Symptoms, Causes, and Consequences Stroke

Sunday, August 28, 2011

Cerebrovascular diseases including stroke (brain blood vessel) which is marked by the death of brain tissue (cerebral infarction) which occurred due to reduced blood flow and oxygen to the brain. Decreased blood flow and oxygen could be due to blockage, constriction or rupture of blood vessels.

WHO defines that stroke is a function of the symptoms of nervous system deficits caused by cerebrovascular disease and not by others from it.

Stroke was divided into two types: Hemorrhagic stroke and ischemic stroke. 

Ischemic stroke is blockage of blood vessels that cause blood flow to the brain in part or whole stop. 80% of strokes are ischemic strokes. Ischemic stroke is divided into three types, namely: 

1. Thrombotic stroke: thrombus formation process that make clotting. 
2. Embolic stroke: the closing of an artery by a blood clot. 
3. Systemic Hipoperfusion: Decreased blood flow to all parts of the body due to an interruption of heart beats.

Hemorrhagic stroke is a stroke caused by rupture of blood vessels of the brain. Nearly 70% of cases of hemorrhagic strokes occur in people with hypertension.

Hemorrhagic stroke there are two types, namely:

1. Intracerebral haemorrhagic: bleeding that occurs in brain tissue. 
2. Subarachnoid haemorrhagic: bleeding that occurs in the subarachnoid space (a narrow space between the brain surface and the layer of tissue covering the brain).

Signs and Symptoms of Stroke

Based on its location in the body, symptoms of stroke is divided into the following:

1. Parts of the central nervous system: muscle weakness (hemiplegia), stiffness, decreased sensory function 
2. Brain stem, where there are 12 cranial nerves: decreased ability to smell, taste, hear, and view the partial or total, decreased reflexes, impaired facial expression, impaired breathing and heart rate, weak tongue.
3. Cerebral cortex: aphasia, apraxia, memory decline, hemineglect, confusion.

If signs and symptoms disappear within 24 hours, expressed as a transient ischemic attack (TIA), which is a small attack or initial stroke attack.

Stroke Causes
Medical risk factors, including hypertension (high blood pressure), cholesterol, atherosclerosis (hardening of the arteries), heart disorders, diabetes, family history of stroke, migraine.

Behavioral risk factors, including smoking (active & passive), unhealthy foods (junk food, fast food), Alcohol, Lack of exercise, Snoring, Oral Contraception, Drugs, Obesity.

80% of the trigger stroke is hypertension and arteriosclerosis, according to statistics. 93% of people with diseases of thrombosis related to high blood pressure disease.

The trigger stroke is basically, an uncomfortable mood (angry), drinking too much alcohol, smoking and happy eating fatty foods.

Agony Post-Stroke

Already Falling Stairs hit Pula, saying that's right for people with Stroke.

After a stroke, brain cells die and the hematoma formed who will be reabsorbed gradually. This natural process is completed within 3 months. At that time, 1 / 3 of the survivors become dependent and may develop complications that can lead to death or disability

It is estimated there are 500,000 people affected by stroke. Of these:

• 1 / 3 -> can be restored,
• 1 / 3 -> experiencing mild to moderate functional impairment,
• 1 / 3 remaining -> suffered severe functional impairment that requires ongoing patient on the mattress.

Only 10-15% of stroke survivors can return to normal life as usual, the rest have disabilities, so that many stroke patients suffering from stress caused due to disability after a stroke attack.

Stroke due to Other:

• 80% reduction in partial / total arm and leg movements.
• 80-90% have trouble thinking and remembering.
• 70% suffer from depression.
• 30% had difficulty speaking, swallowing, distinguish right and left.

Stroke is no longer just attacking the elderly, yet now tends to strike younger generation who are still productive. Stroke is also no longer belong to citizens of the affluent city, but also experienced by rural residents who live with all the limitations.

This will impact on the declining levels of productivity and can lead to disruption of socio-economic families. In addition to its high cost of post-stroke treatment, which also suffered a stroke is the backbone of the family who usually perform less healthy lifestyles, caused by a solid rushing.

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Low Blood Pressure (Hypotension)

Wednesday, August 17, 2011

Is low blood pressure?
Blood pressure is the force exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs of life, which also include heart rate, respiratory rate, and temperature. Blood pressure produced by the heart pumps blood into the arteries and regulated by the response by the arteries to blood flow.

An individual's blood pressure is expressed as systolic / diastolic blood pressure, for example, 120/80.The systolic blood pressure (top number) is the pressure in the arteries as the heart muscle to contract and pump blood into it. Diastolic blood pressure (bottom number) is the pressure in the arteries as the heart muscle to relax after a contract. Blood pressure is always higher when the heart is pumping (squeezing) than when relaxed.

Systolic blood pressure for most healthy adults falls between 90 and 120 millimeters of mercury (mm Hg). Normal diastolic blood pressure falls between 60 and 80 mm Hg. current guidelines define normal blood pressure as lower than 120/80. blood pressure higher than 130/80 is considered high. High blood pressure increases the risk of developing:

    heart disease,
    kidney disease,
    hardening of the arteries (atherosclerosis or arteriosclerosis),
    eye damage, and
    stroke.

Low blood pressure (hypotension) is pressure so low cause symptoms or signs due to low blood flow through arteries and veins. When blood flow is too low to provide enough oxygen and nutrients to vital organs such as brain, heart, and kidneys, the organs are not functioning normally and may be permanently damaged.

Unlike high blood pressure, low blood pressure is defined primarily by signs and symptoms of low blood flow and not by the number of certain blood pressure. Some individuals may have a blood pressure of 90/50 with no symptoms of low blood pressure and therefore does not have low blood pressure. However, others who normally have high blood pressure may develop symptoms of low blood pressure if their blood pressure dropped to 100/60.

How is blood pressure generated?
During cardiac relaxation (diastole) the heart's left ventricle fills with blood returning from the lungs. The left ventricle then contracts and pumps blood into the arteries (systole). Blood pressure during the contraction pressure (ventricular systolic) when blood is being actively released into the artery is higher than the pressure relaxation (diastolic ventricular). The pulse can we feel when we put our fingers on the artery caused by contraction of the left ventricle.

Blood pressure is determined by two factors: 1) The amount of blood pumped by the heart's left ventricle into the artery, and 2) resistance to blood flow caused by the walls of the arterioles (smaller arteries).

In general, blood pressure tends to be higher if more blood is pumped into the artery or if the arterioles are narrow and stiff. (Narrow and rigid arterioles, by rejecting the bloodstream, increasing blood pressure.) This often occurs when older patients develop atherosclerosis.

Blood pressure tends to be lower if less blood is being pumped into the artery or if the arterioles are larger and more flexible and, therefore, has less resistance to blood flow.

How does the body maintain normal blood pressure?
The body has mechanisms to alter or maintain blood pressure and blood flow. There is a blood pressure sensor in the sense of the arterial wall and send signals to the heart, arterioles, blood vessels, and kidneys that cause them to make changes that lower or raise blood pressure. There are several ways in which blood pressure can be adjusted - by adjusting the amount of blood pumped by the heart into the arteries (cardiac output), the amount of blood contained in blood vessels, arteriolar resistance, and blood volume.

* The heart can speed up and contract more frequently and can eject more blood with each contraction. Both of these responses increase blood flow to the arteries and increase blood pressure.
The veins can expand and narrow. When the blood vessels expand, more blood can be stored in the veins and less blood returning to the heart to pump into the artery. As a result, the heart pumps less blood, and blood pressure is lower.
* Arteriole can expand and narrow. creates less resistance arterioles expanded blood flow and decreased blood pressure, whereas arteriolar narrowing creates more resistance and raise blood pressure.
* The kidneys can respond to changes in blood pressure by increasing or decreasing the amount of urine produced. Urine is primarily water released from the blood. When the kidneys make more urine, the amount (volume) of blood that fills the arteries and decreases, and this lowers blood pressure. If the kidneys make less urine, the amount of blood that fills the arteries and increase blood pressure and this increase. Compared with other mechanisms to regulate blood pressure, changes in the production of urine affect blood pressure slowly over hours and days. (The other mechanism is effective in a matter of seconds.)

For example, low blood volume due to bleeding (such as bleeding ulcers in your stomach or from a bad wound from injury) can cause low blood pressure. The body responds quickly to low blood volume and pressure by the following adjustments which all increase blood pressure:
- Increased heart rate and exemplary a strong contraction of the heart increases, so that more blood is pumped through the heart.
- Narrow veins to return more blood to the heart to pump.
- Blood flow to the kidney decreased to reduce the formation of urine and thus increase the volume of blood in the arteries and veins.
- Narrower arterioles to increased resistance to blood flow

Adaptation of this response will keep the blood pressure within normal limits except blood loss becomes so severe that response is overwhelmed

Is low blood pressure bad for your health?
People who have low blood pressure have a lower risk of stroke, kidney disease, and heart disease. Athletes, people who exercise regularly, people who maintain ideal body weight, and non-smokers tend to have low blood pressure. Therefore, low blood pressure is desirable as long as it is not low enough to cause symptoms and damage organs in the body.

What are the signs and symptoms of low blood pressure?
When blood pressure is not sufficient to provide enough blood to organs, organs are not working properly and can be permanently damaged. For example, if blood flow to the brain is inadequate, brain cells do not receive enough oxygen and nutrients, and the person may feel dizzy, dizzy, or even fainting.

Going from sitting or lying position to a standing position often brings out symptoms of low blood pressure. This occurs because standing causes blood to "settle" in the vein of the lower body, and this can lower blood pressure. If blood pressure is already low, standing can make the low pressure worse, to the point of causing symptoms. Development of light, dizziness, or fainting after standing due to low blood pressure is called orthostatic hypotension. normal individuals can rapidly compensate for the low pressure created by standing with the responses discussed previously and do not develop orthostatic hypotension.

If there is not enough blood pressure to deliver blood to the coronary arteries (arteries that supply blood to the heart muscle), one can experience chest pain (symptoms of angina) or even a heart attack.

When insufficient blood sent to the kidneys, kidney failure to eliminate impurities from the body, for example, urea and creatinine, and increase their levels in the blood occurs (eg, increased blood urea nitrogen or BUN and serum creatinine, respectively).

Shock is a life-threatening condition in which persistent low blood pressure causes organs such as kidneys, liver, heart, lungs, and brain to fail rapidly.

What are the causes of low blood pressure?
Condition that reduces blood volume, reduced cardiac output (amount of blood pumped by the heart), and drugs that often cause low blood pressure.

Dehydration is common among patients with prolonged nausea, vomiting, and diarrhea. A large amount of water lost when vomiting and diarrhea, especially if the patient does not drink a sufficient amount of fluids to replace water discharged.
Other causes of dehydration include exercise, sweating, fever, and heat exhaustion or heat stroke. Individuals with mild dehydration may experience only thirst and dry mouth. Moderate to severe dehydration may cause orthostatic hypotension (spoken by the light, dizziness, or fainting when standing). Protracted and severe dehydration can cause shock, kidney failure, confusion, acidosis (too much acid in the blood), coma and even death.

Moderate or severe bleeding can quickly spend the blood of a person's body, causing low blood pressure or orthostatic hypotension. Bleeding can result from trauma, surgical complications, or from gastrointestinal disorders such as ulcers, tumors, or diverticulosis. Sometimes, bleeding may be very severe and rapid (eg, bleeding from ruptured aortic aneurysm), causing shock and rapid death.
Severe inflammation of organs in the body such as acute pancreatitis can cause low blood pressure. In acute pancreatitis, fluid leaves the blood vessels to enter the inflamed tissue around the pancreas and abdominal cavity, depleting the blood volume.
Causes of low blood pressure due to heart disease

weakened heart muscle can cause heart failure and reduce the amount of blood it pumps. One common cause of heart muscle is weak is the death of most of the heart muscle caused by the attack, the heart of a large single or repeated smaller heart attacks. Other examples of conditions that can weaken the heart include medications that are toxic to the heart, the heart muscle infection by viruses (myocarditis), and heart valve disease such as aortic stenosis.
Pericarditis is inflammation of the pericardium (sac around the heart). Pericarditis can cause fluid to collect in the pericardium and compress the heart, restricting the ability of the heart to fill and pump blood.
Pulmonary embolism is a condition in which blood clots in the veins (deep vein thrombosis) breaks off and travel to the heart and lungs eventually. A large blood clot can block blood flow to the left ventricle from the lungs and greatly reduces the blood back to the heart to pump. Pulmonary embolism is a life-threatening emergency.
A slow heart rate (bradycardia) can decrease the amount of blood pumped by the heart. Heart rate for healthy adults is between 60 and 100 beats / minute. Bradycardia (resting heart rate is slower than 60 beats / minute) does not always lead to low blood pressure. In fact, some highly trained athletes can have resting heart rates in the 40s and 50s (beats per minute) without symptoms. (Slow heart rate, offset by a stronger contraction of the heart that pumps more blood than non-athletes), but. In many patients bradycardia can cause low blood pressure, lightheadedness, dizziness and even fainting.
Some common reasons for bradycardia include: 1) sick sinus syndrome, 2) heart block, and 3) drug toxicity. Many of these conditions occur in the elderly.

sick sinus syndrome: Sick sinus syndrome occurs when the heart's electrical system can not generate signals fast enough to maintain a normal heart rhythm.

Heart block: Heart block occurs when a particular network that sends electric currents in the heart damaged by heart attacks, degeneration of atherosclerosis, and drugs. Heart block prevents some or all of the electrical signals from reaching the remaining liver, and this prevents the heart from the contract as quickly as would otherwise be.

Drug poisoning: Drugs such as digoxin (Lanoxin) or beta blockers for high blood pressure, may slow the transmission of electricity in the heart of chemical and can cause bradycardia and hypotension (see below "Treatment that causes low blood pressure").
An abnormally rapid heartbeat (tachycardia) also can cause low blood pressure. The most common examples of tachycardia causing low blood pressure is atrial fibrillation. Atrial fibrillation is a cardiac disorder characterized by an electric discharge from the rapid and irregular heart muscle causing the ventricles to contract irregularly and (usually) quickly. Rapidly contracting ventricles do not have enough time to fill maximally with blood before each contraction, and the amount of blood pumped though heart rate decreased more rapidly. Other abnormal heart rhythms such as ventricular tachycardia fast can also result in low blood pressure, sometimes even life-threatening shock.
Drugs that cause low blood pressure

Drugs such as calcium channel blockers, beta blockers, and digoxin (Lanoxin) can slow the rate at which the heart contracts. Some parents are very sensitive to these drugs because they are more likely to have a diseased heart and electrical conduction tissue. In some individuals, slow heart rate can be dangerous even with small doses of the drug.
Medications used in treating high blood pressure (such as ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and alpha-blockers) may be too low blood pressure and cause the symptoms of low blood pressure especially among the elderly.
Water pills (diuretics) such as furosemide (Lasix) can decrease blood volume by causing excessive urination.
Medications used to treat depression, such as amitriptyline (Elavil), Parkinson's disease, such as levodopa-carbidopa (Sinemet), erectile dysfunction (impotence), such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) when used in combination with nitroglycerin, can cause low blood pressure.
Alcohol and narcotics also can cause low blood pressure.
Other conditions that cause low blood pressure

Vasovagal reaction is a common condition in which healthy people while developing low blood pressure, slow heartbeat, and sometimes fainting. Vasovagal reaction is usually brought on by emotions such as fear or pain of blood after being taken, starting intravenous infusions, or with gastrointestinal upset. Vasovagal reactions are caused by voluntary activity (autonomic) nervous system, particularly the vagus nerve, which secretes hormones that slow the heart and dilate blood vessels. The vagus nerve controls the heart rate (slowing down). The vagus nerve also controls the functions of the digestive tract and senses activity in the digestive system. Thus, some people can have a vasovagal reaction from businesses in the bowel movement or vomiting.
Postural (orthostatic) hypotension is a decrease in blood pressure suddenly when a person stands up from sitting, squatting, or supine (lying down) position. When a person stands, gravity causes blood to settle in blood vessels in the legs, so that less blood reaches the heart to pump, and as a result of reduced blood pressure. The body usually responds automatically to a decrease in blood pressure by increasing the rate at which the heart rhythm and constriction of blood vessels to return more blood to the heart. In patients with postural hypotension, this compensating reflex fails to occur, resulting in symptoms of low blood pressure. Postural hypotension can occur in people of all ages but is much more common among older people, particularly those on medications for high blood pressure and / or diuretics. Other causes include postural hypotension, dehydration, adrenal insufficiency (discussed later), a long break, diabetes causes damage to the autonomic nerve, autonomic nerve damage with alcoholism, and some rare neurological syndromes (eg, Shy-Drager syndrome), which damage the autonomic nerves.
Another form of postural hypotension usually occurs in young healthy people. After long standing, heart rate and individual drops of blood pressure, cause dizziness, nausea, and fainting spells. In these people, one of the autonomic nervous system response to long standing by directing the heart to slow and blood vessels to dilate.
micturition syncope is a temporary reduction in blood pressure and loss of consciousness due to urination. This condition usually occurs in elderly patients and may be due to the release by the autonomic nervous hormone that lowers blood pressure.
adrenal insufficiency, for example, because of Addison's disease, can cause low blood pressure. Addison's disease is a disorder where the adrenal glands (small glands next to the kidney) are destroyed. Adrenal glands were destroyed can no longer produce enough adrenal hormones (specifically cortisol) are necessary to maintain normal body function. Cortisol has many functions, one of which is to maintain blood pressure and heart function. Addison's disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and, sometimes, darkening of the skin.

-Septicemia is a severe infection in which bacteria (or other infectious organisms such as fungi) enter the blood. Infection usually originates from the lungs (as pneumonia), bladder, or in the abdomen due to diverticulitis or gallstones. The bacteria then enter the blood where they release toxins and cause life-threatening blood pressure and low depth (septic shock), often with damage to several organs.
-Anaphylaxis (anaphylactic shock) is a fatal allergic reaction to drugs such as penicillin, intravenous iodine are used in some x-ray studies, foods such as peanuts, or bee stings (insect stings). In addition to weight reduction on blood pressure, individuals may also experience itching, wheezing, and throat swelling with difficulty breathing. shock is caused by enlarged blood vessels that contain blood and release of water from the blood into the tissues.

How is low blood pressure diagnosed and evaluated?

In some individuals, particularly a relatively healthy, the symptoms of weakness, dizziness, fainting and low blood pressure increases suspicion. In others, the events are often associated with low blood pressure, such as heart attack has occurred causing the symptoms.

Measuring blood pressure, sometimes both in lying on his back () and the standing position is usually the first step in diagnosing low blood pressure. In patients with symptoms of low blood pressure, often marked decrease in blood pressure on standing, and patients may experience orthostatic symptoms. Heart rate increased very often. Having low blood pressure has been identified as the cause of symptoms, the goal is to identify the causes of low blood pressure. Sometimes the cause may be immediately obvious (such as blood loss due to trauma, or sudden shock after receiving x-ray dyes that contain iodine). At other times, the cause can be identified by testing:

-CBC (complete blood count). CBC may show anemia due to blood loss or a high white blood cells because of infection.
-Blood electrolyte measurements can indicate dehydration and mineral depletion, renal failure (kidney failure), or acidosis (excess acid in the blood).
Cortisol levels can be measured to diagnose adrenal insufficiency and Addison's disease.
-Blood and urine cultures be performed to diagnose a bladder infection and septicemia, respectively.
-Radiological studies, such as chest x-ray, abdominal ultrasound, and computerized tomography (CT or CAT) scan can detect pneumonia, heart failure, gallstones, pancreatitis, and diverticulitis.
-Electrocardiograms (EKG) can detect abnormal heart beats slow or fast, pericarditis, and heart muscle damage either from a previous heart attack or Reduced blood supply to the heart muscle that do not cause heart attacks.
-Holter monitor recordings are used to diagnose the occasional episodes of abnormal heart rhythms. If the abnormal rhythm occurs occasionally, a standard EKG done during a visit to the doctor's office may not show abnormal rhythm. A Holter monitor is a continuous recording of heart rhythm for 24 hours which is often used to diagnose the occasional episodes of bradycardia or tachycardia.
Treat-activated event recorder. If episodes of bradycardia or tachycardia is rare, 24-hour Holter recording may not capture these sporadic episodes. In this situation, patients can use the event-activated recorder for patients up to four weeks. The patient presses the button to start recording when she felt the start of the abnormal heart rhythm or symptoms may be caused by low blood pressure. The doctor then analyzes the tape at a later date to identify the abnormal episodes.
-Echocardiograms is the examination structure and movement of the heart using ultrasound. Echocardiograms can detect pericardial fluid due to pericarditis, the level of damage to heart muscle from heart attack, heart valve disease, and rare tumors of the heart.
-Ultrasound examination of venous leg and chest CT scans may detect deep venous thrombosis and pulmonary embolism.
-Tilt-table test is used to evaluate patients suspected of suffering from postural hypotension or syncope due to autonomic nervous abnormalities. During tilt-table test, patients lie on the examining table with an intravenous infusion administered while the heart rate and blood pressure are monitored. then the table is tilted upright for 15 minutes to 45 minutes. Heart rate and blood pressure were monitored every few minutes. The purpose of this test is to try to reproduce the postural hypotension. Sometimes doctors may manage epinephrine (Adrenalin, Isuprel) intravenously to induce postural hypotension.

How is low blood pressure treated?

Low blood pressure in healthy subjects without symptoms or organ damage needs no treatment. However, all patients with symptoms possibly due to low blood pressure should be evaluated by a physician. (Patients who have experienced a large drop in blood pressure than their normal levels even without the development of symptoms should also be evaluated.) Physicians need to identify the causes of low blood pressure because the treatment will depend on the cause. For example, if the treatment causes low blood pressure, drug dose may be reduced or the drug was stopped, though only after consulting a doctor. Adjustment of treatment should not be done.

- Dehydration is treated with fluids and minerals (electrolytes). Mild dehydration without nausea and vomiting can be treated with oral fluids and electrolytes. Moderate to severe dehydration usually is treated in a hospital or emergency room with intravenous fluids and electrolytes.
- Blood loss can be treated with intravenous fluids and blood transfusions. Persistent and severe bleeding should be treated immediately.
- Septic shock is an emergency and treated with intravenous fluids and antibiotics.
- Blood pressure drugs or diuretics are adjusted, modified, or terminated by the doctor if they are causing symptoms of low blood pressure.
- Bradycardia may be due to treatment. Doctors can reduce, modify or discontinue treatment. Bradycardia due to sick sinus syndrome or heart block treated with a pacemaker implant.
- Tachycardia is treated depending on the nature of the tachycardia. Atrial fibrillation can be treated with oral medications, electrical cardioversion, or a catheterization procedure called pulmonary vein isolation. Ventricular tachycardia can be controlled with medication or with an implanted defibrillator.
- Pulmonary embolism and deep venous thrombosis treated with blood thinners, initially with intravenous heparin and oral warfarin (Coumadin) later.
- Pericardial fluid can be removed with a procedure called perikardiosentesis.
- Postural hypotension can be treated by increasing water and salt * intake, increasing intake of caffeinated beverages because caffeine constricts blood vessels, using compression stockings to compress the leg veins and reduce the pooling of blood vessels in the legs, and in some patients, the use of a drug called midodrine (ProAmatine ). The problem with ProAmatine is that despite increasing blood pressure in an upright position, supine blood pressure may become too high, thus increasing the risk of stroke. Mayo Clinic researchers found that drugs used to treat muscle weakness in Myasthenia gravis is called pyridostigmine (Mestinon) increases blood pressure upright but not supine blood pressure. Mestinon, a drug anticholinesterase, works on the autonomic nervous system, especially when a person stands. Side effects include mild abdominal cramping or increased frequency of bowel movements. * Note: Increasing salt intake can cause heart failure in patients with existing heart disease and should not be undertaken without consulting a doctor.
- Postprandial hypotension refers to low blood pressure occurs after a meal. Ibuprofen (Motrin) or indomethacin (Indocin) may be beneficial.
Vasovagal syncope can be treated with several types of drugs such as beta blockers [eg, propranolol (Inderal, Inderal LA)], a selective inhibitor of serotonin Reuptake [fluoxetine (Prozac), escitalopram oxalate (Lexapro), paroxetine (Paxil), sertraline (Zoloft) , citalopram (Celexa), fluvoxamine (Luvox)], fludrocortisone (Florinef) (a drug that prevents dehydration by causing kidney (s) to retain water). A pacemaker can also help when a patient fails drug therapy.

Low Blood Pressure Overview

- Low blood pressure, also called hypotension, blood pressure is low enough so that blood flow to organs and symptoms of inadequate and / or signs of low blood flow develops.

- Low pressure, without symptoms or signs, are usually unhealthy.

- The symptoms of low blood pressure, including mild dizziness, and fainting. These symptoms are most pronounced when individuals move from lying or sitting position to standing position (orthostatic hypotension).

- Low blood pressure causes inadequate blood flow to the organs can cause strokes, heart attacks, and kidney failure. This is the most severe form is a shock.

- Common causes of low blood pressure include reduced blood volume, heart disease, and drugs.

- Causes of low blood pressure can be determined with blood tests, radiological studies, and cardiac testing to look for arrhythmias.

- Treatment of low blood pressure is determined by the cause of low pressure

References:
Medlineplus, "Vital Signs." WebMD, "Alpha blocker medications for prostatitis." Hilz MJ, Marthol H, Neundorfer B. "Syncope - a systematic overview of classification, pathogenesis, diagnosis and management," Fortschr Neurol Psychiatr. 2002 February; 70 (2) :95-107. Park Nicollet Methodist Hospital, "postural hypotension." American Family Physician, "Off-Label Applications for SSRIs."

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Portal Hypertension

Portal hypertension is the increase in blood pressure in the vascular system called the portal vein system. Normally, blood vessels originating from the stomach, intestines, spleen, and pancreas, merged into the portal vein, which then branch into smaller vessels and travels through the heart. If the vessels in the liver are blocked, it is difficult for blood to flow causing high pressure in the portal system.

When the pressure becomes too high, blood backs and find other ways to flow back to the heart, which is pumped to the lungs, where it gets removes waste products and pick up oxygen. The blood can travel to the deep veins (esophageal varices esophagus), the abdominal skin, and veins of the rectum and anus (hemorrhoids) to get around the blockage in the liver.

What Causes Portal Hypertension?
The most common cause of portal hypertension is cirrhosis of the liver. Cirrhosis results from scarring of the liver injury caused by hepatitis, alcohol abuse, or other causes of liver damage. In cirrhosis, scar blocking blood flow through the liver.

Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry blood from heart to heart, and parasitic infection called schistosomiasis. Sometimes the cause is unknown.

What Are the Symptoms of Portal Hypertension?

The occurrence of portal hypertension may not always be associated with specific symptoms that identify what is happening in the liver. However, if you have liver disease leading to cirrhosis, high portal hypertension development opportunities.

The main symptoms and complications of portal hypertension include:

* Gastrointestinal bleeding: a bench to stay black, or blood in stools, or vomiting of blood due to spontaneous rupture and hemorrhage from varices.
* Ascites (accumulation of fluid in the abdomen).
* Encephalopathy or confusion and forgetfulness caused by poor liver function.
* Reducing the level of platelets, blood cells that help form blood clots, or white blood cells, cells that fight infection.

How is Portal Hypertension Diagnosed?

Usually the doctor makes a diagnosis of portal hypertension based on the presence of ascites or dilated or varicose veins as seen on physical examination of the abdomen or the anus. Various laboratory tests, X-ray tests, and endoscopic examinations can also be used

How is Portal Hypertension Treated?
Unfortunately, most causes of portal hypertension can not be treated. Instead, treatment focuses on preventing or managing complications, especially bleeding from varices. Diet, medications, endoscopic therapy, surgery, and radiology procedures all have a role in treating or preventing complications. Other treatment depends on the severity of symptoms and on how well your liver function.

therapy.This Endoscopy is usually the first line of treatment for variceal bleeding, and consists of either an appeal or sclerotherapy. Appeal is a procedure in which the digestion that uses rubber bands to block the blood vessels. Sclerotherapy is sometimes used when the appeal can not be used and the procedure in which a solution is injected into the bleeding varices causing them to scar.

Treatment. Nonselective beta blockers (nadolol or propranolol) may be prescribed alone or in combination with endoscopic therapy to reduce the pressure on varicose veins and reduce the risk of rebleeding. Nonselective beta blockers are also prescribed to prevent varicose veins in patients with first hemmorrhage the perceived risk of bleeding varices. Appeal esophageal varices have also been used for that purpose, especially in patients who are intolerant to beta blockers. The drug lactulose can help treat confusion and other mental changes associated with encephalopathy.

What Life Should Changes Made for Portal Hypertension?

Maintaining good nutritional habits and maintaining a healthy lifestyle will help you avoid portal hypertension. Some things you can do to improve your liver function is as follows:

* Never use alcohol or drugs.
* Do not take any over-the-counter or prescription medications or herbal medications without first consulting your doctor or nurse. (Some medications can make liver disease worse.)
* Follow the dietary guidelines given by your doctor or nurse, including: eating low sodium (salt) diet. You may be asked to consume no more than 2 grams of sodium per day. Reducing protein intake may be necessary and only if the confusion is a symptom. A dietitian can make a meal plan for you.

Other Treatment Options

For those with portal hypertension, if endoscopic therapy, drug therapy, and / or dietary changes failed to control variceal bleeding, you may need one of the following procedures to reduce the pressure in blood vessels. Decompression procedures include:

* Transjugular intrahepatic portosystemic shunt (TIPS): This procedure involves placing a stent (a tubular device) in the center. The stent connects the hepatic vein with the portal vein.
* Distal splenorenal shunt (DSRS): This procedure connects you to the vein from the splenic vein of the left kidney to relieve pressure on the varices and control bleeding.

Tests Are Required Before TIPS and DSRS procedures
Before accepting one of the procedures for portal hypertension, the following test may be performed to determine the extent and severity of your condition:

* Evaluate your medical history
* Physical examination
Blood tests
* Angiogram (X-ray test that takes pictures of blood flow in certain arteries)
* Ultrasound
* Endoscopy

Before either TIPS or DSRS procedure, your doctor may ask you to have other preoperative tests, which may include an electrocardiogram (ECG) (a test that records the electrical activity of your heart), chest X-ray, or additional blood tests. If your doctor thinks you will need additional blood products (eg plasma), they will be ordered at this time.

What Happens at the TIPS procedure?
During the TIPS procedure, the radiologist makes a tunnel through the heart with a needle, connecting the portal vein to one of the hepatic veins (veins connected to the liver). A metal stent that is covered with a thin plastic material, placed in this tunnel to keep the tunnel open.

The procedure reroutes blood flow in the liver and reduces pressure in all abnormal veins, not only in the stomach and esophagus, but also in the intestine and liver.

This is not surgery. The radiologist who performed the procedure in the space under the guidance of X-rays. This process lasts for one to three hours, but you have to stay in hospital overnight after the procedure.

How successful TIPS procedure is?
TIPS procedure to control bleeding quickly more than 90% of patients with portal hypertension. However, in about 20% of patients, the shunt may narrow, causing varices bleed again later.

Complications What Is the Association of TIPS?

narrowing or blockage of the shunt may occur within the first year after TIPS procedure. Follow-up ultrasound examinations are often performed after the TIPS procedure to detect complications. Signs of blockage include increased ascites (accumulation of fluid in the abdomen) and re-bleeding. This condition can be handled by a radiologist who returned extend parallel with a balloon or repeats the procedure for placing a new stent.

Encephalopathy, or abnormal brain function, can occur with severe liver disease. Hepatic encephalopathy may be worse when blood flow to the liver is reduced by TIPS, which can result in toxic substances reaching the brain without first metabolized by the liver. This condition can be treated with medication, diet, or by creating a shunt which can not be accessed.

What Happened on the DSRS procedure?
DSRS is a surgical procedure where the vein from the spleen (called the splenic vein) is removed from the portal vein and attached to the left renal vein (renal). This surgery selectively reduces the pressure on the varices and control bleeding related to portal hypertension. This is usually done only in patients with good liver function.

A general anesthetic is given before surgery, which lasted about four hours. You have to stay in the hospital from seven to 10 days.

How this DSRS Surgery Success?

DSRS control bleeding in more than 90% of patients, with the highest risk of rebleeding whatever happens within the first month. DSRS procedure provides long-term control of bleeding is good in patients with portal hypertension.

What Is the Association of Surgical Complications DSRS?

Ascites, an accumulation of fluid in the abdomen, can occur with surgery DSRS. It can be treated with diuretics and restricted sodium intake

Follow-Up Care Procedures Following TIPS or DSRS

Follow-up care for the TIPS and DSRS may differ depending on where the procedure performed. Below find basic guidelines.

* Ten days after hospital discharge, meet with your surgeon or hepatologist (liver specialist) to evaluate your progress. Lab work will be done at this time.
* Six weeks after the TIPS procedure (and again three months after the procedure), had an ultrasound so your doctor can check that the shunt is functioning properly. You will have an angiogram (an x-ray of blood vessels) only if the ultrasound shows that there is a problem. You also will have lab work done at the moment.
* Six weeks after DSRS procedure (and again three months after the procedure), met with the surgeon to evaluate your progress. Lab work will be done at this time.
* Six months after either the TIPS or DSRS procedure, have an ultrasound to make sure the shunt is working properly. Also, visit the surgeon or hepatologist.
* Twelve months after either procedure, to have another ultrasound shunt. Also, you may have an angiogram so your doctor can check the pressure inside your blood vessels in the shunt.
* If the shunt is working properly, every six months after the first year of follow-up appointments, have an ultrasound, lab work, and visit with your doctor.
* More frequent follow-up visits may be needed, depending on your condition.
* Attend follow-up as scheduled to ensure that the shunt is functioning properly. Be sure to follow the dietary recommendations that you provide your health care provider.

Another treatment for Portal Hypertension

* Liver transplantation. This is done in cases of end-stage liver disease.
* Devascularization. A surgical procedure to remove varicose veins bleed. This procedure is done when a TIPS or shunt surgery is not possible or not successful in controlling bleeding.
* Paracentesis. This is a procedure in which the accumulation of fluid in the abdomen (ascites) directly removed

SOURCE:
Cleveland Clinic Department of Gastroenterology, Merck Manual

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Congenital Heart Disease

Congenital heart disease is a type of defect or abnormality in one or more structures of the heart or blood vessels that occurs before birth.
This defect occurs when the fetus develops in the womb and affects 80-10 of every 1,000 children.
bawaanl heart defects may produce symptoms at birth, during childhood, and sometimes not until adulthood.
Approximately 500,000 adults in the U.S. suffer from congenital heart disease.

What Causes Congenital Heart Disease?
In some people, the causes of congenital heart disease is unknown. However, there are several factors associated with an increased chance of getting congenital heart disease. Risk factors include:

Genetic or chromosomal abnormalities like Down syndrome in children.
Using certain drugs or alcohol or drug abuse during pregnancy.
Maternal viral infections, such as rubella (German measles) in the first trimester of pregnancy.
The risk of having a child with congenital heart disease is higher if a parent or sibling has a congenital heart defect - increase the risk of eight in 1000 to 16 in 1000.

What type of Congenital Heart Problems Are There?
The most common heart defects are:

Heart valve defect. Narrowing or stenosis of valves or complete closure of inhibiting or blocking blood flow to the front. Other valve defects include leaky valves that do not close properly and allow blood to leak backward.
Defects in the wall between the atria and ventricles of the heart (atrial and ventricular septal defect). These defects allow oxygen and unoxygenated abnormal mixing of blood between the right and left heart.
Abnormalities of the heart muscle that can lead to heart failure.
What Are the Symptoms of Congenital Heart Disease in Adults?
Congenital heart disease can be diagnosed before birth, after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. In adults, if symptoms are present, they may include:

Shortness of breath.
Limited ability to exercise.
How is Congenital Heart Disease Diagnosed?
Congenital heart disease is often first detected when a doctor you hear abnormal heart sounds or heart murmur when listening to your heart.

Depending on the type of doctor you hear a murmur, he may order further testing such as:

    Echocardiogram or transesophageal echocardiogram (TEE)
    Cardiac catheterization
    Chest X-ray
    Electrocardiogram (ECG or EKG)
    MRI

How is Congenital Heart Disease Treated?
Treatment is based on the severity of congenital heart disease. Some mild heart defect does not require any treatment. Others can be treated with medication, procedure, or surgery. Most adults with congenital heart disease should be monitored by a heart specialist and take measures to prevent endocarditis (a serious infection of the heart valves) throughout their lives.

How can I prevent endocarditis?
Those who have congenital heart disease have an increased risk for endocarditis, even if the heart is repaired or replaced through surgery. To protect yourself:

Tell all doctors and dentists you have congenital heart disease. You may want to bring the card with this information.
Call your doctor if you have symptoms of infection (sore throat, general body aches, fever).
Caring for your teeth and gums to prevent infection. See your dentist for regular visits.
Antibiotics according to the American Heart Association guidelines before you undergo any procedure that may cause bleeding, such as dental work (even basic dental cleaning), invasive tests (each test which may involve blood or bleeding), and most or minor surgery. Check with your doctor about the type and amount of antibiotics that you should take.
Congenital heart defects in Children
There are several congenital heart defects are detected and treated in early childhood. Most of them are abnormal connections between veins and arteries, and blood vessels (such as the aorta and arteries of the lungs). This connection can allow normal unoxygenated blood flow to the body, not to the lungs, allowing oxygen or blood flow to the lungs instead of to the body. They can also cause heart failure. Some examples of congenital heart disease in infants and children include: 

• Patent ductus arteriosus (when blood bypasses the lungs preventing oxygen to circulate throughout the body). 
• Tetralogy of Fallot (four different heart defects that occur together). 
• Transposition of great arteries (the blood from the left side of the heart and liver mixed with the right side because of the large arterial connections are not correct). 
• Aortic coarctation (aortic pinch). 
• Heart Valve Problems

What Are the Symptoms of Congenital Heart Disease in Infants and Children?
Symptoms of congenital heart disease in infants and children include:

• Cyanosis (a bluish color of the skin, nails, and lips). 
• Rapid breathing and poor eating. 
• Less weight. 
• Recurrent lung infections. 
• Inability to exercise.

How is Congenital Heart Defects in Children Treated?
Most of the congenital heart defect will require surgery or interventional procedures to correct the problem. Often children with congenital heart disease will also require treatment with drugs to improve heart function as well.

Children and adults with congenital heart disease should be treated by a cardiologist specializing in congenital heart disease. Several types of diseases may require a team approach as the child grows into adulthood.

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Rheumatic Heart Disease / Rheumatic fever

Does rheumatic heart disease and rheumatic fever?
Rheumatic heart disease (PJR) is a condition where cardiac valve damaged by rheumatic fever.

Rheumatic fever begins with a Sore Throat (also called streptococcal pharyngitis). Strep throat is caused by Group A Streptococcusbacteria. This is the most common bacterial infection of the throat.

Rheumatic fever is an inflammatory disease. It can affect many connective tissues of the body - particularly the heart, joints, brain or skin. Anyone can get acute rheumatic fever, but usually occurs in children five to 15 years. Rheumatic heart disease can last a lifetime.

Incidence of rheumatic fever / rheumatic heart disease is low in the United States and most other developed countries. However, it continues to be the main cause of cardiovascular mortality during the first five decades of life in developing countries.

What are the symptoms of Strep Throat?

Symptoms include (but are not limited to):
sudden onset sore throat
pain on swallowing
fever, usually 101-104 ° F
headache
red throat / tonsillitis
abdominal pain, nausea and vomiting can also occur, especially in children
In some people, strep throat is very mild with only a few symptoms. Also, more frequent sore throats are caused by viruses of the streptococcal infection. Viral throat infection did not increase the risk of rheumatic fever and is not treatable with antibiotics.

What are the symptoms of rheumatic fever?
Symptoms may include:

fever
painful, tender, swollen red joints
pain in one joint is moving to another
heart palpitations
chest pain
shortness of breath
skin rash
fatigue
Small, painless nodules under the skin
Symptoms of rheumatic fever usually appear about three weeks after a strep throat.

How can I prevent rheumatic heart disease?

The best defense against rheumatic heart disease is to prevent rheumatic fever from ever occurring. By treating strep throat with penicillin or other antibiotics, doctors can usually stop acute rheumatic fever from developing.

People who had rheumatic fever are more susceptible to recurrent attacks and heart damage. That is why they will get continuous antibiotic treatment monthly or daily, perhaps for life. If their hearts have been damaged by rheumatic fever, they are also at increased risk for developing infective endocarditis (also known as bacterial endocarditis), infection of the heart lining or valves.

In 2007, the American Heart Association updated guidelines for prevention of endocarditis and concluded that there is no conclusive evidence linking dental, gastrointestinal or genitourinary tract procedures with the development of endocarditis. The use of prophylactic antibiotics before dental procedures is now recommended ONLY for patients with the highest risk of adverse outcome resulting from endocarditis, such as patients with artificial heart valves, previous endocarditis, or those with specific forms of congenital heart disease. The guidelines no longer recommend prophylaxis before dental procedures for patients with rheumatic heart disease unless they also have one of the underlying heart conditions that are listed in atasWhat They do

Antibiotic prophylaxis to prevent endocarditis is not only longer recommended for patients undergoing gastrointestinal or genitourinary procedures.

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Heart Disease

The heart is one of the most important organ whose main function to pump blood throughout the body. Like other organs, the heart can also be attacked by various diseases.

Heart disease is a condition that causes the heart can not carry out its functions properly. There are a variety of disorders and diseases that can affect any part of the heart. The most common heart disease is coronary heart disease that can lead to sudden death heart attacks.

The cause of coronary heart disease is the narrowing and blockage of arteries due to excessive buildup of fatty substances in the lining of artery walls of the coronary vessels. It is influenced by a less healthy diet that accompanied sedentary lifestyle, cigarette addiction, hypertension, high cholesterol and thus affect the formation of blood clots. As a result blood flow to the heart is hampered thereby disrupting the blood vessels of the heart as a pump which in turn will trigger a heart attack.

In addition to coronary heart disease, there are also other heart diseases caused by abnormalities at birth such as an imperfect heart, heart valve disorders, and weakening of heart muscle. Another cause is the bacteria that cause infections of the heart.

Key Factors of Heart Disease Risk Exposure

To avoid the chance of heart disease, it helps us identify risk factors. Here are some risk factors that warrant concern:

1. Age and Gender. Men under age 50 are at higher risk compared with women in the same age group. After menopause, a woman's risk increases because of the sharp decline of the hormone estrogen is protective.
   
2. Descendants of the family. Research shows that if there is a history of heart problems in the family, their offspring are more likely to develop a similar problem. 
3. Diabetes (diabetes). Diabetics can suffer heart disease as a complication of the disease.
4. Smoking (exposed to cigarette smoke). Smoking is directly responsible for approximately 20 percent of all deaths from heart disease and nearly 50 percent of heart attack in women aged under 55 years old. Smoking increases blood pressure and include toxic chemicals such as nicotine and carbon monoxide, into the bloodstream. These chemicals, will further damage the arteries. Smokers also get them involved inhaling smoke are at risk of having problems at heart. Research reveals that people who do not smoke who live with smokers have an additional risk of heart attack. Therefore, by quitting smoking can reduce a person's own risk and can even save the lives of loved ones who do not smoke.
5. High blood pressure (hypertension). High blood pressure (hypertension) can injure the arterial wall and allows the channel to enter the arteries of LDL cholesterol and increase the accumulation of plaque. As the plaque deposits increased, there was more of a barrier to blood flow and thus there was an increase in blood pressure which increases the risk of heart attack.
6. Overweight (obesity). Excess weight increases the high blood pressure and abnormal amounts of fat. Avoid or treat obesity (overweight) is the main way to avoid diabetes. Diabetes would then increase the risk of coronary heart disease.
7. Sedentary lifestyle. People who are sedentary are at risk of heart attack is higher. They spend most of their day without being physically active and exercising regularly. Heart attacks often occur in these people after heavy activities such as working hard in the garden, jogging, lifting heavy loads, or shoveling snow. But the risk is decreased among those exercising regularly. The streets were relaxed for 20 to 30 minutes three or four times a week can reduce the risk of attack. With regular exercise can improve the heart's ability to pump and can lower cholesterol levels and lowering blood pressure. 
8. Stress (emotional distress). Based on the research, stress can cause this narrowing of the arteries and reduce blood flow to 27 percent. Narrowing of meaning can even be seen in arteries affected by mild disease. Other research suggests that severe stress can cause rupture of the arterial wall that trigger heart attacks.

Just to know the risk factors for the disease is not enough. Necessary action to prevent the occurrence of this disease. In addition, it is important to know the symptoms of heart disease. Rapid and precise handling can reduce the harm they cause. Please visit our Heart Disease Symptoms to find some common signs and symptoms of heart disease.

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Insurance To Protect The Life Or Economic Value?

Friday, August 12, 2011

I've heard the opinion of some people about life. Some say: "Life is God's business. Insuring our souls means precedes the will of God. "

So roughly. And in fact, quite a lot of people who are allergic to hear the word 'insurance'. Funny thing is, those who are allergic to this life insurance did not hesitate to insure a car, motorcycle or houses they have.

Hence, it is not surprising if the majority owner of a motor vehicle to protect the economic value of the vehicle with insurance, while only about 3% only Indonesian who consciously protect themselves with the economic value of life insurance.

Actually, life insurance not to protect our souls. But rather to protect the economic value ourselves. For example, if today we are able to provide 5 million dollars every month for our family a decent living, then life insurance helps us to ensure that the economic life of our family with 5 million expenditure could be kept awake, 'even if' something happens that causes us no longer able to produce that kind of money. We do not expect this 'something' was happening.

But who can ensure the future?

Therefore, try to ponder: If the economic value of a car or a house we just covered, why do not we protect the economic value ourselves? Is a car or a house worth more than ourselves?

If our employees, try to check whether the companies in which we work is to provide life insurance for us. These companies typically provide a good life insurance for his employees. But there are two things we need to do:

First, ask your human resources department, whether the insurance provided is only valid as long as we work at the company, or it could proceed alone if we stop working.

In general, if employees resign or retire, then life insurance will automatically be disconnected. Therefore, consideration should be to buy their own insurance. Unless we plan to continue working as a professional.

But consider also, if we retire, whether that protection can be taken away as a retirement package or not.

Secondly, if the company has been providing life insurance that we can manage its own (can be taken away and resumed his own) then maybe it's time to do financial planning or school fees of children in the future.

Some people prefer to save every month in the bank, and not taken-take. No matter if we can be disciplined way. But if not, maybe insurance education can be a way out.

Apart from that, education has the advantage of insurance protection side, which is not owned by the resp.

The principle is: if there is 'something' in us, then our children still get guaranteed financing of education in accordance with what we have planned.

Although we are not interested in buying an insurance policy, we need not hesitate to consult with an insurance agent. There is no harm if we understand the mechanism of this model of financial planning.

At least, we can compare it with financial planning strategies that we are currently running. Although we do not buy insurance policies from them, they are usually happy to help us to design our long-term financial plan. That is, we can get a free consultation about our financial planning. Not bad right?

Currently many insurance combined with investment. So, you get the benefit of protection, as well as we can see the portion of the money you paid as savings or investment that continues to grow and develop.

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Thursday, August 11, 2011

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Cashless Health Insurance Buying Tips

Wednesday, August 3, 2011

"Cashless health insurance" is health insurance that provides facilities Hospital Partner (Provider) for participants so that if the participant should be cared for in a hospital then the participants' partners will be cared for in Class rooms are taken in accordance with the plan and not have to bother bother to spend money - to deposit the room (which is usually quite burdensome for you, especially when emergencies) plus the cost of doctors, medicines, surgery and other costs borne by the "cashless health insurance" until the patient is out of the Hospital, as participants in health insurance cashless you will be given a membership card, which simply indicated to the RS Partners.

So the next question is whether all health insurance means that there is a health insurance card cashless? of course not the case, there are several companies that provide health insurance cards to its customers but if the customer still must pay the first sick of all hospital costs to later in reimburge to insurance companies, for that you as a prospective customer must be observant and carefully before buying, be sure to See your dealer that offered health insurance is cashless.

In the cashless health insurance there are still some facilities also benefit coverage and cost components that we need to know, because as a customer you deserve to get the best, for it is here we will give you some tips on buying a cashless health insurance:

1. Look for the "cashless health insurance" a long period of coverage (up to age above or more than 70 years) because of your condition is even more vulnerable and require a relatively large costs for health care when you get older age.
2.  Find a cashless health insurance is the minimum requirement applies inapnya hospitalized less than 24 hours
3. Find the cost of drug coverage according to the bill, it is necessary to remember every year health care cost inflation is relatively high
4. Find the cost of coverage both general and specialist physicians who fits the bill
5. Find the insurance operating costs and the appropriate surgery bill
6. Make sure the cost of medical consultations, drugs before and after hospitalization according to the bill because of unusual costs before and after hospitalization is quite large and burdensome you later
7. Search for "cashless health insurance" that the hospital provider number and spread it where you live
8. Make sure your membership in the cashless health insurance can be renewed any day your medical condition, meaning there is a written agreement in the policy stating that your membership in the cashless health insurance can be extended
9. Buy health insurance that suits your lifestyle, if you prefer the amenities of good care, it is advisable to buy products with the benefits of a high room
10. If you prefer to go abroad for hospital treatment, buy products with the highest benefit, taking into account the high cost of overseas treatment
11. To avoid bear the excess cost of treatments use the rooms according to the class rooms are covered by a product that you have
12. Choose the health insurance that provides hospitalization benefits abroad including America, Canada and Japan

Similarly, a few tips on buying a "cashless health insurance" this time, may help those of you who are still confused in choosing the cashless health insurance that suits you and your beloved family.

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Health Insurance Cash Plan as a Substitute For Income

"Cash Health Insurance plan" is health insurance that provides replacement value of your economy when you are hospitalized, cashplan health insurance is better known by health insurance with replacement cost hospital room.

Here are some advantages of this cashplan health insurance:

1. Cashplan health insurance premiums are the cheapest compared to other types of health insurance, life insurance companies usually provide this plan as a rider in a link unit that they offer
2. Could double claim, cash plan health insurance benefits is that they allow you to make a claim on more than one health insurance policy you have
3. Receive a copy of receipt, to submit claims as described double point 2 above you simply attach a copy of all hospital costs, doctor's diagnosis etc. legalized by the hospital where you were treated.

Cash Health Insurance plans can be an alternative for those of you who want to have health insurance but with a minimal budget, though not all at the cost of health insurance cover by this species, but at least you get the reimbursement amount sufficient funds lighten your load when I have to get hospice care , especially if you are an employee who obtain health care costs from the budget office cashplan of health insurance can be a substitute for your income.

Cashplan health insurance is the maximum you can do by combining it with cashless health insurance so that when you are required to obtain any hospital treatment you will be earning (the replacement value of the economy) should when you are healthy and working.

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When It Is Appropriate To Buy Health Insurance?

How important is "health insurance" for you and your family? If your answer is important, whether you already have it? if it is, then congratulations to you, if you do not have, why? What have yet to find the best health insurance for you and your family? or is there another reason?

Whatever your reason, it is your right and also the risk that you have to bear their own countries, why not?

A few days ago I received a call from a friend who I had not met the last time I met him disebuah show our friend's wedding about a year ago, there we only had time to exchange business cards, and he expressed his intention to take "insurance health "and want to know more about the program" health insurance "of our company.

I had contacted him several times to make appointments as well as providing explanations on the program "health insurance" that we have, but because of his incredible busy as an entrepreneur who is often out of town and so forth, we finally have not met again since then it.

Until a few days ago he called me to ask the terms and conditions how premium "health insurance" for his parents who was 57 years old, and he relates that a few days ago one of his parents a mild stroke and to this day still being treated in hospital. and he asked whether such a case, parents are still acceptable to be participants? he is also willing to pay more, as long as acceptable.

In principle I would help him to apply for health insurance at the time his parents had returned from the hospital, but I say that I did not dare to promise a lot and he was quite understanding and willing to accept explanations from me.

Father / Mother Dear I hope the true story of the above can be a material evaluation and introspection for you, remember "You can not always insured", so according to you, when it is appropriate to buy "health insurance?"

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Is There An Ideal Health Insurance?

Everyone without exception should have health insurance that would guarantee health care costs or care when someone falls ill or have an accident. Moreover, although we have been keeping good health, the disease can come unexpectedly. On the other hand, health care costs continue to rise.

Nearly 70 percent of Indonesia to finance their own doctor or hospital costs. There are various reasons that make the community is still reluctant to take the insurance services, among others, for fear of being deceived insurance agent, be bothered to make a claim of treatment, and many are unfortunately out of funds to pay for insurance.

According to Tri Djoko Santoso, a financial planner, health insurance is included in an effort to protect ourselves and also riches. "There are so many diseases that can make a person poor for spending of property," said Chairman of the Indonesian Institute of Financial Planning.

Owned health insurance is health insurance should be pure, not mixed with the investment. It is intended that manfaaat obtained higher. For example the replacement cost of hospitalization or surgery is greater.

Tri Djoko added that an employee who already receive health insurance from any office should still protect themselves with health insurance. "Insurance was no limit. Usually if one employee to pay too high because of critical illness, the next year the insurance company would not it be included again in the program, "he said.

Choosing the right insurance products is not a trivial matter. It takes jelian and thoroughness because the fund purchases the customer does not belong to someone else, but yours. Loss or risk of error remains borne by the buyer purchase insurance, not the other party.

To prevent losses due to insurance, there are several things to consider potential borrowers, namely:

- It should be understood that the insurance premium is a cost, not investment. In other words, our money will be lost if during the validity of our policyholders in good health.

- Ask your insurance agent in detail to each item that is written in the policy. For example, the exclusion of disease conditions that are not guaranteed, whether the insurance coverage covers only outpatient services or inpatient care?

- Because of cost, potential insurance buyers should ask a friend or someone who feels more understanding about insurance. Not infrequently an explanation about the disease written in English so that it can lead to a wrong meaning.

- Ask about the claims procedure. The more quickly and easily process a claim, the better kuliatas bureaucratic insurance companies concerned. That is why, consider the track record of the insurance companies will be selected.

- Tell the truth if you already suffer from certain diseases before the inception of the policy.

source: kesehatan.kompas.com

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Best Health Insurance and Good Health Insurance

Many health insurance companies that claim their products are the best health insurance, so confuse lay people. The question is, of all the best insurance products that, where health insurance is good for you?

I held up a thumb for you, who have realized the importance of having protection. Not many people have insurance awareness let alone think of to protect the health of family members (family insurance).

I give my special appreciation for people like you who choose the path to find out / information before determining pilihannnya.

People choose to take insurance in general is aware of the importance of health.
If I may ask, Why did you take Insurance?1. Because health care is expensive.
2. Hospital costs are increasingly rising.
3. Health conditions are not always predictable is always good.
4. Do not have protection from the office / place of work, if ill, no one ease the cost burden.
5. High risk my job, working in the field.
6. So if treated in hospitals could be free.

If the reasons above into your base to have protection, I think almost all health insurance products in Indonesia has been able to cover it all.

But you need to remember the disease / health is a serious problem that must be prepared as well as possible, so before you have to consider that health insurance you need is not to protect you / family from health risks today or tomorrow, but a few years or perhaps decades ahead.

Several things into consideration include:
- How much benefit for hospitalization.
- Outpatient
- Ambulatory surgery, etc..

Many people assume that by having the protection of the above states that the insurance they will be suitable for him.

Fact: There are many benefits of outpatient / inpatient used by customers

Some people take this protection semata2 just want to double claim of protection has been provided by the office where she worked.

They think inpatient / path is the ultimate protection in choosing insurance, you try to remember when your last hospitalization at the Hospital?
3 years ... 4 years ... even when I was old school ... that means the benefit is very rarely used.

Be aware that the benefits of inpatient / path associated with the amount of premiums to be paid. When you decide to take this benefit needs to be seen how many days a year you will be protected?

There are three things more important than just the benefits of inpatient / road course, you need to look at and be a consideration in choosing a good health insurance, three important things are in general not all life insurance companies / health mengcovernya brave, important things that is ...

1. CRITICAL DISEASE COVER
Most feared disease of all people today are CRITICAL ILLNESS, be it heart disease, cancer, tumors, stroke, etc.. The disease each year is increasing the number of sufferers, due to unhealthy lifestyle, stress, even as obesity.

And according to a survey conducted by WHO, 90% of people die earlier due to hit the critically ill. This means that only about 10% of people who die in natural conditions. Hmm .. very little not ...

For the critical illness is also cost countless expensive, if it's been hundreds of millions can be imagined ten, twenty and even thirty years later, it could be billions right? This is what we have to look at and pay attention!

Check and ask your insurance agent that offers:
1. Does having insurance protection for the critically ill?
2. How many different types of critical illness dicovernya?
3. If there is, check how much protection is reserved for critically ill and you try to think and count again been given enough protection costs compared with the requirement that costs as incurred?

This is important, because not all health insurance provides protection for the critically ill, some exist but have very little cash value, it does not help you!
Do not forget to check and ask, usually good health insurance that will provide savings benefits for free when customers affected by critical illness.

The question:
"With the lifestyle that we run it now, within the period 20-30 ahead, is there a possibility we are exposed to one of the critical illness?"

2. TOTAL PERMANENT DISABILITY COVER
In addition to critically ill is still something else that is also high risk levels such as sickness or accident disability, total permanent disability and even allowing one could no longer work.

If this happens to customers,
Ask as much detail as possible whether conducted by the insurance company:
1.Mengeluarkan protection costs, and close the policyholder (a breakup), or
2.Mengeluarkan protection and benefit cost savings to its customers free of charge until a certain age, and other ongoing protection.

My advice, choose the insurance that gives the option number 2, because we all know when someone is having total permanent disability, automatically he could not do the job up as before, for some companies in Indonesia is a state of such employee will be given consideration for policy "early retirement" on the employee. You will understand what I mean.
Ohya do not forget to look for insurance that provides protection with a total permanent disability pay claims directly rather than "repaid".

3. DURATION OF PROTECTION
If you decide to have a current protection, then you also have to calculate up to what age you will be protected, because of course the difference in 5 years will be very important for you instead? Health insurance claims its products are good to have the longest period of protection, especially for critical illness benefits (to customers aged 70 years).

Also look for health insurance are not reducing the benefits / benefits in the event of a claim from one of the critical illness or total permanent disability the claim will be accepted if the beneficiary if the insured dies.
A good health insurance always puts the customer in a position to "win"
This means that any cost benefits (critical illness / total permanent disability) issued to its customers does not interfere with the cost of benefits (life) more, because many insurers are quick to have cost a great protection, it reduces the cost of the benefit is mutual.

Ask more details about the company's financial strength not only from the information agent / ads served but the real accomplishment achieved by the company.

Do you already have health insurance benefits above? If not, you should question the financial consultant (agent) your health insurance.

For those of you who do not have protection, we are here to help you to see what benefits you would get with the insured.

Many of the facts occurred, many people off guard to choose not to have insurance, the wrong choice of health insurance, and not considering other factors.
So as I mentioned earlier that if you are not keen in considering the benefits of protection, it is feared will actually cause serious problems in financial planning, not even the few who finally "broke" because the claim is given insufficient for health costs, because it's focus to see the benefits you will receive later.

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