Dr. Pramod Kumar Sharma

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.

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 have a concern or query you can always consult an expert & get answers to your questions!

A heart attack allows you to get a double take on life. Once you survive it, you tend to realize how close your brush with death has been and how important your lifestyle choices can be. Most people go on to live a productive life after a heart attack provided they can adhere to making healthy choices. Here's what you can do if you have experienced your first attack and want to change for the better:

1. Start at the hospital: A person usually stays in the hospital for 3 days after an attack to monitor their condition. This duration increases if you have complications that involve procedures like a bypass surgery. Your first significant change will come to your medication routine. Your existing dosages may be adjusted and you'll possibly prescribed newer medicines that will treat and control your symptoms. You'll not only need to know the names of all your medicines but when you have to take them. Its best you know exactly why are taking each of them, if there are other more economic alternatives since this may last a lifetime and what side effects they may have.

2. Maintaining your mental health: Once bitten, twice shy applies for heart attack victims too. Not only do they live in a constant worry about another attack, every small symptom like a harmless muscle pull can trigger the fear factor. You also get into the "heart patient" dependent mode based on how much help you need to recover. Check for support groups and other heart attack survivors in your locality to see how they are coping. Read more about your recovery and try to keep a positive frame of mind.

3. Go for cardiac rehab: Many hospitals have a rehabilitation program that you can participate in as an outpatient or you can go to a clinic that specializes in it. Such programs help speed up your recovery. It is run by people who will hand hold you in bringing positive changes in your life to protect and strengthen your heart. You'll learn activities that positively improve heart functions and reduce your chances of developing complications or dying from heart disease. You'll also benefit from exercises that'll be taught by a certified exercise specialist. 

4. Making lifestyle changes: Quitting smoking is an obvious one. You'll now have to lead a more active lifestyle with daily exercise. You'll also need to actively manage your diabetes and obesity. None of these changes can happen in a day. In fact, behavioural scientists suggest that you need to practice a new activity continuously for twenty one days for it to become a habit. 
 

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.

Regular use of 750 mgs of vitamin c helps to prevent deposition of LDL in blood vessels

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. 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.

• Medication.
• 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!

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.

If your child has a congenital heart defect, it means that your child was born with a problem in the structure of his or her heart. Some congenital heart defects in children are simple and don't need treatment. Other congenital heart defects in children are more complex and may require several surgeries performed over a period of several years.

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.When to see a doctor

Serious congenital heart defects are often diagnosed before or soon after your child is born. If you notice that your baby has any of the signs or symptoms above, call your child's doctor.

If your child has any of the signs or symptoms of less serious heart defects as he or she grows, call your child's doctor. Your child's doctor can let you know if your child's symptoms are due to a heart defect or another medical condition.

In case you have a concern or query you can always consult an expert & get answers to your questions!

A sudden cardiac arrest is not same as a normal heart attack. While a heart attack refers to the blocking of blood flow to the heart, a sudden cardiac arrest refers to when the heart stops beating unexpectedly. Sudden cardiac arrests occur without warning and often this condition is triggered by electrical malfunctioning in the heart that causes arrhythmia. When the heart stops beating, blood cannot be pumped to the brain and other organs and the person loses consciousness. If a patient does not receive immediate treatment, this could be fatal. Hence it is important to know what first aid a person experiencing a sudden cardiac arrest requires.

Help

Do not wait for someone else to help a person experiencing a sudden cardiac arrest. The first few moments after such an experience are critical and hence your decision to help is what could save the person’s life.

Call a Doctor

The first thing to do when you see someone experiencing a cardiac arrest is to call emergency and request an ambulance. If you do not have a phone available, ask someone else to do it.

CPR

After a cardiac arrest, it is essential to get the heart to start beating again as soon as possible. CPR or Cardiopulmonary resuscitation can save lives in this situation. If you are trained in this procedure, start with 30 chest compressions before checking the patient’s airway and performing rescue breathing. If you are not trained in CPR, ask the people around if anyone else is.

If no one around can perform CPR, start hands-only CPR. Make the person lie flat on their back and kneel next to their shoulders. Place the heel of one palm in the centre of the person’s chest with the other hand over it. Keep your elbows straight and position your elbows such that they are directly over your hands. Use your upper body weight to push down straight on the person’s chest and release. Try and achieve a rate of 100 compressions a minute. Continue until the person starts breathing again or medical help arrives.

Use an Automated External Defibrillator (AED)

If an AED is available, place the electrode pads on the person’s chest as shown in the diagrams that come along with the AED. Follow the visual and voice prompts. Do not worry if the AED shocks the patient as this electrical therapy can help restart the heart.

In case you have a concern or query you can always consult an expert & get answers to your questions!