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Get to know heart cancer (Cardiac cancer)

Heart cancer (Cardiac cancer) is extremely rare and is typically a result of cancer spreading from other organs like the lungs, breasts, or intestines. It usually spreads to the outer walls of the heart or the pericardial cavity. However, primary cancers originating in the heart itself, such as angiosarcoma and rhabdomyosarcoma, typically develop in the heart's middle wall and arise from vascular cells or heart muscles. Due to its rarity, the causes and risk factors for heart cancer are still unknown, and no early screening method exists. Consequently, there's no known way to prevent the disease. The symptoms mirror those of other heart diseases combined with common cancer symptoms. Common symptoms of heart cancer include: Fatigue Shortness of breath Chronic cough Low-grade fever Swelling of the face and neck Jugular vein distension Enlarged liver Ascites (fluid in the abdomen) Pitting edema in both legs Diagnosis is typically performed through CT scans, echocardiography, Cardiac CT, and Cardiac MRI, which help visualize tumor locations and assess the spread. Heart cancer often doesn't respond well to radiation or chemotherapy. Surgery to remove the tumor is generally required, although complete removal is only possible in certain cases. If the cancer spreads to the coronary arteries, bypass surgery may be needed to prevent complications like a heart attack. In case of any unusual symptoms, it’s crucial to seek medical attention promptly. While there’s no direct prevention, maintaining overall health remains essential in reducing the risk of other diseases.

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Coronary Artery Disease and CT Calcium Score: An Eloquent Explanation

Coronary Artery Disease and CT Calcium Score: An Eloquent Explanation   Coronary artery disease refers to a condition where the blood vessels that supply oxygenated blood to the heart muscles, known as coronary arteries, become narrowed.   Coronary artery disease can be caused by the accumulation of fat or calcified deposits, which narrow the arteries. This leads to a reduced flow of oxygenated blood to the heart muscles, potentially resulting in myocardial ischemia. The occurrence of chest pain is often observed as a symptom, and it can be a precursor to life-threatening conditions such as myocardial infarction.   CT Calcium Score: Detecting Calcified Deposits in the Coronary Arteries   The CT Calcium Score is a diagnostic test used to measure the amount of calcified deposits on the walls of the coronary arteries. It involves the use of computed tomography (CT) imaging to assess the quantity of calcium accumulated within the walls of the coronary arteries. This test provides valuable information about the presence of calcified deposits, even in small quantities. The Calcium Score screening is a rapid, non-invasive procedure that utilizes low radiation exposure and does not require the injection of contrast agents.   Individuals who should undergo examination:   Those with a family history of cardiovascular disease. Those with high cholesterol levels. Those with high blood pressure. Those with diabetes. Those who are overweight. Those with a history of smoking. Those who do not engage in physical exercise. Those who are over 55 years of age. Women who have reached menopause.   The interpretation of calcium levels:   Calcium Score Risk Level Chances of Developing Coronary Artery Calcification 0 Very Low Risk Minimal chances of developing atherosclerosis or myocardial infarction and high-risk coronary artery disease in the future. 1-100 Low Risk It is highly unlikely or very low chance of developing coronary artery calcification. 101-400 Moderate to High Risk A moderate to high risk of developing myocardial infarction or congestive heart failure and high-level coronary artery blockage. >400           High Risk A high risk of developing myocardial infarction or congestive heart failure and coronary artery calcification at a high level, regardless of the presence or absence of symptoms.     FAQ   Question: What are the treatment options for a patient with blocked heart arteries and dead heart muscles? Should immediate treatment be administered when the doctor detects dead heart muscles?   Answer: From the question, it is understood that the patient has undergone an examination and has been diagnosed with blocked heart arteries. Sudden dead heart muscles, also known as acute myocardial infarction, occur when blood flow to the heart arteries is obstructed, resulting in insufficient blood supply and eventual death of the heart muscles. The cause is often the rupture of atherosclerotic plaque, leading to blood clot formation and depriving the heart muscles of blood. Patients may experience chest tightness or pressure, shortness of breath, and radiating pain in the neck, arm, or back. The symptoms are usually severe and last for more than 30 minutes.   Treatment options depend on the patient's symptoms, any accompanying complications, and other coexisting conditions such as kidney disease or diabetes. The physician will assess the situation in consultation with the patient and their family to determine the appropriate treatment approach, taking into account additional test results such as an electrocardiogram (EKG) and blood tests.   Treatment may involve:   Administering medications to dissolve blood clots for patients without contraindications. Performing balloon angioplasty to dilate the blocked arteries and placing stents to provide support.   In summary, achieving favorable outcomes in the treatment of acute myocardial infarction depends significantly on the duration of symptoms before receiving treatment. Whether it involves opening blocked arteries through medication or balloon angioplasty with stent placement, prompt medical intervention is crucial. With timely treatment, the results are generally positive, and the risk of complications is minimized.   Thank you for your inquiry.   Answered by: Phonthip Phitakthepasombat Head of Cardiology Department

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Does coffee contribute to longevity?

Does coffee contribute to longevity?   For many centuries, coffee has been ranked among the top three most popular beverages. However, the impact of coffee on our health has only recently come to light with the emergence of scientific studies. A significant epidemiological study was conducted by the National Institutes of Health (NIH) in the United States. The study analyzed health data from 400,000 volunteers aged between 50 and 70 years who were in good health and free from any diseases at the beginning of the study in 1995. However, by 2008, 50,000 individuals from this group had passed away.   It is surprising to note that men who consumed 2-3 cups of coffee per day had a 10% lower chance of mortality compared to those who did not drink coffee. Similarly, in the case of women who consumed the same amount of coffee, the mortality rate was even lower at 13%. Although the exact impact of coffee on longevity remains uncertain, this correlation is particularly intriguing.   Other recent studies on coffee have revealed significant health benefits associated with moderate consumption, around 4 cups per day (150 ml per cup). It has been found that coffee can reduce the risk of type 2 diabetes, skin cancer, testicular cancer, and recurrence of breast cancer (after treatment).   Furthermore, animal studies have indicated another important aspect of coffee. It has the ability to modify the biochemistry within the brain, which can potentially protect against cognitive decline. In 2012, a study conducted at the University of Illinois investigated this by subjecting mice to a condition of temporary oxygen deprivation in the brain, resulting in impaired memory formation. One group of mice was then given an equivalent amount of coffee consumed by an average human, while the other group did not receive any coffee. It was discovered that the group receiving coffee demonstrated a 33% faster recovery in memory formation compared to the group without coffee. Detailed examination of the brain revealed that caffeine interferes with the effects of adenosine, a chemical substance that normally provides energy to cells. However, when adenosine leaks from cells due to damage or oxygen deprivation, it triggers a cascade of biochemical processes leading to inflammation and ultimately impairs brain function or contributes to dementia.   In 2012, a study on humans conducted by researchers from the University of South Florida and the University of Miami investigated the level of caffeine in adults with early-stage memory impairment and assessed it again later. The study found that individuals without caffeine in their blood experienced a more significant progression of cognitive decline compared to those with caffeine.   There is still much more to be studied and understood about coffee.   "We are not sure if the blockade of adenosine alone is sufficient to prevent or equalize brain aging," said Gregory, a professor at the University of Illinois.   In 2011, a study conducted by the University of Southern Florida used genetically modified mice to induce Alzheimer's disease, similar to humans. When these mice were given caffeine alone, there were no beneficial effects in preventing cognitive decline. However, the protection against cognitive decline was similar to providing mice with a moderate amount of coffee. On the other hand, coffee heavily sweetened with sugar (as in some energy drinks) was found to be ineffective in preventing cognitive decline.   Therefore, consuming 1-3 cups of coffee per day may be a good reason to hope for protection against cognitive decline.   By Dr. Kitti Trakulrattanavong, Cardiologist   (Note: The original article was previously translated into Thai, from a New York Times article by Gretchen Reynolds "This is your brain on coffee," published on June 6, 2013. This article is an English translation of the Thai translation previously posted on Vibhavadi Hospital website.)     Word count: 619

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How To Exercise Properly?

How To Exercise Properly?   By Dr. Warong Lapannan, Division of Internal Medicine, Bhumibol Hospital and Medical Consultant, Vibhavadi Hospital.   If you ask each doctor, you may get different answers, but generally, it is recommended to do moderate to intense exercise for about 20-30 minutes at least 4 times a week. People who enjoy exercising are believed to be less prone to heart disease, simply because their hearts are generally stronger than those who do not exercise regularly.   However, the deeper reason is that exercise helps to expand blood vessels, resulting in a reduction in blood pressure, which is a major risk factor for heart disease. It also helps increase the level of good cholesterol, HDL, and the most amazing thing is that exercise stimulates the production of new cells to replace damaged cells, especially in the heart.   Nowadays, people who do not exercise regularly may encounter problems, perhaps due to lack of time or an unsuitable environment. Therefore, let's hear some opinions and recommendations from the National Control and Prevention Association and the American Society of Sports Medicine. They recommend doing moderate-intensity activities that are part of daily routines such as washing cars or cleaning the house for about 1 hour or gardening for about 45 minutes, 3-4 times a week, which is beneficial for the heart. Interestingly, it is not necessary to do all activities at once, you can do them intermittently. In this way, there is no excuse for not having time to exercise. Therefore, walking is perhaps the most suitable exercise for people of all ages.

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Cigarettes and Health

Cigarettes and Health   By Dr. Warong Lapannan, Division of Internal Medicine, Bhumibol Hospital and Medical Consultant, Vibhavadi Hospital.   Although there are warnings about the dangers of smoking printed on cigarette packages, such as the fact that smoking causes heart disease, cancer, emphysema, impotence, and other health issues, smoking-related diseases continue to be a public health concern every year. In the United States, for example, it was discovered in 1990 that one out of every five deaths was caused by smoking, resulting in a significant loss of money for healthcare. American society itself has made extensive efforts to combat smoking, as evidenced by the data showing that in 1965, 40% of Americans smoked, but by 1995, that number had decreased to 24.7%. Large cigarette manufacturers in America, facing the grim prospect of lawsuits and the financial burden of treating smoking-related diseases, have sought a way out by exporting American cigarettes to other countries. This, in turn, has led to an increase in smoking-related deaths in those countries, with advertising campaigns costing hundreds of millions of dollars each year. Those who have a taste for cigarettes and enough wealth try to acquire them for consumption, despite governments imposing hefty taxes on cigarettes. Whether they are Thai cigarettes or foreign ones, cigarette smoke is equally terrifying because it contains up to 4,700 different substances, some of which are carcinogenic, allergenic, and irritants to the respiratory system, but most notably nicotine, carbon monoxide, and hydrogen cyanide.   When nicotine is inhaled into the lungs, it is absorbed into the bloodstream, and its effects are similar to a substance called adrenaline, which stimulates the nervous system, causing increased blood pressure, palpitations, and irregular heartbeats.   Carbon monoxide binds with hemoglobin molecules, preventing them from carrying oxygen, resulting in a state of oxygen deprivation at the cellular level. In cigarette smoke, there are substances that destroy the endothelium, the lining of blood vessels, causing them to become rigid and constricted, reducing the level of HDL (good cholesterol), and promoting the easy occurrence of blocked blood vessels.   Cigarettes are a significant cause of more than 10 types of cancer, including lung cancer, respiratory and oral cavity cancers, and digestive system cancers, such as liver cancer, because they contain nearly 50 carcinogenic substances. Smoking also triggers chronic bronchitis, a leading cause of emphysema, which is comparable to destroying small air bubbles, resulting in large honeycomb-like structures. The surface area for oxygen exchange in the lungs is reduced, leading to insufficient oxygen in the air expelled. One has to rely on oxygen tanks constantly, even minor physical movements become tiring, and on bad days, lung inflammation or even lung rupture can occur.   For you, dear women who are contemplating having children, it is essential to listen attentively to this information. Based on studies, it has been discovered that infants born to mothers who smoke during pregnancy not only tend to have low birth weight but also have a fourfold increased likelihood of developing a mischievous and predisposition to theft behavior as they grow up. This phenomenon is also observed in female children. Why does this happen? One prevailing theory suggests that nicotine in cigarettes may impact the brain development of the fetus in the womb. Even if the mother herself does not smoke but resides with a father who smokes in the bedroom or within the house, it may still not be safe.   Studies have found that the majority of smokers, around 90%, initiate smoking before the age of 20. This should serve as a strong warning to prevent the perils of smoking and intensify efforts to protect children from falling into the habit. This way, they will not become adults who are addicted to smoking in the future. Importantly, research has shown that all types of addictive drugs, including marijuana, narcotics, heroin, and others, have their origin in cigarettes. So, if you are already a smoker, don't despair. If you consider quitting, take a moment to listen to this study's findings. They discovered that if you quit smoking today, the rate of heart disease and stroke will decrease by up to 50% within 1-2 years. However, if you want to reach the same risk level as non-smokers, it will take longer, approximately 10-15 years. It might seem like a long time, but it is worth it because not only heart disease but also cancer, emphysema, and other illnesses will diminish, allowing you to enjoy a vibrant life and be free from preventable diseases.   For further information, please contact the Vibhavadi Heart Center at 0-2561-1111, extension 1322.  

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Heart Failure ? Are You At Risk? Check These Symptoms, Causes & Prevention.

What is Heart Failure? Heart failure refers to a condition where the heart is unable to pump enough blood to nourish the body adequately. Heart failure does not mean the heart stops beating. We refer to heart failure as Congestive Heart Failure, which is when the heart fails to work properly, leading to insufficient oxygen supply to various tissues. If the left side of the heart fails, there will be an accumulation of fluid in the lungs, resulting in a condition called Pulmonary Edema. If the right side of the heart fails, there will be fluid retention in the legs, causing swelling. Heart failure symptoms can occur suddenly, such as after a heart attack, or gradually, as in diseases affecting heart valves or heart muscle.   Causes of Heart Failure: As we age, the contracting ability of the heart decreases. If there are conditions that make the heart work harder or lead to a loss of its pumping ability, heart failure can occur. In addition, certain behaviors increase the risk of heart failure, such as smoking, obesity, consuming high-fat diets, and lack of exercise. These factors can all contribute to the development of heart failure. There are multiple causes of heart failure, and sometimes the exact cause may not be known.   Commonly identified causes include: Coronary Heart Disease, where the arteries supplying blood to the heart become narrow. Patients often have a history of chest pain. When the blood supply to the heart muscle is inadequate, the heart cannot pump blood efficiently. If the affected area is extensive, it can lead to sudden-onset heart failure. Cardiomyopathy, which can be caused by certain viral infections, leading to inflammation of the heart muscle and heart failure. Hypertension (High Blood Pressure), which causes the heart muscle to thicken and work harder, resulting in heart failure. Rheumatic Heart Disease, which affects heart valves, causing them to become narrow or leaky, resulting in heart failure. Lung diseases, such as chronic obstructive pulmonary disease (COPD), can contribute to right-sided heart failure. Abnormal heart rhythms, such as bradyarrhythmia (slow heart rate) or tachyarrhythmia (fast heart rate), can prevent the heart from pumping blood effectively. Toxins, such as alcohol or illicit drugs, can damage the heart muscle. Thyroid disorders can also contribute to heart failure.   Symptoms of heart failure: Patients may experience mild symptoms that they may not pay attention to, and many seek medical attention only when the symptoms become severe. Patients diagnosed with heart failure should be aware of the symptoms and monitor them closely. If the symptoms worsen, it is important to seek medical advice. The common symptoms include:   Easy fatigue: If heart failure is mild, fatigue may occur only during strenuous activities (dyspnea on exertion). As heart failure worsens, even normal activities can cause fatigue, and patients may feel tired even at rest. If fatigue worsens, medical consultation is necessary. Shortness of breath: After lying down for 1-2 hours, patients may experience shortness of breath, which improves when they sit up (orthopnea). Some individuals may be unable to lie flat at all. Easily exhausted Swollen feet or abdomen due to fluid retention Rapid weight gain Persistent cough, especially if it produces pink or bloody phlegm, requires immediate medical attention as it may indicate pulmonary edema. Nausea and loss of appetite due to decreased blood supply to the digestive system Memory impairment and confusion Palpitations and rapid heartbeat   Treatment: Heart disease is a condition characterized by continuous destruction of the heart muscle, leading to symptoms of heart failure. Patients must cooperate in the treatment process, following these treatment principles:   Behavioral adjustments Medication usage Treatment of underlying causes, such as balloon angioplasty or heart valve surgery Implementation of devices to control heart rhythm   Prevention: Preventing the occurrence of the disease, known as primary prevention, is the best approach.   Modifying lifestyle behaviors to reduce the risk of heart disease, such as regular physical exercise, consuming high-quality and low-fat food, avoiding salty and processed foods, maintaining a normal weight, managing stress, refraining from smoking, and limiting alcohol consumption. Treating existing conditions, such as managing hypertension, diabetes, cholesterol, narrowed blood vessels, or leaky valves of the heart. Undergoing regular annual physical examinations to detect heart disease early.   For further information, please contact the Heart Center at Vibhavadi Hospital, Tel: 0-2561-1111, ext 1

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Salt and its Relationship with High Blood Pressure

Salt and its Relationship with High Blood Pressure In an interview with Dr. Banhan Koanankul, a cardiologist and consultant at the Vibhavadi Heart Center, on the topic "Salt and its Relationship with High Blood Pressure" on the Happy & Healthy program aired on FM 102 from 9:30 to 10:00 AM. This interview went live on Saturday, May 23rd, 2009 and its transcripts are available here for everyone to read. Here are some beneficial healthcare tips.   Salt and its impact on high blood pressure By Dr. Banhan Koanankul, Cardiologist and Consultant at the Vibhavadi Heart Center Happy & Healthy Radio Program, Saturday, May 23rd, 2009, FM 102 from 9:00 to 10:00 AM.   DJ: How is salt important and related to high blood pressure?             Professor Banhan: Firstly, we need to understand the characteristics of salt, which is naturally white, with a salty taste. It occurs naturally and dissolves in water, breaking down into silver-colored sodium ions with a positive charge and greenish toxic chlorine ions with a negative charge. Salt is a combination of these two elements. Salt is essential for sustaining life and has much greater significance than we might think in its current applications, with an annual consumption reaching up to 300 million tons. It is used to make soap, dye fabrics, tan leather, bleach paper, preserve food, refrigeration equipment, and melt snow on roads, to name a few. The human body, consisting mostly of water, contains approximately 60% water. Another crucial component, aside from water, is salt, which accounts for about 15% of the body's composition. Sodium plays a role in regulating the water balance within cells and is also vital in facilitating electrical signals between nerve cells, controlling muscle contractions and relaxations. Additionally, it helps metabolize proteins and carbohydrates in the body. Therefore, salt is essential for maintaining life. If there is a lack of salt, the body will become weak and fatigued, and the functioning of the nervous and muscular systems will decline. A normal person requires about 400 milligrams of salt per day, which is replenished through the bloodstream. However, excessive salt consumption can be one of the causes of high blood pressure. If one already has high blood pressure, it is necessary to reduce the amount of salt intake to maintain blood pressure within the normal range.   DJ: How does high blood pressure occur?            Professor Banhan: Blood pressure, or blood force, is a component that allows the continuous circulation of the heart and blood vessels. The contraction of the heart muscle generates pressure to propel a certain amount of blood from the lower left chamber of the heart into the major arteries. Then, there must be continuous blood pressure to move the blood through the large arteries, aided by the special properties of these arteries that can expand when the heart muscle contracts. The walls of the major arteries bulge to accommodate the volume of blood coming from the heart's contraction. As the heart muscle relaxes, the muscle of the major arteries contracts back to its original state, creating pressure to propel the blood through the smaller arteries throughout the body, nourishing every cell with oxygen from red blood cells. Oxygen is crucial for cell survival, as the absence of oxygen in cells can lead to organ failure and even loss of life.             The normal range of blood pressure during the heart's contraction/relaxation phase is ideally 120/80 millimeters of mercury. To diagnose high blood pressure, blood pressure must be measured, and if the blood pressure is equal to or higher than 140/90 millimeters of mercury, it falls into the category of high blood pressure. The causes of high blood pressure are divided into two types: known causes, resulting from abnormalities in organs such as the kidneys, adrenal glands, or endocrine system, and another type, which is high blood pressure of unknown origin, accounting for approximately 90% and often associated with risk factors and environmental factors. The major risk factors contributing to high blood pressure include salt, which encompasses not only white salt but also all sources of salt in various forms, such as salty meat, salted fish, fish sauce, soy sauce, and various dipping sauces that contain salt. Currently, obesity is a prevalent condition that leads to insulin resistance, resulting in high blood pressure and diabetes. Additionally, smoking and abnormal lipid levels are also significant risk factors for heart and vascular diseases.   DJ: How dangerous is high blood pressure?   Professor Banhan: High blood pressure, which was previously believed to be merely a condition of the circulatory system, has now been discovered to be a disease that involves molecular changes in genetics, different from other diseases. High blood pressure is related to every organ in the body that requires oxygen, making it a condition that can occur anywhere. Therefore, it is called a complex disease. For example, if the red blood vessels in the brain rupture or the small red blood vessels in the brain burst, it can lead to a sudden stroke. Similarly, if the red blood vessels of the heart rupture, it can cause a sudden heart attack. If the red blood vessels of the kidneys rupture, it can lead to kidney failure. And if the red blood vessels in the legs and feet rupture, that part of the organ will be lost. Generally, symptoms of high blood pressure often start without any noticeable signs or gradually appear as dizziness, headaches, decreased concentration, irritability, stress, and if left untreated, it can escalate to the aforementioned complications, resulting in premature death or a lower quality of life. Although high blood pressure can be treated and prevented, it requires changing behaviors and reducing major risk factors as mentioned earlier, such as increasing physical activity and making proper dietary choices by selecting low cholesterol foods and reducing fatty and fried foods. Additionally, the amount of food consumed (calories) should not exceed the energy requirements of the day to avoid obesity. It is necessary to control weight within the appropriate range by using a simple rule: subtract one hundred from the person's height in centimeters, resulting in the weight that should not be exceeded for males. For females, reduce it by an additional 10%.   The correct principles of exercise are: 1. Exercise continuously without breaks for at least 30 minutes. 2. Exercise regularly every day or at least four days a week. 3. There are two types of exercise: aerobic, which focuses on continuous movement of all organs, increasing the level of exercise until reaching a steady state, and another type that requires generating power by contracting muscles to support exercise, such as weightlifting. Humans have a backbone consisting of a total of 34 joints to be used in all forms of activities and benefit movement, resulting in flexibility and convenience in daily life. Therefore, taking care of these joints to prevent joint diseases requires exercise to ensure their nourishment and training to maintain smooth and obstacle-free movement, allowing a high quality of life in the long run.   To summarize this interview, if salt consumption can be reduced by half, it can help reduce the global mortality rate from stroke and sudden heart muscle death by approximately 2.5 million people per year. Changing behaviors in food choices, regular and continuous exercise, and avoiding smoking, will help you maintain a healthy heart and blood vessels, as well as enhance the quality of life.   "Salt is a part of life. Therefore, if you take care of your salt consumption, your life will be vibrant."

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Enlarged Heart Condition: What Is It, And What Are The Diagnostic And Treatment Approaches?

Enlarged Heart Condition: What Is It, And What Are The Diagnostic And Treatment Approaches?   Dr. Semchai Pho-Boon Cardiologist at the Heart Center, Vibhavadi Hospital                Enlargement of the heart can be categorized into two major types. Enlargement due to thicker than normal muscle. Imagine someone who exercises intensively and builds up their muscles. Similarly, if the heart muscles are required to work harder, such as in cases of high blood pressure or valve leakage, the muscle of the heart may become thicker. Another cause is when the heart size increases because the heart muscle doesn't squeeze properly, resulting in blood pooling in the heart chambers like a water balloon, leading to enlargement.               There are several diseases that can cause heart enlargement, such as high blood pressure, valve leakage or regurgitation, coronary artery disease, heart failure, and diabetes, among others. Additionally, there are cases where the heart muscle thickens without a known cause.                Enlargement of the heart may not necessarily exhibit any abnormal symptoms. If symptoms do occur, they are usually related to the underlying disease or heart failure, such as easy fatigue, shortness of breath, or chest tightness. Physical examinations can indicate if the heart is significantly enlarged, but generally, these exams aim to identify the causes rather than measure the size of the heart. Essential tests include electrocardiography (ECG) and chest X-ray (including the heart and lungs). If the heart muscle is significantly thicker than normal or there has been a previous history of heart muscle problems, it can be detected through the ECG. However, ECG is a less sensitive test, which means that even if the ECG is normal, it does not guarantee that the heart is not enlarged or free from heart disease. Chest X-ray provides a good assessment of the heart size but can be prone to errors depending on technical factors such as the distance between the heart and the film and the patient's breathing. Therefore, it is common to rely on special examinations in many cases. This is done to gather as much information as possible to make an informed decision regarding diagnosis and treatment.   Diagnostic Approaches:             There is no single best method of examination without limitations. Currently, the most widely accepted method for assessing heart size is echocardiography, which uses high-frequency sound waves to create images. The ultrasound machine emits high-frequency sound waves that penetrate various organs. These sound waves reflect differently depending on the type of tissue they pass through, such as blood, bones, or muscles. These reflections are recorded by the computer and used to generate images of the organ being examined. Therefore, when the heart is examined, the chambers of the heart, the functioning of the valves, the heart muscle, and its ability to contract can be observed. This method provides more detailed information compared to other examinations. However, it does not visualize the coronary arteries and may have limited clarity in obese patients or those with lung diseases (except when examined via an esophageal tube). The individuals who should undergo this examination depend on the clinical situation, but it is generally performed when there is a suspicion of heart enlargement.               Individuals experiencing symptoms of heart failure, coronary artery disease, high blood pressure, or abnormalities in cardiac function should undergo this examination to assess the contractile ability of the cardiac muscles. Furthermore, individuals who are found to have an enlarged heart on X-ray should seek to have further diagnosis, to confirm any abnormalities; this depends on the discretion of the cardiologist. For patients who are at risk of coronary artery disease, such as diabetes, if an enlarged heart is detected from the X-ray, a thorough examination should be conducted as well. This is because enlarged hearts do not necessarily present symptoms that require treatment.                 The treatment for an enlarged heart involves addressing the underlying causes, such as treating high blood pressure, performing cardiac valve surgery, or managing heart failure. Although treatment may not visibly reduce the size of the heart on an X-ray for some individuals, it helps prevent further enlargement over time.   For additional information, please contact the Heart Center at Vibhavadi Hospital, at 0-2561-1111, ext 1.

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How to Exercise to Boost Immunity

How to Exercise to Boost Immunity                 This article from the New York Times from October 2009, was translated into Thai and arranged by Dr. Kitti Trakulratnawong, a cardiologist at Vibhavadi Hospital. It will give you the motivation to exercise more.   Exercise can be done in various ways to strengthen the body's immune system. An interesting study was conducted recently, consisting of two parts.   The first study, published in a scientific journal last year, involved researchers dividing mice into two groups. The mice in the first group did not have to exercise, while the mice in the second group were made to walk on a treadmill until exhausted.   After three days, both groups of mice were exposed to the influenza virus. Within 2-3 days, the mice in the exercise group showed a higher incidence of flu compared to the mice in the non-exercise group. Additionally, the symptoms experienced by the exercise group were more severe.   The second study, published in a journal related to researchers from Illinois University, involved dividing mice into three groups before infecting them with a highly virulent strain of the influenza virus.   The first group of mice was allowed to rest, the second group was given light exercise by running for 20-30 minutes, and the third group was made to run vigorously for 2 and a half hours until exhausted. All groups followed the same routine for three days.   When the mice contracted the flu, the results were as follows:   -              The first group had a higher mortality rate than the control group. -              The second group had a mortality rate of 12%. -              The third group had a mortality rate of 70%, and even the surviving mice experienced more severe flu symptoms than those in the non-exercise group.   Based on these two previous studies, it becomes apparent that there is a delicate balance between exercise and immune response. Moderate exercise can effectively enhance the body's immune system and prevent diseases. However, excessive exercise can lead to a weakened immune system, making it easier to contract diseases and experience more severe symptoms.   What constitutes excessive exercise?   Although there is no universally agreed-upon definition among researchers, excessive exercise often refers to engaging in physical activity for a prolonged period of time, exceeding 1 hour, with a significantly increased heart rate and rapid breathing, to the point where one feels genuinely exhausted. Examples include running a marathon or playing a 90-minute football match.   The connection between intense exercise and increased susceptibility to infections is not yet fully understood, but it is believed that after intense physical activity, the body's immune response is temporarily suppressed. The more intense and prolonged the exercise, the longer the immune response suppression period. Sometimes, this period can last for 2-3 hours or even 2-3 days.   A recent study published in August 2009 in the Journal of Strength and Conditioning Research aimed to test the immune levels in the saliva of 24 professional soccer players before and after a 70-minute football match.   Before the game, the immune levels in their saliva were within normal range, but after the game, the immune levels of several players decreased significantly.   The relationship between exercise and the immune system has become more apparent when examining the cellular level in experimental mice. When infected with the flu virus, the mice's bodies were stimulated to increase TH1-Type helper immune cells, leading to inflammation and various changes in the body. This response is the first line of defense against viruses. However, if this inflammation persists for too long, the beneficial effects turn into drawbacks, as inflammation starts damaging the body's cells. Nature then seeks to restore balance by gradually increasing another set of immune cells called TH2 helper cells to counteract the inflammation, much like pouring water on a raging fire of TH1 cells.   The body requires a delicate balance of TH1 and TH2 helper cells, and this equilibrium must be maintained with precision.   Example Experiment from Illinois University:   A mouse that exercises moderately will have an increased TH2 immune response, albeit slightly, after the TH1 immune response has occurred (in response to infection). The slight acceleration of the immune response can have beneficial effects in combating the flu.   "Moderate exercise helps reduce TH1 slightly and increase TH2 slightly, just the same."   Conversely, excessive exercise will push TH1 excessively. It is akin to the body building the first line of defense incompletely, making it easier for viruses to invade the body. After intense exercise, such as marathon running, the immune system is suppressed temporarily. It is a time when you have nothing to shield yourself with. Therefore, during this period, it is advisable to avoid close contact with people who cough, wash hands frequently, get a flu vaccine, and if you have taken all precautions but still feel unwell, rest your body and refrain from further exercise.   Generally, moderate exercise such as walking or jogging strengthens the immune system, reducing the severity and duration of mild infections. However, it should be practiced with caution. That means if you feel unwell, especially fatigued, have a fever, you should stop exercising until you feel better. If you have only mild symptoms like a runny nose, exercise may improve your condition. Nonetheless, prolonged exercise (for hours) should be avoided as it can disrupt the balance of the TH1 and TH2 immune systems.   Having understood the theoretical explanation, let's now look at the actual occurrences among individuals who engage in excessive exercise. It turns out that the consequences are not too severe. The latest research findings revealed that out of 694 participants in the Stockholm Marathon in 2000, reports of influenza or other infections were found in a three-week period before and after the race. 1 in 5 reported falling ill during that time, which is higher than the general population. However, this also means that the majority of runners, 80%, did not experience any illness.   Translated by Dr. Kitti Trakulratnawong Cardiologist, Vibhavadi Hospital

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Cancer: 3 main causes and prevention methods

According to the Cancer Institute, in the year 1998, there were 90,000 Thai people diagnosed with cancer. This number does not include those who were not diagnosed, did not show symptoms, or did not seek treatment from traditional medicine practitioners.   In terms of causes of death among Thai people, cancer is the second leading cause, following only heart disease.   Although medical science has made significant advancements in diagnosing cancer quickly and effectively treating it, including through radiation or chemotherapy, the percentage of people who die from cancer remains high.   Causes of Cancer   There are over 100 types of cancer that affect humans, and the causes vary widely. This is one reason why the effectiveness of cancer treatment can vary.   No one wants to be diagnosed with cancer, so it's important to understand what causes it.   Scientists have known for over 20 years that cancer is a disease caused by abnormalities in the genes within cells, which control cell division. If there is an increase in the number of these abnormal cells, it can result in cancer. These genes, known as oncogenes, can be passed down genetically or can result from exposure to chemicals such as free radicals.   The underlying factors in the development of cancer are related to three things:   Host (patient) Agent (cancer-causing substance, pathogen) Environment (environmental conditions)   Host (the patient) The patient themselves is an important factor because the cells in our body, which amount to almost fifty trillion cells, are affected. If any one cell becomes abnormal, the immune system will go into action. If this system doesn't work properly, it opens up the opportunity for cancer cells to multiply. It is not surprising that people who experience high levels of stress are more likely to suffer from cancer, because their immune system is weakened.   Agent (cancer-causing substance, such as radiation and pathogen) Radiation exposure, such as in the case of a nuclear factory explosion or a nuclear war, can cause an increased risk of leukemia and skin cancer. Hepatocellular carcinoma (liver cancer) is known to be associated with a substance called aflatoxin, which is found in moldy legumes. Those who are chronically infected with the hepatitis B virus (HBV carrier) also have an increased risk of developing liver cancer by up to 200 times. Patients with this type of infection, who do not show any symptoms, must undergo regular screening for liver cancer every 6 months to 1 year using ultrasound.   Another type of cancer that occurs in the gastrointestinal tract, commonly found in Northeast Thailand, is caused by eating raw fish contaminated with nitrosamine-type substances, which are produced by fermenting protein with soil bacteria.   Colorectal cancer is another type of cancer that is strongly associated with people who eat a lot of meat but do not consume foods with high fiber content, such as vegetables and grains. This leads to chronic constipation, which increases the risk of carcinogenic toxins that can affect the cells in the colon.   As the example mentioned earlier is just a small part of all the causes of cancer, because in most cases we still cannot find the real cause of those cancers. However, we can see that there is a significant correlation with the food we consume. As the famous saying goes, "You are what you eat," and this holds true in terms of cancer as well.   Environment As previously mentioned, carcinogens and infections are important factors in cancer development. The issue of toxins, cigarette smoke, and charred foods are some examples of factors that generate free radicals that can destroy cells. Infections with certain viruses can cause cervical cancer or cancer of the mouth and throat, which is also called oral cavity cancer. Women who engage in sexual activity from a young age have a higher risk of developing cervical cancer.             Preventive Measures If we summarize the methods for preventing cancer, we can separate them as follows:   Avoiding known risk factors, such as poisons, cigarette smoke, processed and charred foods, and red meat. Eating natural foods such as fruits, vegetables, and grains that are fresh and clean, and avoiding consuming too much of the same kind of food, in order to receive a variety of nutrients. Exercising regularly and getting proper rest and relaxation. Drinking plenty of water and having regular bowel movements to prevent constipation. Having a positive mindset, looking at the world in a positive light, and addressing problems in the right way. Undergoing regular cancer screening, especially for breast and cervical cancer, and not forgetting that cancer can be treated when detected early.   Four misconceptions about cancer The National Cancer Institute, under the direction of Dr. Weerawut Imhomsan, established a campaign in 2014 to address the misconceptions about cancer. The 4 main topics of this campaign are as follows:   Misconception 1: We should not talk about cancer because it is a sad or embarrassing topic.   The truth is that talking about cancer, including providing accurate knowledge about cancer in society, can help people understand how to take care of themselves from prevention to early screening for cancer. Entering into proper treatment and achieving good treatment results, and having the opportunity for patients to talk and consult with others, including siblings and caregivers, can help reduce anxiety and provide accurate guidance for caregivers to properly take care of patients.   Misconception 2: Cancer is a disease with no warning signs.   The reality is that many types of cancer have symptoms and early warning signs that are widely publicized around the world. The 7 warning signs of cancer include:   Changes in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast or elsewhere Indigestion or difficulty swallowing Obvious change in a wart or mole Nagging cough or hoarseness   While these symptoms may or may not be cancer, if it is a cancer that has just started to show symptoms, there is a high chance of a cure with proper treatment.   Misconception 3: We can't do anything about cancer.   It is called cancer because it is a matter of fate and luck, and we can't do anything about it. However, the truth is that we can prevent ourselves from getting many types of cancer by promoting knowledge of the risk factors that cause cancer, by avoiding risk factors, and by working together at all levels, from individuals to society and national policies, including controlling and implementing laws effectively. This can reduce the overall incidence of cancer by up to 40%.   Misconception 4: We don't have the right to receive cancer treatment.   Currently, all patients have the right to receive cancer treatment under the three health care funds, namely the National Health Security Fund, which covers treatment for all diseases for 30 baht, the Social Security Fund, and the Civil Servant Medical Benefit Scheme. Therefore, patients do not have to spend their own money or receive treatment in an unacceptable manner.   How do tumors and cancers differ from each other?   Tumors: are masses of tissue that grow in organs, and can cause compression problems, but cannot invade into other tissues. If it needs to be treated, it can be removed surgically.   Cancer: is a tumor that can spread to other tissues, including those in close proximity or far away. It can be more difficult to treat than tumors because cancer tends to leave small cells behind in the body, even after surgery.   Therefore, cancer treatment must attempt to destroy these small cells in various ways, such as using chemotherapy, radiation therapy, and various types of biologic therapies.     Physician Dr. Warong Lapanan, M.D. Department of Cardiac Medicine

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Exercise can Reduce Risk of Cardiovascular Diseases

Cardiologist age, Heart Center, Vibhavadi Hospital reveals the second highest number of deaths from heart disease after cancer Plus, it tends to be found in younger people more and more. Most recently, it was found in a 29-year-old patient. Exercise can Reduce Risk of Cardiovascular Diseases Cardiologist age, Heart Center, Vibhavadi Hospital reveals the second highest number of deaths from heart disease after cancer Plus, it tends to be found in younger people more and more. Most recently, it was found in a 29-year-old patient. Heart disease tends to be on the rise, as stated by Dr. Semchai Phaboon, a cardiologist affiliated with the Heart Center of Vibhavadi Hospital. This increase can be attributed to lifestyle factors such as consuming convenient, unhealthy food. In the past, wars and infectious diseases were the main causes of death, but presently, cancer and cardiovascular disease have become the leading causes. Cardiovascular disease has two main risk factors: irreversible factors such as gender (which is more prevalent in men than women) and age (men over 40 years old and women over 50 years old are at higher risk), as well as heredity (having parents or direct relatives with heart disease). Additionally, there are modifiable risk factors such as smoking. According to the statement, diseases such as diabetes, high blood pressure, and high cholesterol are risk factors for coronary heart disease. Additionally, abdominal obesity, characterized by a waist circumference exceeding 36 inches in men and 32 inches in women, as well as abnormalities in blood sugar, are increasingly becoming risk factors as well. Preventative guidelines should primarily focus on modifiable factors, including smoking cessation. This applies not only to individuals who smoke, but also those who are regularly exposed to cigarette smoke. Research has shown that smokers tend to have a lifespan ten years shorter than non-smokers. Experts in the field emphasize the importance of regular screenings for high blood pressure, diabetes, and abnormal blood fat levels. Early detection and treatment can significantly reduce the risk of long-term complications. For mild cases, dietary and exercise modifications can be effective, but medication may be necessary for more severe cases. Finally, exercising appropriately and consistently is crucial in reducing the risk of heart disease and coronary heart disease. Experts recommend that good exercise routines include a warm-up period to stretch muscles and prevent injury, followed by a gradual increase in intensity and duration, and ending with a gradual cool-down to bring the body and heart back to a resting state. It is recommended to exercise for at least 20-30 minutes, 3 times a week or more, but those with risk factors should not be overly anxious, as chest tightness does not always indicate heart disease. Dr. Semchai advises individuals at risk of cardiovascular disease to pay attention to specific symptoms, such as chest tightness that radiates to the neck, lower jaw, shoulder, and left arm while exerting or over-exercising. If the pain lasts longer than 5 minutes, seeking medical attention is recommended. According to Dr. Semchai Phaboon, patients with heart muscle or valve diseases may experience fatigue, abnormal shortness of breath, and difficulty lying down at night. For diseases related to the electrical system of the heart, patients may experience palpitations, fatigue, and fainting. It is crucial to be aware of these symptoms and seek medical attention promptly at a hospital equipped to handle heart-related conditions. Time is of the essence in these situations.

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