain of a heart attack can also occur in epigastric area, like heartburn.
3.Shortness of breath & sweating:
Shortness of breath is caused by the increase in weight and also because of the lack of exercise. There are certain symptoms-
- Without exertion, you’ll start sweating or will have a breathing problem.
- Shortness of breath can also cause chest pain or fatigue.
- Women can feel shortness of breath while lying down but it eases when they are sitting upright.
- Sweating can also occur. Excessive sweating without any reason is a common symptom.
This type of pain is one of the most common heart attack symptoms
- Chest pain may differ in both men and women.
- It can be characterized by a sense of fullness, heaviness, squeezing or pressure on the chest.
- The pain can last for few minutes or it can also return.
- This discomfort can also spread down to the back or arms or to the neck and head.
5.Neck and Back pain:
These kinds of pains are more common in women than in men.
- Neck pain can differ and people also misinterpret it at times.
- Neck pain can also lead to back pain, the pain either be gradual or sudden or recurrent.
- Jaw pain can also be the result of neck pain.
If you’re feeling anxious, make a note of it.
- Heart attack patients have said that at times they feel that something is wrong or weird.
- They stress about everything and start feeling anxious.
7.Feeling Dizzy or lightheaded:
This is one of the most common symptoms of heart attack in women.
- You start shaking for no reason.
- Feeling faint from shortness of breath and start sweating.
If you notice any of the above symptoms consult your doctor and take necessary steps. Make a note of the symptoms and explain it to your doctor. Don’t ignore any signs or symptoms.
Heart transplant in India: A heart transplant is a surgical procedure that is employed for patients who have end-stage heart failure or severe coronary artery disease. In this procedure, the diseased heart is usually replaced with a healthy heart from decreases donor that is a person who has recently died. This is the last option that the doctor has when all the other treatment procedures have failed.
The Heart Transplant Procedure:
It’s quite natural for anyone to feel nervous, emotional and anxious about the surgery. The heart transplant surgery acts like a new pump which pumps the blood and does not cause any behavioural changes in the body. It takes about 4 to 6 hours for the surgery to be completed.
- The heart transplant surgery is usually done in a hospital. The patient is not awake during the surgery and is given an anaesthetic.
- The surgeon will cut your breastbone to get access to your heart.
- The medicine is injected into the patient’s body through the intravenous (IV) line in the arm.
- The breathing is supported with help of a ventilator.
- The surgeon will open your chest and connect the heart’s arteries and veins to the heart-lung bypass machine.
- He then removes the diseased heart and connects the arteries and veins from the heart-lung machine to the donor
- The heart transplant is complete when the surgeon closes your breastbone with a wire which stays there forever.
How long is the wait for the heart transplant?
Once the patient is considered suitable for a heart transplant then he or she is put on the waiting list. Once you are on the list, a suitable heart may come along the way within few days, or months or years. Usually, it’s not that easy to find a suitable heart. Only 8 out of 10 people receive the heart transplant they require.
What happens after the heart transplant?
The duration of stay in the hospital will depend upon your health condition after the surgery. You will have to have regular health check-ups for a year after the surgery. You will be physically weak after the surgery and so you have to avoid heavy activities such as lifting and pushing until your breastbone is completely healed. It will take about 4 to 6 months to for the breastbone to heal completely.
How will life be after the heart transplant?
After complete recovery from the surgery, you can proceed with your routine life activities. The only care is you should take medicines on regular basis. Your medications include immune-suppressants that help prevent the donor heart from infection. Without this, your body will recognize the donor heart as a foreign body and will try to reject it. Over ¾ of the heart transplant patients live for over 5 years.
Cardiac allograft vasculopathy is a common and serious complication of a heart transplant. It is an aggressive form of atherosclerosis that over months or years can block the heart’s arteries and cause the failure of the donor’s heart. Over time, your donor heart will fail due to the same reason that caused your old heart to fail. Very few people will be eligible for a second heart transplant surgery.
Despite these risks, heart transplant has a considerably good success rate that has improved over many decades of research. The survival rates are about 85% at one year after surgery, with survival rates decreasing by about 3 to 4 % each additional year after surgery because of serious complications.
Who performed the first successful heart transplant surgery?
Panangipalli Venugopal has pioneered heart transplant surgery in India. He was the first surgeon to successfully perform a heart transplant surgery. The count is now standing at 26 successful transplantations. He was the first surgeon in Asia to have performed the implantation of left ventricular assist device lasting for more than 90 days. He was the first one to introduce stem cell therapy in India, by implanting the stem cell for repairing the myocardium. This was then used as an alternative to transplantation.
Best hospitals for heart transplantation in India:
Although India has some of the best medical facilities for heart surgeries, it is not very easy for a patient to decide which is the best hospital for heart transplant surgery. So we provide you with a list of hospitals and the facilities they provide so that you can choose your option.
The following is the list of the best and approved hospitals for heart transplantation in India:
Heart transplant hospital in Delhi:
Delhi has over 30 healthcare facilities with proven records of good heart patient care and world-class facilities. Some of the trusted health care centres in Delhi are:
- Fortis escort heart institute and research centre
- Medanta – the medicity
- Indraprastha Apollo hospital
- Apollo cardiac centre
- Max super speciality hospital
- Metro hospital and heart institute.
Heart transplant hospital in Mumbai:
Mumbai has over 40 cardiology healthcare centers. Some of the trusted healthcare centers in Mumbai are:
- Apollo hospital
- Ambani hospital
- Breach candy hospital
- Tata memorial hospital
- Kakilaben Dhirubhai hospital
Heart transplant hospitals in Chennai:
Chennai has over 25 heart surgery hospitals which perform different kinds of surgeries. Till now, Chennai has done about 142 surgeries. Some of the trusted centers are:
- Rajiv Gandhi government general hospital
- Apollo hospital
- Frontier Lifeline hospital
- Global hospital
- Fortis hospital
- Sri Ramachandra medical college and research institute
Heart transplant hospitals in Bangalore:
There are over 20 cardiology centers in Bangalore. Some of the trusted healthcare centers are:
- Fortis Malar
- Apollo hospital
- Sakra world hospital
- Jayadeva hospital
- Manipal heart foundation
Some of the top surgeons specialized in Heart surgeries are listed below:
- Dr.Naresh Trehan
- Dr.S.K. Sinha
- Dr.Sandeep Attawar
- Dr.Praveen Agarwal
- Dr.Subhash Chandra
- Dr.Balram Airan
- Dr.Satish Javali
- Dr.Sunil Vanzara
- Dr.Suresh Joshi
- Dr.S. Bhattacharya
- Dr .Arun Visvarajan
- Dr.Rahul Chandola
- Dr.Paul Ramesh
- Dr.K.R. Balakrishnan
- Dr.Gilbert Joseph
- Dr.Tameem Ahmed
- Dr.Devi Shetty
The cost of heart transplantation in India:
Of all the surgeries performed in India, heart transplantation is the most expensive. The total cost of organ transplant ranges from between INR 20,00,000 to 25,00,000. Even after the surgery, you will have to take special care and regular medications. The medications will cost around INR 30,000 per month. You will have to continue this for a few months after the surgery. In some cases, the air ambulance may be used to bring the donor heart from one location to another. This will cost around 7-10 lakhs.
Benefits and Risks of heart transplants:
According to a survey conducted, 87% of the patients who receive heart transplants survive about one year. 73% of the patients may live for about 5 years. Today’s heart transplant recipients live longer after the surgery than those who received the surgery 10 years ago. Many transplants recipients are advised to do swimming, walking and a lot more physical exercises to remain healthy.
The improved life expectancy of heart transplant recipients is due to the immunosuppressive drugs which reduce the body’s ability to reject new organs. Rejection is the major risk of the transplant surgery. Sometimes the immune system might send out antibodies to reject the new organ. In many cases, the rejection may cause extensive damage to the organ.
One should also be aware of the possible side effects of using immunosuppressants. It may elevate cholesterol levels and blood pressure. People taking immunosuppressive drugs are advised to avoid grape juice. This is because the combination of both increases the blood levels and causes nausea, vomiting, and lightheadedness.
The second risk is that of infection. There is every possible way that the new organ may be infected. In that case, people have to immediately rush to the doctor to get it treated. Infection of the new organ may cause:
Researches are being carried out to find ways to reduce the risk of infection and rejection. To know more about the heart transplant surgery and the best hospitals and surgeons log on to Free Doctor Helpline or call us at +918010555444.
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Even most of the medically acquainted people today often get confused between heart attack and heart failure, what to talk of the less literate ones ! To understand this difference, one has to first get to know about the mechanism of functioning of heart.
The Function of the Heart
The main function of the heart is to ensure blood supply to different organs. This is done by regular beating of the heart. This beating is ensured by an electrical impulse produced by the heart muscle on its own. As every other organ, heart muscle too, requires regular blood supply to meet its daily expenses. The particular artery which supplies the blood to the heart muscles is known as the coronary artery.
What is Heart Attack?
Now, there are several factors like excessive intake of fat, smoking, lack of exercise etc. which may cause blockage in the coronary artery. The result will be lesser blood supply to the heart muscles eventually causing the deadening of heart muscle which is technically known as myocardial infarction, or in more common terms, heart attack. The severity of the heart attack will depend upon the extent of the blockage. This blockage is checked by a diagnostic process called coronary angiography. If found, the cardiac surgeon tries to clear the process through another intervention called angioplasty. If there is a chance of relapse of the blockage, or constriction of the artery, an implant known as stent is placed inside. However, if the cardiologist finds it difficult to clear the blockage, that portion of blocked artery is bypassed and blood supply is restored from some other part. This is known as the bypass surgery.
What is Heart Failure ?
Heart failure or cardiac arrest is an electrical failure of the heart muscle. As discussed earlier, for proper and regular beating of the heart, electrical impulses are generated in the heart muscle. Due to several reasons like ageing, or blockage of impulse routes in heart, it may go slow, irregular or stop at all. Such event may cause irregularity in the rhythm of the heart. A faster hear rate called tachycardia, while the slower heart rate is called bradycardia. There is another case where the heart beat goes irregular, the case known as arrhythmia. A special case where the heart goes slower sometimes and faster at some other occasions, is known as the sick sinus syndrome. In case of complete failure of this electrical impulse, the heart stops immediately, the condition known as the cardiac arrest or heart failure. Any such electrical irregularity could be easily detected by a simple ECG.
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To regulate this electrical activity, an artificial device called pacemaker is implanted. This is an instrument which acts as a silent spectator till the heart is functioning on its own. As soon as the impulse rate falls below 60 beats per minute, the device starts generating impulse so as to maintain the beating in the desired rhythm. Artificial pacemakers are single chambered and dual chambered, The latter one ensures the better coordinated heart rhythm as it supplies the impulse to both, atrium and ventricles of the heart via separate electrodes.
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