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?
1. Stay calm. 
2. 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 hospital. 

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 loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder 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 Electrophysiologist 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 to 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 Electrophysiologist 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.

Palpitations - Everything You Need to Know

Congestive heart failure is a chronic progressive condition that affects the pumping power of your heart muscles. Simply referred to as heart failure, congestive heart failure can be life-threatening. It does not mean that the heart has stopped working. Rather, it means that the heart pumping power is weaker than normal. As a result, the heart cannot pump enough oxygen and nutrients to meet the body s needs. Over a period of time, the reduced ability of the heart causes the organs to receive less amount of oxygenated blood.

Signs and symptoms of congestive heart failure: In the early stages of congestive heart failure, you most likely won t notice any changes in your health. If your condition progresses, you will experience gradual changes in your body. The hallmark and the most common symptom of congestive heart failure is shortness of breath and it may occur while you are at rest, doing any activity that exerts your body, when you are lying flat or while getting up from sleep. Some of the other most common symptoms of congestive heart failure include a persistent and unexplained cough, swelling in the legs, ankles, abdomen, or hands, tiredness, changes in thinking and memory, nausea, rapid heart rate, and dizziness or light-headedness.

Causes of congestive heart failure: Congestive heart failure is most likely to occur in people who have other conditions that weaken the heart. The risk also increases by several lifestyle factors that are bad for the heart. Risk factors for congestive heart failure include congenital heart defects, high blood pressure or cholesterol, obesity, asthma, chronic pulmonary disease, coronary heart disease, heart infection, reduced kidney function, a history of heart attack, irregular heart rhythms, abuse of alcohol and drugs, smoking, and old age. Though there are over a hundred other less common causes of heart failure, the exact cause of congestive heart failure is often idiopathic or unknown. Congestive heart failure might also exacerbate by unhealthy lifestyle habits. Specific habits such as smoking, excessive use of alcohol, obesity, lack of exercise, high salt intake, noncompliance with medications, and other therapies may increase the risk of congestive heart failure.

Diagnosis of congestive heart failure: A doctor or cardiologist will perform a physical exam. This may involve listening to the heart for abnormal heart rhythm. Some common tests that are done to help with the diagnosis of congestive heart failure include an electrocardiogram, chest X-ray, series of blood tests, echocardiography, stress test, magnetic resonance imaging (MRI) and cardiac catheterization.

Treatment of congestive heart failure: The goal of treatment for congestive heart failure is to have the heart beat more efficiently so that it can meet the energy needs of the body. Specific treatment depends upon the underlying cause of heart failure. You and your doctor may consider different treatment, depending on your overall health and how far your condition has progressed. There are several medications that can be used to treat congestive heart failure. ACE inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cannot tolerate ACE inhibitors. Beta blockers can reduce blood pressure and slow a rapid heart rhythm. Diuretics reduce your body s fluid content. A surgery such as angioplasty is recommended if medications are not effective on their own.

Congestive Heart Failure - Signs & Symptoms You Must Not Ignore!

Hypertension or High Blood Pressure can trigger as well as worsen complications related to diabetes. Most people suffering from diabetes tend to develop hypertension later in their lives. Diabetes tends to increase one s blood pressure, making him/her even more vulnerable to other heart diseases and cardio-vascular disorders. Diabetes often leads to a condition known as atherosclerosis, which is the hardening of the arteries. A combination of diabetes and hypertension drastically increases the risk of suffering from a heart disease. The risks of kidney diseases and retinopathy (damage to the tiny blood vessels present in the retina) also go up, resulting in blindness. With age, chronic hypertension can also result in numerous cognitive disorders such as dementia or Alzheimer s disease (degenerative mental disorder).

How to prevent Diabetes and Hypertension?
1. Walking for about 40 minutes each day or engaging in any type of aerobic exercise can better one s heart health. Chalk out an exercise plan upon consulting the doctor
2. Limit drinking and abstain from smoking
3. Go for regular kidney check-ups
4. Eat food rich in fiber such as vegetables, fruits, breads or whole grain cereals
5. Examine blood pressure as well as blood sugar levels regularly at home
6. Practice relaxation techniques such as meditation or yoga to cut down on stress level; as stress is one of the major contributors to diabetes and the subsequent hypertension
7. Shed off your extra pounds as blood pressure escalates with weight

Hypertension and Diabetes - How They are Related?

Heart Care Tips For a Heart Patient

A heart patient has to always live with caution. This World Heart Day, let us understand what it takes to keep our heart in good health. In fact, by following certain rules, one can lead a smooth life despite being a heart patient.
The major risk factors of heart diseases are smoking, high blood pressure, diabetes, physical inactivity, obesity, and high cholesterol. In addition to these, there are factors which add to the heart condition. They are stress, alcohol, sleep apnea and C - reactive protein.

Food and exercise play a major role in the well-being of a heart patient. It is important to engage in exercises as prescribed by your heart specialist. Follow these dos and don’ts with respect to food.

Say YES To:

1. Poultry and fish for the requirement Omega 3 and Protein
2. Raw nuts, flax seeds, avocados, olive oil, fish oils etc which make up the body's need of healthy fats.
3. Fruits and vegetables for the body's nutrient needs.
4. Whole grains and legumes which provide energy and fiber to the body.
5. Protein and calcium which come from unsweetened yoghurt, egg whites, low-fat/non-fat cheese and skimmed or double toned milk.

Say NO To:

1. Fried foods, cakes and pastries, since they have trans-fats or other harmful fats.
2. Foods high in sodium and sugar, especially packaged goods.
3. Rice, pasta, white breads, sugary foods.
4. Sausage, bacon and red meat.
5. Full cream milk, whole milk cheese and sweetened yoghurt.

If you would like to consult with me privately, please click on 'Consult'.

 Heart Care In Your Hands: World Heart Day Special Tips

It is true that most people are aware of the fact that  angina  is a term which has something or the other to do with the heart. That being said, very few would be able to answer a question regarding what exactly it is, in a satisfactory manner. So would it not make sense to know more about it and become one of the few?

The term is derived from the ancient language of Latin and refers to a tightness that is felt or a squeezing of the chest. This happens when there is not enough oxygen-rich blood which is reaching the area of the heart muscle. While many people think that angina is a disease, it is actually not true to think that it is! As a matter of fact, it is a symptom of coronary artery disease. It is this disease which is the most common disease which affects the heart.

But why exactly does a person experience angina? Well, the lack of blood which is rich in oxygen occurs when it so happens that the coronary arteries become narrower than they normally should be. This generally happens due to the build-up of plaque. The condition in which this happens is known as atherosclerosis.

When it comes to the sort of people who are at a higher risk of developing angina, it can be said that those who smoke tobacco really do increase their risk, as do those who are overweight or obese and have other lifestyle diseases such as diabetes.

In order to avoid angina, the most important thing a person can possibly control is his or her lifestyle. In fact, a lot of the risk factors related to angina are attributable to the lifestyle a person chooses to lead. Cholesterol levels can be controlled if a person puts enough attention and effort in. Also, avoiding a lifestyle that is sedentary by exercise can not only help with cutting the risk of angina but also the risks of other conditions such as high blood pressure. It is ironic that high blood pressure is one of the potential signals of angina!

It is to be noted that while most people just call angina as it is, there are various types-

Stable angina is when the heart is working harder than usual and medicine helps improve this.

Unstable angina occurs even at rest and is unpredictable. It may also be a signal of a coming heart attack.

Variant and microvascular angina is relievable by medicine and is generally rare.

What Is Angina?

The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease. 

Causes of increased blood pressure: 

Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN) 
Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN. 
Other Causes of secondary hypertension are: 

Kidney problems 
Thyroid hormone disorders 
Congenital heart defects 
Chronic alcohol abuse 
Adrenal gland tumours 
Chronic use of medications like birth control pills, pain killers, etc. 
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are: 

Age 
Family history 
Being obese or overweight 
Sedentary lifestyle 
Smoking 
Alcohol consumption 
Excessive salt intake 
Stress levels 
Ethnic background 
Symptoms: 

Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure. 
Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken. 
If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings. 
Management: 

This includes a combination of diet and lifestyle modifications. 

Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements. 
Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously. 
Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting

High Blood Pressure - All You Need To Know About It!

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