Aarogyam

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. 

They include- 

1. Conditions like: 
   • Obesity or excess weight 
   • Diabetes 
   • High Blood pressure 
   • High cholesterol 
   • Heart Diseases 
2. Lack of exercise 
3. Age, usually above 65 
4. Consumption of tobacco or smoking 
5. 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. 

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
2. It comes with long term benefits
3. The procedure is safe as well as feasible