The aorta is the large artery that exits in the heart and delivers blood to the body. It begins at the aortic valve that separates the left ventricle of the heart from the aorta and prevents blood from leaking back into the left ventricle after a contraction, which is actually when the heart pumps blood. The various sections of the aorta are named based upon “arch-like” initial design and the location of the aorta in the body. Thus, the beginning of the aorta is referred to as the ascending aorta (basically meaning the blood going against resistance due to the vessel being a hill for the blood to go up), followed by the arch of the aorta, then the descending aorta (which is the blood going downward via gravity with the help of the heart pumping the blood of course). The portion of the aorta that is located in the chest (called thorax) is referred to as the thoracic aorta, while the abdominal aorta (the part of the aorta below the thorax region) is located in the abdomen. The abdominal aorta extends from the diaphragm (at the bottom of the lungs like a floor to divide the lungs from the organs in the abdomen) to the mid-abdomen where it splits into the iliac arteries and when it reaches the legs the femoral arteries now start which supplies to the legs oxygenated blood. This is why commonly a cardiac catheterization to visualize the aorta and sometimes the left side of the heart is done starting in the femoral artery since in time it diverts into starting the abdominal aorta.

An aneurysm is an area of a localized widening (dilation) of a blood vessel. The word “aneurysm” is borrowed from the Greek “aneurysma” meaning “a widening”.

An aortic aneurysm involves the aorta, the major artery that leaves the heart to supply blood to the body. An aortic aneurysm is a dilation or bulging of the aorta..

Most aortic aneurysms are fusiform. They are shaped like a spindle (“fusus” means spindle in Latin) with widening all around the circumference of the aorta. (Saccular aneurysms just involve a portion of the aortic wall with a localized out pocketing).

What is inside an aortic aneurysm?

The inside walls of aneurysms are often lined with a blood clot that forms because there is stagnant blood. The wall of an aneurysm is layered, like a piece of plywood.

Who is most likely to have an abdominal aortic aneurysm?

Abdominal aortic aneurysms tend to occur in white males over the age of 60. In the United States, these aneurysms occur in up to 3.0% of the population. Aneurysms start to form at about age 50 and peak at age 80. Women are less likely to have aneurysms than men and African Americans are less likely to have aneurysms than Caucasians.

There is a genetic component that predisposes one to developing an aneurysm; the prevalence in someone who has a first-degree relative with the condition can be as high as 25%.

Collagen vascular diseases that can weaken the tissues of the aortic walls are also associated with aortic aneurysms. These diseases include Marfan syndrome and Ehlers-Danlos syndrome

Aortic aneurysms can develop anywhere along the length of the aorta but the majority are located in the abdominal aorta. Most of these abdominal aneurysms are located below the level of the renal arteries, the vessels that provide blood to the kidneys. Abdominal aortic aneurysms can extend into the iliac arteries.

What shape are most aortic aneurysms?

Most aortic aneurysms are fusiform. They are shaped like a spindle (“fusus” means spindle in Latin) with widening all around the circumference of the aorta. (Saccular aneurysms just involve a portion of the aortic wall with a localized out pocketing).

Stayed tune for Part II on Aortic Aneurysms tomorrow!

“Gaseous chemical element, symbol: O, atomic number: 8 and atomic weight 15,9994. It’s of great interest because it’s the essential element in the respiratory processes of most of the living cells and in combustion processes. It’s the most abundant element in The Earth’s crust. Nearly one fifth (in volume) of the air is oxygen. Non-combined gaseous oxygen normally exists in form of diatomic molecules, O₂, but it also exists in triatomic form, O₃, named ozone.  In normal conditions oxygen is a colourless, odourless and insipid gas; it condensates in a light blue liquid. Oxygen is part of a small group of gasses literally paramagnetic, and it’s the most paramagnetic of all. Liquid oxygen is also slightly paramagnetic.

Oxygen is essential for all forms of life since it is a constituent of DNA and almost all other biologically important compounds. Is it even more drammatically essential, in that animals must have minute by minute supply of the gas in order to survive. Oxygen in the lungs is picked up by the iron atom at the center of hemoglobin in the blood and thereby transported to where it is needed.

Every human being needs oxygen to breathe, but as in so many cases too much is not good. If one is exposed to large amounts of oxygen for a long time, lung damage can occur. Breathing 50-100% oxygen at normal pressure over a prolonged period causes lung damage. Those people who work with frequent or potentially high exposures to pure oxygen, should take lung function tests before beginning employment and after that. Oxygen is usually stored under very low temperatures and therefore one should wear special clothes to prevent the freezing of body tissues.”

Now don’t get me wrong oxygen is an element that is a must for most creatures that live in the world both now and since it began but there is dangers to any element especially if mixed with some other element causing a negative result in the end. So you wonder how oxygenation can have pros and cons and why oxygen would ever have dangers to it, well let’s take a deeper look.

Oxygenation may refer to:

Oxygen saturation (medicine), the process by which concentrations of oxygen increase within a tissue

Oxygenation (environmental), a measurement of dissolved oxygen concentration in soil or water

–Great Oxygenation Event, an ancient event that led to the rise of oxygen within our atmosphere

–Water oxygenation, the process of increasing the oxygen saturation of the water

–Dioxygen complex, the chemical details of how metals bind oxygen

Of course, oxygen has its good points. Besides being necessary for respiration and the reliable combustion engine, it can be liquefied and used as rocket fuel. Oxygen is also widely used in the world of medicine as a means to imbue the body with a greater amount of the needed gas. But recent studies indicate that administering oxygen might be doing less good than hoped—and in fact be causing harm. No one is immune to the dangers of oxygen, but the people who might most suffer the ill effects are infants newly introduced to breathing, and those who are clinically deceased.

Oxygen regarding the medical view:

There are a variety of injuries and ailments for which modern medicine dictates oxygen therapy. Look at the medical aspect, the common wisdom is that by filling the lungs with pure O₂, one is pushing more of the vital gas into the blood, and thus to organs that are weakened and in need of support. It has also long been known that even at partial pressures, pure oxygen can be toxic—a fact with which scuba divers and astronauts are intimately familiar. Recent studies have indicated that the human body responds to pure oxygen, even at normal pressures, in a negative way.

When pure O₂ is introduced to the lungs, autonomic reflex increases respiration. The increased rate of breathing means that a much larger load of carbon dioxide is released from the body, which causes the blood vessels to constrict. Despite the increased amount of available oxygen in the lungs, the circulatory system is hampered, and cannot deliver precious O₂ as well as it could when breathing normal atmosphere.

Ronald Harper, a neurobiology professor at UCLA, conducted observations on a group of healthy teenagers breathing various gas mixes using functional magnetic resonance imaging (fMRI). His findings showed that in some subjects the pure O₂ caused the brain to go clinically bonkers. Brain structures such as the hippocampus, the insula, and the cingulate cortex all displayed an adverse reaction; they in turn spurred the hypothalamus, the body’s main regulatory gland, into a fervor. The hypothalamus regulates a myriad of things, including heart rate, body temperature, and is the master of a variety of other glands. The introduction of pure oxygen prompts the hypothalamus to flood the body with a cocktail of hormones and neurotransmitters which serve to hamper heart rate, and further reduce the circulatory system’s effectiveness. But Harper also found that by adding a mere 5% CO2, all the detrimental effects found in pure oxygen are negated.

There are circumstances, however, where even the proper mix of gases would prove inadequate. Modern medicine has long taught that after respiration stops, the brain can only survive for six to seven minutes without oxygen before its cells begin to die in droves. In order to combat this, standard procedure has been to aggressively attempted to restore breathing and heartbeat immediately upon cessation, CPR. The base premise on which this protocol is designed may be in error but only if continuing longer than the AHA guides us to do CPR. For there is more than just to lack of oxygen in patients who die having CPR done to them for death (Ex Exacerbation of a disease, multi – organ failure, years of CHF, etc… Even thought lack of 02 is part of the reason for the death in the end. There was a cause for it happening and leading to lack of 02 is the prime entity to death of all diseases leading up to this in a human.).

Upon examining heart cells and neurons deprived of oxygen under a microscope, Dr Lance Becker of the University of Pennsylvania found there was no indication that the cells were dying after five or six minutes. In fact, they seemed to endure the state for up to an hour without adverse affect. Given this unexpected observation, the researchers were forced to investigate why human resuscitation becomes impossible after only a few minutes of clinical death. The answer they uncovered was that the body’s cells were not dying of oxygen starvation; they were expiring due to Reperfusion—the sudden reintroduction of oxygen to a dormant cell = Programmed cell death! The cells reintroducing oxygen back into the cell from outside the cell in the bloodstream caused the destruction of the red blood cells, the RBCs carry oxygen to all our tissues sites. You would think that would save the cells in sending more oxygen out to the tissues but like we’re told from childhood too much of almost anything can hurt or kill you (Ex. Food/work/stress…)

Take a patient with severe emphysema they do get oxygen in their body but the problem is that oxygen gets air spaced elsewhere rather than all the 02 breathed in going in the red blood cells at the lungs exchange for 02 at the bottom of the lungs with CO2 (carbon dioxide) sent from the cells to the lungs to leave the body. Than the cells go off throughout the bloodstream having our tissues utilize from the red blood cells the oxygen it needs (a transfer of 02 to our tissues).   Upon return of the red blood cells that took the CO2 from the tissues to keep the tissues more oxygenated, so they can do their function as an organ. Oxygen deprivation to a severe state is Oxygen Starvation to our bodies leading to death, if not reversed. Also with the severe COPD emphysema pt their body adjusts to having high C02 levels compared to a person without emphysema. A normal person’s brain functions to sending messages out to cause us to breath when our 02 level is low but to a severe emphysema pt the low C02 levels causes their brain to send out messages to breath, so if you give an emphysema pt over 2L of 02 for several hours if will turn the brain off and the pt deceases (except when a emphysema pt is in respiratory distress since it is needed and temporary support of higher oxygen levels than when stable and out of respiratory distress their at 2L of 02 again).

Inside the cells, the culprit seems to be in the mitochondria, which is the cell’s power plant where sugar and oxygen are converted to usable energy. Mitochondria are also responsible for apoptosis—the organized, controlled self-destruction of a cell. Normally apoptosis occurs in situations such as the cell being damaged beyond repair, infected by a virus, an attempt to prevent cancer, or aiding in initial tissue development. The process effectively kills and dismantles the cell allowing the body’s usual waste management functions to carry the cell’s remains away. For reasons not entirely clear, reperfusion triggers apoptosis—the oxygen intended to save the cell actually causes cellular suicide.

Armed with this new information about how cells react to oxygen, it is clear that current emergency care is not altogether ideal, and new protocols are under investigation. Dr Becker proposes that induced hypothermia may slow cell degradation, and if a means can be found to safely reintroduce oxygen to tissues, a clinically dead person—who still has trillions of living cells—could be resuscitated after being an hour dead.

This glorious future is still on the horizon, but to imagine the practical application leads one to ponder the multitude of accidents and injuries that are currently fatal, but will one day be treatable. Emergency Medical Personnel could arrive on the scene, and inject the patient with a slurry of ice and salt that lowers the body temperature to about 92° F. In a hypothermic state, the patient is hauled to the hospital, where instead of frantically trying to restart the heart, doctors patch up the problem, prevent apoptosis , and then restart the heart. Though it won’t save everyone, these findings may lead to a future where a person made up of perfectly good human cells is not written off as dead merely because their heart has stopped beating. The miracle of modern medicine, it seems, is on the cusp of determining the true distinction between dead and mostly dead.

“Nothing compares to the joy of coming home to a loyal companion. The unconditional love of a pet can do more than keep you company. Pets may also decrease stress, improve heart health, and even help children with their emotional and social skills.  An estimated 68% of U.S. households have a pet.  Interacting with animals has been shown to decrease levels of cortisol (a stress-related hormone) and lower blood pressure. Other studies have found that animals can reduce loneliness, increase feelings of social support, and boost your mood.”

National Institute of Health NIH News in Health (https://newsinhealth.nih.gov/2018/02/power-pets)

Animals play an important role in many people’s lives.  In addition to seeing-eye dogs and dogs that can be trained to detect seizures, animals can also be used in occupational therapy, speech therapy, or physical rehabilitation to help patients recover.  Aside from these designated therapeutic roles, animals are also valued as companions, which can certainly affect the quality of our lives.  Is that companionship beneficial to our health? The better we understand the human-animal bond, the more we can use it to improve people’s lives.

Over 71 million American households (62%) have a pet, and most people think of their pets as members of the family. Some research studies have found that people who have a pet have healthier hearts, stay home sick less often, make fewer visits to the doctor, get more exercise, and are less depressed.  Pets may also have a significant impact on allergies, asthma, social support, and social interactions with other people.

Impact on Physical Health

Companion animals may improve heart health by lowering blood pressure and regulating the heart rate during stressful situations.  In a 2002 study, researchers measured changes in heart rate and blood pressure among people who had a dog or cat, compared to those who did not, when participants were under stress (performing a timed math task).  People with a dog or cat had lower resting heart rates and blood pressure measures at the beginning of the experiment than non-pet owners.  People with a dog or cat were also less likely to have spikes in heart rates and blood pressure while performing the math task, and their heart rates and blood pressure returned to normal more quickly. They also made fewer errors in their math when their pet was present in the room.⁴  All these findings indicated that having a dog or cat lowered the risk of heart disease, as well as lowering stress so that performance improved.

A similar study found that having your dog in the room lowered blood pressure better than taking a popular type of blood pressure medication (ACE inhibitor) when you are under stress.⁵

Children’s exposure to companion animals may also ease anxiety.  For example, one study measured blood pressure, heart rate, and behavioral distress in healthy children aged 3 to 6 at two different doctor visits for routine physicals.  At one visit a dog (unrelated to the child) was present in the room and at the other visit the dog was absent.  When the dog was present, children had lower blood pressure measures, lower heart rates, and less behavioral distress.⁶  Research on the health benefits of child and animal interaction is limited.  Further research is needed on how pets influence child development and specific health outcomes.

These findings suggest that the social support a pet provides can make a person feel more relaxed and decrease stress.⁷  Social support from friends and family can have similar benefits, but interpersonal relationships often cause stress as well, whereas pets may be less likely to cause stress.  The social support provided by a pet might also encourage more social interactions with people, reducing feelings of isolation or loneliness.  For example, walking with a dog has been found to increase social interaction, especially with strangers, compared to walking without a dog.⁸

Among elderly people, pet ownership might also be an important source of social support that enhances well-being.  In one study, elderly individuals that had a dog or cat were better able to perform certain physical activities deemed “activities of daily living,” such as the ability to climb stairs; bend, kneel, or stoop; take medication; prepare meals; and bathe and dress oneself.  There were not significant differences between dog and cat owners in their abilities to perform these activities.  Neither the length of time of having a dog or cat nor the level of attachment to the animal influenced performance abilities.    Companion animals did not seem to have an impact on psychological health but researchers suggested that a care-taking role may give older individuals a sense of responsibility and purpose that contributes to their overall well-being.

“In the United States, the most common type of heart disease is coronary artery disease (CAD), which leads many to heart attacks. You can greatly reduce your risk for CAD through lifestyle changes and, in some cases, medication. CAD consists of cholesterol and placque build up, even tar if a smoker, that can be deadly in time with blocking the arteries called atherosclerosis. This in time left untreated can lead to a heart attack or even silent heart attack. CAD also is the brittling of the arteries causing narrowing of the arteries called arteriosclerosis. Here it is the ending result is the blood supply is affected in not getting enough oxygen to the tissue, in particular the heart for CAD.

It is still the number one killer even greater than cancer in both men and women today.”

AHA American Heart Association

Heart disease what is it?

Your arteries can get stretched in high blood pressure and it puts the arteries at risk for an auto immune response which allows LDL particles to go in these stretched out areas causing build up of bad cholesterol in the arteries and imbeds fat causing the placque build up = narrowing of the arteries.

We need to reduce inflammation in the arteries.  To prevent, reduce, and treat heart disease if already diagnosed with.  Reduce all sugars, cut back on fatty foods, exercise daily, increase of your whole grains, fresh fruits, and vegetables.

We need to use all 4 food groups but eat the healthy ones in the right portions.  Which I can provide to you later how to go about this.

Coronary artery disease can cause a heart attack. If you have a heart attack, you are more likely to survive if you know the signs and symptoms, call 9-1-1 immediately, and get to a hospital quickly. People who have had a heart attack can also reduce the risk of future heart attacks or strokes by making lifestyle changes and taking medication.   Don’t put off the chest pain or discomfort in the chest or pain down the L arm for if your right you want to prevent the heart attack before it occurs and if you already had an attack the sooner treated the better.  Reperfusion of blood to the heart is the KEY in treatment.  Chest pain to the heart is lack of oxygen getting to the heart tissue=ischemia.  This is due to lack of oxygenated blood to the heart that causes the ischemia. We alone can’t treat it but we can prevent it before CAD even sets in through good health practices daily, healthy dieting daily and balancing rest with exercise daily is the key to prevent Heart Disease.                                              

Look at our diet alone in America:

Take the elements that are in our foods=Sugars or Carbohydrates or Fats.  Simple CHO likes bread, rice, pasta along with fats and complex sugars all convert to simple sugars in the stomach and when it goes through digestion the simple sugar reaches the blood stream filling it up with sugar which first does get utilized to our tissues and cells but if still extra sugar in the blood stream (which is caused to excess in the size of your meal or too many eating moments in the day) that sugar has to go somewhere which is by filling up the liver with it.  In the liver the glucose gets converted from active sugar=glucose to glycogen=inactive sugar that stores in this organ.  This is so if and when the body needs extra sugar for energy in our body and we don’t eat the inactive glucose glycogen will get released back into the blood stream and change to glucose and be used.  Since we eat so much in America it usually isn’t the case.  Obesity is so large in our country and this is why.   When it reaches full and can’t store anymore glucose extra glucose in the blood stream has to go somewhere.  So now the glucose gets stored in our fatty tissue=weight gain.  This is what you see with eating through on a regular basis day in & day out too much food compared to the activity or exercise you do for the day.  If no daily exercise then your  fat storage build up is high=weight gain.How do we go about preventing CAD and getting healther.  Well see if this makes sense to you, it did to me.  First, genetic abnormalities contribute to the risk for certain types of heart disease, which in turn may lead to heart failure.  However, in most instances, a specific genetic link to heart failure has not been identified.  SO THE KEY TO PREVENTION OF Heart Disease, CAD IS TO LIVE AS HEALTHY AS POSSIBLE IN YOUR ROUTINE HABITS,  YOUR DIETING OF THE 4 FOOD GROUPS, MAINTAINING YOUR WEIGHT IN A THEREPEUTIC RANGE (look as calculating BMI online for free to find out what your weight range is for your height), and BALANCING REST WITH EXERCISE TO HELP DECREASE THE CHANCE OF GETTING HEART FAILURE.

“Yersiniosis refers to the illnesses caused by Y. enterocolitica and less often by Y. pseudotuberculosis infections. Infection occurs most often in young children. Common symptoms in children are fever, abdominal pain, and diarrhea, which is often bloody.

Most people become infected by eating contaminated food, especially raw or undercooked pork, or through contact with a person who has prepared a pork product, such as chitlins. For example, babies and infants can be infected if their caretakers handle contaminated food and then do not wash their hands properly before handling the child or the child’s toys, bottles, or pacifiers.  People occasionally become infected after drinking contaminated milk or untreated water, or after contact with infected animals or their feces.  On rare occasions, people become infected through person-to-person contact. For example, caretakers can become infected if they do not wash their hands properly after changing the diaper of a child with yersiniosis.”

CDC – Centers for Disease Control and Prevention  (https://www.cdc.gov/yersinia/faq.html)

“Agoraphobia is fear of and anxiety about being in situations or places without a way to escape easily or in which help might not be available if intense anxiety develops.  The situations are avoided, or they may be endured but with substantial anxiety. About 30 to 50% of people with agoraphobia also have panic disorder.  Agoraphobia without panic disorder affects about 2% of women and 1% of men during any 12-month period. Peak age at onset is the early 20s; first appearance after age 40 is unusual.”

Merck Manual Professional Version (https://www.merckmanuals.com/professional/psychiatric-disorders/anxiety-and-stressor-related-disorders/agoraphobia)

What is Agoraphobia:

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed. You fear an actual or anticipated situation, such as using public transportation, being in open or enclosed spaces, standing in line, or being in a crowd.

The anxiety is caused by fear that there’s no easy way to escape or get help if the anxiety intensifies. Most people who have agoraphobia develop it after having one or more panic attacks, causing them to worry about having another attack and avoid the places where it may happen again.

People with agoraphobia often have a hard time feeling safe in any public place, especially where crowds gather. You may feel that you need a companion, such as a relative or friend, to go with you to public places. The fear can be so overwhelming that you may feel unable to leave your home.

Agoraphobia treatment can be challenging because it usually means confronting your fears. But with psychotherapy and medications, you can escape the trap of agoraphobia and live a more enjoyable life.

How Agoraphobia is Diagnosed:

• Signs and symptoms
• In-depth interview with your doctor or a mental health professional
• Physical exam to rule out other conditions that could be causing your symptoms
• Criteria for agoraphobia listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Treatments for  Agoraphobia :

Agoraphobia treatment usually includes both psychotherapy and medication. It may take some time, but treatment can help you get better.

1.) Psychotherapy

Psychotherapy involves working with a therapist to set goals and learn practical skills to reduce your anxiety symptoms. Cognitive behavioral therapy is one of the most effective forms of psychotherapy for anxiety disorders, including agoraphobia.

Generally a short-term treatment, cognitive behavioral therapy focuses on teaching you specific skills to better tolerate anxiety, directly challenge your worries and gradually return to the activities you’ve avoided because of anxiety. Through this process, your symptoms improve as you build on your initial success.

You can learn:

• What factors may trigger a panic attack or panic-like symptoms and what makes them worse
• How to cope with and tolerate symptoms of anxiety
• Ways to directly challenge your worries, such as the likelihood of bad things happening in social situations
• That your anxiety gradually decreases if you remain in situations and that you can manage these symptoms until they do
• How to change unwanted or unhealthy behaviors through desensitization, also called exposure therapy, to safely face the places and situations that cause fear and anxiety

If you have trouble leaving your home, you may wonder how you could possibly go to a therapist’s office. Therapists who treat agoraphobia are well aware of this problem.

If you feel homebound due to agoraphobia, look for a therapist who can help you find alternatives to office appointments, at least in the early part of treatment. He or she may offer to see you first in your home or meet you in what you consider a safe place (safe zone). Some therapists may also offer some sessions over the phone, through email, or using computer programs or other media.

If the agoraphobia is so severe that you cannot access care, you might benefit from a more intensive hospital program that specializes in the treatment of anxiety.

You may want to take a trusted relative or friend to your appointment who can offer comfort, help and coaching, if needed.

2.) Medications

Certain types of antidepressants are often used to treat agoraphobia, and sometimes anti-anxiety drugs are used on a limited basis. Antidepressants are more effective than anti-anxiety medications in the treatment of agoraphobia.

• Antidepressants. Certain antidepressants called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), are used for the treatment of panic disorder with agoraphobia. Other types of antidepressants may also effectively treat agoraphobia.
• Anti-anxiety medication. Anti-anxiety drugs called benzodiazepines are sedatives that, in limited circumstances, your doctor may prescribe to temporarily relieve anxiety symptoms. Benzodiazepines are generally used only for relieving acute anxiety on a short-term basis. Because they can be habit-forming, these drugs aren’t a good choice if you’ve had long-term problems with anxiety or problems with alcohol or drug abuse.

It may take weeks for medication to relieve symptoms. And you may have to try several different medications before you find one that works best for you.

Both starting and ending a course of antidepressants can cause side effects that create uncomfortable physical sensations or even panic attack symptoms. For this reason, your doctor likely will gradually increase your dose during treatment, and slowly decrease your dose when he or she feels you’re ready to stop taking medication.

3,) Alternative medicine

Certain dietary and herbal supplements claim to have calming and anti-anxiety benefits. Before you take any of these for agoraphobia, talk with your doctor. Although these supplements are available without a prescription, they still pose possible health risks.

For example, the herbal supplement kava, also called kava kava, appeared to be a promising treatment for anxiety, but there have been reports of serious liver damage, even with short-term use. The Food and Drug Administration has issued warnings but not banned sales in the United States. Avoid using any product that contains kava until more-rigorous safety studies are done, especially if you have liver problems or take medications that affect your liver.