Electrocardiogram

An electrocardiogram or ECG is a non-invasive diagnostic test to record the electrical voltage in the heart so as to understand its functioning and regularity of heart beats. The electrocardiogram or EKG can help in diagnosing cardiovascular disease. The ECG is used to check for any damage to the heart and regulate the functioning of the pacemaker.

An electrocardiogram measures the electrical activity within the heart, thereby throwing light on the how the heart muscles function. This test is not painful. An ECG is recommended for patients who complain of regular chest pain or palpitations to check for the normal functioning of the heart. It can help in detecting heart attack or (ischaemia) ischemia. If a patient suffers from hypothermia, pulmonary embolism, mitral stenosis or left ventricular hypertrophy, an EKG can help in diagnosis.

Other non-cardiac problems such as drug overdose or electrolyte imbalance can be diagnosed with an EKG. Abnormal results from an ECG test may be indicative of arrhythmia, myocarditis, impending heart attack or enlarged heart.

Sleep Apnea

Sleep apnea is a sleep disorder that is characterized by repetitive episodes of upper airway obstruction. While it can lead to daytime drowsiness and lethargy, it can be potentially life threatening if left untreated. Sleep apnea is a condition where the blockage of the airway prevents air from getting into the lungs. This leads to snoring at regular pace and short periods of time where the breathing ceases. Apnea is the lack of spontaneous breathing. The patient may become limp and lifeless, have a seizure or turn bluish.

This is followed by sudden attempts to breathe with a loud gasp and snort. Consequently this condition affects the sleep and the person is not well rested. Besides the oxygen levels remain low leading to drowsiness and tiredness. Severe sleep apnea is likely to cause pulmonary hypertension. A large neck or collar size can be one of the causes of obstructive sleep apnea. Sleep apnea can be potentially life threatening since it can cause heart attacks or strokes.

Prolonged apnea is called as respiratory arrest. In children, this can quickly lead to cardiac arrest in which the heart stops beating whereas in adults, cardiac arrest usually is the first to happen followed by respiratory arrest. In adults, common causes of apnea and respiratory arrest include choking, drug overdose, near-drowning, head injury and cardiac arrest. In children, the causes may be different - prematurity, swelling of the airways, choking on a foreign object, seizures, regurgitating food or near-drowning.

Obstructive sleep apnea: This is a condition where tissues of the body obstruct the airways during sleep. Obstructive Sleep apnea is common in obese men who sleep on their backs. Other factors include Smoking, heavy alcohol consumption, emphysema, and an inherited tendency toward a narrowed airway.

Diagnosis of sleep apnea

• ECG to show arrhythmia during sleep
  
  
• Echocardiogram to study the heart functioning
  
  
• Thyroid function tests
  
  
• Sleep studies
  
  

Sleep apnea treatment

Treatment for sleep apnea can range from lifestyle modification, medication to even surgery in some cases. Weight loss and avoiding smoking are some of the changes that may need to be introduced into the lifestyle to prevent episodes of sleep apnea.

The risk of obstructive sleep apnea choking can be reduced by avoiding alcohol, tobacco smoking, tranquilizers and sedatives before bed. There is a surgical procedure called as LAUP (Laser Assisted Uvula Palatoplasty) where removal of the offending tissue is done to allow for unobstructed airflow.

Sleep apnea is often treated with surgery that removes the cause of obstruction. Enlarged tonsils or adenoids are removed to cure sleep apnea. Another sleep apnea surgery is UPPP - Uvulopalatopharyngoplasty, which involves removal of excess tissue from the back of the throat. This is done to increase the size of the upper airway. Usually it involves removal of the soft palate that hangs down the back of the throat. Such sleep apnea surgery is performed under general anesthesia. These days it is done under local anesthesia with laser assistance. Nasal reconstruction surgery straightens the nasal septum and shrinks the nasal tissue, thereby improving nasal airway. Changing the bony structure in the upper airway allows air to move more freely, especially during sleep.

The CPAP (Continuous Positive Airway Pressure) mask uses air pressure to push the tongue forward. This opens the throat to air and reduces snoring and apnea. It does not cure sleep apnea but relieves the patient by preventing recurrent episodes. Personalized sleep apnea masks are created to fit exactly on your face, nose, cheeks, lips and forehead. The sleep apnea mask is secured well so that there are no leaks.

Seizures

Seizures are conditions when there is abnormal functioning of the brain leading to uncontrollable muscle spasms, altered levels of consciousness and behavior. This is usually traced to abnormal electrical discharge within the brain. Seizures may be localized or affect the whole body. Seizures are classified into 3 based on the severity of attack and response:

• Grand Mal - In this type of seizure, the whole body is racked with convulsions. There can be lack of consciousness or coma
  
• Petit Mal - Only a part of the body is affected by this seizure
  
• Absence - A type of seizure where the affected person is in a stupor and cannot be roused.

Seizures can occur due to poisoning, drug overdose, head injury or medical conditions such as hypoglycemia or neurological abnormality. Fever, brain tumor or other vascular problems can also trigger a seizure. If the brain experiences a sudden lack of oxygen, it can lead to a seizure. Febrile seizures are usually noticed when an infant or small child has high fever, greater than 102 degrees F. The child loses consciousness and experiences uncontrolled shaking of the body. Typically this seizure lasts for a minute or two. Seizures of this kind are not to be mistaken for epilepsy. Though they can be terrifying, febrile seizure attacks must be tackled with care. Place the child on the ground or safe place. Do not restrain movements and wait for the seizure to subside. Do not attempt to feed the child immediately after a febrile seizure. Most seizures are self-limiting. What is essential is to ensure that the person does not get injured during a seizure. Seek seizure first aid. Call a doctor at once if you notice labored breathing or bluish pallor. Epilepsy is a medical condition that is characterized by marked pattern of chronic seizures. Various tests such as spinal tap, heat CT scan or MRI and EEG (Electroencephalogram) can help in identifying the cause for the seizures.