Doctors in Maxcure Hospitals
Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.
What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.
Primary symptoms may include
- Shortness of breath: This may occur while you are exercising or performing activities which are mildly exerting.
- Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
- Angina or chest pain: You may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
- Heart attack: Heart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:
- Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
- Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
- Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery. In case you have a concern or query you can always consult an expert & get answers to your questions!
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:
- Family history
- Being obese or overweight
- Sedentary lifestyle
- Alcohol consumption
- Excessive salt intake
- Stress levels
- Ethnic background
- 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.
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
In case you have a concern or query you can always consult an expert & get answers to your questions!
The treatment of heart disease has come a long way and one of the more important and fairly common devices used to correct rhythmic problems of the heart is a pacemaker. A pacemaker is a device which is put inside the chest or sometimes even the abdomen to send electrical pulses to the heart to keep it beating at a normal rate.
Pacemaker for heart failure
However, the implications in case of heart failure make the usage of the pacemaker much more complicated. In such cases, the device used is a special type of pacemaker which is also called a bi-ventricular pacemaker. This device sends electrical signals to pump the ventricles of the heart so that they can pump at the same time.
There are many factors to be aware of before undergoing this treatment. Some of the factors to consider are mentioned below.
- Requirement for a pacemaker in case of heart failure - When a patient has heart failure, their ventricles or lower chambers of the heart aren't able to pump enough blood into it. This could be due to physical problems with the heart or problems with the electrical system within it which cannot function normally. The doctor will perform multiple tests to determine whether a patient is the right candidate for a pacemaker for heart failure.
- The procedure - In most cases the device is fitted into the chest and it is done without an open heart surgery. Precautions and post operative care for a minor surgery should be followed. The doctor makes a minor incision on the chest and then inserts the device along with three leads which are connected to the ventricles to ensure they keep pumping properly. Sometimes another device known as the ICD or the implantable cardioverter-defibrillator may be put in to shock the heart back to a normal rhythm in extreme cases where the change of sudden death from high heart rate is a possibility.
- Immediate post operative care - As mentioned above, the surgery involved in putting a pacemaker is a minor one and the patient is usually discharged in next 2-3 days or may be more depending on the comorbidities & complexity of the scenario. However, in most cases, people can go home the next day fairly easily although some monitoring is done for the next few days with daily reporting.
In case you have a concern or query you can always consult an expert & get answers to your questions!
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.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Cardiomyopathy includes diseases involving the heart muscle. These diseases have various causes, types, symptoms and modes of treatment.
The heart muscle gets enlarged, thick or rigid. In several cases, the heart muscle tissue is replaced with a scar tissue. As this condition worsens, the heart gets weaker and the ability to pump blood is disrupted, which can cause heart failure or irregular beating of the heart. The weakened state of the heart can lead to valvar diseases.
The different types of cardiomyopathy are:
- Hypertrophic Cardiomyopathy: This is a common form and affects people of all ages. Men and women are affected equally. This condition arises due to the enlargement and thickening of the heart muscle. The ventricles, the septum and the lower heart chamber usually thicken, which causes obstruction in pumping of blood by the heart. This disease also causes stiffness in the ventricles, and cellular changes in the tissue.
- Dilated Cardiomyopathy: This form of cardiomyopathy develops due to the enlargement and weakening of the ventricles. The issue arises from the left ventricle and develops over time. It may even affect the right ventricle. More effort is put in by the heart muscles for pumping blood and slowly the heart is unable to pump blood effectively. This condition may lead to heart failure, valve diseases or blood clots in the heart.
- Restrictive Cardiomyopathy: This disease occurs due to the stiffening of the ventricles, without thickening of the walls of the heart. The ventricles are not allowed to relax and do not receive a sufficient volume of blood supply. This condition causes heart failure and valvar problems over time.
- Arrhythmogenic Right Ventricular Dysplasia: This rare form of cardiomyopathy occurs when fat or fibrous tissues replace the muscle tissue of the right ventricle. This causes arrhythmias and disruption in the electrical signals of the heart. It generally affects teens and may cause cardiac arrest in athletes.
- Unclassified Cardiomyopathy: Some types of cardiomyopathy of this category include left ventricular non compaction where the ventricles develop trabeculations. Takotsubo cardiomyopathy is another disease where immense stress causes failure of the heart muscles.
Treatment: Many cases of cardiomyopathy come and go away on their own. Treatment for other cases depends on the severity and symptoms. The major treatment methods are:
Lifestyle changes meant for a healthier heart.
- Nonsurgical methods.
- Surgery and implants
Modes of surgery for treatment of cardiomyopathy include:
- Septal myectomy
- Heart transplant
Implant devices such as Cardiac resynchronization therapy (CRT) device, Implantable cardioverter defibrillator (ICD), Left ventricular assist device and pacemakers are fitted into the heart for better performance.
Cardiomyopathy can be of many different types, each arising from different situations and conditions. The mode of treatment depends on the severity of the complication or on the basis of symptoms. In case you have a concern or query you can always consult an expert & get answers to your questions!
Cholesterol is one of those terminologies that need a clear and fresh understanding, right from scratch. It is nothing but obvious and common for you to primarily know about the ill effects of cholesterol and what it does to your body; from increasing the risks of cardio-vascular diseases to adding to your waistline. However, it is time we all got a fresh perspective on what cholesterol is.
So, to start off, what is actually cholesterol?
It is waxy substance produced by the liver which plays an important role in the proper functioning of the cells, digestive process and synthesis of Vitamin D in the body. As cholesterol is a fat based substance that does not dissolve in blood, it is transported, throughout the body, by a protein called the ‘lipoprotein’. The lipoproteins that carry cholesterol are of two types: Low-Density
Lipoprotein (LDL) and High Density Lipoprotein (HDL)
Why is LDL ‘bad’?
LDL is known as ‘bad’ cholesterol as it is responsible for plaque formation that reduces flexibility of the arteries and tends to clog them.
Why is HDL ‘good’?
HDL is known as the ‘good’ cholesterol because it gets rid of excessive LDL from the arteries and transports them to the liver where they can be broken down. Too much of bad cholesterol in the body can lead to clogged arteries that may result in stroke or a heart attack. Now that you know that too much LDL cholesterol is bad for you, you need to keep it under control while raising the good cholesterol (HDL) levels.
In order to do that, you need to make certain modifications in your lifestyle.
Some of them can be:
- Eat foods that are good for the heart: Avoid eating saturated fats and trans-fats as they raise LDL levels in the body. Instead, choose foods that are rich in the heart healthy monounsaturated fats such as almonds and olive oil. Also, include foods that are rich in Omega-3 fatty acids such as fish oil; these fatty acids increase HDL levels in the blood.
- Exercise regularly: Exercise not only helps you to lose calories but also increases the good cholesterol levels in the body. Aim for 20-30 minutes of cardiovascular exercises in the form of brisk walking, running or cycling to keep your heart muscles healthy.
- Stop smoking: Smoking can cause the blood vessels to narrow down, thus increasing blood pressure, owing to the constriction of the blood vessels. Quit smoking right away and your ticker will thank you for it. Remember to limit alcohol consumption as well.
- Maintain optimal weight levels: It’s time to get rid of all the excess fat from the body, especially the visceral fat (abdominal fat). Obesity increases the risk of heart diseases and also has a negative effect on the cholesterol levels.
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.
Having bradycardia implies that your heart beats very slowly. For the vast majority, a heart beats from sixty to hundred pulses a minute while very few are viewed as ordinary. In case your heart beats under sixty times each minute, it is slower than usual. A moderate heart rate can be ordinary and solid. On the other hand it could be an indication of an issue with the heart's electrical framework.
For a few people, moderate heart rate does not create any issues. It can be an indication of being exceptionally fit. Sound youthful grown-ups and sports persons frequently have heart rates of fewer than sixty beats a minute. In other individuals, bradycardia is an indication of an issue with the heart's electrical framework. It implies that the heart's regular pacemaker isn't working right or that the electrical pathways of the heart are disturbed.
A moderate heart rate may make you:
- Feel blurry eyed or woozy.
- Feel short of breath and feel that it’s harder to work out.
- Feel tired.
- Have neck pain or an inclination that your heart is beating or rippling (palpitations).
- Feel bewildered or experience difficulty concentrating.
- Black out, if a moderate heart rate causes a drop in pulse.
A few people do not have side effects, or their indications are mild to the point that they think they are quite recently part of getting more seasoned. You can discover how quick your heart is beating by checking your heart rate. In case your pulse is moderate or uneven, talk to a specialist.
How bradycardia is dealt with depends on what is causing it. Treatment likewise relies on symptoms. Given below are some of the symptoms:
- In case harm to the heart's electrical framework causes your heart to pulsate too quickly, you will presumably need a pacemaker. A pacemaker is a gadget put under your skin that revises the moderate heart rate. Some people might have a kind of bradycardia that requires a pacemaker.
- In case another medical issue, for example, hypothyroidism or an electrolyte irregularity, is bringing about a moderate heart rate, treating that issue may cure the bradycardia.
- In case a medicine is making your heart to pulsate too gradually, your specialist may change the dosage or recommend an alternate drug. In case you can't quit taking that medicine, you may require a pacemaker.
Bradycardia is frequently the aftereffect of another heart condition, so finding a way to carry on with a heart-solid way of life will enhance your general health. This may include:
- Showing at least a bit of restraint and dedication to a good diet routine that includes a considerable amount of organic products, vegetables, whole grains, fish, and low-fat or nonfat dairy foods.
- Being gradually on most, if not all, days of the week. Your specialist can let you know what type of exercise is okay for you.
- Getting more fit in case you have to, and maintaining a solid weight.
- Not smoking.
- Overseeing other medical issues, for example, hypertension or elevated cholesterol.
Most people associate fiber to be good for the digestive system, as it adds roughage and therefore helps in avoiding constipation. When we dig deeper, the fiber seems to do good not just to the stomach, but to the heart as well. Those who are prone to develop heart diseases should make an attempt to include more fiber in their diet and reap the rich benefits it offers.
There are two classifications of fibers
Dietary is found in diet products and functional is added fiber through various food supplements. Soluble and insoluble fiber, based on their solubility in water. Most foods contain some amounts of both. The insoluble one has more digestive benefits, as it adds to the roughage and both types have cardiac benefits.
Read on to know some of the cardiac benefits of fibers.
- Reduces cholesterol: There is good cholesterol which is essential for the body, and there is bad cholesterol that causes heart disease. Fibers reduce the amount of bad cholesterol in circulation, as it can bind to the cholesterol, in order to, remove it from the body, which otherwise would get into circulation and lead to plaque formation and heart diseases.
- Reduces blood pressure: Because the cholesterol does not circulate in the bloodstream, the blood is not as vicious and therefore the vessels do not have to exert much pressure and allows free flow. A diet changed to whole grains can show a marked difference in people with hypertension.
- Weight management: Eating fiber means more bulk and fewer calories so that a person feels full after eating smaller amounts. This is a great way to lose weight and bring pre-existing heart disease under control.
- Stroke prevention: The circulating cholesterol usually gets sluggish and settles down along the walls of the blood vessels. This attracts more cholesterol, which eventually forms, what is knowns as plaque. When this plaque attains a considerable size, it gets dislodged, circulates in the bloodstream, and can reach any of the vital organs. When it reaches the heart or brain, it can lead to heart attack or stroke. By removing the cholesterol which leads to all these complications, fiber reduces the incidence of stroke and heart attacks.
- Management of diabetes: Blood pressure, increased weight and heart diseases all are predisposing factors and have common contributing factors as does diabetes. Controlling all these helps in prolonging the onset of diabetes and reducing its severity too.
High-fiber diet mainly reduces cholesterol which helps in multiple ways to maintain not just a healthy body but also improves the overall quality of life. In case you have a concern or query you can always consult an expert & get answers to your questions!
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?
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.
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?
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 hospita
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 looper recorder, is like holter, but it records rhythm for longer durations.
ILR - Internal loop recorde 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
What is EPS?
EPS stands for Electrophysiology study. By this test a trained electro-physiologist 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 2-3 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 electro-physiologist 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 -
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.