Chat with a HEART SPECIALIST.....

A chat with Dr.Devi Shetty (Heart Specialist),
Narayana Hrudayalaya, Bangalore was arranged by WIPRO for its employees .
The transcript of the chat is given below. Useful for everyone.


Qn: What are the thumb rules for a layman to take care of his heart?

Ans:
1. Diet - Less of carbohydrate, more of protein, less oil
2. Exercise - Half an hour's walk, at least five days a week; avoid lifts and avoid sitting for a longtime
3. Quit smoking
4. Control weight
5. Control blood pressure and sugar

Qn: Is eating non-veg food (fish) good for the heart?

Ans: No

Qn: It's still a grave shock to hear that some apparently healthy person
gets a cardiac arrest. How do we understand it in perspective?

Ans: This is called silent attack; that is why we recommend everyone past the age of 30 to undergo routine health checkups.

Qn: Are heart diseases hereditary?

Ans: Yes

Qn: What are the ways in which the heart is stressed? What practices do you suggest to de-stress?


Ans: Change your attitude towards life. Do not look for perfection in everything in life.

Qn: Is walking better than jogging or is more intensive exercise required to keep a healthy heart?

Ans: Walking is better than jogging since jogging leads to early fatigue and injury to joints

Qn: You have done so much for the poor and needy. What has inspired you to do so?

Ans: Mother Theresa , who was my patient

Qn: Can people with low blood pressure suffer heart diseases?

Ans: Extremely rare

Qn: Does cholesterol accumulates right from an early age
(I'm currently only 22) or do you have to worry about it only after you are above 30 years of age?

Ans: Cholesterol accumulates from childhood.

Qn: How do irregular eating habits affect the heart ?

Ans: You tend to eat junk food when the habits are irregular and your body's enzyme release for digestion gets confused.

Qn: How can I control cholesterol content without using medicines?

Ans: Control diet, walk and eat walnut.

Qn: Can yoga prevent heart ailments?

Ans: Yoga helps.

Qn: Which is the best and worst food for the heart?

Ans: Fruits and vegetables are the best and the worst is oil.

Qn: Which oil is better - groundnut, sunflower, olive?

Ans: All oils are bad .

Qn: What is the routine checkup one should go through? Is there any specific test?

Ans: Routine blood test to ensure sugar, cholesterol is ok. Check BP, Treadmill test after an echo.

Qn: What are the first aid steps to be taken on a heart attack?

Ans: Help the person into a sleeping position , place an aspirin tablet under the tongue with a sorbitrate tablet if available, and rush him to a coronary care unit since the maximum casualty takes place within the first hour.

Qn: How do you differentiate between pain caused by a heart attack and that caused due to gastric trouble?

Ans: Extremely difficult without ECG.

Qn: What is the main cause of a steep increase in heart problems amongst youngsters? I see people of about 30-40 yrs of age having heart attacks and serious heart problems.

Ans: Increased awareness has increased incidents.. Also, sedentary lifestyles, smoking, junk food, lack of exercise in a country where people are genetically three times more vulnerable for heart attacks than Europeans and Americans.

Qn: Is it possible for a person to have BP outside the normal range of 120/80 and yet be perfectly healthy?

Ans: Yes.

Qn: Marriages within close relatives can lead to heart problems for the child. Is it true?

Ans : Yes, co-sanguinity leads to congenital abnormalities and you may not have a software engineer as a child

Qn: Many of us have an irregular daily routine and many a times we have to stay late nights in office. Does this affect our heart ? What precautions would you recommend?

Ans : When you are young, nature protects you against all these irregularities. However, as you grow older, respect the biological clock.

Qn: Will taking anti-hypertensive drugs cause some other complications (short / long term)?

Ans : Yes, most drugs have some side effects. However, modern anti- hypertensive drugs are extremely safe.

Qn: Will consuming more coffee/tea lead to heart attacks?

Ans : No.

Qn: Are asthma patients more prone to heart disease?

Ans : No.

Qn: How would you define junk food?

Ans : Fried food like Kentucky , McDonalds , samosas, and even masala dosas..

Qn: You mentioned that Indians are three times more vulnerable. What is the reason for this, as Europeans and Americans also eat a lot of junk food?

Ans: Every race is vulnerable to some disease and unfortunately, Indians are vulnerable for the most expensive disease.

Qn: Does consuming bananas help reduce hypertension?

Ans : No.

Qn: Can a person help himself during a heart attack (Because we see a lot of forwarded emails on this)?

Ans : Yes. Lie down comfortably and put an aspirin tablet of any description under the tongue and ask someone to take you to the nearest coronary care unit without any delay and do not wait for the ambulance since most of the time, the ambulance does not turn up.

Qn: Do, in any way, low white blood cells and low hemoglobin count lead to heart problems?

Ans : No. But it is ideal to have normal hemoglobin level to increase your exercise capacity.

Qn: Sometimes, due to the hectic schedule we are not able to exercise. So, does walking while doing daily chores at home or climbing the stairs in the house, work as a substitute for exercise?

Ans : Certainly. Avoid sitting continuously for more than half an hour and even the act of getting out of the chair and going to another chair and sitting helps a lot.

Qn: Is there a relation between heart problems and blood sugar?

Ans: Yes. A strong relationship since diabetics are more vulnerable to heart attacks than non-diabetics.

Qn: What are the things one needs to take care of after a heart operation?

Ans : Diet, exercise, drugs on time , Control cholesterol, BP, weight.

Qn: Are people working on night shifts more vulnerable to heart disease when compared to day shift workers?
i
Ans : No.

Qn: What are the modern anti- hypertensive drugs?

Ans : There are hundreds of drugs and your doctor will chose the right combination for your problem, but my suggestion is to avoid the drugs and go for natural ways of controlling blood pressure by walk, diet to
reduce weight and changing attitudes towards lifestyles.

Qn: Does dispirin or similar headache pills increase the risk of heart attacks?

Ans : No.

Qn: Why is the rate of heart attacks more in men than in women?

Ans : Nature protects women till the age of 45.

Qn: How can one keep the heart in a good condition?

Ans : Eat a healthy diet, avoid junk food, exercise everyday, do not smoke and, go for health checkup s if you are past the age of 30 ( once in six months recommended) ..

Coronary Artery Disease


Also called: CAD, Coronary arteriosclerosis, Coronary atherosclerosis

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.
CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. As the buildup grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain ( angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.
Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.

Angina

Angina is chest pain or discomfort you get when your heart muscle does not get enough blood. It may feel like pressure or a squeezing pain in your chest. It may feel like indigestion. You may also feel pain in your shoulders, arms, neck, jaw or back.
Angina is a symptom of coronary artery disease (CAD), the most common heart disease. CAD happens when a sticky substance called plaque builds up in the arteries that supply blood to the heart, reducing blood flow.
There are three types of angina: stable, unstable and variant. Unstable angina is the most dangerous. It does not follow a pattern and can happen without physical exertion. It is does not go away with rest or medicine. It is a sign that you could have a heart attack soon.
Not all chest pain or discomfort is angina. If you have chest pain, you should see your health care provider.

Heart Attack

Also called: Also called: MI, Myocardial infarction
Each year over a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get help immediately. It's important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include
Chest discomfort - pressure, squeezing, or pain
Shortness of breath
Discomfort in the upper body - arms, shoulder, neck, back
Nausea, vomiting, dizziness, lightheadedness, sweating
These symptoms can sometimes be different in women.
What exactly is a heart attack? Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat – called an arrhythmia - that causes a severe decrease in the pumping function of the heart. A blockage that is not treated within a few hours causes the affected heart muscle to die.

Coronary Artery Bypass Surgery


Also called: Also called: Bypass surgery, CABG, Coronary artery bypass graft
If you have coronary artery disease (CAD), the arteries that supply blood and oxygen to the heart muscle become hardened and narrowed. If lifestyle changes and medicines don't help, your doctor may recommend coronary artery bypass surgery.
The surgery uses a piece of a vein from the leg or artery from the chest or wrist. The surgeon attaches this to the coronary artery above and below the narrowed area or blockage. This allows blood to bypass the blockage. Some people need more than one bypass.
You may need bypass surgery for various reasons. Another procedure for CAD, angioplasty, may not have widened the artery enough. In some cases, the angioplasty tube can't reach the blockage.
A bypass also can close again. This happens in more than 10 percent of bypass surgeries, usually after 10 or more years.

Stent Procedure

What is a stent and how is one used?

A stent is a wire metal mesh tube used to prop open an artery during angioplasty. The stent is collapsed to a small diameter and put over a balloon catheter. It's then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold. This holds the artery open. The stent stays in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain). Within a few weeks of the time the stent was placed, the inside lining of the artery (the endothelium) grows over the metal surface of the stent.

When are stents used?
Stents are used depending on certain features of the artery blockage. This includes the size of the artery and where the blockage is. Stenting is a fairly common procedure; in fact, over 70 percent of coronary angioplasty procedures also include stenting.

What are the advantages of using a stent?
In certain patients, stents reduce the renarrowing that occurs after balloon angioplasty or other procedures that use catheters. Stents also help restore normal blood flow and keep an artery open if it's been torn or injured by the balloon catheter.

Can stented arteries reclose?
Yes. Reclosure (restenosis) is also a problem with the stent procedure. In recent years doctors have used new types of stents called drug-eluting stents. These are coated with drugs that are slowly released and help keep the blood vessel from reclosing. Stents that are not coated with drugs are called bare metal stents. As detailed below, it is very important that patients with either type of stent take their anti-clotting medicines as directed.

What precautions should be taken after a stent procedure?
Patients who've had a stent procedure must take one or more blood-thinning agents. Examples are aspirin and clopidogrel. These medications help reduce the risk of a blood clot developing in the stent and blocking the artery. Some recent studies have suggested that blood clots may develop later on (more than a year after stent placement) in the drug-eluting stents. Therefore it is really important to stay on your medications as long as your cardiologist recommends. Aspirin is usually recommended for life, and clopidogrel is generally used for one to 12 months (depending on the type of stent) after the procedure. Clopidogrel can cause side effects, so blood tests will be done periodically. If you are taking this medication, it is important that you don't stop taking it for any reason without consulting your cardiologist who has been treating your coronary artery disease..

For the next four weeks a magnetic resonance imaging (MRI) scan should not be done without a cardiologist's approval. But metal detectors don't affect the stent.

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