Tandy Delany
|Подписчиков
О себе
Anabolic Steroids: Uses, Abuse, And Side Effects
## 1️⃣ Men’s Heart Health – What Every Man Should Know
| Topic | Key Take‑aways |
|-------|----------------|
| **Why men are at higher risk** | • Men tend to develop coronary heart disease (CHD) about a decade earlier than women.
• Higher prevalence of smoking, heavy alcohol use, and work‑related stress. |
| **Common warning signs** | • Chest pressure or discomfort that lasts >20 min.
• Pain radiating to jaw, shoulder, arm, back, neck, or stomach.
• Shortness of breath, nausea, sweating, dizziness without obvious cause. |
| **Risk‑factor checklist (check all that apply)** | • Age ≥45 (men) / ≥55 (women)
• Hypertension
• Hyperlipidemia
• Diabetes mellitus
• Family history of early MI <60 yr old
• Smoking or exposure to secondhand smoke
• Sedentary lifestyle
• Obesity (BMI ≥30)
• Chronic stress, depression. |
| **What to do if you suspect a heart attack** | 1. Call emergency services immediately.
2. Chew an aspirin 325 mg (if not allergic) and swallow it.
3. Do not drive yourself; wait for help.
4. Stay calm, sit or lie down, breathe slowly.
5. Follow dispatcher instructions until EMS arrives. |
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## 2. How to Reduce the Risk of a Heart Attack
| Category | Key Actions |
|----------|-------------|
| **Lifestyle** | • **Quit smoking** – seek nicotine‑replacement therapy or counseling.
• **Limit alcohol** – no more than 1 drink/day for women, 2 for men.
• **Healthy diet** – Mediterranean style (olive oil, nuts, fish, whole grains; low in processed meats).
• **Regular exercise** – at least 150 min/week moderate or 75 min vigorous aerobic activity plus muscle‑strengthening twice a week. |
| **Weight & Metabolism** | • Maintain BMI <25 kg/m² if possible.
• Monitor waist circumference (<80 cm for women, <94 cm for men).
• Manage dyslipidemia (LDL < 100 mg/dl; consider statins per guidelines). |
| **Blood Pressure** | • Keep systolic < 130 mmHg and diastolic < 80 mmHg.
• Use lifestyle measures first, add ACE‑I/ARB or calcium‑channel blockers as indicated. |
| **Glycemic Control** | • HbA1c <7 % for most patients; consider lower targets in those without significant comorbidities and good adherence.
• Prefer metformin if tolerated; consider GLP‑1 RA or SGLT2i if high CV risk, especially with heart failure or CKD. |
| **Renal Protection** | • ACE‑I/ARB at nephroprotective doses unless contraindicated (e.g., hyperkalemia, worsening creatinine >30 % after 4–6 weeks).
• Monitor potassium and creatinine weekly for first month, then monthly. |
| **Blood Pressure Targets** | <130/80 mmHg for patients with CKD or diabetes; <140/90 for others, unless frail or older >75 y where <150/90 may be acceptable. |
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## 3. Management of Acute Kidney Injury (AKI)
| Step | Details |
|------|---------|
| **1. Identify & Stage AKI** | Use KDIGO criteria:
• Increase serum creatinine ≥0.3 mg/dL within 48 h or ≥50% within 7 d
• Urine output <0.5 mL/kg/h for 6–12 h |
| **2. Reversible Causes** | • Hypovolemia: start isotonic fluids (1 L over 24 h, then titrate)
• Nephrotoxic drugs: discontinue ACEI/ARB, NSAIDs, antibiotics (e.g., aminoglycosides), contrast agents
• Ischemic events: treat hypotension or cardiac arrhythmias |
| **3. Monitoring** | • Daily BUN/Cr, electrolytes, volume status
• Check for electrolyte disturbances (hyperkalemia, hyponatremia) |
| **4. Management of Acute Kidney Injury (AKI)** | • If Cr >2 mg/dL or oliguria (<0.5 mL/kg/h), consider nephrology referral.
• Initiate fluid therapy cautiously; avoid overloading if heart failure is present.
• Use diuretics to manage volume overload, but monitor renal function and electrolytes.
• If severe AKI, initiate renal replacement therapy (dialysis) based on standard indications. |
| **5. Follow-Up** | • Schedule follow-up visits at 1 month, then every 3–6 months or sooner if symptoms worsen.
• Reassess BP, HR, symptoms, and medication adherence during each visit. |
---
## Key Points for the Patient
- **Take your medications exactly as prescribed; do not skip doses.**
- **Monitor your blood pressure at home (if possible) and record the readings.**
- **Watch for new or worsening symptoms such as shortness of breath, swelling, chest pain, palpitations, dizziness, or fainting.**
- **If you notice any of these signs, contact your cardiologist immediately.**
- **Lifestyle changes—healthy diet, exercise, limit alcohol, avoid smoking—greatly help control blood pressure and heart rhythm.**
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### Summary
Your cardiology team has reviewed the latest data from your Holter monitor. The findings indicate an overall improvement in arrhythmia burden but some residual irregularities remain. Your blood pressure is within target limits; however, continued monitoring of BP and HR is recommended to maintain optimal cardiovascular health. Adjustments to medication or further investigations may be considered if future monitoring shows increased arrhythmic activity or symptomatic changes.
Feel free to reach out with any questions about these results or next steps in your care plan.
