Posterior Interventricular Artery Regurgitation (PIVAR)

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Cardiovascular and Respiratory Disease (A - Z)

Posterior Interventricular Artery Regurgitation (PIVAR) is a medical condition that affects the heart’s ability to pump blood efficiently. It occurs when the valve between the two lower chambers of the heart, called the ventricles, doesn’t close properly. This allows blood to leak backward, causing various symptoms and complications.

Types of PIVAR:

  1. Primary PIVAR: Caused by damage or abnormalities in the heart valve itself.
  2. Secondary PIVAR: Resulting from underlying conditions such as heart disease or hypertension.

Causes of PIVAR:

  1. Rheumatic Fever: A complication of untreated strep throat that can damage heart valves.
  2. Endocarditis: Infection of the heart valves.
  3. Congenital Heart Defects: Abnormalities present at birth.
  4. Cardiomyopathy: Disease of the heart muscle.
  5. Atherosclerosis: Buildup of plaque in the arteries.
  6. High Blood Pressure (Hypertension): Increases strain on the heart.
  7. Heart Attack: Damage to the heart muscle.
  8. Aging: Wear and tear on heart valves over time.
  9. Trauma: Injury to the chest or heart.
  10. Autoimmune Disorders: Conditions where the immune system attacks the body’s own tissues.
  11. Medications: Certain drugs may affect heart function.
  12. Genetic Factors: Family history of heart disease.
  13. Obesity: Excess weight can strain the heart.
  14. Smoking: Increases the risk of heart disease.
  15. Diabetes: Can damage blood vessels and the heart.
  16. Alcohol Abuse: Can weaken the heart muscle.
  17. Illegal Drug Use: Certain substances can damage the heart.
  18. Thyroid Disorders: Imbalance in thyroid hormones can affect heart function.
  19. Chronic Kidney Disease: Impairs heart function.
  20. Lupus: An autoimmune disease that can affect various organs, including the heart.

Symptoms of PIVAR:

  1. Shortness of Breath: Especially during physical activity or when lying flat.
  2. Fatigue: Feeling tired even with minimal exertion.
  3. Swelling: Particularly in the legs, ankles, or abdomen.
  4. Irregular Heartbeat: Palpitations or a sensation of skipped beats.
  5. Chest Pain: Discomfort or pressure in the chest.
  6. Dizziness or Fainting: Due to decreased blood flow to the brain.
  7. Coughing: Especially at night or when lying down.
  8. Difficulty Sleeping: Waking up short of breath or with a racing heart.
  9. Reduced Exercise Tolerance: Inability to tolerate physical activity as before.
  10. Fluid Retention: Resulting in weight gain.
  11. Nausea or Loss of Appetite: Due to decreased blood flow to the digestive system.
  12. Anxiety or Restlessness: Feeling uneasy or nervous.
  13. Pale or Bluish Skin: Especially in the fingers or lips.
  14. Weakness: Feeling weak or unable to perform daily tasks.
  15. Rapid Weight Gain: Due to fluid retention.
  16. Swollen Neck Veins: Visible swelling of veins in the neck.
  17. Difficulty Concentrating: Impaired cognitive function due to decreased blood flow.
  18. Sudden Cardiac Arrest: In severe cases.
  19. Depression: Feeling down or hopeless.
  20. Decreased Urination: Due to fluid buildup in the body.

Diagnostic Tests for PIVAR:

  1. Echocardiogram: Uses sound waves to create images of the heart and valves.
  2. Electrocardiogram (ECG or EKG): Records the heart’s electrical activity.
  3. Chest X-ray: Provides images of the heart and lungs.
  4. Cardiac MRI: Produces detailed images of the heart.
  5. Cardiac Catheterization: Involves threading a catheter into the heart to assess blood flow and pressure.
  6. Stress Test: Measures heart function during physical activity.
  7. Transesophageal Echocardiogram (TEE): Uses a probe inserted into the esophagus to obtain detailed images of the heart.
  8. Blood Tests: Check for markers of heart damage or infection.
  9. Holter Monitor: Records heart rhythm over a 24-hour period.
  10. Coronary Angiography: Evaluates blood flow in the coronary arteries.
  11. Doppler Ultrasound: Assesses blood flow through the heart and blood vessels.
  12. Exercise Stress Test: Measures heart function during exercise.
  13. Nuclear Stress Test: Uses radioactive tracers to assess blood flow to the heart.
  14. CT Scan: Provides detailed images of the heart and blood vessels.
  15. PET Scan: Measures blood flow and metabolic activity in the heart.
  16. Ambulatory ECG: Records heart rhythm over an extended period.
  17. Tilt Table Test: Evaluates heart rate and blood pressure response to changes in position.
  18. B-type Natriuretic Peptide (BNP) Test: Measures a hormone released by the heart in response to stress.
  19. Electrophysiology Study: Assesses the heart’s electrical system.
  20. Carotid Ultrasound: Checks for blockages in the carotid arteries.

Treatments for PIVAR:

  1. Medications: Including ACE inhibitors, beta-blockers, diuretics, and anticoagulants.
  2. Lifestyle Changes: Such as quitting smoking, maintaining a healthy weight, and exercising regularly.
  3. Dietary Modifications: Including a low-sodium diet to reduce fluid retention.
  4. Cardiac Rehabilitation: Exercise and education programs to improve heart health.
  5. Surgery: Options include valve repair or replacement, coronary artery bypass grafting (CABG), and heart transplant.
  6. Percutaneous Valve Repair: Minimally invasive procedures to repair heart valves.
  7. Implantable Devices: Such as pacemakers or implantable cardioverter-defibrillators (ICDs) to regulate heart rhythm.
  8. Cardiac Resynchronization Therapy: Involves implanting a device to improve coordination of heart contractions.
  9. Heart Valve Balloon Valvuloplasty: Procedure to widen a narrowed heart valve using a balloon catheter.
  10. Left Ventricular Assist Device (LVAD): Mechanical pump implanted to assist heart function.
  11. Alcohol Septal Ablation: Procedure to treat hypertrophic cardiomyopathy.
  12. Heart Valve Repair: Surgical procedure to restore function to a damaged heart valve.
  13. Ablation Therapy: Destroys abnormal heart tissue causing irregular heart rhythms.
  14. Heart Transplant: Replacement of a diseased heart with a healthy donor heart.
  15. Coronary Artery Bypass Surgery: Redirects blood flow around blocked coronary arteries.
  16. Valve Replacement: Surgical procedure to replace a damaged heart valve with a mechanical or biological valve.
  17. Pacemaker Implantation: Device implanted to regulate heart rhythm.
  18. ICD Implantation: Device implanted to monitor and treat irregular heart rhythms.
  19. Ventricular Restoration Surgery: Procedure to reshape the left ventricle after a heart attack.
  20. Extracorporeal Membrane Oxygenation (ECMO): Provides temporary heart and lung support in severe cases.

Drugs Used in PIVAR Treatment:

  1. Lisinopril: An ACE inhibitor to lower blood pressure.
  2. Metoprolol: A beta-blocker to reduce heart rate and blood pressure.
  3. Furosemide: A diuretic to reduce fluid buildup.
  4. Warfarin: An anticoagulant to prevent blood clots.
  5. Aspirin: Antiplatelet medication to prevent clot formation.
  6. Digoxin: Strengthens heart contractions.
  7. Spironolactone: A diuretic and aldosterone antagonist.
  8. Clopidogrel: Antiplatelet medication to prevent blood clots.
  9. Atenolol: Beta-blocker to reduce heart rate and blood pressure.
  10. Hydralazine: Dilates blood vessels to reduce blood pressure.
  11. Diltiazem: Calcium channel blocker to lower blood pressure.
  12. Amiodarone: Antiarrhythmic medication to regulate heart rhythm.
  13. Valsartan: An angiotensin II receptor blocker to lower blood pressure.
  14. Rivaroxaban: An anticoagulant to prevent blood clots.
  15. Simvastatin: Statin medication to lower cholesterol.
  16. Nitroglycerin: Vasodilator to relieve chest pain.
  17. Carvedilol: Beta-blocker to reduce heart rate and blood pressure.
  18. Verapamil: Calcium channel blocker to lower blood pressure.
  19. Enalapril: ACE inhibitor to lower blood pressure.
  20. Heparin: Anticoagulant to prevent blood clots.

Surgeries for PIVAR:

  1. Valve Repair: Restores function to a damaged heart valve.
  2. Valve Replacement: Replaces a damaged heart valve with a mechanical or biological valve.
  3. Coronary Artery Bypass Surgery (CABG): Redirects blood flow around blocked coronary arteries.
  4. Heart Transplant: Replacement of a diseased heart with a healthy donor heart.
  5. Pacemaker Implantation: Device implanted to regulate heart rhythm.
  6. Implantable Cardioverter-Defibrillator (ICD) Implantation: Device implanted to monitor and treat irregular heart rhythms.
  7. Left Ventricular Assist Device (LVAD) Implantation: Mechanical pump implanted to assist heart function.
  8. Alcohol Septal Ablation: Procedure to treat hypertrophic cardiomyopathy.
  9. Ablation Therapy: Destroys abnormal heart tissue causing irregular heart rhythms.
  10. Ventricular Restoration Surgery: Procedure to reshape the left ventricle after a heart attack.

In summary, Posterior Interventricular Artery Regurgitation is a complex condition that requires careful management and treatment. With the right interventions, individuals with PIVAR can lead fulfilling lives and reduce the risk of complications. Early diagnosis and appropriate medical care are crucial in improving outcomes for those affected by this condition.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

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References

 

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