Tachycardia is a condition characterized by an accelerated heart rate (more than 100 beats per minute). If the tachycardia is disproportionate to the situation (usually occurring at rest), it is evaluated as a pathological phenomenon. Physiologically, it can arise during physical exertion (e.g., during sports), stress, but it can also be a symptom of diseases (fever, anaemia, thyroid disorders, etc.), known as sinus tachycardia. 

Pathological tachycardias originate within the heart and can vary in nature, from minor to life-threatening. They are caused, in a minority of cases, by a congenital anomaly of the cardiac conduction system, but in the majority of cases, they result from acquired heart disease (inflammation, cardiomyopathy, degenerative changes, ischemia). Tachyarrhythmias may also arise due to changes in the body’s internal environment or the influence of certain drugs that have arrhythmogenic side effects. 

Tachycardias are further subdivided according to their origin into supraventricular tachycardias (atrial fibrillation, atrial flutter, atrial tachycardia, AV re-entry tachycardias) and ventricular tachycardias (monomorphic or polymorphic ventricular tachycardia, ventricular fibrillation).

 Pathological tachycardias are diagnosed by ECG examination.

Heart failure is a condition where the heart muscle is weakened and unable to perform its pumping function efficiently, causing blood that should be pumped to all organs of the body to accumulate in the venous circulation. 

The causes of heart failure include coronary artery disease or heart attack, inadequately controlled blood pressure, valvular defects, cardiomyopathies, arrhythmias, among others. It is possible to prevent its occurrence by addressing these underlying diseases. Heart failure is divided based on whether the predominant symptoms are due to right or left ventricular involvement, resulting in right-sided or left-sided heart failure.

Treatment involves managing the underlying disease, medical therapy, and in cases of severe cardiac dysfunction, the implantation of cardiac resynchronization therapy devices or a cardioverter-defibrillator to prevent life-threatening arrhythmias, circulatory support devices and, in indicated cases, heart transplantation.

Syncope is a transient loss of consciousness that arises suddenly due to temporary insufficient blood flow to the brain. It passes on its own, and the person regains consciousness without intervention. Vasovagal syncope, a type of reflex syncope, generally has a good prognosis, does not shorten the patient’s lifespan, and typically does not require treatment. However, the downside is that injury can occur during a fall.

What is coronary artery disease?

Coronary Artery Disease (CAD) is damage to the blood vessel walls caused by the deposition of fat and calcium. This buildup can lead to the narrowing or closure of the blood vessels, thereby restricting the blood supply to the heart muscle. The coronary arteries are the three major blood vessels that supply blood to the heart. The heart itself is a muscle that pumps blood and oxygen to the rest of the body. The disease known as “atherosclerosis” damages the walls of the coronary blood vessels. A significant reduction in the blood supply to the heart muscle causes angina pectoris, which is ischemic chest pain.

What is a heart attack?

A sudden, complete interruption of blood flow to part of the heart muscle will manifest as a myocardial infarction. A heart attack, or myocardial infarction (MI), is a life-threatening emergency requiring immediate medical care. It happens when blood flow to a part of the heart suddenly stops, and the muscle cells do not get enough oxygen. Usually, a heart attack is caused by a blockage in one or more coronary arteries. Without a blood supply, the heart cannot function properly. The heart’s function is reduced or even fails completely. In the latter case, death can occur suddenly. If only a small part of the heart muscle is affected, the heart may be injured but still able to function with reduced capacity. However, the longer the heart’s circulation is impaired, the higher the risk that the muscle cells will die and be replaced by scar tissue. This scar tissue is unable to perform the tasks of the muscle and the heart will never regain its original strength and capacity. Sometimes scar tissue can cause irregular heartbeats because it cannot conduct the electrical impulses that control the heart’s action. If the heart is severely damaged, even a little stress can overload its capacity and cause a potentially fatal heart attack. That is why it is crucial to find and treat a blockage in blood flow as quickly as possible.

What is peripheral artery disease?

Peripheral artery disease (PAD) affects the arteries of the legs, kidneys, and other parts of the body besides the brain and heart. It narrows or blocks the arteries, reducing blood flow. Since many people are unaware of this disease, it is often not recognized early and therefore treated too late. The most common cause of peripheral artery disease is the build-up of fatty plaque in the arteries, called atherosclerosis. The plaque consists of cholesterol, blood fats, cellular waste, calcium, and a protein called fibrin. By narrowing or blocking the arteries, plaque reduces normal blood flow (ischemia). Without enough oxygen-rich blood, organs and tissues stop functioning. The most common type of peripheral artery disease is critical limb ischemia (CLI).

CLI means that blood flow to one or more limbs, such as the arms, legs, or feet, is severely blocked. Fifty to seventy-five percent of patients with peripheral artery disease also suffer from cerebral and/or coronary atherosclerosis, which can cause stroke or heart attack.

Some risk factors that increase the chance of developing PAD can be influenced, while others cannot: 

• Age (over 45 for men, over 55 for women) 
• Family history 
• Heart and blood vessel disease 
• Diabetes 
• Smoking 
• Hypertension (high blood pressure) 
• High blood cholesterol levels (LDL, sometimes called “bad” cholesterol) 
• Triglyceride levels (a type of fat found in the blood) 
• Low levels of “good” cholesterol (HDL) 
• Being overweight or obese
• Excessive alcohol consumption
• Excessive stress
• Lack of exercise

What is Diabetic foot?

Diabetic foot is one of the most common complications of diabetes mellitus. It results from damage to the nerve fibres and blood vessels of the lower limbs.

Damage to nerve fibres is called diabetic polyneuropathy. It is manifested by tingling, burning, pain in the lower limbs, and can lead to a loss of sensation in the legs. When a diabetic patient loses sensation in the feet, they may be unaware of issues such as as wearing a tight shoe, a bent sock, or minor bumps and abrasions. Infection can get into these tiny wounds and further impair wound healing.

Damage to blood vessels in prolonged diabetes causes a decrease in blood flow to the lower extremities, resulting in inadequate oxygen and nutrient supply to the tissues. This leads to slower wound healing and prolonged infection. Severely infected wounds never heal with inadequate blood supply.

In cases where the wound on the leg does not heal despite care, the patient may undergo amputation of one or more toes, the foot, or variously large parts of the lower limb. Severe infection can spread through the blood throughout the body and cause organ failure. In such cases, amputation of the limb is the only life-saving option.

What can a patient with diabetes do for the health of their feet? From the perspective of the underlying disease, good blood sugar control is important, and for the long term. Therefore, strict adherence to the treatment and dietary measures recommended by the diabetologist is necessary.