Dr. Anil Dhall, a renowned cardiologist is at present associated with the Sarvodaya Hospital and Research Center at Faridabad. An alumnus of the Armed Forces Medical College, Pune, he pursued his M.D from INHS Ashvini, Mumbai. Then, he went on to pursue DM in Cardiology from GB Pant Hospital, Delhi.
Dr. Dhall had spent 25 years with the Indian Armed Forces before he opted for voluntary retirement. He has successfully established, set up and managed the Interventional Cardiology program and has also started the first Cardiac Catheterisation Laboratory of Army Hospital (Research & Referral), Delhi Cantonment. He has been awarded the Sena medal by the President of India and has been deputed with the United Nations Organisation.
Dr. Dhall?s special interests include Carotid Angioplasty, Complex Coronary Interventions, Peripheral Interventions, Endovascular Aortic Aneurysm Repair, and Cardiac Resynchronisation Therapy. He has a professional membership with several bodies like American Heart Association, Vascular Society of India, Indian Heart Rhythm Society, Indian Academy of Echocardiography, Cardiological Society of India, Association of Physicians of India and many others. A successful cardiologist for the last 34 years, he has also taught and demonstrated various techniques related to his field in various parts of the world.
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Treatment of Hip Disorders
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Cardiac Ablation Procedure
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Carotid Angioplasty And Stenting Procedure
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Implantable Cardioverter-Defibrillators (Icds) Tre
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Even though I was fit and fine, it was shocked when I got to know that I need pacemaker. The lab in the Dr Anil Dhall's Clinic was very clean and well managed. In the past i consulted so many doctors, but nobody was able to help me with my issue, but he has helped me immensely. His treatment suited me the best and now I am fine. With great ease Anil Dhall explained us the problem and how the treatment will be carried out.
I was panicked, because I never thought my mother will suffer from stroke like this. I took my mother to Dr Anil, he has broad knowledge in the field of cardiology. He is so pleasant to talk to and always ready to answer your doubts. So many doctors I consulted, but his treatment was the best. I am glad that we consulted him as my mom's condition has improved to great extent after his treatment.
It's been more than 2 months that I was experiencing thyroid disorder which highly increased my cholestrol level. I consulted Dr Anil, he has broad knowledge in the field of cardiology. The treatment he gave was very effective,. I owe him a big thanks for helping me maintain my cholestrol level.
Maine ek saal pehle dr Anil Dhall se asthma ka treatment liya tha .Itna accha mujhe kabhi mehsus nahn hua unki ki medicine ne to mujhe ekdum theek kar diya. I am very thankful to him and unke staff to ko bhi Dr Anil Dhall's Clinic Gurgaon mei
dr Anil Dhall did my angiography at Dr Anil Dhall's Clinic in Gurgaon His results are amazing and I highly recommend him. He is a very good doctor.
Dr Anil Dhall is an excellent cardiologist. He always focus on preventive cardiology and his advices are commendable.
Heart attack or myocardial infarction mostly occurs when the flow of blood to the heart is blocked due to one or more reasons. The most prominent reason could be high fat or cholesterol that results in plaque build up in the coronary artery. The restricted blood flow has the potential to damage or even destroy the heart muscle. Some of the symptoms that can be helpful when it comes to the identification of a heart attack are listed below.
1. Discomfort in the Chest - Your chest may feel tight and pressured when you are about to be hit by a heart attack. Pain or discomfort in the chest is usually central typically felt behind the sternum, the central bone of chest. It may not be pain, it may be only discomfort, it may only be in upper part of tummy, very commonly confused with a gas problem. It is often accompanied by a painful sensation in the chest or arms. If a chest pain lasts more than 15-20 min it can be assumed to be a heart attack. This aching sensation may even spread to your back, neck or jaw.
2. Feeling of inconvenience - Often before the heart attack, the person may have feelings of nausea, ingestion, abdominal pain or a heartburn.
3. Breathing problems - Another prominent symptom of heart attack is shortness of breath which is accompanied by cold sweat and fatigue.
If you think you are getting a heart attack, you should immediately take one tablet of Aspirin, 4 tablets of a drug called Clopidogrel, and one tablet of Atorvastatin 80 mg and rush to the nearest possible medical facility as time is very important in the treatment of an acute heart attack.
Palpitations is the feeling that you experience when your heart beats abnormally. Heart palpitations can be felt in the form of rapid, fluttering or pounding heartbeats. They can be frightening as when you palpate, you heart beats so hard that it even skips a beat and the sensations are so strong that they can be felt all through your chest, neck, and throat.
Palpitations are also common especially in young people because of abnormal electrical circuits in heart from birth. However, they may have normal hearts on Echo. Such palpitations are curable by a nonsurgical methods called Radiofrequency Ablation.
Palpitations can be triggered as a result of a number of reasons like stress, certain medications, exercise etc.
Here are a few prominent causes of heart palpitations.
Causes unrelated to the Heart -
- Anxiety, fear, and stress
- Consumption of alcohol and drugs like caffeine, nicotine etc.
- Consumption of street drugs likes cocaine, amphetamines etc.
- Certain medical conditions such as thyroid, anemia, dehydration, low blood pressure and low sugar levels etc.
- Hormonal changes that occur as a result of menstruation, pregnancy, menopause etc.
- Certain nutritional and herbal supplements
- Certain medications like asthma inhalers, diet pills etc.
- Abnormal levels of electrolyte
- Sensitivity to certain food items like some carbohydrates
Causes related to the Heart -
- Coronary artery disease
- Prior instances of heart attack
- Congestive heart failure (a condition wherein your heart's chambers get affected)
- Problems associated with the heart valves or the heart muscles
Immediate Relief Mechanisms-
It is crucial to go to the most easily available doctor to get an ECG done during palpitations as ECG will give an exact diagnosis, which helps in identifying the clear line of treatment.
Here are a few techniques that can help you in getting immediate relief from heart palpitations until you are able to visit a doctor in case of a serious condition.
- Cough it out
- Splash cold water on your face or take a cold shower
- Practice slow, deep breathing exercises
Atrial fibrillation is a form of irregular heartbeat or arrhythmia, which you may experience due to a problem in the electrical system of the heart. Such a problem causes the upper parts of the heart or the atria to fibrillate. Due to this quivering, the normal rhythm between the lower parts of the heart and the atria gets disrupted. The ventricles are likely to beat faster in an irregular rhythm. This is a severe condition where the blood may get collected in the atria; this could lead to the formation of blood clots. These clots can block the blood flow and lead to a stroke.
Several conditions cause strain and damage to the heart. These include the following:
- High blood pressure or hypertension
- Heart attack
- Valvular diseases
- Coronary artery disease
- Medical problems like heart failure, lung diseases, high level of thyroid or pneumonia
- Heart surgeries
- Excess consumption of alcohol
The primary symptoms of atrial fibrillation include the following:
- Light-headedness and dizziness
- Shortness of breath
- Feeling weak and fatigued
- Feeling as if the heart is pounding, fluttering or racing (known as palpitations)
- Feeling that the beating of the heart is uneven
- Chest pain and fainting
In many cases of atrial fibrillation, the symptoms may be absent.
Conducting several tests, physical examinations and an analysis of your health history is the first step towards diagnosing atrial fibrillation. An electrocardiogram (ECG) needs to be carried out for the detection of this condition. This test is performed for checking problems regarding the electrical activity of the heart. Other laboratory tests and an echocardiogram maybe required as well. An echocardiogram helps in observing the pumping function of the heart and to check whether the valves have been damaged.
The treatment options for atrial fibrillation depend on the cause, symptoms and the risks of getting a stroke. Several medicines are used for treatment along with other methods. They are as follows:
- Blood thinning medicines for the prevention of a stroke.
- Heart rate control medicines which will prevent irregular beating of the heart.
- Rhythm control medicines for restoring the heart’s rhythm to normal.
- A process known as cardioversion may be used to bring the heartbeat to a normal rhythm. This can be carried out by medicines or an electric shock therapy known as electrical cardioversion.
- In case of severe symptoms, ablation may be carried out where the affected areas of the heart are destroyed by the creation of a scar tissue.
With the increasing prevalence of diabetes, it is being considered as the next big epidemic – completely related to lifestyle. India has become the diabetes capital of the world with increasing prevalence. The age of onset of diabetes is reducing, with children having diabetes and requiring insulin. The complications arising out of diabetes are also more – there is no bodily system which is not affected by diabetes. For someone who is diabetic, keeping blood sugars under check is the constant challenge. Uncontrolled blood sugars can lead to transient complications including loss of consciousness and fatigue and long-term complications including neuropathy and retinopathy.
What is CGMS:
Continuous glucose monitoring system is an FDA approved device. This device has a sensor that is placed either in the belly area or on the arm. These sensors identify the sugar levels in the body fluid and send it to a wireless which is worn by the monitor patient as a belt. Readings can be obtained at regular intervals, ranging from every 5 to 15 minutes.
CGMS measures blood sugar levels every 15 mins, that is 96 times a day The data can be downloaded into a persona device – smartphone, tablet, or laptop and used for further analysis. It does not replace the need for routine monitoring, but helps improve vigilance with a constant monitoring. It can help detect trends and patterns and helps the doctor identify periods of the day when the sugars are too high or too low. The amount of insulin or antidiabetic medication required can be adjusted based on sugar levels. The exercise regimen can be defined including the type, time, and duration of workout. Meal planning can be customized to suit body needs in a better manner. Night-time sugar lows which often go undetected can be monitored with the alarm Highs or low between meals (especially with snacking) can be tracked Determine treatment efficacy. The biggest advantage of CGM devices is that they provide information on what is happening to your blood glucose level every few minutes.
CGMS measures blood sugar levels every 15 mins, that is 96 times a day. The newest devices display glucose readings on a screen so you can see – in real time - whether glucose levels are rising or falling. Some systems also contain an alarm to let you know when your glucose reaches high or low levels. Some devices are able to display graphs revealing glucose levels collected over a certain number of hours on its display screen. The data collected on all devices can be uploaded to a computer for graphing and further important trend analysis.
Whom is it for?
If you think this is a great way to constantly watch your sugars, it is not required. The following people would benefit from this. People with insulin pump usage Those who have frequent fluctuations in sugar level, which is not clearly explained Those who are not aware of low sugars, and may have problems with fatigue or loss of consciousness Gestational diabetes.
Continuous glucose monitoring systems (CGMS) may not make life with diabetes any easier. But they can definitely improve health, if you can deal with the hassle and expense. So how do you know if such a system is right for you? You can easily and discreetly view your current glucose values continuously throughout the day, without having to do a finger stick. It’s easy and discreet. The monitors have “trend arrows” that show you if your level is rising or falling quickly, so you can prevent highs and lows.
Continuous glucose monitoring can help “identify fluctuations and trends that would otherwise go unnoticed with standard HbA1c tests and intermittent fingerstick measurements. The device can capture dangerously low overnight blood sugar levels which often go undetected, reveal high blood sugar levels between meals, show early morning spikes in blood sugar, evaluate how diet and exercise affect blood sugars, and provide up to a 72-hour complete review of the effects of changes made to your therapy by your health-care team.
If you are a dedicated investigator, you can use CGMS to understand what’s happening with your blood sugar levels.
In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart.
When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.
This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.
Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.
Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.
Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches – lifestyle changes, medications, and surgery.
- Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
- Medications: A number of medications would be used depending on patient’s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
- Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.
In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.
Angina or angina pectoris is the pain, discomfort or tightness in the chest that occurs when the blood flow to the heart muscle cells is not enough to meet its energy needs. It is not a disease itself but rather a symptom of the coronary heart disease.
What are the different types of angina?
1. Stable angina: It is the commonest form of angina. It can be triggered by stress or physical activity and usually only lasts a few minutes.
2. Unstable angina: It happens when you're resting or aren't very active. The pain is strong and long lasting, and may keep recurring. It may be a signal of an impending heart attack.
3. Variant angina: This might take place when you're asleep or at rest. This sudden tightening or narrowing of the heart's arteries causes a lot of pain.
How u know what your are experiencing is an angina pain?
You might be having angina pain if you suffer from one or more of these symptoms:
- Chest pain
- Pain in your arm, neck, jaw and back
- Numbness or loss of feeling in your arms, shoulders or wrists
Immediate Relief from Angina
If previously advised by a certified doctor, patients can take antiplatelet medicines which are blood thinners and prevent unstable angina. Final treatments include angioplasty (repair of a blocked blood vessel through surgery), insertion of a coronary artery stent (a tube that is used to treat weakened arteries) or a heart bypass surgery for serious complications. If you wish to discuss about any specific problem, you can consult a Cardiologist.
A heart attack does not always have obvious symptoms, such as pain in your chest, shortness of breath and cold sweats. In fact, a heart attack can actually happen without a person knowing it. This condition is known as a ‘silent heart attack’, medically known as ‘silent ischemia’, occurring due to the shortage of oxygen supply to the heart muscle. The causes of a silent heart attack are similar to that of a heart attack.
- Conditions like:
- Lack of exercise
- Age, usually above 65
- Consumption of tobacco or smoking
- High consumption of alcohol
A silent cardiac arrest makes one more vulnerable to another heart attack that could be fatal. Diagnosis: The only method to diagnose if you had a silent heart attack is through imaging tests, such as echocardiogram, electrocardiogram, Holter Monitoring or others. These tests can show certain changes which might be indicative of a heart attack. An analysis of one’s overall health and the symptoms can aid in deciding whether few more tests are required.
How would you prevent a silent heart attack?
1. Get your cholesterol and blood pressure count tested regularly.
2. Refrain from smoking.
3. Get your VO2 max checked regularly.
4. Live a healthy lifestyle: Refrain from smoking and excessive alcohol consumption; exercise daily, eat healthy.
5. Control high blood pressure, cholesterol, and diabetes
6. Be aware of your body and call on a doctor if you feel there’s anything which is bothering you.
Are you experiencing irregular and fluctuating heartbeats? Is your heartbeat too fast or too slow? If yes, then it signifies that you are suffering from arrhythmias or abnormal heart rhythms. This is a disorder which affects the heart rate or heart rhythm and the heartbeat becomes irregular.
Causes of abnormal heart rhythms
Arrhythmias occurs due to problems with the electrical conduction system of the heart. In this case, abnormal signals might occur; the electrical signals might get blocked or slowed down, or the electric signals may travel in different paths throughout the heart. Abnormal heartbeats are commonly caused by the following:
- Abnormal potassium levels in the body
- Heart attacks or due to a damaged heart muscle, owing to a previous heart attack
- Inborn heart diseases
- Cases of an enlarged heart and heart failure
- Overreaction of the thyroid gland
- Several other substances or medicines may lead to arrhythmias, such as alcohol, stimulant drugs, caffeine, nicotine, and antidepressant medicines or blood pressure medicines.
Common symptoms of this condition apart from irregular heartbeat patterns include chest pain, fainting, dizziness and light-headedness, trouble in breathing and paleness.
Diagnosis of abnormal heart rhythms
For the diagnosis of arrhythmias, your doctor will use a stethoscope to listen to your heartbeat. Several health monitoring devices are used to detect abnormal heart rhythms. These include the Holter monitor and the event monitor, or a loop recorder.
Other diagnosis tests which are required to be carried out include coronary angiography, ECG or electrocardiogram, and an echocardiogram. A test known as an electrophysiology can be undertaken for getting a closer look at the electrical system of the heart.
Treatment for abnormal heart rhythms
When a case of arrhythmias is severe, urgent treatment is required for restoring the heart’s rhythm to normal. The different forms of treatment are as follows:
- Electrical shock therapy such as defibrillation or cardioversion
- Implanting of a heart pacemaker for a short term
- Certain medications which are given through the veins or orally
- A group of medicines known as anti-arrhythmic drugs is used for the prevention of recurrence of the condition and to keep the heart rate from fluctuating continually.
- Cardiac ablation may be carried out for destroying some areas in the heart from where the rhythm problems are caused.
- An implantable cardiac defibrillator is used in people who are at a risk of facing cardiac death.
In case you experience abnormal heart rhythm, you must consult a doctor immediately. You should only start taking medicines and follow a treatment after it has been recommended by a doctor.
Lifestyle is one of the best defences against heart disease. All you need to do to maintain good heart health is to just make simple but significant changes to your lifestyle. By doing so, you end up minimising the risk factors associated with heart disease such as coronary artery disease.
The lifestyle changes that you must make for a healthy heart are:
1. Be physically active - Research by Harvard University shows that watching television for 2 hours a day can increase your chances of developing heart disease by 15%. But if you exercise or indulge in some kind of physical activity for about 30 minutes every day, you can significantly improve the health of your heart as any kind of physical activity improves your blood circulation as well as blood pressure.
2. Maintain a healthy body weight - Having a low body weight or a high one can also put you at risk of getting heart disease. For a good heart health, you need to protect it from fatigue and damage. By keeping your weight at an optimum level, your blood circulation, as well as body fluids, end up working efficiently, protecting your heart from unnecessary strain.
3. Have a balanced diet - Foods that are low in calories but high in fibre and nutrients are what your heart needs to stay healthy. A very common cause of heart disease is the consumption of high cholesterol foods like processed meats, desserts, etc. Including seafood like tuna or salmon, whole grains, fruits and vegetables, and lean proteins such as chicken and fish to your diet can reduce your risk of developing heart disease.
4. Manage stress - Stress is another factor that causes you to have poor heart health. To prevent the damaging effect that stress can have on your heart, exercising is what you should do. This is because when you exercise, you release endorphins (brain chemicals that trigger a feel-good feeling in your body), which help in improving your physical and mental makeup. Additionally, exercising has also been found to reduce your chances of dying from a heart attack.
5. Quit smoking - Research reveals that smoking raises your chance of getting heart disease by about 2-4 times. It causes plaque (fatty deposits) to accumulate and harden in your arteries, making your heart to exert itself harder than normal. By kicking the habit, you reduce the strain that is caused to your lungs, thereby to your heart. If you wish to discuss about any specific problem, you can consult a Cardiologist.
A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.
While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.
When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.
Why it's done
Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by several conditions, including:
- A weakening of the heart muscle (cardiomyopathy)
- Coronary artery disease
- Heart valve disease
- A heart problem you're born with (congenital heart defect)
- Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
- Failure of a previous heart transplant
- In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.
Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include:
- Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
- Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
- Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.
Factors that may affect your eligibility for a heart transplant
A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:
- Are an advanced age that would interfere with the ability to recover from transplant surgery
- Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
- Have an active infection
- Have a recent personal medical history of cancer
- Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking
What happens after the transplant?
Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.
In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.
Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.
Once you feel fit and able, you can start doing things like light vacuuming or light gardening. If you wish to discuss about any specific problem, you can consult a Cardiologist.