“Infections prolong hospital stays, create long-term disability, increase resistance to antimicrobials, represent a massive additional financial burden for health systems, generate high costs for patients and their family, and cause unnecessary deaths”

World Health Organization

“Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.”

MAYO CLINIC

Hyponatremia is a condition that occurs when the level of sodium in your blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that’s in and around your cells.

In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water during endurance sports causes the sodium in your body to become diluted. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening.

Hyponatremia treatment is aimed at resolving the underlying condition. Depending on the cause of hyponatremia, you may simply need to cut back on how much you drink. In other cases of hyponatremia, you may need intravenous fluids and medications.

Sodium we know what systems it effects from yesterday’s article on sodium in general of how it works in the human body.  If you don’t know and didn’t get a chance to read it yesterday stop this article going to yesterday’s to read over the general information of how sodium works and effects the human body.  This will help you understand the signs and symptoms easier.

Hyponatremia signs and symptoms may include:

• Nausea and vomiting
• Headache
• Confusion
• Loss of energy and fatigue
• Restlessness and irritability
• Muscle weakness, spasms or cramps
• Seizures
• All the way to a ComaA normal sodium level is between 135 and 145 milliequivalents per liter (mEq/L) of sodium. Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.
• Many possible conditions and lifestyle factors can lead to hyponatremia, including:
• Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance playing a particular role in acid and base balances inside our blood stream working with in particular potassium.

• Certain medications. Some medications, such as some water pills (diuretics), antidepressants and pain medications, can cause you to urinate or perspire more than normal.  Medications that increase your risk of hyponatremia include thiazide diuretics as well as some antidepressants and pain medications. In addition to the recreational drug Ecstasy has been linked to fatal cases of hyponatremia.
• Heart, kidney and liver problems. Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in your body, which dilutes the sodium in your body, lowering the overall level.
• Syndrome of inappropriate anti-diuretic hormone (SIADH). In this condition, high levels of the anti-diuretic hormone (ADH) are produced, causing your body to retain water instead of excreting it normally in your urine.
• Chronic, severe vomiting or diarrhea. This causes your body to lose fluids and electrolytes, such as sodium.
• Drinking too much water. Because you lose sodium through sweat, drinking too much water during endurance activities, such as marathons and triathlons, can dilute the sodium content of your blood. Drinking too much water at other times can also cause low sodium.
• Dehydration. Taking in too little fluid can also be a problem. If you get dehydrated, your body loses fluids and electrolytes.
• Hormonal changes. Adrenal gland insufficiency (Addison’s disease) affects your adrenal glands’ ability to produce hormones that help maintain your body’s balance of sodium, potassium and water. Low levels of thyroid hormone also can cause a low blood-sodium level.
• The recreational drug Ecstasy. This amphetamine increases the risk of severe and even fatal cases of hyponatremia. In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in coma and death.Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness.
• Call your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headache, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care.
• Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage. This may be related to the effect of women’s sex hormones on the body’s ability to balance sodium levels.
• In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer — and symptoms and complications are typically more moderate.
• Also for older adults they may have more contributing factors for hyponatremia, including age-related changes, taking certain medications and a greater likelihood of developing a chronic disease that alters the body’s sodium balance.

“If you suspect that someone has had a brain injury, the first step is to talk with the person, share your observations, and encourage the person to get help. The next step is for the person to share a medical, family and military history with the physician.”

Harvey E. Jacobs, Ph.D. and Flora Hammond, M.D

If you could split the brain right down the middle into two symmetrical, or equal parts, you would have a right and left hemisphere. Although equal in size, these two sides are not the same, and do not carry out the same functions.

Robert W. Sperry (awarded the Nobel Prize in 1981. While studying the effects of epilepsy)

“The brain stem controls the flow of messages between the brain and the rest of the body.”

MedicineNet.com (http://www.medicinenet.com/script/main/art.asp?articlekey=2517)

“The brain is a soft mass of supportive tissues and nerves connected to the spinal cord. Some of the nerves in the brain go right to the eyes, ears and other parts of the head. Other nerves connect the brain with other parts of the body through the spinal cord to control personality, senses and body functions from breathing to walking.”

Neurology and Neuro Surgery of John Hopkins Medicine http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/brain_tumor/about-brain-tumors/how-the-brain-works.html

“Catheter ablation for SVT utilizing radiofrequency ablation (electrocautery injury) was developed in the 1980’s and has since revolutionized the treatment of SVT.”

UNC Healthcare (Center for vascular and heart care)

TREATMENT APPROACHES

The long, flat line between impulses indicates an abnormally slow heartbeat.

In some cases, arrhythmias may not require treatment. Other arrhythmias can be controlled by treating the underlying cause. Arrhythmias that cause symptoms may require one or more of the following treatments to reduce the number or duration of arrhythmic events.

Medications. Common medications for suppressing arrhythmias include:

• Beta-blockers;
• Calcium channel blockers;
• Digitalis; and
• Antiarrhythmic agents.

Digitalis should not be used for certain arrhythmias, such as WPW syndrome. People with atrial fibrillation are typically prescribed an anticoagulant to minimize their risk of clotting and stroke.

Cardioversion. This procedure restores a normal heartbeat by transmitting a brief electric shock through the chest to the heart. Usually an outpatient procedure that is performed in a hospital while the patient is under heavy sedation or anesthesia, it is commonly used to treat:

• Atrial fibrillation;
• Atrial flutter; and
• Ventricular arrhythmias.

Radiofrequency Catheter ablation. A catheter with an electrode tip is positioned on the affected area. The catheter delivers energy to destroy tissue that is interfering with the normal transmission of electrical impulses through the heart. It is most commonly used for:

• SVT – Supra Ventricular Tachycardia (Pulse over 100);
• Atrial fibrillation-particularly newly diagnosed;
• Atrial flutter; and
• Certain types of ventricular arrhythmias.

Catheter ablation for SVT utilizing radiofrequency ablation (electrocautery injury) was developed in the 1980’s and has since revolutionized the treatment of SVT. With catheter ablation, a procedure is performed entirely through intravenous catheters inserted into the veins in the leg and sometime the shoulder. It is a minimally invasive procedure. That is, no open heart surgery is needed. Generally, procedures can be performed on an outpatient basis. Overall cure rates with catheter ablation is >90% and can be as high as 96-98% depending on the specific type of SVT.

During a catheter ablation procedure, catheters (long wire electrodes) are advanced through the veins in the leg up to the heart.

Various measurements of the electrical system are performed. If a person is in normal rhythm at the time of the procedure, an attempt is made then to reproduce the SVT by pacing the heart through the catheters. Occasionally an intravenous medicine called isoproterenol is required to “rev up” the heart in order to reproduce the SVT. Once the SVT is reproduced, the specific type of SVT can be diagnosed using the catheters in the heart.

Once the SVT is diagnosed, to cure the SVT, an ablation catheter is advanced to the heart. An ablation catheter is capable of delivering small radiofrequency lesions (electrocautery burns) on the order of 4-5 mm in diameter. These radiofrequency lesions have no long-term adverse consequences. Depending on the type of SVT, these radiofrequency lesions are delivered in various locations of the heart.

Occasionally, more complex diagnostic and ablation techniques are required for catheter ablation of SVT. This may be the case particularly in patients with other heart problems or a history of heart surgery. In such situations, sophisticated 3-dimensional mapping techniques using a balloon catheter may be used to identify the location necessary to successful ablate the SVT

Pacemaker. A small electronic device that is surgically implanted under the skin near the collarbone. A pacemaker regulates a slow or erratic heartbeat by sending rhythmic electrical charges to the right atrium and right ventricle. Pacemakers are frequently used to treat Sick Sinus Syndrome.

Maze procedure. A physician makes multiple incisions through the atrium. The resulting scar tissue conducts impulses through the heart’s electrical system in a way that allows normal conduction but does not sustain atrial fibrillation. Since it is a form of cardiac surgery, it is reserved for those patients who have undergone a failed catheter ablation or as an add-on for those having a surgical procedure for another condition.

Cardiac arrhythmia, also known as cardiac dysrhythmia or irregular heartbeat, is a group of conditions in which the heartbeat is irregular, too fast, or too slow.

Susheel K. Kodali, MD is the co-director of the Heart Valve Center at NewYork-Presbyterian/ Columbia University Medical Center.