white coat syndrome

Most of us feel quite uncomfortable when visiting a doctor’s office. The atmosphere is always strict, and, since childhood, you may remember nothing good ever comes from visiting doctors. They always push and prod until you wince with pain, as if they know where it’s going to hurt the most. So whenever you enter their office, you remember all those times that brought you pain, and even when they smile at you, it’s hard to relax completely.

For most people, this fear of doctors is nothing but a small discomfort. However, some individuals develop a so- called “White coat syndrome.” This syndrome stems from  childhood fear of doctors and can spell lots of trouble for you. “How?” – you might ask. Well, white coat syndrome is also known as white coat hypertension, meaning that, whenever a person sees a doctor in a white coat, or even enters a clinic, their blood pressure begins to rise.

This can provide doctors with very misleading results, making them think the patient might have mild hypertension. While in reality, the patient might be completely healthy. Moreover, the medications they prescribe might make the patient  feel unwell. If a person takes antihypertensive drugs while having normal blood pressure, the blood pressure will become sub-normal and make him/her feel faint.

Symptoms of White Coat Syndrome

White coat syndrome (otherwise known as white coat hypertension) is a condition where the patient exhibits elevated levels of blood pressure when they see a doctor in white coat. This phenomenon has been linked to anxiety that some people experience when they visit a clinic. This can be very troublesome and lead to incorrect diagnosis and treatment.

There is also a contrasting phenomenon called “masked hypertension”. If the patient has this condition and when visiting a doctor, the patient  experiences the blood pressure dropping to normal levels, while being elevated throughout the day. This can prevent the patient from receiving treatment since the doctor might not suspect that something is amiss.

Making a Correct Diagnosis

Studies show that as many as 15%-30% of people who are thought to have mild hypertension, in truth, have normal blood pressure when not exposed to a clinical environment. Moreover, there is no correlation between the age or sex of the patient and the rate at which this condition appears.

In order to exclude false positive results, patient self-measurement or ambulatory blood pressure monitoring is used. However, even those methods are not foolproof since blood pressure is still affected by daily variables such as stress, physical activity, and duration of sleep.

In another study conducted by Turkish scientists, the blood pressure of 438 patients was elevated. This study revealed that taking blood pressure in clinical settings produces a considerable number of false-positive results:

  • 38% of the people had normal blood pressure
  • 15% had sustained hypertension
  • 43% had white coat hypertension
  • 2% had masked hypertension.

These results show that, in this particular study, 45% of the cases resulted in measurements of false blood pressure as a result of being taken in clinical settings. This presents a serious issue since this means taking blood pressure in clinical settings yields unreliable results. This is the reason why 24 hour ambulatory monitoring should be compulsory before antihypertensive treatment is prescribed. This will prevent healthy people from taking drugs that they don’t need. It also helps to identify people with masked hypertension,  otherwise they would go untreated.

Moreover, the same study showed that, even people who are using antihypertensive drugs and have normal blood pressure at home, may exhibit white coat hypertension, which makes it difficult for the doctor to evaluate the effectiveness of the treatment.

Should White Coat Syndrome be Treated?

There is still debate as to whether patients with white coat syndrome should receive any kind of treatment. The majority of scientists agree that patients with “white coat” syndrome should not receive any kind of antihypertensive therapy since this may lead to hypotension. However, patients with white coat hypertension should still be more wary and check their blood pressure more often as, statistically, they are more prone to developing heart disease than people who are normotensive.

 

 

Coronary heart disease (CHD)coronary-heart-disease is a disease in which plaque, through a process called atherosclerosis, accumulates inside the arteries that supply oxygen-rich blood to the heart. The plaque, over many years can slowly narrow the arteries supplying the heart or break off and travel from the diseased artery and completely block blood flow elsewhere. Another threatening scenario can occur when a blood clot forms at the site where the plaque breaks off the diseased artery. Similarly to plaque formation, the blood clot can narrow and completely obstruct blood flow as it increases in size.

Cardiac tissue is made up mostly of cardiac muscle. Smooth muscle, in addition to nervous, connective and endothelial tissue forms the vessels, valves and electrical conduction system supporting the overall function of cardiac muscle. The contracting and relaxing cardiac muscle is responsible for pumping blood throughout the body and has poor to no regenerative capacity once damaged.

flu vaccine provoke a heart attack

Over the years, many studies have shown a tie between heart disease and influenza. In one 2003 study published in the New England Journal of Medicine, a study group with various types of heart issues that received the flu vaccine were 20 % less likely to die from heart problems in a hospital, and 50 % less likely to die in the year after the vaccination. The study results were remarkable but logical. The heart works harder if the body suffers of any kind of viral infection, including the flu, and heart sufferers, which had heart attacks or operations to forestall them, have weakened hearts.

The study analysts also discovered that the life extension rate is not connected only to avert the flu, but in their opinion, influenza vaccine could have auxiliary features that guard heart patients from suffering any heart related problems in the year after the vaccination. The study concluded that this finding does not mean that people who did not take the shot, and died from a heart disease, had influenza. (The shot was approved for heart patients, NOT the nasal spray)

smoking-bad

The dangers of smoking have been well-established since the 1950s. However, millions of individuals across the globe continue on with their daily addiction to cigarettes and other tobacco products. The chemicals involved in this unhealthy habit harm almost every organ in the body and contribute to millions of preventable deaths each year.

The nearly 4,000 chemicals present in cigarettes are especially damaging to the heart and blood vessels. The entire cardiovascular system is built upon efficiently functioning vessels, proper blood flow, and the powerful pumping of the heart. Unfortunately, smoking causes severe damage to all of these functions, which leads to heart failure and a variety of other cardiovascular diseases.

Heart failure and SexualityMost of the people who suffer from heart failure ask themselves at one point or another: “Is it safe for me to have sex?” As you might already know – the body may age, but the spirit stays young. Therefore, people in a more mature age group seek and desire love and companionship just as much as the younger generation.

pregnancy and CVD

At one time, women that had heart disease (elevated blood pressure, heart defects from birth often noted by the presence of heart murmurs, irregular heartbeats, etc.) were advised not to get pregnant. This has changed because most women with heart disease can have successful, healthy pregnancies and healthy babies with some special guidance and planning.

Certainly, pregnant women with co-occurring heart/cardiac disease present special management issues but most of the issues can be overcome with proper medical care, diet, exercise, nutrition, and medication if prescribed by your doctor. Pregnancy is a stressful condition, sometimes emotionally for women and always it is always physically stressful. Your heart is called upon to provide nourishment for two so it needs to work significantly harder supplying blood to both you and your baby.

Heart failure and physical activity

If you have experienced heart attack, heart failure or have been diagnosed with cardiovascular disease, what now?
After receiving treatment, what can you do to improve cardiovascular health and physical fitness?
The answer to both questions is cardiac rehabilitation.
Cardiac rehabilitation employ a number of medical programs designed by physicians that help a patient recover from serious heart problems. These programs are specialized to meet the specific needs of the patient. An entire panel of professionals including doctors, nurses, dietitians, exercise therapists and physical therapists work to provide a safe recovery.

To learn more about Cardiology, we recommend the following websites:
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