Myths & Facts Of Heart

Dr. Vijay Dikshit (M.S., M.Ch, FICC) Chief Cardiac Surgeon Apollo Hospitals Hyderabad

Normal Heart

Diseases of Heart

• Congenital (Birth defects) • Valve diseases • Coronary Artery Diseases

NORMAL CORONARY ANATOMY

Coronary Heart Disease (Plaque, Atherosclerosis)

What Is Heart Attack?

• Coronary artery becomes blocked - usually by a clot.

• Blood flow is closed off and a heart attack begins.

• If blockage continues, parts of the heart muscle start to die.

• Heart may stop beating.

Heart Attack

Presentation Of CAD

• No symptoms • Angina • Heart attack • Sudden death

Myocardial Infarction or Heart Attack Symptoms

: – Uncomfortable pressure – Fullness – Squeezing pain – Pain spreading to the shoulders – Neck and arms – Chest discomfort and light headedness – Anxiety / nervousness – sweating

Cardiac Misconceptions

• • Heart disease is caused by ‘stress’ ‘worry’ or ‘overwork’ If you’ve had a heart attack you are bound to die of heart disease • Rest restores the heart • Any excitement or shock could cause another heart attack

Risk Factors Of Coronary Artery Diseases Major

– Diabetes – High Blood Pressure – Abnormal Cholesterol – Family History – Smoking – STRESS

Minor

– Obesity – Inactivity – Diet – Gout – Hormonal Disorders

Changeable Risk Factors

• Hypertension • Serum cholesterol • Obesity • Diabetes Mellitus • Physical Inactivity • Cigarette Smoking • Alcohol Intake

Non Modifiable Risk Factors

• Age • Family History • Gender

ECG

• Normal ECG does not mean a normal heart • ECG indicates the condition of the heart at the time of recording.

• ECG does not have any prognostic value

TMT

Coronary Angiography

C.T Coronary Angiogram

Prevention Of CAD

• Diet • Cholesterol • Exercise • Smoking • Alcohol • Stress

Diet and Prevention of CAD

• High fiber low fat • Predominantly vegetarian food • Choose nonfat or low-fat products.

• Use lean meats - choose chicken, fish, turkey • Switch to fat-free milk - gradually reduce the fat content of the milk you drink.

Cholesterol

• • • • Everybody needs cholesterol, it serves a vital function in the body.

It is a component of the nerve tissue of the brain and spinal cord as well as other major organs.

Frequently measured to promote health and prevent disease.

A major component of the plaque that clogs arteries.

Types of Cholesterol

Lipoproteins - 4 main classes • Chylomicrons • Very low density lipoproteins (VLDL) • Low Density Lipoprotein (LDL) • High Density Lipoprotein (HDL)

The Facts About Fat

• Certain fats are essential for good nutrition and health.

• Fats provide essential fatty acids which the body can’t manufacture.

• Act as insulators to maintain body temperature.

• Improve the palatability of food and promote digestion.

Cholesterol Level

Total Cholesterol LDL Cholesterol Desirable < 200 100 HDL Cholesterol Triglyceride > 40 150 Border line 200 – 240 100 – 150 30 - 40 150 - 200 High Risk > 240 > 150 < 30 > 200

Good Cholesterol

• • HDL is known as the good cholesterol.

• • It helps carry some of the bad cholesterol out of the body. • It does not have the tendency to clog arteries.

Levels should be >35.

High levels of HDL >60 can actually negate one other risk factor.

Bad Cholesterol

• LDL is known as bad cholesterol. It has a tendency to increase risk of CHD.

• LDL’s are a major component of the atherosclerotic plaque that clogs arteries.

• Levels should be <130

Exercise and CVD

• • • • • • Serves several functions in preventing and treating those at high risk.

Reduces incidence of obesity.

Increases HDL Lowers LDL and total cholesterol Helps control diabetes and hypertension Those at high risk should take part in a specially supervised program.

Cigarette Smoking

• Causes an increase in blood pressure • Lowers the levels of HDL • Within 1 year of quitting, CAD risk decreases, within 2 years it reaches the level of a nonsmoker.

Alcohol Consumption

• In small amounts it acts as a vasodilator.

• In large amounts it acts as a vasoconstrictor & adds to the caloric intake • The good & Bad affects of Alcohol are divided with a very fine line!

Treatment

• Drugs • Angioplasty & Stent • Coronary Artery Bypass Surgery

Angioplasty & Stent (PTCA)

Coronary Artery Bypass Surgery (CABG) – The most frequently performed major surgery. – Surgery reroutes or Bypasses blood around clogged arteries.

Operating Room

Robotic Surgery

Conclusion

• Coronary Artery Disease is highest among Indians.

• It is highly preventable and controllable with diet and exercise.

• With present treatment of Angioplasty & Coronary Bypass Surgery person can live long and fruitful life