Patient Review Highlights
I found the answers provided by the Dr. Avinash Wankhede to be very helpful. Good words for our healthy life
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.
- Conditions like:
- Lack of exercise
- Age, usually above 65
- Consumption of tobacco or smoking
- High consumption of alcohol
A silent heart attack 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.
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:
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.
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.
Genetic Testing: Family members may opt for genetic testing to check if they carried genes of an inherited disorder.
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.
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:
- Abnormal potassium levels in the body
- Heart attacks or due to a damaged heart muscle, owing to a previous heart attack
- Inborn heart diseases
- Cases of an enlarged heart and heart failure
- Overreaction of the thyroid gland
- Several other substances or medicines may lead to arrhythmias, such as alcohol, stimulant drugs, caffeine, nicotine, and antidepressant medicines or blood pressure medicines.
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:
- Electrical shock therapy such as defibrillation or cardioversion
- Implanting of a heart pacemaker for a short term
- Certain medications which are given through the veins or orally
- 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.
- Cardiac ablation may be carried out for destroying some areas in the heart from where the rhythm problems are caused.
- 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.
Most people associate fibre to be good for the digestive system. It helps to add roughage and therefore helps in avoiding constipation. When we dig deeper, the fibre seems to do good not just to the stomach but to the heart as well. Those who are prone to develop heart disease should make an attempt to include more fibre in their diet and reap the rich benefits it offers.
There are two classifications of fibres
Dietary are found in diet products and functional being added fibre through various food supplements. Soluble and insoluble fibre, based on their solubility in water. Most foods contain some amounts of both. The insoluble one has more digestive benefits, as it adds to the roughage. Both types have cardiac benefits.
Read on to know some of the cardiac benefits of fibres.
- Reduces cholesterol: There is good cholesterol which is essential for the body, and there is bad cholesterol causes heart disease. What fibres do is reduce the amount of bad and overall cholesterol in circulation. The fibre binds to the cholesterol and removes it from the body, which otherwise would get into circulation and lead to plaque formation and heart disease.
- Reduces blood pressure: Because the cholesterol does not circulate in the blood stream, the blood is not as viscous and therefore the vessels exert much less pressure to allow for free flow. A diet change to whole grains can show a marked difference in people with hypertension.
- Weight management: Eating fibre means more bulk and fewer calories so that a person feels full after eating smaller amounts. This is a great way to lose weight and bring preexisting heart disease under control.
- Stroke prevention: The circulating cholesterol usually gets sluggish and settles down along the walls of the blood vessels. This attracts more cholesterol, which eventually forms what is knowns as plaque. When this plaque attains a considerable size, it gets dislodged, circulates in the blood stream, and can reach any of the vital organs. When it reaches the heart or brain, it can lead to heart attack or stroke. By removing the cholesterol which leads to all these complications, fibre reduces the incidence of stroke and heart attacks.
- Management of diabetes: Blood pressure, increased weight, and heart disease all are predisposing factors and have common contributing factors as does diabetes. Controlling all these helps in prolonging the onset of diabetes and reducing its severity too.
High-fiber diet mainly reduces cholesterol which helps in multiple ways to maintain not just a healthy body but also improves the overall quality of life.
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.
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. 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.
Several conditions cause strain and damage to the heart. These include the following:
- High blood pressure or hypertension
- Heart attack
- Valvular diseases
- Coronary artery disease
- Medical problems like heart failure, lung diseases, high level of thyroid or pneumonia
- Heart surgeries
- Excess consumption of alcohol
The primary symptoms of atrial fibrillation include the following:
- Light-headedness and dizziness
- Shortness of breath
- Feeling weak and fatigued
- Feeling as if the heart is pounding, fluttering or racing (known as palpitations)
- Feeling that the beating of the heart is uneven
- Chest pain and fainting
In many cases of atrial fibrillation, the symptoms may be absent.
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.
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:
- Blood thinning medicines for the prevention of a stroke.
- Heart rate control medicines which will prevent irregular beating of the heart.
- Rhythm control medicines for restoring the heart’s rhythm to normal.
- 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.
- 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.
Coronary artery disease, also known as coronary heart disease or CHD, is a kind of disease in which a wax-like substance called plaque, builds up in the coronary arteries.
Function of Coronary Artery
The task of coronary arteries is to supply oxygen rich blood to the heart muscles. When there is the growth of plaque in these arteries, the condition is termed as atherosclerosis. Plaque builds up over the years, and it hardens or ruptures with time. When plaque gets hardened, it narrows the coronary arteries and thus disrupts the flow of oxygen-rich blood to the heart muscles causing coronary heart diseases. Millions of people are diagnosed with heart diseases, nowadays.
Though it is true that living with a heart disease is not easy, it is not impossible either. Many people are successfully leading a happy life in spite of having such diseases. With some major changes in your lifestyle, food habits and with the help of exercises and a healthy diet, it is possible to enjoy a happy life, irrespective of your diseases.
Here are six ways that would help you to lead a better life, even if you have been diagnosed with coronary artery disease.
- Lifestyle changes: This is the first point that needs to be kept in mind if you are a CAD patient. Lifestyle changes are essential to make for a better health and life. Smoking and drinking have to be given up completely. It is advised to avoid secondary smoke, as much as possible.
- Exercises: This is the next important activity that needs to be a part of your daily routine to lead a healthy life. Consult with your doctor about the types of exercise that would suit your conditions. Some common exercises that would help are walking, jogging, and swimming, for at least 30 minutes at the most. Choose whichever activity you like doing. The motive of exercises is to get your heart-rate up.
- A Heart healthy diet: Get a chart prepared for your diet by a dietitian or by your doctor. This will keep your disease from getting worse. Stick to a heart-healthy eating plan, which consists of foods that can lower your risk of heart attack, stroke, etc. Include more fruits, vegetables, and other high fibre foods in your daily diet. Go for foods that are low in saturated fats, trans-fats, and cholesterol. Try to include fish into your diet.
- Maintain a healthy weight: Being overweight or obese aggravates any disease. So it is important to keep your body weight perfect.
- Taking medicines as prescribed: It is important to take medicines regularly and as prescribed by the physician.
- Keeping tensions, anxiety to a minimum: These will make the situation worse if you are CAD patient. So try to keep tension and anxiety away and lead a healthy life. If you wish to discuss about any specific problem, you can consult a Cardiologist.
The heart is a muscular organ that pumps blood to the entire body through a network of arteries and veins. This network contains big vessels which branch out further to supply blood to the distant organs. There is, therefore, some pressure that the heart and thereby the vessels need to exert to push the blood through these vessels. This is known as blood pressure, and normal pressure levels range from 90-140(systolic)/60-90(diastolic) mm of Hg. However, due to various reasons, this pressure could be more, which is one of the first signs of heart disease.
Causes of increased blood pressure:
- Thickening of the blood vessels. With age, the elastic blood vessels naturally turn rigid and less elastic, so there is more pressure required to push blood. It is natural for people over 55 years of age to have higher readings of blood pressure. This is known as primary hypertension (HTN)
- Narrowed blood vessels. This happens due to cholesterol accumulation along the walls of the blood vessels. Faulty dietary habits along with sedentary lifestyle have increased the incidence of hypertension due to this condition, known as atherosclerosis. Critical atherosclerotic narrowing of renal arteries lead to renovascular HTN that is one of the commonest of secondary HTN.
Other Causes of secondary hypertension are:
- Kidney problems
- Thyroid hormone disorders
- Congenital heart defects
- Chronic alcohol abuse
- Adrenal gland tumours
- Chronic use of medications like birth control pills, pain killers, etc.
Unidentified and uncontrolled hypertension can be silent and can lead to more severe conditions like heart attack and stroke. India is fast becoming the new hypertension capital of the world. Some of the common risk factors are:
- Family history
- Being obese or overweight
- Sedentary lifestyle
- Alcohol consumption
- Excessive salt intake
- Stress levels
- Ethnic background
- Hypertension can go undetected for years together, but if there are risk factors like diabetes and high cholesterol, it is advisable to periodically monitor blood pressure.
- Headaches, nosebleeds, and shortness of breath should not be ignored. These can be the first warning signs of hypertension, and if detected early, preventive measures can be taken.
- If there are co-morbid risk factors, it is advisable to constantly keep a check on BP readings.
This includes a combination of diet and lifestyle modifications.
- Quit smoking and alcohol: Of the many wonders quitting smoking can do, reducing BP readings is just one. The improvement would be almost instantaneous. Quit or else reduce alcohol and see dramatic improvements.
- Weight management: Through a combination of diet and exercise, ensure that weight is brought under control. Set a target BMI (Below 26 kg/m2) and work towards it religiously.
- Diet: Reduce salt, increase potassium, increase vitamin D, eat a heart-healthy diet, and see the hypertension readings improve. Please find attached and reviewed copy for health tip for posting
A person usually gets a heart attack when there is a blockage in one of the arteries of the heart. This is an emergency situation that can result in a fatality or death if it is not treated immediately. Not all heart attacks will have a crushing pain in the chest right in the beginning, there are a number of symptoms that can show the slow progression of this attack over a few hours. So how do you know if you are having a heart attack, and what kind of treatment will be required? This article seeks to answer all your questions.
Discomfort in the Chest: The patient will usually feel like there is some pressure and squeezing in the chest or pain or even fullness right in the centre. This pain can come and go every few minutes and it should not be ignored.
Pain and Discomfort in other Parts of the Body: There may be some amount of pain and discomfort in other parts of the body including the arms, the jawline, back, neck, stomach and even the teeth. This pain can also travel down to the abdomen above umbilicus. In case there is persistent pain along with the chest discomfort, then a doctor must be contacted immediately.
Other Symptoms: When you feel breathless without any reason or medical cause, and also when you experience symptoms like anxiety, indigestion, vomiting, nausea, light headedness, dizzy spells and fatigue, you may be suffering from a heart attack.
Immediate Treatment: Once you begin to experience these symptoms along with chest discomfort and chest pain, it is imperative to call the emergency unit of the nearest hospital or get in touch with a doctor. Until then, you will need to lie down and chew aspirin if you are not allergic to the same. This is usually more efficient that swallowing.
Diagnosis of heart attack: Heart attack is diagnosed if patient has 2 criteria out of following 3-
- Pain or discomfort thought to be due to heart disease
- ECG suggestive of heart attack
- Elevated levels of cardiac enzymes (CK-MB and Troponin) in blood test (these levels start rising after 6 to 12 hours of heart attack)
Once you reach doctor an ECG should be done immediately along with blood pressure and pulse. If ECG shows heart attack then immediate action needs to be taken. Remember a normal first ECG does not rule out a heart attack. So a series of ECGs may be ordered by the doctor and at proper time blood test of cardiac enzymes may be done. Ruling out a heart attack may need an observation and testing up to 6 – 12 hours as cardiac enzyme test shows results only after that period. If you wish to discuss about any specific problem, you can consult a Cardiologist.
The term 'chest pain’ is a very common term and is usually used in day to day life. Basically, chest pain refers to the pain that may generate in your chest, shoulder and can travel to your ribs, jaws and towards your arms. The feeling of the pain can be sharp or dull, depending on the severity of your condition and cause.
There can be several reasons behind chest pain. You need to conduct a few tests to examine the real cause of the chest pain. It is always advised by health experts to take the symptoms of chest pain very seriously in order to avoid any serious problem in the future. Most of the severe and life-threatening diseases behind chest pain involve lung and heart problems. People having serious heart problems often feel discomfort, followed by pain in their chest area.
Chest pain which is related to any heart disease such as heart attack usually has symptoms like:
- Feeling of fullness and tightness in the chest region
- Burning or crushing pain, which travels from the chest to jaw, hands and back region.
- Breathing problem
Usually, it is very tough to distinguish whether the pain is associated with a heart problem or not. But generally chest pains which are not related to heart problems involves symptoms like
- Sensation in your mouth
- Problem in swallowing food
- Pain that worsens when you cough
- Burning sensation in your chest
Common causes of chest pain
- Angina: Angina is a medical condition described as a feeling of discomfort or pain in the chest region. This situation occurs when your heart muscles don't receive blood, which contains rich oxygen. Angina is a symptom of Coronary Heart Disease (CHD). The pain can take place in your shoulder, jaw, neck and arms also.
- Lung problems: People with lung disorders can encounter various types of chest pains. But some common causes are:
- Pleurisy: It is a type of medical condition, which occurs due to inflammation of the lining of chest and lungs. Due to this, you feel a sharp pain at the time of breathing, coughing or sneezing.
- Pneumonia: It is a type of lung infection, which causes chest pain.
- Pneumothorax: It is a type of lung disorder, which occurs when a portion of your chest gets collapsed.
- Asthma: It is a type of condition, which occurs due to shortness of breath and causes chest pain while coughing, sneezing and breathing.
- Gastrointestinal problem: Gastroesophageal reflux disease (GERD) is also a common reason for chest pain such as burning sensation in your heart.
- Other causes of chest pain: There are several other reasons of chest pain such as muscle strain, ribs injury, shingles, anxiety and panic attacks. It is always important to visit a physician whenever you encounter any of such chest pain symptoms. If you wish to discuss about any specific problem, you can consult a Cardiologist.