Hello Friends! I am Dr. Anupam Goel. I am a senior interventional cardiologist in Max Hospital, Saket, Delhi.
Today we will discuss a very important issue, I am not sure how best you can see this slide, this is just to say that the heart attack complains increase day by day and unfortunately it is affecting young people. By an estimate of WHO, in next 2 years means by the year 2020, in India, we will have maximum patients of hypertension, diabetes and heart disease. So, we are going to face an epidemic of heart disease. So, I just tell you how the heart disease happens. Normally, our heart arteries are very narrow smooth whole tubes structure. But all the year because of disease and cholesterol deposition the blockage happens and the channel for blood carrying, keeps on reducing. So, what exactly happens is less and less blood reaches the heart and heart is not even getting enough blood for its routine functioning. When this blood supply is interrupted that is when the heart attack happens because those cells of the heart don't get any blood. Suddenly and repeatedly, these holes will never be going to function again.
More important than heart attack itself because of awareness not many of us know about heart disease in women. Whenever we think of heart disease, we think about male but unfortunately, as we have more data, the heart diseases in men are reducing.
This is the data from the United State not from our on the country. Because of ignorance or prognosis, societies not aware of heart disease in women, the death in women are increasing because of heart disease. When we see the causes of death in women, cancers are a very important part but much more than that heart and circulatory disorders are the biggest reason any women will die. So, what we have is, heart disease is the no.1 killer in women. And heart disease causes 1 in every 3 deaths in women. Every 3rd one is dying because of heart disease. 90% of women are at the risk of developing heart disease but they are not aware of it. It suddenly affects them and causes the bad prognosis. Let's bust some myths. Most of us believe that the heart disease is of men. But heart disease can affect both men and women, in fact, 50k women in a year die because of heart disease.
The women die because of heart diseases as compared to all the cancers combined together. And because of under-diagnosis and treatment, even the doctors are less aware of it, women face more adverse outcome. And why would it happen? Because none of us relate to heart disease to women. So, they come to an emergency late. they keep on thinking that it could be gastritis or something else and they are busy taking care of each other. And it could also be because the heart disease presents differently in women.
In a man classical signs, you would all know. The heart attack would present as a heaviness or like an elephant sitting on the chest. But in women, it can very vague. They will be like not feeling well, palpitation and just unwell. It can't be just simple chest pain. So, most of the women just confused about their heart attack presentation and would be late in getting treatment. the good thing is 80-90% heart diseases are preventable. So, if we are aware, we are able to take care of the risk factors. There is a large proportion of heart disease which we can prevent.
So, we will discuss some important risk factors which can take care of to prevent disease. Some risk factors are non-modifiable. Like the family history of heart disease. if there is the strong history of heart disease and in one genetics than one is likely to have heart problems. So, it is advancing age. But there are a few risk factors which we can control. Like high blood pressure, high cholesterol, high sugar, smoking, more weight and some newer risk factors like CRP level and clotting factors. few of these which are relevant, diabetes, 2/3 of all diabetics will die of heart disease eventually.
Risk of having a heart problem in women, if she is diabetic as compared to the women who are non-diabetic and in men also, the risk of heart disease increases 3 times, if they are diabetic. So, diabetics have to be more conscious about their heart conditions. Than smoking. Smoking is one single most preventable risk factor which is responsible for heart disease. It is relevant in both male and female. Especially, a young woman who smokes is at the very high risk of heart disease. And if somebody is on oral contraceptive because of their age or anything, the risk of heart disease is compounded with smoking.
So, what smoking does, it causes the plaque. The cholesterol deposits the arteries to burst. They form a clot and causes a heart attack suddenly. it reduces good cholesterol. It gets burned by smoking which causes one to have more heart attack. And smokers who have a heart attack, they are more likely to die young. When one quite smoking, then the risk of developing a heart attack comes to 1/3 in the next 2 years. But you know, it takes almost 10-15 years for the risk to come back to normal as compared to somebody who has never smoked.
So, I request everybody to quit smoking. 3rd is physical inactivity. So, inactivity is a very important factor in our Indian culture to cause a heart attack. We should all exercise not because it burns calories and helps in weight loss but it increases good cholesterol. It helps us in keeping our heart healthy. One should try to stay active physically. Just get up in the morning and walk. Walking is a good exercise which will help you in preventing heart disease. One more important factor is obesity, BMI. if the BMI is less than 25% is normal.
Beyond that, it becomes overweight and predisposes one would have more and more heart attack. Heart attack increases almost 6 times as compared to a normal weight person in those persons who are very heavyweight. So, we should all be very careful about our own body weight. Till very recently we didn't know that women are at the highest risk of heart disease. Thanks to research and data which we have. Now we know women are more likely to have heart disease. The disease starts in early childhood. It is a gradual process. Small changes in our lifestyle can make a big difference. We all need to prevent it. So, we all should start with lifestyle changes but if one has risk factors, it is a good idea to see your doctor at earliest. I am with Max Hospital, Saket. If anybody needs any help for their heart health, please don't hesitate. You can contact me and come and see me.
Thank you so much. Take care of your health and your heart.read more
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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? Deposition of LDL cholesterol (low density cholesterol) in inner surface of coronary arteries is the primary reason of these blockages. 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.
A heart attack allows you to 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:
1. 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 to your medication routine. Your existing dosages may be adjusted and you'll possibly 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. Its best you know exactly why are taking each of them, if there are other more economic alternatives since this may last a lifetime and what side effects they may have.
2. 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.
3. Go for 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 benefit from exercises that'll be taught by a certified exercise specialist.
4. Making lifestyle changes
Quitting smoking 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, behavioural scientists suggest that you need to practice a new activity continuously for twenty one days for it to become a habit.
Am 78 years old female ,case of hypertensive and diabetes mellitus ,I am taking cardace h 5mgm morning And nebistar 5 MGM in night ,BP is normal. I am having allergic cough and spitting of yellow sputum ,my question is why am having such cough, is that due to the Cardace h tablet ?plz answer my question ,thank you.
Sir I'm 42 years old male. I'm a patient of hypertension. My BP range 150/95 I'm working with a MNC company where I have dinner shift duty Please advise me a treatment and how can I handle this Rajeev.
My age 47 yr. Old. Last few days I am suffering from chest pain during walking in the morning in the midday it is normal. I have checked total cholesterol -177, blood sugar-101, uric acid -7.9.i am taking medicine tazloc beta, ecosprin gold after the heart stroke since 2008. Please Suggest me what can I do. For better health. Regularly exercise, walking I am doing.
We are all aware that the incidence of heart disease is increasing in India. Generally, the average age of heart patients in India is a decade younger, that means there are younger patients suffering from heart disease in India.