Dr. Avinash

In addition to pumping blood to various organs, the heart also has its own blood supply, through which it receives its oxygen and nutrient supply. In patients with coronary artery disease and atherosclerosis, there is a narrowing of the blood vessels which reduces the amount of blood flow to the target organs, including the heart.

When this happens in the heart, there is chest pain due to overexertion of the heart muscles. There could be two patterns to this chest pain. With regular exertion like exercise, there would be chest pain, and most patients are familiar with this pattern.

This is known as angina pectoris or stable angina. In some people or in some instances, chest pain occurs which is sudden and not of a predictable pattern. It could be related to extreme exertion or stress. This is known as unstable angina and can lead to heart attack and be life-threatening.

Stable angina or angina pectoris has a stable, predictable pattern which most patients get familiar with over a period of time and learn to manage. Read on to know more about the signs and symptoms and management techniques.

Signs and symptoms: Stable angina usually occurs after a round of physical exertion. The patient feels a feeling of tightness in the chest which feels like the chest being squeezed. The pain can gradually spread to the shoulder, arms and even the neck. The pain can also be induced by eating, exposure to cold, emotional stress. It lasts for about 15 minutes and is relieved by rest and sublingual nitroglycerin. The pain intensity does not change with position or coughing. In addition, the patient may also experience shortness of breath, fatigue, profuse sweating, nausea, and dizziness.
The patient may be able to detect signs on further testing including ECG, echocardiography and stress testing. Features like cardiomegaly, altered ejection fraction would be detected based on the severity of the disease.

Treatment: Immediate treatment to relieve the pain includes resting and sublingual nitroglycerin. On an ongoing basis, the treatment would include 3 approaches – lifestyle changes, medications, and surgery.

1. Lifestyle changes: Regular exercise, smoking cessation, reduced fat intake, reduced alcohol consumption, weight loss, and stress management are some lifestyle changes to be made to improve symptoms.
2. Medications: A number of medications would be used depending on patient’s symptoms. Aspirin to prevent clotting, medications to control blood pressure and cholesterol and diabetes.
3. Surgery: In patients with advanced coronary artery disease, revascularization methods may be required, which includes angioplasty and coronary bypass.

In a person with known risk factors, it is advisable to have regular checkups so that the disease progression can be controlled and symptoms managed with minimal intervention.

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

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 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.

Our heart is basically a muscle. So when this muscle weakens the heart is unable to do its function i.e., to pump blood throughout our body and keep us alive.

The heart muscle gets progressively weak due to a disease called cardiomyopathy.

There are different types of cardiomyopathy caused by different causes. Untreated cardiomyopathy can lead to heart failure or early death. Treatment can’t cure the condition but can give you extra healthy years of life and prevent serious complications.

Cardiomyopathy has 4 main types, they are:

1. Dilated Cardiomyopathy: This is the most common form and its principal cause is that your heart muscle becomes too weak to pump blood. The heart muscles stretch and become thinner in this case leading to the four chambers of the heart to expand causing a pathology called an enlarged heart.

2. Hypertrophic Cardiomyopathy: This happens due to genetics. It occurs when the walls of your heart thicken and prevent the flow of blood through this natural pump.

3. Arrhythmogenic Right Ventricular Dysplasia: This is a rare form of cardiomyopathy. It causes sudden deaths of athletes and is caused when fat and fibrous tissues replace muscle in the right ventricle of the heart.

4. Restrictive Cardiomyopathy: This is the least common form of the disease. The cause is the stiffening of the ventricles, the part of the blood which receives blood. When these stiffen, the heart doesn’t get enough blood to oxygenate. Scarring of the heart due to heart disease and a heart transplant operation can be a cause of this stiffening.

5. Ischemic Cardiomyopathy: Ischemic cardiomyopathy is caused due to coronary artery disease which causes blood vessels supplying blood to the heart to become narrow. The heart doesn’t get enough oxygen and a person can die due to a heart attack.

6. Other types of cardiomyopathy are grouped into this category and can include:

   • Left ventricular noncompaction happens when the left ventricle has trabeculations, projections of muscle inside the ventricle.

   • Peripartum cardiomyopathy, another form of the disease can occur during or after pregnancy. This is a form of dilated cardiomyopathy and can be fatal. There’s no documented cause.

   • Alcoholic cardiomyopathy is caused due to alcoholism causing an enlargement of the heart.

   • Takotsubo cardiomyopathy, or broken heart syndrome, happens when extreme stress leads to heart muscle failure. Though rare, this condition is more common in post-menopausal women.

Treatment

Doctors will decide the treatment after finding out the extent of damage due to cardiomyopathy.

Few people will not require treatment till symptoms like chest pain, dizziness, shortness of breath and edema appear.

Others whose life is affected due to symptoms are treated with lifestyle changes and medicines. The bad news is that cardiomyopathy can’t be cured but can only be managed and controlled by doing the following:

1. Heart-healthy lifestyle changes are key. You will be advised to maintain a healthy weight, eat a modified diet, get enough sleep, manage stress, and quit smoking.

2. Exercise is also crucial to keep the heart healthy and maintain a healthy weight through regular bouts of low-intensity exercise.

3. Medications for high blood pressure will be prescribed to prevent water retention, keep the heart beating normally, prevent blood clots and reduce inflammation.

4. Pacemakers and defibrillators can be implanted.

5. Surgery like heart transplant can be done as a last resort.

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

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.

Causes
Several conditions cause strain and damage to the heart. These include the following:

1. High blood pressure or hypertension
2. Heart attack
3. Valvular diseases
4. Coronary artery disease
5. Medical problems like heart failure, lung diseases, high level of thyroid or pneumonia
6. Heart surgeries
7. Excess consumption of alcohol

Symptoms
The primary symptoms of atrial fibrillation include the following:

1. Light-headedness and dizziness
2. Shortness of breath
3. Feeling weak and fatigued
4. Feeling as if the heart is pounding, fluttering or racing (known as palpitations)
5. Feeling that the beating of the heart is uneven
6. Chest pain and fainting

In many cases of atrial fibrillation, the symptoms may be absent.

Diagnosis
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.

Treatment
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:

1. Blood thinning medicines for the prevention of a stroke.
2. Heart rate control medicines which will prevent irregular beating of the heart.
3. Rhythm control medicines for restoring the heart’s rhythm to normal.
4. 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.
5. 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.

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

In today’s time, modern lifestyle certainly has made a living a lot simpler, but it has also invited early death rate.

What does study say?
As per the data made by the National Healthcare Center, it has been found out that over the past few years, the number of death rates is increasing due to heart attack and the prime reason for the same is stress and an unhealthy diet. Often we tend to search online for what things can be done to prevent such early death due to a heart attack. In that case, you have to make up your mind and ensure that the diet regimen, workout session and changes in lifestyle are followed in the right manner.

Preventive measures to reduce risk of a heart attack:
It does not matter what is your current age, looking at the changes that a human is going through with the lifestyle there is no doubt that even young people are prone to this problem.

Here are some important tips that can help you from a heart attack.

1. A healthy diet is the best option: Avoid eating junk food, cholesterol based food, or the do no drink much as these slowly reduce your life quality. Cholesterol based or high-fat food increases the risk of heart attack. Junk food is all about taste, and there is nothing healthy included in it. Instead switch to healthy diet plan rich in fibre, vitamins, and minerals that can regulate the body. Choosing healthy meat with the leanest cuts and restricting down the sugar intake will have a good impact on your overall health.
2. Workout is another answer for All Your Problem: It is always better that you are physically active so that you can keep the heart rate at a good speed. This will speed up metabolism rate, burn unnecessary calories, and increase the rate of your heart so that you can lose weight at the same time stay active. Besides, physical activities like aerobics and swimming are some high-intensity workout that reduces the risk of heart attack to a great extent. Right from kids to adults above 60 years of age should perform a workout of at least 30 minutes even a walk is fine, but staying physically active is extremely important.
3. Regular preventive health checkup should be done.

These are just some of the tips that can help you improve your quality of life. Your doctor is your life saver. He is the one who can guide you at every step and help you understand the right way to stay fit and healthy in the long run. Instead of just ignoring the symptoms, if you notice any make sure you speak with your doctor about the same and take necessary preventive measures as advised. In case you have a concern or query you can always consult an expert & get answers to your questions!

Some people have a sore throat which they think will go away sooner rather than later. Well, while it may not seem serious, rheumatic heart disease means that it could potentially be! But, how exactly?

A sore throat usually comes about on account of bacteria affecting the region of the throat.

Sometimes what can happen is that the same bacteria can go all the way to the heart and damage the valves of it. This is very serious as the health of a person fundamentally depends on the health of his or her heart!

When a sore throat does not seem to be getting better even after about three days go by, the first thing which is to be done is to see a doctor. This is due to the fact that delays can result in the situation getting worse. As a result of this, treatment can get more complex. And who wishes to compound their own miseries, after all?

Rheumatic fever is an inflammatory disorder caused by a Group A strep throat infection. It affects the connective tissue of the body, causing temporary, painful arthritis and other symptoms. In some cases, rheumatic fever causes long-term damage to the heart and its valves. This is called rheumatic heart disease.

Children who are aged between five and fifteen years of age are at risk of rheumatic heart disease. Now, while it is true that children are likely to fall sick more often than adults as their immune systems may not be all that strong, a special eye is to be kept out for rheumatic heart disease. The general symptoms which a parent should look out for are a sore throat, a cough and a fever. The tough part is that these symptoms appear which a range of other conditions!

When it comes to knowing that rheumatic heart disease is what is affecting a person, a special blood test is taken and if there is a need, an ECG and some other measures confirm rheumatic heart disease. Penicillin is a wonder drug and it is used in the treatment of rheumatic heart disease, as well. It is the general form of treatment, in fact, and people with the disease are often put on a course of injections. This means that they need to have an injection every 21 days until you reach 25 years so as to make sure that there is no further damage which can affect the valves of the heart. The importance of this cannot be impressed enough.

It is unfortunate that in many cases, people only discover that they have rheumatic heart disease once they reach adulthood. The valves of the heart may be leaking or significantly damaged by the time that the discovery is made. Is it not a lot better to save oneself from this sort of situation?

Signs and symptoms of rheumatic fever

1. Carditis: inflammation of the heart muscle and heart tissue. Carditis can cause a rapid heart rate, fatigue, shortness of breath and exercise intolerance. This is the most serious of the symptoms and may have long-term effects on health. 
2. Arthritis: swelling, redness and pain in the joints, especially knees, ankles, elbows and wrists. This is a common symptom and occurs in approximately 70 percent of people who have rheumatic fever
3. Splotchy rash that doesn’t itch
4. Subcutaneous nodules: tiny, hard lumps under the skin
5. Fever

How to Prevent Rheumatic Fever

Practicing proper hygiene methods can help prevent strep throat. These include:

1. covering your mouth when coughing or sneezing
2. washing your hands
3. avoiding contact with people who are sick
4. avoiding sharing personal items with people who are sick

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. 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.

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

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.

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. 

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

Cholesterol is one of those terminologies that need a clear and fresh understanding, right from scratch. It is nothing but obvious and common for you to primarily know about the ill effects of cholesterol and what it does to your body; from increasing the risks of cardio-vascular diseases to adding to your waistline. However, it is time we all got a fresh perspective on what cholesterol is.

So, to start off, what is actually cholesterol?
It is waxy substance produced by the liver which plays an important role in the proper functioning of the cells, digestive process and synthesis of Vitamin D in the body. As cholesterol is a fat based substance that does not dissolve in blood, it is transported, throughout the body, by a protein called the ‘lipoprotein’. The lipoproteins that carry cholesterol are of two types: Low-Density

Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL)

Why is LDL ‘bad’?
LDL is known as ‘bad’ cholesterol as it is responsible for plaque formation that reduces flexibility of the arteries and tends to clog them.

Why is HDL ‘good’?
HDL is known as the ‘good’ cholesterol because it gets rid of excessive LDL from the arteries and transports them to the liver where they can be broken down. Too much of bad cholesterol in the body can lead to clogged arteries that may result in stroke or a heart attack. Now that you know that too much LDL cholesterol is bad for you, you need to keep it under control while raising the good cholesterol (HDL) levels.

In order to do that, you need to make certain modifications in your lifestyle.

Some of them can be:

1. Eat foods that are good for the heart: Avoid eating saturated fats and trans-fats as they raise LDL levels in the body. Instead, choose foods that are rich in the heart healthy monounsaturated fats such as almonds and olive oil. Also, include foods that are rich in Omega-3 fatty acids such as fish oil; these fatty acids increase HDL levels in the blood.
2. Exercise regularly: Exercise not only helps you to lose calories but also increases the good cholesterol levels in the body. Aim for 20-30 minutes of cardiovascular exercises in the form of brisk walking, running or cycling to keep your heart muscles healthy.
3. Stop smoking: Smoking can cause the blood vessels to narrow down, thus increasing blood pressure, owing to the constriction of the blood vessels. Quit smoking right away and your ticker will thank you for it. Remember to limit alcohol consumption as well.
4. Maintain optimal weight levels: It’s time to get rid of all the excess fat from the body, especially the visceral fat (abdominal fat). Obesity increases the risk of heart diseases and also has a negative effect on the cholesterol levels.

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