Dr. Rajiv Agarwal

Atrial fibrillation is a condition that results in rapid heartbeat leading to heart failure, stroke, and other cardiac complications. In this condition, the upper valves of the heart beat irregularly. Some of the common symptoms of this condition include weakness, heart palpitations and shortness of breath. There could be several episodes of Atrial fibrillation. Although it is not life threatening, there could be serious complications owing to the nature of the condition. Atrial fibrillation can also lead to a condition known as the ischemia.

What are the different types of Atrial fibrillation?

1. Occasional- This condition is also known as paroxysmal fibrillation. Here the symptoms come and go. For few patients, the symptoms might stay for a few minutes, for others, it can stay up to hours before everything becomes normal again.
2. Persistent- The beat of the heart does not go back to normal. Medication along with electric shocks might be required to amend the condition.
3. Long-standing persistent- This is the kind of Atrial fibrillation that can last up to 12 months at stretch.
4. Permanent- This is the type where the erratic rhythm of the heartbeat can’t be restored. Long term medication is required to fix the condition.

What are the possible causes of Atrial fibrillation?
Some of the possible causes of Atrial fibrillation include Coronary artery disease, sleep apnea, viral infection, lung diseases, exposure to tobacco, caffeine, etc, metabolic imbalance, hyperactive thyroid gland, viral infections, congenital heart defects, stress due to illness, pneumonia and surgery, history of heart surgeries etc.

What are the risk factors for Atrial fibrillation?
Here are some of the common risk factors for this condition:

1. Age plays a critical role in any cardiac related disorder. The older a person is, the greater are the chances of Atrial fibrillation
2. High blood pressure along with unhealthy lifestyle can increase the risk of Atrial fibrillation
3. People with a history of obesity can get this disease
4. Chronic conditions such as kidney disease, metabolic syndrome, thyroid problems can lead to Atrial fibrillation
5. People with an existing heart condition such as heart problem, heart palpitation, valve failure, coronary artery disease etc have an increased risk of suffering from Atrial fibrillation.

How is Atrial fibrillation diagnosed?
A doctor might use one of the many tests or diagnostic technique that are available to diagnose this condition:

1. ECG- This is first but an important test to fathom whether there are any irregularities in the heart beat. The sensor presents in the ECG machine throws heart bit diagram in the form of graphs.
2. Echocardiogram- This is a technique wherein sound waves are passed through the heart and an image is taken to understand about any possible irregularities. This is a fine test that can readily detect underlying and structural heart diseases.
3. Blood tests- Blood tests can help to identify any thyroid irregularity or other condition that might lead to Atrial fibrillation.

Heart attacks often show some visible signs for concern. While many may not face the chest-clutching moment, there are other symptoms that are hard to miss. In fact, some heart attack symptoms are not even related to the chest. People suffering from cholesterol, diabetes, high blood pressure or above the age of 60 should especially be more careful about these symptoms.

Here is a list of few alarming signs and symptoms of a heart attack:

1. Discomfort in the chest: This is the most visible and common signs of a heart attack. A blocked artery can lead to a heart attack with symptoms such as tightness, pressure and intense pain in the chest. The discomfort typically last for a minute or longer. It must be kept in mind that a heart attack is entirely possible without feeling any pain whatsoever.
2. Heartburn, nausea, stomach pain and indigestion: Many people reportedly face these symptoms before a heart attack. It is more likely for a woman to face these symptoms compared to a man. These conditions can happen in isolation as well. But a combination of these symptoms to a person suffering from blood pressure, high cholesterol should be taken seriously.
3. The pain slowly shifts to the arm: This is another classic example of a heart attack. A symptom that starts from the left side of the body and radiates down. Even a constant and dull pain in the arm has resulted in heart attacks for many patients.
4. Feeling of light-headedness: A sudden feeling of lightheadedness along with an acute chest pain is a very good sign of a heart attack. This symptom necessarily indicates that the blood pressure of the person has suddenly decreased and the heart is not able to pump enough blood.
5. Jaw or throat pain: Jaw or throat pain by itself is nowhere related to the heart. Going by common beliefs, it can arise from sinus, muscular issue or simply a cold. Medical science states otherwise. If an ongoing chest pain spreads towards jaw or throat, it can well be an ensuing heart attack. Seeking immediate medical attention is necessary in such cases.
6. Snoring: Loud snoring that sounds like choking or grasping can be a sign of sleep apnea. This is a condition when an individual stop breathing for few seconds making the heart pump more blood. If the condition persists, a doctor might suggest doing a sleep pattern analysis using a CPAP machine to identify if there is any possible threat of a heart attack.
7. A persistent cough: A long lasting cough that produces pink mucus can be a very visible sign of a heart failure. This is the condition when the heart can’t keep pace with the demands of the body. This should be immediately reported to a doctor.

The heart is a wonderfully designed pump that takes care of proper functioning of the body. There are two separate channels, through which pure and impure blood flows through. Blood flow in these two designated networks is one-sided completely and controlled by valves. There are 2 sets of valves as below:

1. Aortic and pulmonary valves which controls blood flow from the ventricles to the aorta and to the lungs respectively
2. The mitral and tricuspid valves control blood flow from the atria (upper chambers) to the ventricles (lower chambers).

These valves are meant to be elastic and fibrous and open and close freely to allow for blood flow. Due to various reasons, they can become stenosed (hard and narrow) and depending on which valve is affected, complications arise accordingly.

The aortic valve is extremely important in that its proper functioning ensures that pure, oxygenated blood reaches various parts of the body. Due to various reasons, this valve may not open and/or close properly. Some causes include calcium deposits, advanced age, rheumatic fever, endocarditis, etc. With age or deposits, the valve opening can become narrow and reduce the amount of blood flowing into the aorta. The following symptoms and complications arise out of this.

1. The heart needs to put extra pressure to pump out blood into the aorta
2. The left ventricle therefore grows thicker
3. The symptoms will take a long time to manifest, as the heart will work on alternate measures, but after a certain point, symptoms will show up including chest pain, fatigue with minimal exertion, shortness of breath, and racing heartbeats.
4. As the heart has its own compensating mechanisms, symptoms show up when the condition is much serious. Therefore, onset of these symptoms requires immediate medical attention.

Diagnosis: This could be diagnosed with routine medical exam when the heart is being checked or it could only be diagnosed when the symptoms are seen as above. Treatment is easier in the earlier case, and requires more rigorous attention.

Management: If the stenosis is mild and was detected on routine exam, then it needs to be monitored periodically. Surgery is usually not done, unless it is very severe. However, preventive measures can be taken including

1. Avoiding over-exertion
2. Heart-healthy diet can be taken to prevent further damage
3. Reduce sodium intake
4. Quit smoking

If the stenosis is severe, then surgery is the only definitive treatment measure. Valve surgery can be either a

1. Balloon valvuloplasty – the valve opening is enlarged
2. Replacement – valve replacement is usually done as an open heart surgery.

Though aortic stenosis is a serious condition, it is also rare and can be managed by adopting an overall healthy lifestyle. In case you have a concern or query you can always consult an expert & get answers to your questions!

Namaskar!

I am Dr. Rajiv Agarwal. I am senior director of cardiology at the Max Smart Super Specialty Hospital in Saket New Delhi. I will be talking to you today about heart disease and its prevention. Koi shak nhi hai ki aaj ki tarik me hiredya rog no.1 killer gina jata hai. It is the most dreaded health problem today. It can strike people in the prime of life. Apparently healthy people can suddenly have a problem and har ek ko pta hai ki uske circle me kbhi na kbhi kisiko koi asmik aisa heart attack ho gya ya even nidhan ho gya, to islia har koi iske bare me chintit hai. To sawal ye uthta hai ki kya ye chiz hmari genes me hai. Agar hmari genes me hai to hum kuch kar nhi skte. Hum to kehte hain ki ye to hoga to hoga.

Dusra ye hai ki hmare bhagya me likha hua hai. Ye bhagwan ki den hai. It is an act of God. Lekin vaigyanik tathye ye kehte hain ki aaj ki date me 80% hirdya rog ko hum predict kar skte hain. Hum ankda lga skte hain ki hirdya rog hoga kin hi. Or sath sath simple tarikon se uchit Jeevan shaili se or simple treatment se hum hirdye rog ko rok bhi skte hain. Ye kewal me nhi kehta. Ye kayi anusandhan hue hain. Lot of investigation has been done. World health organization has a position statement on this saying that 80% of disorders like heart attack and stroke can be predicted and prevented by simple measures. So, this is something which is the duty of the medical community to communicate to the public at large. And it is but natural that public would follow if it is effectively communicated.

To hamara daitva hai ki hum apko btayen. Or aap apni jeewan shaili agar achi hai to usko or acha krne ki koshish kren or jo kamiyan hain usko dur kren. Abhi kuch ankade aye the ki hyadatar Hindustan me physical activity ka level bhut hi kam hai. To ye sari chizen hain jinpe humko goor krna hoga. To isko hum ek concept de skte hain jisko kehte hain life simple 7. Ye American Heart Association has started this moment. So, you need to answer 7 simple questions which do not require any special knowledge. And base on that you can predict you risk of heart disease and it tells you what to do to improve it. Not only heart attack but brain stroke, heart failure even cancer and depression are considered o be lifestyle related disorder. So, ye jo jeevan shaili se taluk rkhne vali jo bimariyan hain, non-communicable diseases, ye sari jo hain hum apni jeevan shaili k map dand se inko parkh k keh skte hain ki hum kis level par hain.

To isme sabse pehle point to apki physical activity ka aat hai. Are you physically active. If you are doing at least 15 mins of moderately vigorous activity everyday than you can give yourself 2 points. You are doing none than you can give yourself zero point. Next you can look at you diet. To aap healthy balance diet kha rhen hain ki nhi. Healthy balance diet ka mtlb bilkul fat free nhi hai. Isme apko sare food products lene hain. Khane me protein ki matra achi honi chaiye. Thoda bhut tel or ghee lekin dalda nhi. Sugar or nama ka sewan jhan tak ho apko kam krna hai. Quki ye apki risk ko badhate hain. Fruits, vegetables or nuts, ye sab apko lene hain. Fast food, samosa, kachori ye sab apko avoid krna hai. To aap healthy diet le rhen hain. Teesre apka vajan kaisa hai apki height k mutabik. Iske bhi kayi ankade hain. Isko hum body mass k index ke taur pe dekh skte hain. Apka blood pressure kaisa hai.

Ye to apko napna hi pdega. Apka blood sugar kaisa hai ye bhi napna pdega. Kayi logo ko pta bhi nhi hota ki unhe diabetes hai. Apka cholesterol kaisa hai. Aakhiri jo point hai or abhi tobacco diwas bi hua tha. Jisme btaya gya tha ki duniya bhar me 70 lakh logon ki mrityu har saal preventable mrityu ho rhi hai. To tobacco har rup se apke lia nuksan deh hai or jaan leva ho skta hai. Chahe vo heart disease se ho ya cancer se ho. To tobacco in every form, be it cigarette, be it biddi, gutka, kheni, paan masala or even the latest trend of e-cigarettes is all bad. These are to be avoided at all cost. So, with the 7 simple points, aap bhagya ko kosne ki bjaye aap bhut kuch kar skte hain. Apni life ki quality bhi achi rkhen usi se apki life aage badhti hai. Enjoy the journey which is called life.

Thank You!