Dr. Amit Sinkar

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

Heart attacks often show some visible signs for concern. While many may not face the chest-clutching moment, there are other symptoms that are hard to miss. In fact, some heart attack symptoms  are not even related to the chest. People suffering from cholesterol, diabetes, high blood pressure or above the age of 60 should especially be more careful about these symptoms. Here is a list of few alarming signs and symptoms of a heart attack:

1. Discomfort in the chest: This is the most visible and common signs of a heart attack. A blocked artery can lead to a heart attack with symptoms such as tightness, pressure and intense pain in the chest. The discomfort typically last for a minute or longer. It must be kept in mind that a heart attack is entirely possible without feeling any pain whatsoever.
2. Heartburn, nausea, stomach pain and indigestion: Many people reportedly face these symptoms before a heart attack. It is more likely for a woman to face these symptoms compared to a man. These conditions can happen in isolation as well. But a combination of these symptoms to a person suffering from blood pressure, high cholesterol should be taken seriously.
3. The pain slowly shifts to the arm: This is another classic example of a heart attack. A symptom that starts from the left side of the body and radiates down. Even a constant and dull pain in the arm has resulted in heart attacks for many patients.
4. Feeling of light-headedness: A sudden feeling of lightheadedness along with an acute chest pain is a very good sign of a heart attack. This symptom necessarily indicates that the blood pressure of the person has suddenly decreased and the heart is not able to pump enough blood.
5. Jaw or throat pain: Jaw or throat pain by itself is nowhere related to the heart. Going by common beliefs, it can arise from sinus, muscular issue or simply a cold. Medical science states otherwise. If an ongoing chest pain spreads towards jaw or throat, it can well be an ensuing heart attack. Seeking immediate medical attention is necessary in such cases.
6. Snoring: Loud snoring that sounds like choking or grasping can be a  sign of sleeping apnea. This is a condition when an individual stop breathing for few seconds making the heart pump more blood. If the condition persists, a doctor might suggest doing a sleep pattern analysis using a CPAP machine to identify if there is any possible threat of a heart attack.
7. A persistent cough: A long lasting cough that produces pink mucus can be a very visible sign of a heart failure. This is the condition when the heart can’t keep pace with the demands of the body. This should be immediately reported to a doctor.

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

A heart attack and Cardiac Arrest may sound like terms that have the same medical meaning. They are not. While a heart attack occurs when the flow of blood to the heart is blocked, a cardiac arrest occurs when the heart stops to beat. You might want to know the causes behind the conditions and the symptoms and signs that one may experience. Read on to know about them.

What is a heart attack and what is a cardiac arrest?
When the flow of blood towards the heart gets blocked, a heart attack occurs. This may be due to a clot in the arteries or plaque buildup on the walls of the arteries. A sudden cardiac arrest occurs when the affected individual's heart malfunctions as well as it stops to beat all of a sudden.

Thus, it is evident that heart attack is actually a circulation problem whereas cardiac arrest is an electrical problem. During a heart attack, blood rich in oxygen is not allowed to reach a particular part of the heart because of a blocked artery. If quick treatment is not done for reopening the blocked artery, then that specific section of the heart which receives nourishment from that artery tends to die.

In cardiac arrest, as the heart stops beating unexpectedly, so organs like brain, lungs, etc. also stop receiving blood. It results in a sudden fall in blood pressure as well as the circulatory system tends to collapse. Usually, the affected individual loses consciousness because the flow of blood to the brain decreases. Death might follow if emergency treatment is not carried out immediately.

Quite like the conditions are different, the symptoms are also different. Here are some of the most common symptoms of both heart attack and sudden cardiac arrest. It will assist you in understanding that both these health issues are different.

Symptoms of a heart attack:
Pressure or pain in abdomen or chest, trouble breathing, sweating, dizziness, chest tightening feeling, pain that spreads to arm or jaw, losing unconsciousness, heart palpitation, etc. are some of the basic signs. According to studies, nearly one-thirds of the heart attack patients do not undergo chest pain during heart attacks.

Particularly women experience atypical symptoms other than the ones that are mentioned above. Few of them include gastric pain, vomiting, nausea, breathing problem without any chest pain, getting unconscious, etc.

Symptoms of Cardiac Arrest:
Collapse, dizziness, trouble in breathing, chest pain, blue discoloration of face, etc. are the most common sudden cardiac arrest's signs. A huge number of people who experience cardiac arrest do not experience any symptoms at all.

Though both heart attack and cardiac arrest are linked to each other some way or the other, yet they are different. However, both the conditions need immediate medical assistance, an absence of which may prove fatal.

It is not just the skin or eye color that you inherit through your genes, it is also the chances of you having a heart attack. It has been proven beyond doubt that if heart diseases run in your family, then you are very likely to develop them too. Another worrying factor is that there are a whole lot of heart diseases which are hereditary, not just an isolated condition. Whether it is congenital heart disease (which is present at birth) to atherosclerotic (which is usually associated with ageing), all of them are hereditary.

If that worried you, there is good news. A family history definitely puts you at risk of developing heart disease, but it is all in your hands to overcome this risk and even completely eliminate it. Read on to know more!

1. Eat right: A healthy diet is the single most important contributor to your health. If your diet is rich in fiber (whole grains, vegetables, fruits), rich in omega-3 fatty acids, reduced hydrogenated and trans fat, it works wonders for your heart. Stay away from processed and packaged foods and eat fresh as much as possible. Eating seasonal fruits, taking vitamin supplements if required, using olive oil, and drinking green tea goes a long way in improving heart health. While these are good options for anybody, if you have a family history of heart disease, these become almost mandatory.
2. Exercise: In addition to the processed and junk foods, lack of exercise is another accelerator for heart disease. Pick up a form of exercise you enjoy and see the difference. Be it walking, cycling, jogging, or hitting the gym, work out a regimen that suits you and consistently work at it to see the best results.
3. Smoking: Smoking is one habit which damages the body in multiple ways. If there is a family history of heart disease, this accelerates the onset very rapidly. So, quit smoking, or at least reduce to prevent the onset of heart disease.
4. Alcohol: This gives a quick high, but damages your life in the long run. In addition to the alcohol per se, the accompanying foods are also a major culprit (fried and oily). Moderate alcohol consumption is definitely advised if your family has a history of heart attacks.
5. Stress Management: Stress is believed to the accelerator for heart disease, so if there is a family history too, it definitely needs to be managed. Unwind and see the difference. Meditation or music, exercise or enjoying with friends and family, pick your way to unwind.

So, while you may have inherited the chances of developing a heart disease, the above measures can help you prolong onset, and if done religiously, prevent heart disease too.

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

There is no fixed definition for the best diet. It solely depends on the health condition, requirement, and restrictions of a patient that a diet can be planned that can help deal with or prevent a particular health threat while ensuring overall good health.

Cholesterol is becoming a widely known threat responsible for inflammation and forming blood clots which may lead to strokes and heart attacks. Since it is a growing concern, it is recommended the patient follows a proper diet that can help in keeping the cholesterol level in the blood under control. To make such a best diet, below are few necessary and practical tips.

Opt For Healthier Fats
One must remember that the saturated fat found in the dairy products and red meat raise the level of the bad cholesterol or LDL, instead of reducing it. Receiving around 7 percent of the regular calorie need of the body is necessary from saturated fats. Therefore, one needs to opt for healthier saturated fats, such as canola or olive oils, monounsaturated fat products, low-fat dairy products, etc.

Increase the Intake of Fiber
The more the sources of fiber will be there in one’s diet, especially the soluble ones, the more health benefits one can have from that diet regarding the cholesterol reduction. Fresh fruits, oat bran, oats, beans, vegetables, and lentil are excellent sources of fiber and must be there in one's diet to make it the best.

Avoid having Trans Fats
Trans fats are known to increase the bad cholesterol(LDL) and reduce the good cholesterol (HDL). Therefore, eliminating sources of trans fats from one's diet will automatically contribute to keeping the cholesterol levels under control. Usually, it is the fried foods, various commercial products such as snack cakes, crackers or cakes, junk foods that are filled with trans fats and must be avoided.

Include Whey Protein
Whey protein has found to be a good source of reducing LDL or low-density lipoprotein and maintaining a balance in the overall cholesterol production inside the body. Therefore, including foods like ricotta cheese, yogurt, cereals, oatmeal, etc., each of them being rich in whey, can be a smart way of making one's diet more heart-friendly.

Add Omega 3 Fatty Acid Rich Foods
To make your diet a cholesterol reducer, try eating foods that are rich in omega 3 fatty acid. Though this particular fat is not associated with affecting the LDL cholesterol, it helps in the good cholesterol or HDL level in the blood, reducing both the triglycerides in the blood and blood pressure. Walnuts, ground flaxseeds, almonds, fishes like salmon, herring and mackerel are a few good sources of omega 3 fatty acid.

Apart from making the diet healthier and heart friendly, one should consider making some lifestyle changes such as to exercise regularly, to quit smoking, etc., to make the diet more effective and its results long-lasting.

E R E C T Pnemonic for High Blood Pressure Causes

• E R E C T is simple pnemonic to know causes for High blood pressure.
• E - stands for Essential Hypertension which means it has no cause and is found in 85% of people
• R - stands for Renal/Kidney related cause for hypertension like kidney stones, kidney failure etc
• E - stands for Endocrine causes for hypertension like Tumurs of Adrenal gland situated just above kidneys or excess consumption of steroids or oral contraceptives
• C - stands for Coarctation of aorta a birth defect in aorta which is major blood vessel coming out of heart which needs correction
• T - stands Toxemia of pregnancy which happens during second or third trimester of pregnancy
• Except for Essential hypertension all other causes are for hypertension are curable that means Hypertension also in these patients are curable, hence look for these secondary causes