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Doctor in CIMS Hospital
Dr. Tejas V Patel
Services
Treatment of Heart Attack
Balloon Angioplasty Procedure
Treatment of Blocked Arteries
Heart Valve Replacement Treatment
Treatment of Blockage, Atherosclerosis & Heart Att
Coronary Angioplasty Treatment
Angioplasty Stent Surgery
Angiography Radial Approach
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What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat.
It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.
Types of palpitations?
Normal (Benign) -
These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc.
They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.
Abnormal -
These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart.
These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.
Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures.
Palpitations are more likely to be abnormal In people who have some existing heart disease and these patients should report to their doctor at the earliest.
What to do during palpitations?
Stay calm.
Call for help. (If u are alone avoid driving, use a taxi or auto) Go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospita
Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists.
They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.
Which investigations are used to diagnose palpitations?
ECG - Taken during palpitations and when the patient is normal is a very helpful tool.
Holter - Externally applied recorder which continuously records heart rhythm for 24 hrs.
ELR - Extended looper recorder, is like holter, but it records rhythm for longer durations.
ILR - Internal loop recorde is attached within the body for recording rhythm for long duration.
EPS - Electrophysiology study, is the most sure shot test to diagnose, identify and treat
palpitations.
What is EPS?
EPS stands for Electrophysiology study. By this test a trained electro-physiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation.
It is a simple and safe procedure of 2-3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).
It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.
In the procedure electro-physiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.
What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient -
Drug therapy
Cardioversion - where either a drug or electric shock is given to stop palpitations immediately.
Ablations using many sophisticated computer softwares
Device Therapy like ICD (Internal cardiac defibrillator)
Combination of all the above therapies.
Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.
What is Radial Angioplasty?
Angioplasty is a medical procedure done when you have coronary artery disease. A sticky deposit due to high cholesterol blocks the arteries so the blood flow is compromised. Angioplasty restores the blood flow in your heart.
How is it done?
• A long, thin tube called a catheter is inserted into the vein or artery in the wrist and into the heart
• You will be given anaesthesia around the punctured site so you would not feel a thing
• A balloon is attached at the end of the catheter to open the blocked arteries
• Sometimes, a small metal mesh-like device called stent is put inside to support the blood vessels
• Direct pressure is applied to the incision to stop the blood flow
• The wound is bandaged
• Angina - Chest pain due to reduced blood flow to the heart
• Myocardial infarction or heart attack - Chest pain due to blocked blood flow to the heart
• Atherosclerosis - Increased accumulation of fat and cholesterol in arterial walls
• High cholesterol - Increased low-density lipoprotein cause high cholesterol in the blood
Who can have it?
Patients with the good blood supply in both their hands through radial and ulnar arteries are eligible for radial angioplasty.
After the procedure, the radial artery may become blocked. If the ulnar artery has good blood flow, there will not be any problem.
Some tips after your angioplasty:
• The patients can start walking right away after the sedatives wear off
• Be careful about the punctured area
• Rest your forearm on a pillow
• Do not bend your wrist for 8 hours after the procedure
• Refrain from using your wrist for a day
• Do not lift heavy weights for at least 2 days
• Remove the bandage on the second day to fasten the healing process
• If you feel the punctured site beating or it starts to bleed, call your doctor immediately
• Do not forget to follow up after 1 month
Radial angioplasty helps the patients to recover faster than those who do femoral angioplasty (the catheter is put through the groin area). Thus, doctors usually recommend the former if the necessary conditions are met.
The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles. The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives.
Symptoms: The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting
- Profuse sweating
- Difficulty breathing
- Dizzy or fuzzy feeling
- Tired, extreme fatigue
- Anxious, apprehensive feeling
However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.
Diagnosis: Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis. In addition to a detailed examination and history, the following two tests will be performed.
- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.
- Blood tests: Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack. A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.
- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.
Management: Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function.
- Dissolve the clot - Using thrombolytics like clopedigrol
- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles
- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.
- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used
- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.
Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
Heart disease doesn't affect all women in the same way and neither does it have the same warning signs as heart diseases in men. For women, heart disease is a bigger threat than breast cancer. Cardiovascular diseases also kill more women than men as the disease progresses differently in men and women. Here are a few things you should know about heart diseases.
Women have more atypical symptoms of heart attacks: The classic symptoms of heart attacks are pain in the left arm, chest pain and heart palpitations. Though women may exhibit these symptoms, they are more likely to have atypical symptoms. These include nausea, stomach aches, pain in the shoulders and upper back and extreme fatigue.
Preeclampsia and gestational diabetes can increase risks of heart disease: Even though your blood pressure may go back to normal and conditions like preeclampsia or gestational diabetes may go away post pregnancy, their effects linger on. The risk of heart disease for a woman who suffered from preeclampsia doubles while gestational diabetes can cause glucose intolerance leading to obesity or other such conditions which are risk factors for heart diseases.
Hot flashes could be a sign of heart problems: Hot flashes are usually associated with menopause but may also be a symptom of underlying heart problems. Hot flashes that occur after a exerting a strenuous effort on something can be a sign of angina in women.
Men and women do not face equal risks: Traditional risks to heart diseases such as cholesterol, obesity and high blood pressure affect both men and women but some factors such as diabetes, stress, depression and smoking affect women more than they affect men. Since women tend to lead a more sedentary lifestyle than men, a lack of exercise also affects them more than it affects men. In addition, a low level of estrogen can also increase the risk of cardiovascular conditions. This is usually seen after menopause.
Metabolic syndrome increase your risk of getting a stroke:
There are five metabolic risk factors for heart disease. If you have 3 or more of them, it is termed as metabolic syndrome. These risk factors are:
- A waist circumference of more than 35". This is also called abdominal obesity
- A triglyceride level higher than 150 mg/dL
- A low level of good cholesterol i.e. HDL cholesterol that is less than 50mg/dL
- High blood pressure
- High blood sugar. This could also be a sign of diabetes.
While some factors like genetics are out of our control, most of these factors can be controlled by conscious lifestyle changes. Your doctor may also prescribe medication for the same. Heart disease can occur at any time so do not take your heart for granted.
It is natural to consider whether your heart is beating right and your blood pressure is normal. Also, many tend to think that the blood pressure and heart rate are related to each other. Admit it or not, you must have heard a lot about your heart rate and blood pressure, some of which are outright false. This is the time to debunk them and know what actually the reality is.
Myth #1: Having an erratic heart rate indicates that you will have a heart attack soon
When the heart beats at an abnormal rate, it means you have a condition called palpitation. It may give you feeling as if you have skipped a beat or your heart is racing up. You may also experience a brief flutter or pounding feeling in the chest. The good news is that these sensations are not life-threatening and are generally caused by caffeine, alcohol, medication, stress or exercise.
Myth#2: When the pulse rate is fast, it means you are overstressed
Stress is a condition which may raise the pulse rate. But your heart rate can rise when you feel excited or feel anxious or exercise hard. Even high temperature and high humidity can raise your pulse.
Myth #3: Normal heart rate denotes normal blood pressure
At times, blood pressure and heart rate go hand in hand. For instance, when you feel angry or scared or exercise hard, both of them can go up. But you should note here that they are not always linked. Even if the heart rate is normal, your blood pressure may not be so. It could be too high or too low, but you wouldn’t be able to understand it.
Myth #4: Blood pressure and heart rate are same things
It is important to understand the difference between pulse rate and heart rate. Blood pressure is the term denoting the force of blood moving through the blood vessel. On the other hand, heart rate is the number of times the heart beats in a minute. They are two absolutely separate indicators of health. This means if you have high blood pressure or hypertension, there is no substitute for measuring blood pressure.
Myth #5: Heart rate and blood pressure rise and fall at the same rate
As indicated above, a rising heart rate may not be able to cause the blood pressure to surge at the same rate. Even though the heart is beating more than normal, the healthy blood vessels may dilate to allow easy blood flow. When we exercise, the heart speeds up in order to pump an adequate amount of the blood to the muscles. It could be that your heart rate is doubled, but it is safe since your blood pressure has increased only at a modest rate.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Our survival is solely reliant on the working of the heart. It is this that makes the prospect of a heart failure so fatal and so terrifying. Notwithstanding what the heart evokes, a heart failure is not indicative of a defunct heart; but only a situation when the heart pumps weaker than what is generally deemed as natural. Consequently, the blood flows at a slower rate to the heart and the body that in turn increases pressure in the heart. The oxygen that is produced by the heart in such a scenario is scanty and insufficient for the body.
body responds with its own defense mechanism, as the heart, in an attempt to hold more blood, stretches its chambers. Though this strenuous effort may keep the blood moving, it would gradually and inevitably weary the heart with all the effort. Subsequently, the kidney responds by retaining more salt and fluid in the body. These fluids may accumulate in different parts of the body, mainly in the legs, feet, ankles leading to congestion in the body. This very condition in medical terminology is referred to as congestive heart failure.
Different causes can contribute to the onset of such a fatal condition. Some of them are
- Coronary artery disease: In such a condition, the arteries supply insufficient amount of oxygen and blood to the heart. Subsequently, the heart receives scanty amount of nutrients and oxygen.
- Heart attack: The sudden, unanticipated blockage of the coronary artery and the ensuing stoppage of the flow of the blood lead to a heart attack. The heart muscles are damaged in such a case and prevent the proper functioning.
- Diseases: Though the term may be generic and over expansive, most of the ailments which people suffer from tend to manifest themselves by posing a potential threat to the functioning of the heart. A high blood pressure, kidney disease, even a thyroid disease can cause congestive heart failure.
Every disorder is preceded by certain symptoms, and congestive heart failure is no different. Some of them are
- Fatigue: This is one of the most perceptible symptoms of congestive heart failure. One of the earliest premonitions of an impending heart failure is a nagging sense of weariness and lethargy.
- Swelling: As the condition is characterized by accumulation and build-up of fluids in various part of the body, swelling is an inevitable symptom of this condition and a clear indication of the ailment.
In case you have a concern or query you can always consult an expert & get answers to your questions!
If you had suffered a heart attack recently, it is quite natural to for a patient to feel weak as the heart goes through a tremendous amount of stress during the condition. So, it is very important for a heart patient to know the things that will help you them recover from it. A healthy diet is the first step towards the recovery. A proper diet can not only help you recover quickly, but you won’t suffer from a second attack too. If people had followed this dietary habits beforehand, then they wouldn’t have to face a heart attack in the first place. So, to recover and get back to your daily lifestyle, you must keep these foods in your daily diet.
- Fruits and Vegetables: Fruits and vegetables are a must and are of paramount importance when it comes to recovering from a heart attack. The most significant advantage is that they have lower calories and at the same time they provide sufficient nutrition. They will keep your blood pressure at a standard level and thus promote the health of your heart. Fruits and vegetables that are rich in potassium can also combat and balance the counter-effects that result from sodium. So, avoid your oily snacks and have fruits instead.
- Green Tea: Green tea is highly recommended by doctors for patients that have recently suffered a heart attack. They have been proven to be at risk of heart attack and other health problems related to the heart by 20%. Green tea does not contain any calories and is rich in anti-oxidants which are the main constituents responsible for the recovery.
- Nuts: You must have already been aware of the several advantages of consuming almonds. Another addition to its advantages is aiding the process of recovery after a heart attack. However, it is to be noted that nuts are good for a person who has suffered a heart attack only if they are not salted.
- Whole Grains: The refined grains tend to lose their nutrients while on the other hand whole grains are rich in fiber and nutrients. They will keep your blood pressure in check and promote the well-being of your heart.
What to avoid?
Apart from the items mentioned above, there are several foods that you must avoid at all costs. The first one that comes in this list is the food items that are rich in sugar content. This will lead to an increase in weight and thus aggravate heart problems. You must also avoid salty foods as they will increase your blood pressure. Avoid meats and eggs as much as you can as they are highly rich in cholesterol which is another factor that must be avoided.
Follow a diet chart that incorporates the do’s and don’ts to have a speedy recovery and get back to normal routine.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Sedentary lifestyle and unhealthy food habits result in many lifestyle diseases, coronary heart diseases being one among them. One of the top 10 leading causes of death, heart attack might scare you, and it is necessary to know the facts to avoid risk factors and seek the best treatment.
The coronary arteries supply blood to your heart muscle. But at times, they can become blocked owing to the buildup of cholesterol and other substances known as plaque. It can reduce the flow of blood to the heart. When the blood flow is entirely restricted, it may result in a heart attack.
Doctors typically recommend angiography during or after a heart attack or in the case of angina to find out about the condition of the heart and proceed accordingly. If any blockages are observed, angioplasty would be advised to improve the blood flow to the heart by widening the narrowed arteries. Read on to know further details regarding this.
What is coronary angiogram?
A coronary angiogram is a special X-ray test which helps in detecting if any of the coronary arteries are narrowed or blocked, hindering the optimal flow of blood. It can help your cardiologist understand whether you need any treatment such as stent or angioplasty or simple medical therapy.
During the process of angiography, your doctor would numb a spot in the arm or groin for inserting a thin catheter into the artery. You will get the feeling of a pinprick, and x-rays would be taken as the fluid goes through the coronary artery. After the process is completed, your doctor would discuss the results of the test with you and determine whether you need to undergo angioplasty.
What is coronary angioplasty?
A coronary angioplasty is a process which is used for widening blocked or narrowed blood vessels that supply blood to the heart. The term angioplasty entails using a balloon for stretching open the blocked artery. But the modern approaches to angioplasty procedures involve insertion of a short-wire mesh tube known as a stent. This stent is permanently left alone in the deployed state to allow free flow of blood to the heart.
Coronary angioplasty is often referred to as percutaneous transluminal coronary angioplasty or PTCA. The combination of angioplasty together with stenting is known as a percutaneous coronary intervention. Even though angina can be easily treated with the help of medicine and some lifestyle changes, a coronary angioplasty may be required for restoring the flow of blood to the heart. Doctors recommend undergoing coronary angioplasty as an emergency treatment after a heart attack.
What are the benefits of coronary angioplasty?
The flow of blood through the coronary arteries is massively improved after the coronary angioplasty. Many people find that the symptoms and discomfort are improved after undergoing this treatment. For individuals who have suffered a heart attack, angioplasty can significantly improve the chances of survival.
So, with this awareness, follow the doctor’s advice for a complete recovery from a heart attack. In case you have a concern or query you can always consult an expert & get answers to your questions!
Coronary artery disease is one of the major killer diseases of the modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives.
Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks.
Main causes for coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk.
Symptoms: Reduced blood supply to the target organ causes the following symptoms:
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Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters.
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Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion.
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Palpitations: A sensation where you are able to hear your heartbeat.
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Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina.
Treatment: There are 3 modes to manage this.
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Medications:
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Aspirin to reduce the viscosity of the blood.
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Statin to control the cholesterol levels.
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Beta blockers to control hypertension.
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Nitroglycerin for temporary relief of angina pain.
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Surgical Procedures: Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases.
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Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage.
Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.
In case you have a concern or query you can always consult an expert & get answers to your questions!
