myths & facts of heart dr. vijay dikshit (m.s., m.ch, ficc) chief cardiac surgeon apollo...

Myths & Facts Of HeartMyths & Facts Of Heart

Dr. Vijay Dikshit (M.S., M.Ch, FICC)

Chief Cardiac Surgeon

Apollo HospitalsHyderabad

Dr. Vijay Dikshit (M.S., M.Ch, FICC)

Chief Cardiac Surgeon

Apollo HospitalsHyderabad

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?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 AttackMyocardial Infarction or Heart AttackSymptoms:

– 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 FactorsChangeable 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 CADDiet 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.

CholesterolCholesterol• 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 CholesterolTypes of Cholesterol

Lipoproteins - 4 main classes

• Chylomicrons

• Very low density lipoproteins (VLDL)

• Low Density Lipoprotein (LDL)

• High Density Lipoprotein (HDL)

The Facts About FatThe 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

Desirable Border line High Risk

Total Cholesterol < 200 200 – 240 > 240

LDL Cholesterol 100 100 – 150 > 150

HDL Cholesterol > 40 30 - 40 < 30

Triglyceride 150 150 - 200 > 200

Good CholesterolGood 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 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 CVDExercise 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 SmokingCigarette 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 ConsumptionAlcohol 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)

Coronary Artery Bypass Surgery (CABG)

– The most frequently performed

major surgery.

– Surgery reroutes or Bypasses

blood around clogged arteries.

Operating Room

Robotic Surgery

ConclusionConclusion• 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