Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels. The sinuses stay healthy when the channels are open, which allows air from the nose to enter the sinuses and mucus made in the sinuses to drain into the nose.

Sinus Conditions

• Acute sinusitis (sinus infection): Viruses or bacteria infect the sinus cavity, causing inflammation. Increased mucus production, nasal congestion, discomfort in the cheeks, forehead or around the eyes and headaches are common symptoms.
• Chronic sinusitis (or chronic rhinosinusitis): More than just a series of infections, chronic sinusitis is a persistent process of inflammation of the sinuses.
• Allergic rhinitis: Allergens like pollen, dust mites, or pet dander cause the defenses in the nose and sinuses to overreact. Mucus, nasal stuffiness, sneezing, and itching result.
• Deviated septum: If the septum that divides the nose deviates too far too one side, airflow can be obstructed.
• Turbinate hypertophy: The ridges on the nasal septum are enlarged, potentially obstructing airflow.
• Nasal polyps: Small growths called polyps sometimes grow in the nasal cavity, in response to inflammation. Asthma, chronic sinus infections, and allergic rhinitis can lead to nasal polyps.

Sinus Tests

• Physical examination: A doctor can look into the nose with a lighted viewer to see the turbinates, which may be swollen. She may press or tap on the face over the sinuses to check for pain.
• Computed tomography (CT scan): A CT scanner uses X-rays and a computer to create detailed images of the sinuses. CT scanning can help diagnose chronic sinusitis.
• Magnetic resonance imaging (MRI): Magnetic waves create highly detailed images of the sinuses. CT and MRI scans may be used together.
• Endoscopy (rhinoscopy): Using a flexible tube with a camera on its end, a doctor can examine the inside of the nose and sinuses.
• Sinus cultures: A mucus sample can be taken from inside the sinuses. This is done with a needle or during endoscopy.
• Skin Test for Allergies: Skin testing for various allergens can help determine if allergies are contributing to sinusitis.
• Sinus X-ray: A plain X-ray may show problems with the bones around the sinuses. A CT scan is superior to plain X-ray films.

Cigarette smoking causes more than 480,000 deaths each year in the United States. This is about one in five deaths.

CDC – Centers for Disease and Prevention Control

The facts about smoking

You know that smoking is dangerous. But do you know all the facts?

• Cigarettes cause cancer. Smoking is the number one cause of deaths due to lung cancer, emphysema, and other serious diseases.
• For every person who dies of smoking-related illness, 20 more suffer from a chronic disease due to smoking.
• Smoking doesn t just hurt you. Second-hand smoke from your cigarettes is a serious danger to your children, family, and friends.

The facts are clear: quitting smoking will protect your health. According to the Surgeon General, quitting smoking is the single most important step a smoker can take to improve the length and quality of her or her life.

If you re ready to quit smoking, there are many counseling programs available to the public one being Freedom From Smoking® Online is an innovative smoking cessation program from the American Lung Association®. When you become a member, you’ll get:

• A 7-module program to show you how to quit smoking
• Tools and resources to help you on your quitting journey
• Solid information about preparing to quit
• Guidance through your Quit Day and the first few weeks of being smoke-free
• An online community of fellow quitters to give you ongoing support

Counseling programs like Freedom From Smoking® Online have been proven to greatly increase your chance of quitting successfully.  Whoever you choose quitting is the right choice if you want a healthy and longer life.

Did you know there are more than 7000 chemicals found in a single puff of cigarette smoke?

American Heart Association

Approximately four percent of the U.S. population has either intermittent or permanent Afib. In people over the age of 60, the incidence rises to about nine percent.

AFib is caused by abnormal electrical impulses in the atria, which are the upper chambers of the heart. The result is a rapid and irregular pumping of blood through the atria. These chambers fibrillate, or quiver, rapidly.

Healthline

After reviewing the anatomy and physiology of the human heart and seeing how it functions with the lungs, and blood for carrying oxygen and dispensing carbon dioxide from other areas of the human body to ending spot the lungs in exhaling, now lets learn how cardiac disease effects the heart to function in doing this process.  Today lets talk about atrial fibrillation and Rapid Ventricular Rate/Response.

Some people in the US have this cardiac condition called Atrial Fibrillation where some with this condition even experience Rapid Ventricular Rate or Response with it.

Atrial fibrillation is an irregular and often rapid heart rate that commonly causes poor blood flow to the body.

During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart causing your pulse to be irregular. We know now how the blood flows through the heart but due to the irregularity of the atriums which is not allowing the chambers to fill up to the maximal level they normally did when they didn’t have Atrial Fibrillation is decreasing the cardiac output (blood volume) from the left ventricle to be decreased.   This means the heart and all other tissuesaren’t getting the regular amount of oxygen they got when they were in a regular normal rhythm.  Atrial fibrillation symptoms often include heart palpitations, shortness of breath and weakness.  Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. Some people refer to AF as a quivering heart.  What happens here is primarily the ventricles take over.   With the atriums quivering and the ventricles going at their rate this causes an irregular heart rate HR.  Another problem with an irregular heart rate is this allows blood to pool in the heart putting the patient at risk for clot formation.  As this HR gets more irregular it puts the patient at a higher risk of allowing the clot to break off inside the heart now flowing freely in the blood stream.  If it reaches the lungs and stays there a pulmonary thrombus can occur causing breathing difficulties; if it bypasses the lungs the next place it goes to is the brain putting the person at risk for a stroke and if it reaches back to the heart the patient can have a heart attack.  This why you commonly see patients with atrial fibrillation on the med Coumadin or some form of anticoagulant drug to prevent clots from occurring.

An estimated 2.7 million Americans are living with Afib.

Episodes of atrial fibrillation can come and go, or you may develop atrial fibrillation that doesn’t go away and may require treatment. Although atrial fibrillation itself usually isn’t life-threatening, it is a serious medical condition that sometimes requires emergency treatment. It can lead to complications. Atrial fibrillation may lead to blood clots forming in the heart that may circulate to other organs and lead to blocked blood flow (ischemia) to even stroke/heart attack to pulmonary thrombus as stated earlier.

Treatments for atrial fibrillation may include medications like anticoagulants primarily=usually Coumadin,  antiplatelets= aspirin (platelets are responsible for clotting in our bloodstream) with and other interventions to try to alter the heart’s electrical system such as cardioversion-shocking the heart at low level voltage, more common in newly diagnosed afib. in hope to knock the afib into a regular rhythm called normal sinus rhythm (the best rhythm to be in).

Various studies have reported that electrical cardioversion is over 90 percent effective in converting to a normal sinus rhythm though many people revert back into afib shortly thereafter. Success has been shown to be enhanced when patients are on an antiarrhythmic drug beforehand, which helps prevent reverting back to atrial fibrillation.

Success depends on the size of the left atrium as well as how long the patient has been in afib. Patients with a very large left atrium, one greater than 5 cm, or who have been in constant afib for a year or two, may find that electrical cardioversion is not effective in converting to or maintaining a normal sinus rhythm.

Following a successful electrical cardioversion, the goal is to maintain a normal sinus rhythm, which only happens with about 20–30 percent of patients within the first year if they are not on antiarrhythmic drugs for rhythm control. Overall, the likelihood is quite high that you will revert back into atrial fibrillation, regardless of whether you stay on rhythm control drugs.

When the ventricles beat too rapidly they don’t fill completely with blood from the atria. As a result, they cannot efficiently pump blood out to meet the needs of the body. This can ultimately lead to heart failure in time if not treated.  Just like us running from NY to California most will end up not being able to do it just like the heart can’t run in atrial fibrillation in a high heart rate for a long time,  it also will give out going into failure.  The heart can only compensate in atrial fibrillation in a rapid high heart rate for so long.

A cardiac condition called Rapid Ventricular Rate or Response which is seen sometimes with Atrial Fibrillation which is the heart is overloaded.  Our heart beats lub dub which is first the atriums opening and closing (lub) and than the ventricles opening and closing (dub).  When the heart gets overworked and tries to compensate the atriums can give up and just allow the ventricles to take over to beat which affects the heart and all other tissues to get proper amount of blood with oxygen in time.  Since you loose the atriums (the upper chambers of the heart) and they don’t fill up with the amount of blood volume like they use to.  You loose a lot of blood volume(RBC’s); what the heart pumps out in the left ventricle to our tissues with oxygen get’s decreased in what we call your cardiac output=the volume of oxygenated blood pumped out of the left ventricle.  Well with atrial fibrillation this gets compensated.  In time if this is not repaired the blood goes backwards in how the heart pumps the blood.  It is regurgitating blood back in the heart back in the pulmonary vein back to the lungs putting fluid in the lungs even going further back into the Rt side of the heart and the superior vena cava and even further depending how long this hasn’t been treated.  Heart failure is set up, if not already.

Heart failure as a result of Atrial Fibrillation with RVR is most common in those who already have another type of heart disease like CAD (Coronary Heart Disease, CHF, etc…).

RVR can cause chest pains and make conditions like congestive heart failure worse.   RVR is simply having a high heart rate with the ventricles only pumping.  The HR can be like 140 or 160.  You need to get to an ER to be treated immediately.  This is where you would be started on a IV drip like Cardizem to bring the HR down to get you in controlled atrial fibrillation or some type of medication in bringing the HR down.  HR meaning the heart rate.

There are 2 types of atrial fibrillations controlled and uncontrolled.  If you are seen every 6 months or sooner with atrial fibrillation keeping your pulse under 100, which is controlled atrial fibrillation that is effective in treating it.

If you are with a pulse over 100 your in Uncontrolled Atrial Fibrillation and need your cardiologist to evaluate what needs to be done to bring the pulse under 100 so that it is less stressful for your heart to beat.  Than would be ideal under 100 as opposed to over 100.  It your over 100 higher odds you could go into RVR or just another rhythm more complicated than atrial fibrillation.  The more stressed out your heart is in doing its function the higher the odds your heart will go into problems.  So keep the pulse under 100 if you have afib and if not get checked out by your cardiologist or any doctor now not 2 mths or 2 weeks from now.

Always check with your doctor when you question anything medical about your self but at any time if you feel chest pain, chest discomfort, headache, palpatations, dizziness, shortness of breath or difficulty breathing call your doctor and be resting in hopes that the symptoms decrease to disappear.

If you have chronic atrial fibrillation you can live a completely normal life only with keeping the pulse under 100 and following up with your cardiologist as he/she orders.

“Blood is the fluid of life, transporting oxygen from the lungs to body tissue and carbon dioxide from body tissue to the lungs. Blood is the fluid of growth.”

The Franklin Institute

Lets review the anatomy of the heart, our bodies oxygen is the food to our tissues in keeping them alive through our red blood cells (RBC’s) that carry the O2 to the tissues through a heart and lungs working properly.  The heart in pumping and the lungs in inspiration/expiration (one organ cannot live without the other).                                                                                                                                                              There has to be a systemic way we allow this to work and this is through the heart, lungs, and RBC’s (3 systems that connect with each other). The heart = right side deals with more C02 blood than 02 blood which is blood returning to the heart to get more 02 going first via the Rt. side of the heart to the pulmonary artery, each of which carries blood to the lungs for 02 and C02 exchange to occur. This is for getting more 02 in our RBC’s with allowing them to release C02 at the lungs bases and then return to the left side of the heart.  On the left side of the heart this is blood to be sent through both Lt. chambers (Lt. atria first  and then the Lt. ventricle) of the heart to our blood stream to utilize the new 02 in our RBC’s that they intially obtained at our lungs going now to our body tissues. This is a 24hr/7days a week job for our red blood cells, lungs and heart in functioning to keep the human body alive.

In simpler terms this is how it works: The blood that needs to be refreshed with more 02 always which takes place by the blood in our body entering the right (Rt.) atrium coming from a vessel that brings back mainly carbon dioxide in the blood from the toes and the brain that was previously oxygenated blood that mainly was used up by the tissues and those RBC’s returning on the right side of the heart need to be reoxygenated with higher levels of oxygen.  For the RBC’s to deliver 02 again to tissues in redoing this process all over again it goes through a pathway=our circulatory system.  When the red blood cells need more oxygen it first goes to the Rt. atrium & fills up to its max level in that chamber to going to the Rt Ventricle than through the pulmonary artery to the lungs to get more 02.  Simultaneously while the Right side of the heart does this the left (Lt.) atrium is filling up to its max level than goes to the Lt. Ventricle and out the Aorta to the arteries throughout the body to carry 02 to our tissues through the RBC’s carrying the 02.   Ending line when the Rt. atrium is ready to drop its blood max level into the Rt. ventricle the Lt side does the same thing.  The difference is the 02 and C02 content in Rt and Lt side of the heart (Right side is more C02 in the RBC’S whereas the Left side has more 02 content in the RBCs/blood.                                                                                                               For the blood to get to the atriums to the ventricles they have valves; they open between the chambers simultaneously (the tricuspid valve on the right side and mitral valve on the left side) dropping the blood to the lower chambers of the heart happens simultaneously but only the Rt. side ends up going to the lungs through a pulmonary artery to get more oxygen to send the highly oxygenated blood to the L (left) side of the heart. The job the Rt. side of the heart does this, it just goes from the Rt. side of the heart to our lungs and back to the heart on the Lt. side through the pulmonary veins to the L atrium than the Lt Ventricle going to the aorta this blood gets sent throughout the body; so the path or distance for the Rt. side of the heart to do its function is a short distance = it gets your used up oxygen in the red blood cells (that are high in carbon dioxide) to get more oxygen by going through the Rt. side of the heart sending them to the lungs where they get more O2 and then they are sent back to the Lt. side of the heart.   This is the Rt. side of the heart’s function and explains why the heart muscle on that side of the heart is smaller than the Lt. side.  Now let us look at what the Lt. side of the heart, in what blood it delivers to our tissues with our red blood cells (RBC’s).   The RBC’s reoxygenated that leave the lungs and are sent via the pulmonary vein to the Lt. side of the heart, reaching the Lt. atrium, thus carries a high 02 level in the RBC’s (this blood just came directly from the lungs where O2 and CO2 exchange for the RBC’s took place).  Next the RBC’s go to the Lt. ventricle to our Aorta that sends this high oxygen level of RBC’s out to all our tissues as food to prevent starvation of the tissues.   Again, when the valves open between the chambers of the heart and allowing this blood to fill up in the lower chambers called the Rt. and Lt. ventricles it is simultaneously done.   Also including the valves that open and close in the heart the pulmonary artery and the aorta or the tricuspid valve and mitral valve are simultaneous as well.  The ventricle sending RBC’s out to our circulatory system high in O2 to be utilized by our body tissues is the Lt. Ventrilcle. To do this job takes more effort as opposed to the Rt. side of the heart and that is why the Lt side of the heart has a bigger muscle mass (more of a work out for that side of the heart).

So the way it works with both sides of the heart is the Rt. side sends blood of highly carbon dioxide blood (RBC’s) to the lungs to get re-oxygenated through 2 vessels from the Rt. side of the heart to the lungs that sends this re-oxygenated blood in the RBC’s through 2 vessels.  On the Rt side of the heart you have the Superior Vena Cava which enters the C02 blood into the right atrium and the 2 pulmonary arteries that send that blood from the Rt Ventricle to the lungs to get the 0xygen from them.  Than this blood goes to the Lt. side of the heart  sends this highly oxygenated blood now throughout the top and bottom of the Lt. side of the heart through 2 vessels which are the pulmonary veins dumping the blood in the Lt atrium down into the Lt ventricle and out the aorta that sends this blood throughout our body tissues.  When this oxygen is used all up from the RBC’s dispensing it out to tissues the C02 is taken back from the tissues by RBC’s that replace it with O2 through breathing;   this process starts all over again with these RBC’s returning to the right side of the heart reaching the lungs to get more oxygen to be sent out by the left side of the heart to go out to all our tissues. Ending line the right side of the heart is for higher levels of carbon dioxide in the blood (used up oxygenated blood) to get more oxygen through our RBC’s whereas the left side of the heart sends higher levels of O2 throughout the body all the way to the toes through the RBC’s (a harder job on the left side of the heart=muscle mass of the left side of the heart works out more than the right making the left side of the heart a bigger muscle vs the right side).

Now knowing the anatomy and physiology of the heart let’s now understand more about a cardiac disease RVR=Rapid Ventricular Rate and Atrial Fibrillation and more regarding how they develop and in how it effects the engine of the body, being the heart, and the lungs=the transmission of the body. Like a car if the engine is affected in time the transmission gets affected and if not repaired by the mechanic the car engine will die with the transmission. Same effect with the human engine=the heart. If the heart is affected in time it will effect the lungs and if not repaired the heart will die and so will the lungs with the rest of the body.

Tomorrow Part 2 on Rapid Ventricular Rate and A Fib in how it affects the heart in functioning but how it can be treated to live a fairly normal life.

From the moment it begins beating until the moment it stops, the human heart works tirelessly. In an average lifetime*, the heart beats more than two and a half billion times, without ever pausing to rest. Like a pumping machine, the heart provides the power needed for life.

The Heart Foundation.org