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Diabetes & Heart Disease!

MD - Medicine
General Physician, Delhi
Diabetes & Heart Disease!
Diabetes currently affects more than 62 million Indians, which is more than 7.1% of the adult population. The average age of onset is 42.5 years. Nearly 1 million Indians die due to diabetes every year.
According to the Indian Heart Association, India is projected to be home to 109 million individuals with diabetes by 2035. A study by the American Diabetes Association reports that India will see the greatest increase in people diagnosed with diabetes by 2030. The high incidence is attributed to a combination of genetic susceptibility plus adoption of a high-calorie, low-activity lifestyle by India's growing middle class. The age of onset of Type 2 Diabetes is falling and this condition is now not uncommon among children, adolescents, and young adults even at the age of ten.

At least 68 percent of people age 65 or older with diabetes die from some form of heart disease, and 16% die of stroke.

Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes.
The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease.
A close link exists between diabetes and cardiovascular disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients. People with diabetes, particularly Type 2 Diabetes, may have the following conditions that contribute to their risk for CVD

High blood pressure (hypertension)
Abnormal cholesterol and high triglycerides
Obesity
Lack of physical activity
Poorly controlled blood sugars
Smoking
Many studies have found biological mechanisms associated with DM that independently increase the risk of CVD in diabetic patients. Therefore, targeting CV risk factors in patients with diabetes is critical to minimize the long-term CV complications of the disease. Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke.

How does one know whether suffering from problems or not? Are the symptoms different than in the Non-Diabetic? Angina is chest pain or discomfort that occurs if your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. One may feel pain in the shoulders, arms, neck, jaw, or back. Angina pain often mimics the discomfort of indigestion. However, angina tends to get worse with activity and go away with rest. Emotional stress also can trigger this pain. In case of Myocardial Infarction, there is a complete blockage of one of the blood vessels supplying blood to heart muscle resulting in damage to the cardiac muscles. In this case, symptoms of angina persist with cold sweat, breathlessness & shortness of breath, fatigue, lightheadedness or sudden dizziness. Although the symptoms may vary from person to person.

Some people who have diabetes may have no signs or symptoms of heart disease and can witness a silent heart attack. Diabetes-related nerve damage that blunts pain reception and may explain why symptoms aren't noticed. Thus, people who are diabetic should undergo regular medical check-ups. Tests may reveal a problem much before they witness it. Early diagnosis and management can reduce or delay imminent complications.

40%-75% of individuals with diabetes and no overt signs of coronary artery disease (CAD) suffer from diastolic dysfunction, referred to as diabetic cardiomyopathy which is a result of failure of heart to relax completely after each contraction. This, in itself, may not present with symptoms in its early stages. However, later in progression one may have weakness, shortness of breath, a severe cough, fatigue, and swelling of the legs and feet.

Prevention is always better than cure. If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease. By living a healthy lifestyle, you can help keep your blood pressure, cholesterol and blood sugar in normal levels and lower your risk for heart disease and heart attack. A healthy lifestyle includes the following:

Eating a healthy diet. (DASH Diet)
Maintaining a healthy weight. (BMI <25)
Getting enough physical activity. (30 min of walk daily, 5 days a week )
Quitting smoking or other forms of tobacco.
Limiting alcohol use.
Keeping one s Blood sugars, BP, cholesterol under control.

Heart Blockage - Understanding The Warning Signs Of It!

MCh - Cardio Thoracic & Vascular Surgery, MBBS, MS - General Surgery
Cardiologist, Bhopal
Heart Blockage - Understanding The Warning Signs Of It!
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:



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.
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.
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.
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.
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.
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.
Calf pain: Blocked leg arteries can cause calf pain, especially in smokers . THis is an early sign of possible heart blocks.
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.
3107 people found this helpful

Renal Artery Stenosis - How Surgery Can Treat The Condition?

MBBS, MS - General Surgery, MCh - Vascular Surgery
Vascular Surgeon, Bangalore
Renal Artery Stenosis - How Surgery Can Treat The Condition?
Renal artery stenosis is when the renal arteries (blood vessels which supply blood to the kidneys) are stenosed or narrowed. This is often a result of atherosclerosis, which is caused due to increased levels of cholesterol in the blood. As it passes through the blood vessels, the fat molecules, because of their heaviness, get sluggish and settle down along the walls. This is known as plaque formation. They attract more fat molecules and the plaque continues to grow in thickness, thereby leading to a reduced diameter of the blood vessels. Over a period of time, the reduced blood supply affects the kidney s normal functioning, resulting in a chronic kidney disease and kidney failure.

The kidneys are involved in the removal of toxins from the body, and hence, perform a very significant function. If they do not function well, then there is slow, but a definite accumulation of toxins within the body. This leads to various other complications, affecting almost the entire body and health. Therefore, it is essential that renal artery stenosis is identified and treated to minimize the effect on one s health.

There are two aspects to this

First, there are no clear tell-tale symptoms to identify renal artery stenosis in its early stages.
Second, though there are a lot of medications available, they are only to manage the symptoms and do not help bring back the narrowed arteries to their original. This means the blood supply to the kidneys will continue to be reduced, thereby never restoring its function fully.
This is where surgery comes into the picture. There are three surgical options which are available, and each one of them ensures the renal arteries are restored to their normal functioning.

Renal artery endarterectomy: The main cause of the stenosis, which is plaque, is surgically removed from the affected portions.
Renal artery bypass: The portion of the artery which is affected is surgically removed, and a vein, usually from the leg, is grafted to replace the diseased part of the artery. This restores blood flow to the kidneys and improves their function.
Percutaneous balloon angioplasty and stenting: This is the most commonly used procedure to treat renal stenosis now. It improves stenosis and also helps avoid complications. This is combined with an arteriogram, where the area of diagnosis is confirmed. Then a deflated balloon is passed through the artery and inflated to keep it in place.
A stent is placed so that the balloon does not collapse and cause a re-stenosis. With current advances, this is done using local anaesthesia and sedation. Aspirin is also used on a daily basis to prevent clot formation.
2200 people found this helpful

Is there homeopathy medicine to remove blockage in coronary artery? Is it successful?

MD - Homeopathy, BHMS
Homeopath, Vadodara
Yes there are very good Medicine. But it requires proper case study and selection based on symptoms of the individual patient. Then it is successful.
1 person found this helpful
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Blockages in Heart Arteries - Know Causes Of It!

MBBS, MD - Medicine, DM - Cardiology
Cardiologist, Dehradun
Blockages in Heart Arteries - Know Causes Of It!
Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food) to continuously working heart muscles. Heart muscles which are not tired working from the birth till death, however, cannot sustain long without blood supply.

A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).

But what causes these arteries to block?

Deposition of LDL cholesterol (low density cholesterol) in inner surface of coronary arteries is the primary reason of these blockages. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!

Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.

If LDL is a normal component of blood, why it is deposited in the arteries at first place?

LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart.
2619 people found this helpful

How Diabetes Causes Cardiovascular Problems?

MBBS, Diploma In Diabetology
Diabetologist, Mumbai
How Diabetes Causes Cardiovascular Problems?
Since blood is part of the cardiovascular system, and diabetes is a condition in which the level of glucose in the blood is higher than normal, then is certainly some relationship between the two.

Diabetes and cardiovascular system diseases has been recognized to be closely related to each other due to the so-called insulin resistance syndrome or metabolic syndrome. Some examples of the commonly diagnosed cardiovascular disease are coronary heart disease, stroke, high blood pressure and other heart conditions.

Diabetes is considered a major risk factor in cardiovascular diseases. Other factors that contribute to the possibility of acquiring cardiovascular diseases in diabetic patients include hypertension, smoking, and dyslipidemia.

How Diabetes Causes Cardiovascular Problems?

1. Hypertension: Hypertension in diabetes is considered a major contributor to the increase in mortality from cardiovascular diseases. Diabetic patients, especially those with Type 2, need to always have their blood pressure checked every visit to the doctor. Self-monitoring at home is also a must to maintain and control the rise of blood pressure. The American Diabetes Association recommends a target blood pressure of not more than 130/85 mm Hg to maintain a good level of blood pressure.

2. Arteriosclerosis and Atherosclerosis: Arteriosclerosis is the stiffening or hardening of the artery walls while Atherosclerosis is the narrowing of the artery because of plaque build-up. Atherosclerosis is a form of hardening of the blood vessels/arteries, caused by fatty deposits and local tissue reaction in the walls of the arteries. Diabetes is a documented high risk factor for the development of both Atherosclerosis &amp; Arteriosclerosis . Heart disease and stroke, arising mainly from the effects of atherosclerosis, account for 65 percent of deaths among diabetics.

3. Hyperglycemia: Hyperglycemia means high (hyper) glucose (gly) in the blood (emia). Your body needs glucose to properly function. Your cells rely on glucose for energy. Hyperglycemia is a defining characteristic of diabetes, when the blood glucose level is too high because the body isn't properly using or doesn't make the hormone insulin.

There is a growing recognition that diabetes belongs to a special category of risk factors because it markedly increases risk of CVD. This increase is partly the result of the pernicious effects of persistent hyperglycemia on the vasculature and partly due to the coexistence of other metabolic risk factors.

5. Smoking: Smoking has been determined dangerous to our health. Studies show that smoking indeed increase risk of premature death and cardiovascular disease in diabetic patients.

6. Atrial Fibrillation: Atrial Fibrillation means an irregular and rapid heart rate which can increase the risk of stroke, heart failure and other cardiac issues. Individuals with diabetes are at an increased risk of developing atrial fibrillation. This risk is higher among patients with a longer duration of treated diabetes and poorer glycemic control.

Individuals with insulin resistance or diabetes in combination with one or more of these risk factors are at even greater risk of heart disease or stroke. However, by managing their risk factors, patients with diabetes may avoid or delay the development of heart and blood vessel disease. Your health care provider will do periodic testing to assess whether you have developed any of these risk factors associated with cardiovascular disease.
4364 people found this helpful

Heart Arteries - Know Blockages Of It!

MBBS, DM - Cardiology, MD - Medicine
Cardiologist, Bhopal
Heart Arteries - Know Blockages Of It!
Blockage in heart is a common term used for narrowing of coronary arteries. Coronary arteries are vessels, which supply blood and thus oxygen and food) to continuously working heart muscles. Heart muscles which are not tired working from the birth till death, however, cannot sustain long without blood supply.

A reduction in blood supply gives rise to ischemia of heart muscles commonly manifested as chest discomfort or angina. A sudden complete shutdown of blood supply leads to heart attack leading to permanent damage to heart (if blood flow not reestablished promptly).

But what causes these arteries to block? Deposition of LDL cholesterol (low density cholesterol) in inner surface of coronary arteries is the primary reason of these blockages. LDL a normal component of blood (upto certain limit) starts depositing in arteries as early as 10 years of age!

Deposition of billions of LDL molecules over several years on inner surface of arteries gives rise to visible narrowings in these arteries. Flow ahead of these narrowings is reduced in proportion to the narrowing. At a level of 70 % narrowing the flow is reduced to give ischemia (and angina) during exercise. Gradually increasing degree of narrowing reduces the exercise needed for ischemia and angina; a narrowing of more than 90 % can give symptoms at rest. A sudden clot formation at any of these stages can block the flow suddenly giving a heart attack.

If LDL is a normal component of blood, why it is deposited in the arteries at first place?

LDL above a certain limit in blood starts depositing in the arteries. Diabetes, Hypertension, smoking, less exercise and genetics makes it more sticky thus making narrowing faster. This is why these risk elements need to be properly attended for prevention from heart disease. For treatment medicines are important for stopping the progression of narrowings; angioplasty is a method of fast resolution of blockage; and bypass surgery is the method of creating a whole new blood supply for the affected part of the heart.

COPD and Comorbid conditions!

MBBS, MD -Pulmonary Medicine-Tuberculosis ,Respiratory Disease Medicine , Diploma in Tuberculosis and Chest Diseases (DTCD), European Diploma in Respiratory Medicine
Pulmonologist, Delhi
COPD and Comorbid conditions!
COPD or chronic obstructive pulmonary disease is one of those lung diseases that does not exist in a vacuum. It is associated with at least one or two comorbid conditions like pulmonary hypertension, osteoporosis, dementia, anaemia , hypertension, coronary artery disease (CAD) and depression. It is necessary to seek treatment on time to prevent the aggravation of the condition and development of these comorbid conditions.
1 person found this helpful

Top 10 Cardiologist in Delhi!

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Lakhimpur Kheri
Cardiac problems are very scary and what is more scary is choosing the top cardiologist in Delhi. There are so many cardiologist in Delhi and there are so many type of cardiologist depending on their area of specialization. Clinical cardiologists, adult cardiologist, paediatric cardiologist.

There are few cardiologist who specialize in procedures like electrophysiology, echocardiography, and interventional procedures such as stent placement and balloon angioplasty. Cardiologist are specialized in diagnosing any kind of disorder or dysfunctioning of heart and can perform minimally invasive surgeries like pacemaker implantation.

Here is the list of top 10 cardiologist in Delhi, who are specialized and experts at treating all kind of heart problems:

1. Dr. Anupam Goel

MBBS, MD (Gen. Medicine), DM (Cardiology)

Consultation fees: 1000

Dr. Anupam Goel is a senior Interventional Cardiologist. She is currently associated with Max Super Speciality Hospital, Saket. She has an experience of 25 years in this field. She has done several fellowships in cardiology and is engaged in the academic training, CMEs and as principal clinical investigator at various national and international levels. Her areas of expertise are: Percutaneous Coronary Angioplasty and Stent Implantation, Primary Angioplasty in Acute Myocardial Infarction, Acute Coronary Care, Clinical Cardiology and Coronary Angiography and Angioplasty via Radial Artery Route.

2. Dr. Nitin Kumar

CCT - Cardiology (UK), MRCP (UK), FHEA (UK), MBBS

Consultation fees: 800

Dr Nitin Kumar is a consultant cardiologist with 16 years of national and international experience. He is currently affiliated with Express clinic, Delhi and CREDENCE Super specialty Clinic in Gurgaon. His area of specialisation are transradial interventions (angiography and angioplasty through the wrist), treating acute heart attacks by Primary Angioplasty, management of acute coronary syndromes, complex angioplasty including bifurcation lesions, Intravascular imaging including IVUS and OCT, Fractional Flow Reserve assessment (FFR study) and Rotablation.

3. Dr. Rajiv Agarwal

MBBS, MD - Medicine, DM - Cardiology, Fellowship in Interventional Cardiology

Consultation fees: 500

Dr Rajiv Agarwal is a Senior Interventional Cardiologist and currently works at Max Smart Super Speciality hospital as Senior Director and Unit Head, Department of Cardiology. He has 33 years of experience. His areas of interest are Coronary Interventions & Valvuloplasty, Electrophysiology Study, Device Implantation (including Combo device), Device closures and Peripheral Interventions and also including Bronchial and Renal Artery Embolization. He has been awarded several national and international awards for his contribution in the field of cardiology.

4. Dr. R. R. Mantri

DNB (Cardiology), DM - Cardiology, MD - General Medicine, MBBS

Consultation fees: 1000- 1500

Dr. RR Mantri is a very reputed name in his fraternity. He is currently working as Director Cath Lab & Cardiac Arrhythmia Services, Department of Cardiology, Sir Ganga Ram Hospital, New Delhi. He has experience of more than 35 years as Interventional Cardiologist, Diabetologist and Electrophysiologist. His areas of clinical interest are treating patients suffering from congenital heart diseases, cardiovascular diseases, cardiac valve diseases, hypertension, artery blockages, heart failure, high cholesterol, diabetes due to obesity. He is a pioneer in Transradial Angiography in India.

5. Dr. Anil Saxena

DNB Cardiology, MD - Internal Medicine, MBBS

Consultation fees: 1000

Dr. Anil is currently practicing as Director, Cardiac Pacing & Electrophysiology at Fortis Hospital, Okhla. His areas of clinical interest are Electrophysiologic Study, Catheter RF Ablation of complex arrhythmias, 3D Mapping of Cardiac Arrhythmias with CARTO and Ensite, Implantation of Permanent Pacemakers, Implantation of ICD, Implantation of Biventricular pacemakers (CRT). Implantation of CRT-D (Combo Device), Lead Extraction and Coronary Angiography. He is not only member of some reputed national and international organisations, but also recipetents of many awards.

6. Dr. Viveka Kumar

DM - Cardiology, MD - General Medicine, MBBS

Consultation fees: 1000

Dr. Viveka Kumar has 29 years of practice in the field of Cardiac interventions and Electrophysiology. In years of his practice he has done more than 7500 angioplasties and 2500 balloon valvotomy. He has also handled some complex cases of angioplasties. He is considered to be a pioneer of using advanced technologies like bifurcation and left main angioplasties with Rota Ablation. He has special interest in clinical research and has been associated with principal investigator or a sub-investigator in more than 14 national and international trials.

7. Dr. Ripen Gupta

MBBS, MD - Medicine, DM - Cardiology

Consultation fees: 1000 -1200

Dr. Gupta has 26 years of experience and is considered to be one of the most reputed cardiologists of Delhi. He was the first cardiologist to be awarded the Postdoctoral Fellowship of National Board in Interventional Cardiology instituted by National Board of Examinations. His areas of specializations are treatment of arrhythmia, coronary artery disease and dyslipidemia. He currently practices at Max super speciality, Saket and Dr Ripen Gupta's Clinic, Vasant Kunj, Delhi.

8. Dr. Rajneesh Jain

DM - Cardiology, MD - Internal Medicine, MBBS

Consultation fees: 1500 -2000

Dr. Rajneesh Jain is amongst the most experienced and best cardiologist in Delhi. In 35 years of practice he has handled and treated some very complicated cases of adult cardiac catheterization, angiography, and acute coronary emergencies. Some of other specializations are peripheral angiograms and angioplasty, percutaneous balloon valvuloplasty of all valves, permanent pacemaker implantation. He is currently associated with Sir Ganga Ram Hospital, Delhi.

9. Dr. Nishith Chandra

DM Cardiology

Consultation fees: 1000 -1500

Dr. Chandra, is currently working as a director interventional cardiology, at Fortis Escorts Heart Institute & Research Centre, New Delhi. In his 21 years of practice he is a famous and reputed name in the field. His areas of core interest and specialization are complex coronary interventions including Rotablation, Carotid Interventions, Balloon Valvotomies and Peripheral Vascular Interventions. One of his greatest accomplishment is setting up the Air Ambulance Unit of Escorts Heart Institute that has helped in treating more than 300 critically cases.

10. Dr. Rajiv Bajaj

MBBS, MD - Internal Medicine, DM - Cardiology

Consultation fees: 500

Dr. Rajiv Bajaj is currently associated with Batra Hospital, Delhi. He has experience of 38 years and is amongst the eminent doctors in the field of cardiology. He has performed numerous coronary angioplasties, more than 200 electrophysiology studies and 100 ablations including VT and flutter ablations in adults and pediatric population. His areas of interest are Coronary angioplasty, cardiac catheterization in permanent pacemaker implantations, electrophysiology, echocardiography.
2 people found this helpful

Coronary Artery Bypass Grafting (CABG) - Know Its Type And Benefits!

MBBS, MD, DM, AFESC, FACC
Cardiologist, Guwahati
Coronary Artery Bypass Grafting (CABG) - Know Its Type And Benefits!
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

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.
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.
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:

The survival rate is higher in total artery CABG as compared to the traditional CABG.
It comes with long term benefits
The procedure is safe as well as feasible
1724 people found this helpful