Aplastic Anemia

What is aplastic anemia?

Aplastic anemia is a rare but serious blood disorder. If you have it, your bone marrow doesn't make enough new blood cells. It happens when there is damage to stem cells inside your bone marrow. There are different types of aplastic anemia, including Fanconi anemia.

The causes of aplastic anemia can include:

• Autoimmune disorders, which are the most common cause
• Certain inherited gene changes, such as the one that can cause Fanconi anemia
• Toxic substances, such as pesticides, arsenic, and benzene
• Radiation therapy and chemotherapy for cancer
• Certain medicines
• Viral infections such as hepatitis, Epstein-Barr virus, or HIV
• Pregnancy

In many people, the cause is unknown. This is called idiopathic aplastic anemia.

Aplastic anemia can develop suddenly or slowly. It can be mild or severe. The symptoms of aplastic anemia can include:

• Fatigue
• Weakness
• Dizziness
• Shortness of breath
• Easy bruising or bleeding

Aplastic anemia can cause other problems, including frequent infections and bleeding. It raises your risk of developing a serious blood disorder.

If not treated, aplastic anemia can also lead to heart problems such as an arrhythmia (a problem with the rate or rhythm of your heartbeat), an enlarged heart, or heart failure.

To find out if you have aplastic anemia, your doctor will:

• Take your medical and your family medical histories
• Do a physical exam
• Order tests, such as tests to check if you have low numbers of cells in your bone marrow and blood

If you have aplastic anemia, your doctor will create a treatment plan for you. The plan will be based on how severe the anemia is and what is causing it. Treatments can include:

• Blood transfusions
• Blood and marrow stem cell transplants
• Medicines to suppress your immune system

Because of the risk of blood disorders, your doctor will monitor your condition and screen you for blood disorders regularly.

NIH: National Heart, Lung, and Blood Institute

Artificial Limbs

People can lose all or part of an arm or leg for a number of reasons. Common ones include:

• Circulation problems from atherosclerosis or diabetes. They may cause you to need an amputation.
• Traumatic injuries, including from traffic accidents and military combat
• Cancer
• Birth defects

If you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which is called a prosthesis, can help you to perform daily activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as before.

Ataxia Telangiectasia

Ataxia-telangiectasia (A-T) is a rare, inherited disease. It affects the nervous system, immune system, and other body systems. Symptoms appear in young children, usually before age 5. They include:

• Ataxia - trouble coordinating movements
• Poor balance
• Slurred speech
• Tiny, red spider veins, called telangiectasias, on the skin and eyes
• Lung infections
• Delayed physical and sexual development

People with A-T have an increased risk of developing diabetes and cancers, especially lymphoma and leukemia. Although it affects the brain, people with A-T usually have normal or high intelligence.

A-T has no cure. Treatments might improve some symptoms. They include injections to strengthen the immune system, physical and speech therapy, and high-dose vitamins.

NIH: National Institute of Neurological Disorders and Stroke

Atherosclerosis

What is atherosclerosis?

Atherosclerosis is a condition in which plaque builds up inside your arteries. Plaque is a sticky substance made up of cholesterol, fat, blood cells, calcium, and other substances found in the blood. Over time, plaque hardens and causes your arteries to narrow. That limits the flow of oxygen-rich blood to your body.

Some people may confuse atherosclerosis and arteriosclerosis, but they are not the same thing:

• Arteriosclerosis is hardening of the arteries, which means that the arteries thicken and become less flexible. It can have several different causes.
• Atherosclerosis, which develops from plaque buildup, is a common type of arteriosclerosis.

Atherosclerosis can affect most of the arteries in the body. It has different names, based on which arteries are affected:

• Coronary artery disease (CAD) is plaque buildup in the arteries of your heart.
• Peripheral artery disease (PAD) is plaque buildup in the arteries that carry blood away from the heart to other parts of the body. It most often affects the arteries of your legs, but it can also affect the arteries of your arms or pelvis.
• Carotid artery disease is plaque buildup in the neck arteries. It reduces blood flow to the brain.
• Renal artery stenosis is plaque buildup in the arteries that supply blood to your kidneys.
• Vertebral artery disease is plaque buildup in the arteries that supply blood to the back of your brain.
• Mesenteric artery ischemia is plaque buildup in the arteries that supply your intestines with blood.

Plaque often starts to build up during childhood and gets worse with age. The exact cause is unknown, but researchers believe that this buildup happens when there is damage to the arteries. This damage may be caused by unhealthy lifestyle habits, medical conditions, and your genes.

You may be more likely to develop atherosclerosis if you:

• Have certain medical conditions, including:
  • High blood pressure
  • High blood cholesterol
  • Diabetes
  • Metabolic syndrome
  • Inflammatory diseases such as rheumatoid arthritis and psoriasis
• Have a family history of high blood cholesterol
• Eat a lot of foods high in saturated fats
• Smoke or chew tobacco
• Are older - the risk increases after age 45 men and age 55 in women

In the early stages, atherosclerosis often does not cause any symptoms. You may first notice some symptoms at times when your body needs more oxygen. For example, this could be when you are having physical or emotional stress.

Your symptoms will depend on which arteries are affected and how much blood flow is blocked:

• With coronary artery disease, the symptoms may include angina (a type of chest pain), palpitations (racing or pounding heart), and shortness of breath.
• With carotid artery disease, you may have a bruit. This is a whooshing sound that your health care provider hears when using a stethoscope. You could also have a transient ischemic attack (TIA), sometimes called a mini-stroke.
• With peripheral artery disease, you may have pain, aching, heaviness, or cramping in the legs when walking or climbing stairs.
• With vertebral artery disease, you may have problems with thinking and memory, weakness or numbness on one side of the body or face, and vision trouble. You could also have a transient ischemic attack.
• With mesenteric artery ischemia, the symptoms can include severe pain after meals, weight loss, and diarrhea.

For men, erectile dysfunction (ED) is an early warning sign that you may be at higher risk for atherosclerosis and its complications. If you have ED, talk with your provider about your risk of plaque buildup.

Atherosclerosis can cause other health problems, or complications. For example, if a plaque bursts, a blood clot may form. The clot could block the artery completely or travel to another part of the body. Other possible complications can vary, depending on which arteries are affected. For example, blockages in different parts of the body can lead to complications such as a heart attack, stroke, vascular dementia, or limb loss.

To find out if you have atherosclerosis, your provider:

• Will ask about your medical and family health history
• Will ask about your lifestyle and risk factors for plaque buildup in the arteries
• Will do a physical exam, which will include listening to your heart and the blood flow in your arteries
• Will likely order tests, such as blood tests and heart health tests

If you have atherosclerosis, your provider will work with you to create a treatment plan that works for you. Your plan will depend on which arteries are affected, how much the blood flow is blocked, and what other medical conditions you have. Possible treatments may include:

• Heart-healthy lifestyle changes.
• Medicines to:
  • Manage your risk factors.
  • Treat atherosclerosis or its complications.
  • Treat any medical conditions you have that can worsen plaque buildup.
• Procedures or surgeries to treat diseases or complications that were caused by plaque buildup. The specific type of procedure or surgery will depend on which arteries are affected.
• Cardiac rehabilitation, if you have had certain complications from atherosclerosis.

There are steps you can take to try to prevent atherosclerosis:

• Choose heart-healthy foods, such fruits, vegetables, and whole grains. Limit foods that are high in saturated fats, salt, and added sugars.
• Do regular physical activity. But before you start an exercise program, ask your provider what level of physical activity is right for you.
• Aim for a healthy weight.
• Limit how much alcohol you drink. Drinking less is better for health than drinking more. Men should limit their intake to 2 drinks or less in a day. Women should drink 1 drink or less per day.
• Manage stress.
• If you smoke, quit smoking.
• Avoid secondhand smoke.
• Get enough good-quality sleep.

NIH: National Heart, Lung, and Blood Institute

Atrial Fibrillation

What is atrial fibrillation (AFib)?

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Anyone can develop AFib, but there are certain things that raise your risk for it:

• Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
• Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
• Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
• Having certain health conditions, such as:
  • High blood pressure
  • Diabetes
  • Heart failure
  • Heart valve diseases
  • Obesity
  • Hyperthyroidism
  • Chronic kidney disease
  • COPD and other lung diseases
  • Sleep apnea
• Race. AFib is more common in people with European ancestry.
• Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

• Extreme fatigue, which is the most common symptom
• Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
• Trouble breathing, especially when lying down or when exercising
• Chest pain
• Dizziness or fainting
• Low blood pressure

If AFib is not treated, it can lead to serious health problems (complications) such as:

• Stroke
• Heart failure
• Blood clots
• Sudden cardiac arrest (SCA)
• Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

To find out if you have AFib, your provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
• Will ask about your family history, to find out if you have relatives who have or had AFib
• Will do a physical exam
• May order blood tests
• Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
• May ask you to wear a heart monitor device that records your heart's electrical activity

The treatments for AFib may include:

• Blood thinner medicines that help prevent blood clots from forming.
• Medicines to control your heart's rhythm and rate.
• Following heart-healthy lifestyle changes, such as:
  • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
  • Limiting or avoiding alcohol, because it can increase your heart rate.
  • Aiming for a healthy weight.
  • Getting regular physical activity.
  • Managing stress.
  • Quitting smoking.
• Procedures such as:
  • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
  • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
• Surgeries such as:
  • Surgery to put in a pacemaker to help control the arrhythmia.
  • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
  • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.

There are steps you can take to help lower your risk of atrial fibrillation, such as:

• Making heart-healthy lifestyle changes:
  • Following a heart-healthy eating plan
  • Limiting or avoiding alcohol
  • Aiming for a healthy weight
  • Getting regular physical activity
  • Managing stress
  • Not smoking
• Avoiding illegal drugs, such as cocaine and methamphetamines
• Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
• Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute