Balaji Heart Center

A heart attack can be fatal for any person, and it is necessary for you to know about the signs and symptoms of a heart attack. This will enable you to act early in case you experience the symptoms. Heart attack, also known as myocardial infarction, is a severe condition defined by the death of the heart muscles due to the loss of blood supply. Blood loss commonly occurs due to the blockage of a coronary artery.

Signs of a heart attack
There are many symptoms and signs of a heart attack which you should know. The symptoms usually vary from person to person. Here is a list of the common signs of a heart attack:

1. Chest pain and discomfort: Chest pain is the basic heart attack symptom which occurs in different forms. The chest pain is likely to cause pressure, fullness and a squeezing sensation. It starts from the centre of the chest and may spread to other limbs of the body, such as the head, upper abdomen, back, shoulder, neck or throat. It may reoccur in the chest again.
2. Shortness of breath: A gasping sensation or feeling of shortness of breath may be experienced. Such difficult or laboured breathing is known as dyspnea. The shortness of breath may occur before or after the chest pain.
3. Nausea and vomiting: A feeling of nausea or sickness in the stomach may be experienced. It may be accompanied by belching or burping. In some cases, the heart attack may be associated with a feeling of indigestion. Nausea is commonly experienced by women. The nausea may lead to vomiting.
4. Sweating: Perspiration or sweating occurs during a heart attack and the patient experiences cold sweats in excessive amounts. The sweat will appear in spite of not being active or working out. Due to the clogged arteries, the heart needs to make extra efforts to pump the blood. This produces extra sweat for keeping the body temperature low. Cold sweats and night sweats are also likely symptoms, which indicate a heart attack.
5. Fatigue: Fatigue is another symptom of a heart attack. Exhaustion is caused by a heart attack because of the added stress on the heart for pumping of blood. Feeling tired without any reason might indicate some trouble. Fatigue is more common in women. Light-headedness and dizziness may also be associated with a heart attack.

Heart palpitations may also be experienced sometimes. You should consult a doctor immediately after experiencing any of these symptoms of heart attack.

If you are concerned about the health of your heart, one of the primary and most important things to do is quit smoking. Avoiding and abstaining from smoking will heal the nicotine damage caused to your heart. This will enable you to lead a long and healthy life. Here are the reasons why you should quit smoking for the sake of your heart:

1. Reduced risk of heart attack: The benefits of not smoking start hours after you quit, and the heart rate and blood pressure get normalised slowly. By quitting smoking, your chances of having a heart attack are reduced by 50%.
2. In case of women, quitting smoking has special benefits: Women generally have a smaller body frame than men, and the harmful effects of smoking on a woman’s heart are considered to be more dangerous and concentrated. Female smokers under the age of sixty are more likely to experience a condition known as cholesterol plaque erosion, which is a fatal blood vessel condition. Women smokers are likely (seven times more than men) to develop heart complications due to smoking.
3. When you quit smoking, your heart is no longer exposed to harmful chemicals: Cigarette smoke contains toxins such as arsenic, formaldehyde and benzene. The chemical substances may be hazardous to the blood vessels in your body, and the heart muscles get damaged. Once you quit smoking, these chemicals will no longer enter your body, making your heart healthier.
4. Quitting smoking benefits other people as well: When children and people are exposed to tobacco smoke, their chances of having plaque in their heart’s arteries are enhanced. This may cause a stroke.
5. Quitting smoking reduces the chances of getting hospitalised: A smoker may be at the risk for getting hospitalised because of several conditions such as congestive heart failure, chronic obstructive pulmonary diseases, much more than a non-smoker. After quitting smoking, the chances of being hospitalised decrease within five years.
6. Quitting smoking lowers the risk of having atherosclerosis: Atherosclerosis is a blood vessel disease which is caused due to inflammations all over the body. Because of this, the arteries may stiffen and thicken. Smokers face the risk of acquiring this condition three times more than non-smokers.

You can quit smoking most effectively by combining behavioural support along with prescribed medication. People using this type of multi-treatment are likely to become successful at quitting smoking. You should consult a specialist who is certified in tobacco treatment, who will provide you with a plan. It will include counselling, medicines and a nicotine replacement therapy. If you wish to discuss about any specific problem, you can consult a Cardiologist.

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.

Causes
Several conditions cause strain and damage to the heart. These include the following:

1. High blood pressure or hypertension
2. Heart attack
3. Valvular diseases
4. Coronary artery disease
5. Medical problems like heart failure, lung diseases, high level of thyroid or pneumonia
6. Heart surgeries
7. Excess consumption of alcohol

Symptoms
The primary symptoms of atrial fibrillation include the following:

1. Light-headedness and dizziness
2. Shortness of breath
3. Feeling weak and fatigued
4. Feeling as if the heart is pounding, fluttering or racing (known as palpitations)
5. Feeling that the beating of the heart is uneven
6. Chest pain and fainting

In many cases of atrial fibrillation, the symptoms may be absent.

Diagnosis
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.

Treatment
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:

1. Blood thinning medicines for the prevention of a stroke.
2. Heart rate control medicines which will prevent irregular beating of the heart.
3. Rhythm control medicines for restoring the heart’s rhythm to normal.
4. 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.
5. 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.

For the best diagnosis and treatment of atrial fibrillation, you must consult a doctor as soon as you start experiencing the symptoms of the condition. A doctor will prescribe all that you need for an effective treatment.

Symptoms of Heart Attack

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.

1. 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.
2. 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.
3. 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. If you wish to discuss about any specific problem, you can consult a Cardiologist.

Heart Blocks are a result of plaque buildup in your arteries, which blocks blood flow and circulation to the heart, causing heart muscle damage and heightens the risk for heart attack and stroke.
Arteries which have smooth and elastic walls become thick and restrict blood flow from the cholesterol deposits over the years. Blood clots can also block the arteries that supply oxygen rich blood to the heart. These can eventually lead to strokes and heart attacks.

Some warning signs that you may be at risk of heart blockage:

1. Have you had a mild stroke: Plaque that accumulates in the carotid artery supplying oxygen rich blood to the brain can cause a stroke. People who have had strokes are more prone to heart attacks.
2. Do you often feel fatigue and dizziness: Reduced oxygen from poor circulation and blood flow can result in fatigue and tiredness as well as dizziness.
3. Experiencing shortness of breath: Poor blood flow can lead to shortness of breath from even mild forms of exercise or even from carrying out daily chores or walking.
4. Sudden chest pain: Chest pain or angina result from reduced supply of blood to the heart. It can be felt as pressure, tightness in the chest, squeezing in the chest, numbness or burning.
5. Unexplained lower back pain: This can result from pressure in the spine as a result of pinched nerves due to compressed vertebrae discs as a result of poor blood flow.
6. Erectile dysfunction in men: If an erection becomes difficult or impossible, it could be a warning sign of clogged arteries. These arteries supply blood to the pelvis area and help achieve an erection.
7. Calf pain: Blocked leg arteries can cause calf pain, especially in smokers. This is an early sign of possible heart blocks.
8. Painful, numb and cold hands and feet: Plaque build up in the arteries of the extremities can cause numbness and coldness in the hands and feet.

Remember early detection is the key to prevent or delay heart attacks. If you wish to discuss about any specific problem, you can consult a cardiologist.

Risk factors associated with heart attack

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:

1. Abnormal potassium levels in the body
2. Heart attacks or due to a damaged heart muscle, owing to a previous heart attack
3. Inborn heart diseases
4. Cases of an enlarged heart and heart failure
5. Overreaction of the thyroid gland
6. 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:

1. Electrical shock therapy such as defibrillation or cardioversion
2. Implanting of a heart pacemaker for a short term
3. Certain medications which are given through the veins or orally
4. 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.
5. Cardiac ablation may be carried out for destroying some areas in the heart from where the rhythm problems are caused.
6. 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.

Symptoms of Heart Pain

Most families refer to their newborn baby as their 'bundle of joy'. The news of a child being born brings immense joy to the entire family. However, due to various reasons, a child could be born with some medical abnormalities, which would be known as congenital abnormalities. There are several different types of heart defects that can be congenital. These usually manifest themselves either immediately after birth or in the early years of life. In some cases, the abnormality could be detected on prenatal ultrasounds. In others, it may not be and the family could be caught off guard about the condition. This causes a lot of stress, both for the child, who does not receive regular postnatal care and for the parents immediately after the delivery process.

If the baby has the following symptoms within the first few hours of life, there could be a serious underlying condition, which requires medical attention. The presence and severity of the symptoms would depend on the actual abnormality.

1. The skin is pale gray or blue in color due to excessive venous flow in the system
2. Excessive sweating
3. The child is exerting to breathe regularly
4. Rapid breathing causes added load on the heart accompanied by a grunting noise
5. Flared nostrils i.e. the baby attempts to take in more oxygen with each breath causes flared nostrils
6. Swollen legs, eyes, and abdomen: Fluid retention in the legs and abdomen is quite common, and this could be characteristic of newborns with congenital heart disease
7. Shortness of breath, even during feeding
8. Clubbed fingernails
9. Lethargy and low energy, even with feeding, therefore very poor feeding pattern
10. Chest pain, which may cause the newborn to cry incessantly
11. Low weight gain, as they feed less

In some children, symptoms manifest only during the teenage years or early adulthood. These conditions are not very severe and the symptoms include:

1. Swelling of the hands, feet, and ankles due to fluid accumulation
2. Lowered energy levels, leading to easy fatigue
3. Shortness of breath with even minimal physical activity
4. Inability to exercise
5. Developmental delays and changes in growth milestones
6. Recurrent respiratory tract infections including sinus infections, bronchitis, and pneumonia
7. Endocarditis
8. Pulmonary hypertension
9. Heart failure, where the heart is not able to effectively function and pump blood to all parts of the body.

Some or more of these symptoms should trigger a warning to get the child tested for congenital heart disease. While some would just require a monitoring until severe symptoms develop, severe conditions like holes, abnormal valves, narrowed arteries, and blood vessel abnormalities might require immediate intervention. If you wish to discuss about any specific problem, you can consult a cardiologist.

Ever wondered why you needed to share your family’s health history at a doctor’s clinic? Specific questions regarding health issues of your immediate family or close blood relatives give your doctor an insight into various health risks you might have now or in future. Those are medical conditions inherited by parents or grandparents through genes. Genes are passed from parents to children in DNA of eggs or sperms. Even a single mutation (fault) in gene can influence body systems and may lead to disorders. If any of the parents have a faulty gene, there are 50:50 chances of the child inheriting it.

Hereditary heart diseases are also a result of mutation in one or more genes and tend to run in families. Genes control almost all aspects of cardiovascular system including strengthening blood vessels, pumping capacity or communication of cells in the heart. A single genetic variation is enough to alter cardiovascular processes increasing the risk of developing a heart disease, attack or a stroke. Some of the most common hereditary cardiac disorders include; Arrhythmias, congenital heart diseases and cardiomyopathy. A family history of heart attack or stroke is also an established high-risk factor for the family members. High blood cholesterol, medically known as familial hypercholesterolemia also tends to run in families.

Unfortunately, many of these conditions cannot be prevented since they are acquired through genes. But there are many ways in which these could be managed before they become complicated or fatal.

Let’s look at some ways by which we can deal with hereditary heart diseases and increase a patient’s chances of survival:

1. Early Diagnosis And Treatment: When one person in the family is diagnosed with a heart disease, it is strongly advisable for other family members to go in for screening. An early diagnosis can help in better treatment and management of the disease and impacts positively on patients’ life. Medical screening of siblings is highly recommended in case a person suffers a sudden cardiac death especially at a young age.

2. Watch out for these symptoms at a young age: Abnormal heart rhythm, asthma that does not get better with inhaler, seizures that do not improve with medication, extreme fatigue or shortness of breath are warning signals and need immediate medical attention.

3. Genetic Testing: Family members may opt for genetic testing to check if they carried genes of an inherited disorder.

4. Genetic Counselling: Genetic counselling deals with problems like anxieties and fear of attacks, confusion over disease and emotional difficulties in accepting the situation.

We may not be able to change the family history but we can surely change our environment, lifestyle and habits. Eating healthy and following an active lifestyle does help in prevention and management of such diseases. If you wish to discuss about any specific problem, you can consult a cardiologist.

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.

What are the symptoms of Angina pain?

You might be having angina pain if you suffer from one or more of these symptoms:

- Chest pain
- Heartburn
- Breathlessness
- Nausea
- Dizziness
- Restlessness
- Fatigue
- 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 and ask a free question.

Your diet plays a major role in the health of your heart, so eating healthy should be somewhere on the top of the list for keeping your heart healthy as well. There are numerous heart disorders that occur due to unhealthy food patterns and consumption. Lifestyle factors are the major causes of heart disease, and diet occupies an almost compelling spot when lifestyle factors are taken into consideration. Here is a list of foods that keeps your heart healthy:

1. Salmon: Omega-3 fatty acids are very important for your heart to function optimally. Fishes such as salmon and sardines are rich in omega-3 fatty acids which lower the risk of heart diseases such as arrhythmia (irregular heartbeat) and atherosclerosis (accumulation of plaque in the arterial walls).

2. Oats: Like oats and milk for breakfast!? Congratulations! You are in luck; oatmeal has soluble fibers which help in lowering bad cholesterol levels. Just make sure that there is no added sugar in your oatmeal, as it will defeat the entire purpose.

3. Blueberries: Blueberries are rich in antioxidants that reduce the risks of heart attack and also decrease your blood pressure. So go ahead! Toss some blueberries in your oatmeal to get your daily dose of antioxidants which are such pre-requisites for supreme health.

4. Dark Chocolate: This will probably bring a smile to your lips. Dark chocolates contain polyphenols, a type of flavonoid, which is very good for your heart. Dark chocolate is known to reduce the risks of strokes and heart attacks. Watch the portion size as no matter what its benefits are, dark chocolates are still rich in calories.

5. Citrus Fruits: Citrus fruits such as lemons and Indian gooseberry are rich in compounds that lower cholesterol levels in the body. Tip – Start your day with a lemon juice and warm water. This betters your metabolism and also keeps your heart in fine shape.

6. Soy: Lo Behold Vegetarians! (and non-vegetarians as well). Soy is a protein rich food that is so good for your heart. It also contains heart-healthy fats and fibers that help bring down and normalize cholesterol levels.

7. Tomatoes: Tomatoes are rich in an antioxidant called ‘lycopene’, which is very effective in getting rid of bad cholesterol. It thus helps in keeping your arteries healthy and reduces the risks of heart attacks.

8. Nuts: Nuts such as almonds and walnuts are rich in Vitamin E which helps in lowering bad cholesterol in the body. Avoid nuts that come with added salt. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Coronary artery disease is one of the major killer diseases of the modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives.

Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks.

Main causes for coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk.

Symptoms: Reduced blood supply to the target organ causes the following symptoms:

1. Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters.

2. Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion.

3. Palpitations: A sensation where you are able to hear your heartbeat.

4. Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina.

Treatment: There are 3 modes to manage this.

• Medications:

  • Aspirin to reduce the viscosity of the blood.

  • Statin to control the cholesterol levels.

  • Beta blockers to control hypertension.

  • Nitroglycerin for temporary relief of angina pain.

• Surgical Procedures:  Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases.

• Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage.

Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.