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Conditions And Treatments

Coma

What is a coma?

A coma is a condition of prolonged loss of consciousness. It can be caused by traumatic brain injury, stroke, brain tumors, or drug or alcohol poisoning. Comas can also result from medical conditions such as diabetes or infections.

A coma is a medical emergency. Prompt action is needed to save the patient’s life and brain function. Doctors usually perform a series of blood tests and brain scans to determine the cause of the coma so that appropriate treatment can be administered.

Comas typically do not last more than a few weeks. Individuals who remain unconscious for an extended period may enter a long-term vegetative state, known as a persistent vegetative state or brain death.

Symptoms of a coma

Common symptoms of a coma include:

  • Closed eyes
  • Depressed brainstem reflexes, such as unresponsive pupils to light
  • No limb response except reflexive movements
  • No response to painful stimuli except reflexive movements
  • Irregular breathing

Causes of a coma

Causes of a coma may include:

  • Traumatic brain injury: Often caused by traffic accidents or acts of violence.
  • Stroke: A condition marked by reduced or halted blood supply to the brain.
  • Tumors: Tumors in the brain or brainstem can cause a coma.
  • Diabetes: Extremely high or low blood sugar levels can lead to a coma.
  • Lack of oxygen: Survivors of drowning incidents or those revived after cardiac arrest may not wake up due to oxygen deprivation in the brain.
  • Infections: Infections such as encephalitis and meningitis cause swelling of the brain, spinal cord, or surrounding tissues. Severe infections can lead to brain damage or coma.
  • Seizures: Continuous seizures can result in a coma.
  • Toxins: Exposure to toxins like carbon monoxide or lead can cause brain damage and coma.
  • Drugs and alcohol: Overdoses of illegal drugs or alcohol can lead to coma.

Diagnosing a coma

A patient’s medical history and various tests can help determine the cause of a coma, allowing doctors to choose the most appropriate treatment. The following are some diagnostic methods doctors may use:

1. Medical History

Doctors may ask friends, family, police, or witnesses about:

  • Whether the coma or preceding symptoms began suddenly or gradually
  • Whether the person had or appeared to have vision problems, dizziness, fainting, or numbness before the coma
  • Whether the person has diabetes, a history of seizures or stroke, or other conditions
  • What medications or substances the person may have consumed

2. Physical Exam

This test aims to trigger various reflexive eye movements. The type of response varies depending on the cause of the coma.

Previously, doctors used to squirt very cold or warm water into the ear canal for testing. Nowadays, diagnosis is more commonly based on the following evaluations:

  • Extraocular movement: Do the eyes move up, down, and sideways?
  • Pupils: Do the pupils change size in response to light?
  • Corneal reflex: Does the person blink when the eye is touched with a cotton swab?
  • Cough reflex: Does coughing occur when there are oral secretions?
  • Gag reflex: Is the gag reflex triggered when the back of the throat is touched?

3. Blood Tests

Blood tests can be used to check for:

  • Blood count
  • Signs of carbon monoxide poisoning
  • Presence and levels of legal or illegal drugs
  • Electrolyte levels
  • Blood glucose levels
  • Liver function

4. Brain Scans

Brain imaging tests can help doctors identify any brain injuries or damage.

CT scans or MRIs can reveal blockages or other abnormalities. Meanwhile, an electroencephalogram (EEG) can measure electrical activity in the brain.

Coma Treatment

A coma is a serious medical emergency. Doctors begin by ensuring the patient’s survival. They also stabilize breathing and blood circulation to maximize the amount of oxygen reaching the brain.

Treatment options may include:

  • Glucose for patients in diabetic shock or with brain infections
  • Naloxone for patients in a coma due to severe poisoning
  • Vitamin B1 for patients with alcohol use disorders, which may cause a deficiency of this vitamin

In all coma cases, doctors typically aim to maintain the patient’s blood pressure and ensure proper breathing by protecting the airway.

In some cases, doctors may need to reduce intracranial pressure by draining excess cerebrospinal fluid or prescribing medications to reduce brain swelling, such as mannitol and hypertonic saline.

Have more questions about coma or other medical conditions? Visit Mandaya Royal Hospital Puri. Book an appointment now via the Chat feature on WhatsApp, Book Appointment, or the Care Dokter app, which is available on Google Play and the App Store to make your visit easier, check queue numbers, and access complete information.

Psoriatic Arthritis

What is Psoriatic Arthritis?

Psoriatic arthritis is a form of arthritis commonly experienced by individuals with psoriasis or those with a family history of psoriasis. Arthritis is a condition that affects the joints, with symptoms such as pain and inflammation in and around the joints. Meanwhile, psoriasis causes skin inflammation, with rashes that appear as discolored patches covered with scales (plaques).

Both psoriasis and arthritis are autoimmune diseases, which occur when the immune system mistakenly attacks the body instead of protecting it. Psoriatic arthritis develops when a person has both skin symptoms of psoriasis and inflammation in the joints.

Symptoms of Psoriatic Arthritis

Both psoriatic arthritis and psoriasis are chronic diseases that tend to worsen over time. However, individuals may experience periods during which symptoms improve or temporarily disappear.

Here are some symptoms of psoriatic arthritis to watch out for:

  • Swollen fingers and toes: Psoriatic arthritis can cause painful swelling in the fingers and toes.
  • Foot pain: It can cause pain at points where tendons and ligaments attach to bones, especially at the back of the heel or the soles of the feet.
  • Lower back pain: Some people develop spondylitis due to psoriatic arthritis, which causes inflammation in the joints between the vertebrae and between the spine and pelvis.
  • Nail changes: Nails may develop small pits, become crumbly, or separate from the nail bed.
  • Eye inflammation: Inflammation of the eye, or uveitis, can cause eye pain, redness, and blurred vision. If left untreated, this condition may lead to blindness.

Causes of Psoriatic Arthritis

Some people with psoriasis develop psoriatic arthritis. This type of arthritis sometimes appears years after someone has been diagnosed with psoriasis.

Like psoriasis, psoriatic arthritis is caused by the immune system attacking healthy tissue. However, it is not yet fully understood why some people with psoriasis develop psoriatic arthritis while others do not.

Diagnosis of Psoriatic Arthritis

Doctors diagnose psoriatic arthritis through physical examinations and several tests. They will also ask about symptoms and examine the patient’s skin and joints.

There is no single test that can diagnose this condition. However, doctors may recommend certain tests to rule out other causes of the symptoms. For example, a blood test might be conducted to check for signs of infection.

Additionally, imaging tests may be recommended to examine the joints for damage or inflammation. These imaging tests may include:

  • X-rays
  • MRI
  • CT scans
  • Ultrasound

Treatment of Psoriatic Arthritis

The primary treatment for psoriatic arthritis involves medication, such as:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Steroid injections
  • Disease-modifying anti-rheumatic drugs (DMARDs)
  • Biologic therapies

Doctors may also refer patients to a physiotherapist, occupational therapist, or both. A physiotherapist can teach exercises that help strengthen the joints and prevent further damage.

An occupational therapist can suggest adjustments at home and work. For instance, they may recommend tools that make specific tasks easier.

If you have specific questions regarding psoriatic arthritis or want to consult further about overall skin health, visit Mandaya Royal Hospital Puri. Our hospital is equipped with advanced medical technology and supported by a multidisciplinary team of experienced specialists.

Schedule an appointment now through the Chat feature via WhatsApp, Book Appointment, or the Care Dokter app available on Google Play and the App Store to simplify your visit, view your queue number, and get complete information.

Cardiomegaly

What is Cardiomegaly?

Cardiomegaly is a condition characterized by an enlarged heart. This condition is not a disease in itself, but rather a symptom of another underlying condition.

The term “cardiomegaly” refers to heart enlargement seen on imaging tests, such as a chest X-ray. Once an enlarged heart is detected, other tests are needed to diagnose the condition causing the heart to enlarge.

Symptoms of Cardiomegaly

In some individuals, an enlarged heart does not cause any signs or symptoms. However, others may experience the following symptoms:

  • Shortness of breath, especially when lying down
  • Waking up feeling short of breath
  • Irregular heartbeat (arrhythmia)
  • Swelling (edema) in the abdomen or legs
  • Fatigue
  • Heart palpitations
  • Low energy levels

Causes of Cardiomegaly

Several conditions are associated with an enlarged heart, including:

  • Congenital heart defects: Heart problems present at birth can affect the heart’s structure and function, leading to muscle enlargement and weakness.
  • Damage from a heart attack: Scarring and other structural damage from a heart attack can make it harder for the heart to pump enough blood throughout the body. This strain can enlarge the heart and lead to heart failure.
  • Cardiomyopathy (heart muscle disease): Cardiomyopathy can cause the heart muscle to become stiff or thick, making it more difficult for the heart to pump blood.
  • Fluid buildup in the sac around the heart (pericardial effusion): Accumulation of fluid around the heart can appear as an enlarged heart on a chest X-ray.
  • Heart valve disease: The four heart valves ensure proper blood flow direction. Damage or disease in one of these valves can disrupt blood flow and cause heart chamber enlargement.
  • High blood pressure (hypertension): If someone has high blood pressure, the heart may have to pump harder to circulate blood throughout the body. This extra effort can cause the heart muscle to enlarge and weaken.
  • Pulmonary hypertension (high blood pressure in the lungs’ arteries): The heart must work harder to pump blood between the lungs and heart, which can thicken or enlarge the right side of the heart.
  • Low red blood cell count (anemia): Anemia results in a shortage of healthy red blood cells to carry enough oxygen to tissues. To compensate, the heart pumps more blood, which can lead to enlargement.
  • Thyroid disorders: Both underactive (hypothyroidism) and overactive (hyperthyroidism) thyroid glands can cause heart problems, including heart enlargement.
  • Excess iron in the body (hemochromatosis): Iron can accumulate in various organs, including the heart, leading to swelling of the lower left heart chamber.

Diagnosing Cardiomegaly

Doctors may perform several tests to determine the cause of cardiomegaly, including:

  • Echocardiogram: Uses sound waves to detect problems in the heart chambers.
  • Electrocardiogram (ECG or EKG): Monitors electrical activity in the heart to diagnose irregular heart rhythms and ischemia.
  • Blood tests: Check for substances in the blood linked to conditions causing heart enlargement, such as thyroid disease.
  • Stress tests: Involves walking on a treadmill or cycling while monitoring heart rate and breathing to see how hard the heart works during exertion.
  • CT scan: Uses X-rays to produce detailed images of the heart and other chest structures, useful in diagnosing valve disease or inflammation.
  • MRI scan: Uses powerful magnets and radio waves to create images of the heart.

Treatment for Cardiomegaly

Doctors will provide a treatment plan based on the underlying cause of cardiomegaly. Examples include:

  • Hypertension: ACE inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers
  • Irregular heartbeat: Antiarrhythmic drugs, pacemakers, and implantable cardioverter-defibrillators (ICDs)
  • Heart valve problems: Surgery to repair or replace damaged valves
  • Coronary artery narrowing: Angioplasty with stent placement, coronary bypass surgery, and nitrates
  • Heart failure: Diuretics, beta-blockers, inotropes, angiotensin receptor neprilysin inhibitors (ARNIs), and in some cases, a left ventricular assist device (LVAD)

Have specific questions about cardiomegaly or other heart conditions? Visit Mandaya Royal Hospital Puri. Our hospital is equipped with modern medical technology to handle a variety of heart issues. You can also consult with our experienced cardiologists.

Make an appointment easily through the Chat feature via WhatsApp, Book Appointment, or download the Care Dokter app on Google Play or the App Store to simplify your visit, view queue numbers, and get other important information.

Stomach Cancer

What is stomach cancer?

Stomach cancer is a condition in which cancer cells grow uncontrollably in the stomach. The stomach is an organ located in the upper middle part of the abdomen, just below the ribs. Its function is to help break down and digest food.

Stomach cancer can occur in any part of the stomach. However, in most cases, it develops in the main part of the stomach, known as the body of the stomach.

About 95% of stomach cancer cases begin in the stomach lining and develop slowly. If left untreated, the cancer can form a mass (tumor) and grow deeper into the stomach wall. The tumor can spread to nearby organs such as the liver and pancreas.

Types of stomach cancer

Stomach cancer is categorized based on the type of cells where the cancer originates:

  • Adenocarcinoma

Adenocarcinoma begins in the cells that produce mucus. It is the most common type of stomach cancer. Nearly all stomach cancers are adenocarcinomas.

  • Gastrointestinal stromal tumors (GIST)

GIST originates in specialized nerve cells found in the wall of the stomach and other digestive organs. GIST is a type of soft tissue sarcoma.

  • Carcinoid tumors

Carcinoid tumors are cancers that originate in neuroendocrine cells. These cells are found throughout the body and have some nerve cell functions and hormone-producing functions. Carcinoid tumors are a type of neuroendocrine tumor.

  • Lymphoma

Lymphoma is cancer that begins in immune system cells. Lymphoma can sometimes start in the stomach if the body sends immune cells there to fight infection. Most stomach lymphomas are non-Hodgkin lymphoma types.

Symptoms of stomach cancer

Signs and symptoms of stomach cancer may include:

  • Difficulty swallowing
  • Abdominal pain
  • Feeling bloated after eating
  • Feeling full even after eating small amounts
  • Lack of appetite when you normally would be hungry
  • Heartburn
  • Indigestion
  • Nausea
  • Vomiting
  • Unexplained weight loss
  • Extreme fatigue
  • Black-colored stool

Stomach cancer may not cause symptoms in the early stages. If symptoms do appear, they often include indigestion and upper abdominal pain. Symptoms might not show until the cancer has advanced.

In the later stages, symptoms can include extreme fatigue, weight loss, vomiting blood, and black stool.

Causes of stomach cancer

Anyone can develop stomach cancer. The exact cause is not clearly known.

However, several factors may increase the risk, such as:

  • Being over 50 years old
  • Being male
  • Having a long-term infection caused by Helicobacter pylori (H. pylori)
  • Having certain stomach conditions, such as severe and long-term acid reflux or gastritis
  • A family history of stomach cancer

Diagnosing stomach cancer

Tests and procedures used to diagnose and detect stomach cancer include:

  • Endoscopy

To look for signs of cancer, a doctor may use a small camera to view the inside of the stomach. This procedure is called upper endoscopy. A thin tube with a small camera is inserted through the throat and guided into the stomach.

  • Biopsy

If something in the stomach appears suspicious, a tissue sample may be taken for testing. This procedure is called a biopsy and can be done during an endoscopy. Special instruments are inserted through the tube to collect the tissue sample, which is then sent to a lab for analysis.

Stomach cancer treatment

Here are some treatment options for stomach cancer that doctors may recommend:

  • Surgery

Treatment depends on whether the cancer can be surgically removed. If it cannot be removed, doctors may recommend surgery to help control some symptoms of stomach cancer.

  • Chemotherapy

Chemotherapy is a type of cancer treatment that uses special drugs to kill cancer cells.

  • Radiation therapy

Radiation therapy uses high-energy radiation to destroy cancer cells in the patient’s body.

  • Targeted therapy and immunotherapy

Targeted therapy aims to stop the growth of cancer cells. Immunotherapy uses medications to help the immune system kill cancer cells.

Visit the Integrated Cancer Center at Mandaya Royal Hospital Puri. Our hospital is equipped with modern medical technology to treat various types of cancer. In addition, Mandaya Puri Hospital has a multidisciplinary team of specialist doctors experienced in handling cancer cases.

Use the chat feature via WhatsApp, Book Appointment, or the Care Dokter app—available on Google Play and the App Store—to make your visit easier, check queue numbers, and get complete information.

Pancreatic Cancer

What is pancreatic cancer?

Pancreatic cancer occurs when the cells in the pancreas mutate (change) and multiply uncontrollably, forming a tumor. The pancreas is a gland located between the spine and the stomach. Its function is to produce hormones that regulate blood sugar levels and enzymes that aid in digestion.

Most cases of pancreatic cancer begin in the pancreatic ducts. The main pancreatic duct (Wirsung’s duct) connects the pancreas to the common bile duct. Early-stage pancreatic tumors are not visible on imaging tests. For this reason, many people are not diagnosed until the cancer has spread (metastasized). In addition, this type of cancer is resistant to many cancer drugs, making it difficult to treat.

Here are some types of pancreatic cancer:

  • Exocrine tumors: More than 90% of all pancreatic tumors are exocrine tumors. The most common type of pancreatic cancer is adenocarcinoma, which starts in the cells that line the organs.
  • Neuroendocrine tumors: Less than 10% of pancreatic tumors are neuroendocrine tumors (NETs). Islet cell carcinoma is another name for NETs.

Symptoms of pancreatic cancer

Pancreatic cancer symptoms often do not appear until the disease is advanced. When severe, signs and symptoms may include:

  • Abdominal pain that radiates to the side or back
  • Loss of appetite
  • Weight loss
  • Yellowing of the skin and the whites of the eyes, known as jaundice
  • Pale or floating stools
  • Dark-colored urine
  • Itching
  • New diagnosis of diabetes or worsening of existing diabetes
  • Pain and swelling in the arm or leg, which may be caused by blood clots
  • Fatigue or weakness

Causes of pancreatic cancer

Anyone can develop pancreatic cancer. However, the exact cause is not always known.

A person may be more likely to develop pancreatic cancer if they:

  • Are over the age of 65 (pancreatic cancer is less common in people under 40)
  • Have certain medical conditions, such as chronic pancreatitis
  • Have a family history of pancreatic cancer

In addition, many pancreatic cancer cases are linked to lifestyle factors.

Diagnosis of pancreatic cancer

Early-stage pancreatic cancer is difficult to detect. This is because doctors cannot feel the pancreas during a routine examination and tumors are hard to see with standard imaging tests.

If a doctor suspects pancreatic cancer, they may recommend a combination of tests, which may include:

1. Imaging tests

  • CT scan
  • MRI
  • PET scan
  • Endoscopic ultrasound

2. Blood tests

Blood tests can detect tumor markers—substances that may indicate the presence of cancer.
For pancreatic cancer, levels of carbohydrate antigen (CA) 19-9 may suggest a tumor. CA 19-9 is a type of protein released by pancreatic cancer cells.

3. Laparoscopy

Doctors may use laparoscopy to determine the severity of pancreatic cancer and whether it can be surgically removed. During the procedure, doctors make several small incisions in the abdomen and insert a long tube with a camera at the end to look inside the abdomen for abnormalities. A biopsy is often taken during this procedure.

Treatment for pancreatic cancer

1. Surgery

Surgery is the only realistic way to cure pancreatic cancer. However, it is only recommended if doctors believe they can remove the entire tumor. Otherwise, the benefit may not be significant.

For surgery to be successful, the cancer must be confined to the pancreas. Even then, complete removal may not be possible.
Different surgical techniques are used depending on the tumor’s location and size.

2. Chemotherapy

Chemotherapy uses drugs to kill cancer cells. These drugs can be administered orally or through an IV. Doctors may use chemotherapy as a standalone treatment, especially for advanced pancreatic cancer. It may also be recommended before surgery to shrink the tumor or after surgery to destroy remaining cancer cells.

3. Radiation therapy

Radiation therapy uses high-energy X-rays to kill cancer cells. This treatment is commonly used to treat pancreatic cancer.

Mandaya Royal Hospital Puri has a Comprehensive Cancer Center that can help with the detection and treatment of various types of cancer, including pancreatic cancer. Don’t hesitate to visit our hospital and consult with our team of experienced and specialized doctors.

Use our Chat via WhatsApp feature, Book Appointment, or the Care Dokter app—available on Google Play and the App Store—to simplify your visit, check your queue number, and get complete information.

Angina Pectoris

What is angina pectoris?

Angina pectoris, or angina, is chest pain or discomfort that occurs when a part of the heart doesn’t get enough blood and oxygen. Angina can be a symptom of coronary heart disease. However, this condition can also be caused by other factors.

Angina pectoris is divided into several types, including:

  • Stable angina

Stable angina is the most common form of angina. This type usually occurs during physical activity and subsides with rest or angina medication.

Stable angina is predictable and typically resembles previous episodes of chest pain. The chest pain usually lasts a short time, around 5 minutes or less.

  • Unstable angina

Unstable angina is a medical emergency. This type of angina is unpredictable and can occur even while resting. The pain can worsen and may happen even without significant physical exertion.

The pain associated with this type of angina is typically severe and lasts around 20 minutes or more. In addition, the pain does not subside with rest or medication.

If blood flow does not improve, the heart does not receive enough oxygen, which can trigger a heart attack.

  • Variant angina

Variant angina, also known as Prinzmetal’s angina, is a type of angina not caused by coronary artery disease. This type is caused by spasms in the coronary arteries, which temporarily reduce blood flow.

Severe chest pain is a symptom of variant angina. This condition most often occurs in cycles, usually at rest and during nighttime. The pain can be relieved with angina medications.

  • Refractory angina

A type of angina that occurs frequently despite the patient taking a combination of medications and making lifestyle changes.

Symptoms of angina pectoris

Symptoms of angina include chest pain and discomfort that may feel like:

  • Burning sensation
  • Fullness
  • Pressure
  • Squeezing

Angina pain can also be felt in the arms, neck, jaw, shoulders, or back.

Other symptoms of angina include:

  • Dizziness
  • Fatigue
  • Nausea
  • Shortness of breath
  • Sweating

The severity, duration, and type of angina may vary. New or different symptoms may indicate unstable angina or a heart attack.
New or worsening symptoms should be evaluated by a doctor immediately.

Causes of angina pectoris

Angina occurs when the heart muscle (myocardium) doesn’t receive enough blood and oxygen. Inadequate blood supply is called ischemia.
Angina may be a symptom of coronary artery disease, which occurs when the arteries supplying blood to the heart become narrowed or blocked. This condition may result from:

  • Hardening of the arteries (atherosclerosis)
  • Blood clots
  • Ruptured plaques in the arteries
  • Poor blood flow through narrowed heart valves
  • Decreased heart muscle pumping
  • Coronary artery spasms

Diagnosis of angina pectoris

Doctors will ask about the patient’s medical history and perform a physical exam. They often can diagnose angina based on the symptoms and how or when they occur.
Here are several tests used to diagnose angina:

  • Electrocardiogram (ECG)

This test records the heart’s electrical activity, shows abnormal rhythms (arrhythmias), and detects damage to the heart muscle.

  • Stress test

This test is performed while the patient exercises on a treadmill or stationary bike. It evaluates how the heart functions under stress, such as during physical exertion. Breathing rate and blood pressure are also monitored. A stress test can help detect coronary artery disease.
It may also be used to determine safe levels of physical activity after a heart attack or heart surgery.

  • Cardiac catheterization

A wire is inserted into the coronary arteries. Then, contrast dye is injected into the arteries. X-ray images are taken to identify narrowing, blockages, or other problems in specific arteries.

  • Cardiac MRI

Doctors may perform a cardiac MRI to assess blood flow to the heart muscle.

  • Coronary CT scan

This test evaluates the amount of calcium and plaque in the heart’s blood vessels. It can also show blood flow through the coronary arteries.

Treatment for angina pectoris

The goal of angina treatment is to reduce the number of angina episodes, lessen the severity of symptoms, and lower the risk of heart attack and death. Doctors will provide immediate treatment if the patient experiences unstable angina or chest pain that is different from usual.

The following are some treatments for angina that may be recommended by a doctor:

  • Lifestyle changes, such as eating a healthy diet and exercising regularly
  • Taking specific medications
  • Angioplasty and stent placement
  • Open-heart surgery called coronary artery bypass grafting (CABG)

If you have questions about angina pectoris and are considering treatment, don’t hesitate to visit Mandaya Royal Puri Hospital.

Make an appointment easily via Chat on WhatsApp, the Book Appointment feature, or the Care Dokter app available on Google Play and the App Store to simplify your visit, check your queue number, and access complete information.

Supraventricular Tachycardia (SVT)

What is supraventricular tachycardia (SVT)?

Supraventricular tachycardia (SVT) is a type of heart rhythm disorder (arrhythmia) that originates in the upper chambers of the heart, known as the atria. The main symptom of SVT is a rapid heartbeat.

A normal adult heart rate ranges between 60–100 beats per minute (BPM). In SVT, the heart rate exceeds 100 BPM and may even reach 220 BPM or higher.

Here are several types of SVT:

  • AVNRT (Atrioventricular Nodal Reentrant Tachycardia): The most common form of SVT, caused by electrical signals looping through the AV node twice.
  • Atrioventricular reciprocating tachycardia (AVRT): Occurs when there’s an extra electrical connection between the upper and lower chambers, causing impulses to travel more quickly.
  • Atrial fibrillation: In this condition, the atria beat irregularly and rapidly, increasing the risk of blood clots and stroke.
  • Atrial flutter (AFL): In AFL, the atria can beat very fast (up to 300 BPM), although the ventricles typically follow a regular and slower conduction pattern.
  • Paroxysmal SVT: SVT episodes that occur intermittently and often stop on their own.
  • Atrial tachycardia: This form occurs when the electrical signals originate from somewhere in the atria other than the sinoatrial (SA) node.

Symptoms of SVT

The symptoms of SVT vary depending on how fast the heart is beating. They may include:

  • Heart palpitations
  • Dizziness
  • Sweating
  • Shortness of breath
  • Chest pain
  • Fainting

Causes of SVT

SVT is caused by disturbances in the heart’s electrical signals. These signals are responsible for controlling the heartbeat. In SVT, changes in these signals cause the heartbeat to begin prematurely in the upper chambers of the heart. When this happens, the heart beats faster and does not fill with blood properly. As a result, symptoms such as dizziness or lightheadedness can occur.

To understand the causes of SVT, it’s important to know how the heart normally functions.

The heart has four chambers:

  • Two upper chambers called atria
  • Two lower chambers called ventricles

In the upper right chamber is a group of cells called the sinus node, which generates the signals that initiate each heartbeat. The signal travels across the atria and reaches a group of cells called the AV node, where it usually slows down before continuing to the lower chambers.

In a healthy heart, this signaling process works smoothly, and the heart typically beats 60–100 times per minute at rest. In SVT, the heart beats faster—ranging from 150 to 220 BPM.

Diagnosing SVT

Several tests may be recommended by your doctor to diagnose SVT:

  • Electrocardiogram (ECG/EKG): If SVT is suspected, your doctor may order an EKG. During this test, electrodes are placed on the chest to detect the heart’s electrical activity and produce a printed reading.
  • Holter monitor: A portable EKG device that can be worn at home for 1–2 days to record continuous heart activity. It helps detect irregular rhythms that might not appear during a standard EKG.
  • Echocardiogram: Uses sound waves to create images of the heart’s activity. It shows how blood flows through the heart and its valves.

Treatment for Supraventricular Tachycardia (SVT)

Hospital treatment may be necessary if SVT episodes are prolonged.
Treatment options include:

  • Medications to control SVT episodes (administered as tablets or intravenous infusions)
  • Cardioversion, a procedure that delivers small electric shocks to the heart to restore normal rhythm

If you have more questions about SVT, don’t hesitate to visit Mandaya Royal Hospital Puri. Our hospital is equipped with modern, advanced medical technology and supported by a team of experienced specialists.

Use the Chat via WhatsApp, Book Appointment, or the Care Dokter app—available on Google Play and the App Store—for easier visits, queue tracking, and complete information.

Rheumatoid Arthritis

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes pain, swelling, and stiffness in the lining of the joints (synovium). This condition most commonly affects the joints in the fingers, hands, wrists, knees, ankles, feet, and toes. RA usually affects the same joints on both sides of the body.

In addition to joint symptoms, RA can sometimes affect other parts of the body, such as:

  • Skin
  • Eyes
  • Mouth
  • Lungs
  • Heart

Stages of Rheumatoid Arthritis:

RA progresses in stages, which include:

Stage 1: In the early stage of RA, inflammation occurs in the joint tissue. Patients may feel joint pain and stiffness. X-rays usually do not show bone damage at this stage.

Stage 2: Inflammation begins to damage the cartilage in the joints. Patients may experience stiffness and reduced range of motion.

Stage 3: Inflammation becomes severe and damages the bones. Symptoms include increased pain, more stiffness, and a greater loss of mobility. Physical changes may become visible.

Stage 4: At this stage, active inflammation may subside, but joint function continues to deteriorate. Patients often experience intense pain, swelling, stiffness, and significant loss of mobility.

Symptoms of Rheumatoid Arthritis

Common signs and symptoms of RA typically affect the wrists, hands, and feet, and include:

  • Pain, swelling, and stiffness in more than one joint
  • Low-grade fever
  • Loss of appetite
  • Unintentional weight loss
  • Fatigue
  • Dry eyes
  • Chest pain

Causes of Rheumatoid Arthritis

Several potential causes and risk factors for RA include:

  • Genetic factors: There is some evidence that RA can run in families, though the hereditary risk is considered low since genetics play a minor role.
  • Hormonal factors: RA is more common in women, possibly due to the effects of estrogen. However, the connection is not yet proven.
  • Smoking: Studies suggest that smoking may increase the risk of developing RA.

How Is Rheumatoid Arthritis Diagnosed?

Diagnosing RA in its early stages can be difficult, as its symptoms can mimic other conditions like lupus or psoriatic arthritis.

If you experience symptoms of RA, it’s recommended to see a doctor within six months of symptom onset for early diagnosis and timely treatment.

Doctors will look for clinical signs of inflammation and ask about the duration and severity of symptoms. A physical exam will be conducted to check for swelling, functional limitations, and other signs.

Tests used to diagnose RA may include:

1. Blood Tests:

  • Anti-CCP (anti-cyclic citrullinated peptide antibodies)
  • Rheumatoid factor (RF)
  • Erythrocyte sedimentation rate (ESR or sed rate)
  • C-reactive protein (CRP)

2. Imaging Tests:

  • X-rays or MRI scans can help identify the type of arthritis and track disease progression over time.

Rheumatoid Arthritis Treatment Options

Early treatment with specific medications can significantly improve long-term outcomes for RA. Often, a combination of medications is more effective than a single-drug approach.

Treatment options aim to relieve joint pain, reduce swelling and inflammation, and prevent or slow disease progression. Common medications for RA include:

  • Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
  • Corticosteroids
  • Janus Kinase (JAK) Inhibitors
  • Biologic Agents

Comprehensive Arthritis Care at Mandaya Royal Hospital Puri

Visit the Orthopedic & Movement Center at Mandaya Royal Hospital Puri for a complete evaluation, from early screening to advanced rheumatoid arthritis treatment.

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Coronary Heart Disease

What is Coronary Heart Disease?

Coronary heart disease is a condition that occurs when the heart’s arteries cannot deliver enough oxygen-rich blood to the heart muscle due to narrowing caused by fat deposits (plaque). This condition is also known as coronary artery disease or ischemic heart disease.

The coronary arteries are responsible for delivering blood to the heart muscle. If these arteries are damaged or diseased and unable to deliver oxygen and nutrients to the heart, it can lead to heart attacks and even death.

Symptoms of Coronary Heart Disease

The main symptoms of coronary heart disease include:

  • Chest pain (angina)
  • Shortness of breath
  • Pain in the neck, shoulders, jaw, or arms
  • Feeling faint
  • Nausea

Not everyone with coronary heart disease experiences the same symptoms. In fact, some people may not experience any symptoms at all before being diagnosed by a doctor.

Causes of Coronary Heart Disease

Coronary heart disease is caused by the buildup of fat, cholesterol, and other substances in and on the walls of the heart’s arteries. This condition is called atherosclerosis, and the deposits are known as plaque.

Plaque can cause arteries to narrow, blocking blood flow. Plaque can also rupture, leading to blood clots.

Some common causes of atherosclerosis and coronary heart disease include:

  • Diabetes or insulin resistance
  • High blood pressure (hypertension)
  • Lack of physical activity
  • Smoking or tobacco use

Diagnosis of Coronary Heart Disease

If a doctor suspects you are at risk for coronary heart disease, they may perform a risk assessment. The doctor will also ask about your personal and family medical history and lifestyle, and may order blood tests.

Further tests may be required to confirm a diagnosis of coronary heart disease, such as:

  • Electrocardiogram (ECG)
  • Echocardiogram
  • Chest X-ray
  • Coronary angiogram

Treatment for Coronary Heart Disease

1. Managing Risk Factors

There are several risk factors for coronary heart disease that you can control to prevent its onset, such as quitting smoking, managing cholesterol and blood sugar levels, improving your diet, maintaining an ideal weight, and managing blood pressure.

2. Medications

Doctors may prescribe medications for coronary heart disease, including:

  • Antiplatelets: Medications that reduce blood clotting, such as aspirin, clopidogrel, ticlopidine, and prasugrel.
  • Antihyperlipidemics: Medications to reduce blood lipids (fats), especially low-density lipoprotein (LDL) cholesterol.
  • Antihypertensives: Medications to lower blood pressure.

3. Coronary Angioplasty

Coronary angioplasty uses a balloon to widen the blood vessels, improving blood flow. Though angioplasty may be done on blood vessels in other parts of the body, it can help increase blood flow to the heart.

4. Heart Bypass Surgery

Heart bypass surgery is often performed on people who experience chest pain and have coronary heart disease. During the surgery, a bypass is created by grafting a vein above and below the blocked coronary artery area, allowing blood to flow around the blockage.

The vein is usually taken from the leg, but arteries from the chest and arms can also be used for the bypass graft. Sometimes, multiple bypasses are needed to restore full blood flow to all parts of the heart.

5. Rotablator

A rotablator is a device used to shave off hardened plaque in the coronary blood vessels, especially in cases where plaque is difficult to treat with balloons or stents.

Using a rotablator, doctors can remove blockages and improve or restore blood flow to the heart.

Want to consult further about coronary heart disease or overall heart health? Visit Mandaya Royal Hospital Puri. Our hospital is equipped with modern medical technology to handle various heart conditions. You can also consult with experienced heart specialists.

Schedule your appointment through our WhatsApp Chat feature, Book Appointment, or the Care Dokter app—available on Google Play and the App Store—to ease your visit, check your queue number, and access complete information.

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