Doctor in Columbia Asia Hospital Whitefield
Mitral Valve Replacement Surgery
Vascular Surgery Treatment
Cardiac Ablation Procedure
Coronary Bypass Surgery
Carotid Angioplasty And Stenting Procedure
Cardiac Catheterization Procedure
Implantable Cardioverter-Defibrillators (Icds) Tre
Treatment Of Restenosis
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Dr. Benedict Raj provides answers that are well-reasoned. Sir answered very nicely
Hello I am 34 male height is 5.11 weight is 74 kg suffered heart attack on Jan 9 2017 now after one year my Dr. had advice me to do lipid profile sugar vitamin d12 n ask me to do tmt n 2d echo I want to know can a blockage can be detect in 2d echo if tmt comes positive n 2d echo comes normal what should I do or go for please guide me.
Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food to continuously working heart muscles. Heart muscles, which are not tired working from the birth till death, however, cannot sustain long without blood supply.
A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).
But what causes these arteries to block? Sedentry lifestyle is the most primary reason of these blockages. Cigarette smoke increases the rate of atherosclerosis in the arteries of the heart, legs, and the aorta -- the largest artery in the body. Also, there is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female.
High levels of ''bad'' cholesterol, or low-density lipoprotein (LDL), are also the major contributors to arterial plaque formation. Having high blood pressure also increases the rate at which arterial plaque builds up. It also hastens the hardening of clogged arteries. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!
Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.
If LDL is a normal component of blood, why it is deposited in the arteries at first place?
LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart. If you wish to discuss about any specific problem, you can consult a Cardiologist.
A sudden cardiac arrest is not same as a normal heart attack. While a heart attack refers to the blocking of blood flow to the heart, a sudden cardiac arrest refers to when the heart stops beating unexpectedly. Sudden cardiac arrests occur without warning and often this condition is triggered by electrical malfunctioning in the heart that causes arrhythmia. When the heart stops beating, blood cannot be pumped to the brain and other organs and the person loses consciousness. If a patient does not receive immediate treatment, this could be fatal. Hence it is important to know what first aid a person experiencing a sudden cardiac arrest requires.
Do not wait for someone else to help a person experiencing a sudden cardiac arrest. The first few moments after such an experience are critical and hence your decision to help is what could save the person’s life.
Call a Doctor
The first thing to do when you see someone experiencing a cardiac arrest is to call emergency and request an ambulance. If you do not have a phone available, ask someone else to do it.
After a cardiac arrest, it is essential to get the heart to start beating again as soon as possible. CPR or Cardiopulmonary resuscitation can save lives in this situation. If you are trained in this procedure, start with 30 chest compressions before checking the patient’s airway and performing rescue breathing. If you are not trained in CPR, ask the people around if anyone else is.
If no one around can perform CPR, start hands-only CPR. Make the person lie flat on their back and kneel next to their shoulders. Place the heel of one palm in the centre of the person’s chest with the other hand over it. Keep your elbows straight and position your elbows such that they are directly over your hands. Use your upper body weight to push down straight on the person’s chest and release. Try and achieve a rate of 100 compressions a minute. Continue until the person starts breathing again or medical help arrives.
Use an Automated External Defibrillator (AED)
If an AED is available, place the electrode pads on the person’s chest as shown in the diagrams that come along with the AED. Follow the visual and voice prompts. Do not worry if the AED shocks the patient as this electrical therapy can help restart the heart. If you wish to discuss about any specific problem, you can consult a Cardiologist.
Angioplasty is referred to as a cardiac procedure, which involves widening the narrowed section of a coronary artery. Usually performed by an interventional cardiologist, this procedure is performed in a cardiac catheterization lab, short for a cath lab. An interventional cardiologist takes extra care to review the risks, in addition to obtaining your counsel prior to preparing you for the procedure. The physician also refers to your medical history in order to determine the amount of anesthesia that should be used.
What happens during the procedure?
Although mild sedatives will be administered to help you relax, the process requires you to remain awake throughout the procedure. The procedure of angioplasty involves cardiac catheterization. The doctor numbs the intended site through medications and inserts the catheter. Following such the doctor inserts a thin sheath in your artery, oftentimes in your groin or arm. A long, narrow, empty tube known as a catheter, is then carefully guided through the sheath, through the blood vessels and into the arteries near the heart.
A little amount of liquid is then injected through the catheter, which is moved through the chambers, valves and vessels of the heart. This movement is then pictured with the help of X-rays, with which the doctors can diagnose the condition and working of the coronary arteries and the heart valve.
The surgical procedure lasts for around 1.5 - 2.5 hours, but the preparation and post - surgical procedures may take several hours. A patient is usually made to stay overnight to be monitored by medical personnel.
What to expect before an Angioplasty?
Most people are made to undergo a blood test and electrocardiogram before having an angioplasty. Usually scheduled a day before the procedure, such tests usually require separate appointments. Usually patients are restricted to eat since 12 hours before the exam.
What happens post-procedure?
After the procedure, you will be instructed to remain flat for 5-6 hours without bending your legs, so as to prevent bleeding. The nurse will instruct you as to when you can get up from your bed. You may not be permitted to drink or eat until the groin sheath is removed as such can cause nausea.
If you wish to discuss about any specific problem, you can consult a Cardiologist.
A heart attack makes you rethink and get a double take on life. Once you survive it, you tend to realize how close your brush with death has been and how important your lifestyle choices can be. Most people go on to live a productive life after a heart attack provided they can adhere to making healthy choices. Here's what you can do if you have experienced your first attack and want to change for the better:
- Start at the hospital: A person usually stays in the hospital for 3 days after an attack to monitor their condition. This duration increases if you have complications that involve procedures like a bypass surgery. Your first significant change will come in the form of your medication routine. Your existing dosage may be adjusted and you'll possibly be prescribed newer medicines that will treat and control your symptoms. You'll not only need to know the names of all your medicines, but when you have to take them. It's best you know exactly why you are taking each one of them, if there are other more economic alternatives since this may last a lifetime and what side effects they may have.
- Maintaining your mental health: Once bitten, twice shy applies for heart attack victims too. Not only do they live in a constant worry about another attack, every small symptom like a harmless muscle pull can trigger the fear factor. You also get into the "heart patient" dependent mode based on how much help you need to recover. Check for support groups and other heart attack survivors in your locality to see how they are coping. Read more about your recovery and try to keep a positive frame of mind.
- Go to a cardiac rehab: Many hospitals have a rehabilitation program that you can participate in as an outpatient or you can go to a clinic that specializes in it. Such programs help speed up your recovery. It is run by people who will hand hold you in bringing positive changes in your life to protect and strengthen your heart. You'll learn activities that positively improve heart functions and reduce your chances of developing complications or dying from heart disease. You'll also get benefit from exercises that'll be taught by a certified exercise specialist.
- Make a change in your lifestyle: Quit smoking that is an obvious one. You'll now have to lead a more active lifestyle with daily exercise. You'll also need to actively manage your diabetes and obesity. None of these changes can happen in a day. In fact, behavioral scientists suggest that you need to practice a new activity continuously for twenty one days for it to become a habit. If you wish to discuss about any specific problem, you can consult a Cardiologist.
The heart pumps pure blood to all parts of the body through a network of arteries. These are thicker in the beginning and become finer and thinner as they reach the various organs. These arteries are lined by a layer of epithelial tissues and as blood flows through them, the heavier cholesterol / fat molecules settle down along the walls.
This attracts more and more fat molecules to settle down. This is known as atherosclerosis (hardening of the arteries). Over a period of time, the vessels circumference reduces and the blood supply to the target organ reduces. This impacts proper functioning of these organs and when this happens to the major organs like the heart, kidney or the brain, conditions like stroke or thrombosis or heart attack can occur.
This condition, known as coronary artery disease, is becoming a major cause of deaths. While that is the bad news, the good news is that it is largely lifestyle dependent, and if steps are taken, it can be prevented, and in the early stages, the damage completely reversed.
1. Diet: A low-fat, high-fiber, heart-healthy diet consisting of Omega-3 fatty acids is recommended by doctors, especially to people who are prone to develop heart disease. This also requires reduced salt, increased unsaturated fats, reduced triglycerides and reduced sugar. Include loads of fresh fruits and vegetables, whole grains, nuts and seeds and fish oils. Include multivitamins or other supplements after checking with your doctor.
2. Exercise: Regular exercise in any form increases the efficiency of the circulatory system, keeps the cholesterol levels in check and helps in blood pressure management. Exercise in any form is advisable, based on individual preference. A moderate physical activity of 30 to 45 minutes per day is advisable.
3. Smoking: This is one of the major risk factors for smoking, and quitting or controlling smoking is one of the best methods to prevent coronary artery disease.
4. Alcohol consumption: While moderate alcohol consumption is believed to be healthy for the heart, excessive alcohol consumption is a strict no-no. Binge drinking especially is shown to cause heart attacks.
5. Weight management: Check with your doctor on what is ideal BMI for you and work out a plan to keep your weight under check.
6. Regular medications: If you are on blood pressure or diabetes medications, ensure you do not miss them. Keep a constant check to ensure your readings are managed well.
7. Watch out: Ask your doctor if there are specific symptoms that you need to watch out and seek medical support if you see any of them.
Coronary disease is not treatable fully, but can be prevented and managed effectively to improve the overall quality of life. If you wish to discuss about any specific problem, you can consult a cardiologist.