MERA

HRIDAYA patient information guide

CONTENT

1) HIGH BLOOD PRESSURE

2) HIGH CHOLESTEROL

3) HEART DISEASE: ANGINA

4) HEART DISEASE: ANGIOPLASTY

5) HEART DISEASE: BEING ACTIVE

6) HEART DISEASE: ANTIPLATELET TREATMENT

7) HEART DISEASE: LIFESTYLE CHANGES TO LOWER RISK

8) HEART DISEASE: HOW TO MANAGE YOUR LIFE AFTER A HEART ATTACK

9) HEART FAILURE

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Page No.

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Blood pressure is a measure of the force of

blood against the walls of your arteries. Blood

pressure readings include two numbers, such

as 130/80, or "130 over 80." The first number is

the systolic pressure. This is the force of blood

on the artery walls as your heart pumps. The

second number is the diastolic pressure. This is

the force of blood on the artery walls between

heartbeats, when your heart rests.

If your blood pressure is usually above 140/90,

yo u h ave h i g h b l o o d p re s s u re , o r

hypertension.

Despite what a lot of people think, high blood

pressure usually does not cause headaches or

make you feel dizzy or lightheaded. It usually

has no symptoms. However, it does increase

your risk for heart attack, stroke, heart

failure, and kidney or eye damage. The higher

your blood pressure, the more your risk

increases.

If you have high blood pressure, your doctor

will give you a blood pressure goal. Your goal

What is high blood pressure?

will be based on your health and your age. An

example of a goal is to keep your blood

pressure below 140/90.

Lifestyle changes, such as eating healthy and

being active, are always important to help

lower blood pressure. You might also take

medicine to reach your blood pressure goal.

Take your medicines as prescribed. Call your

doctor if you think you are having a problem

with your medicine. You may take one or more

types of medicine to lower your blood

pressure. If you stop taking your medicine,

your blood pressure will go back up.

See your doctor regularly.

Learn how to check your blood pressure at

home.

If you are taking blood pressure medicine talk

to your doctor before you take decongestants

or nonsteroidal anti-inflammatory drugs

(NSAIDs), such as ibuprofen. Some of these can

What can you do about high blood pressure?

Follow your treatment plan

HIGH BLOOD PRESSURE

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raise blood pressure or interact with blood

pressure medicines.

Ÿ Stay at a healthy weight. This is especially

important if you put on weight around your

waist. If you are overweight, losing even 10

pounds can help you lower your blood

pressure.

Ÿ Try to do moderate aerobic activity at least

2½ hours a week. Or try to do vigorous

activity at least 1¼ hours a week.

Ÿ If you drink alcohol, drink moderately. Limit

alcohol to 2 drinks a day for men and 1 drink

a day for women.

Ÿ Try to limit the amount of sodium you eat to

less than 1,500 milligrams (mg) a day.

Ÿ Follow the DASH (Dietary Approaches to

Stop Hypertension) eating plan. This plan

can help you lower blood pressure. Its

focus is on fruits, vegetables, healthy fats,

and low-fat dairy foods. This type of eating

plan can help you lose weight and also

lower your risk for heart disease.

Ÿ Do not smoke. Smoking increases your risk

for heart attack and stroke. If you need help

quitting, talk to your doctor about stop-

smoking programs and medicines. These

can increase your chances of quitting for

good health.

Call a doctor right away if you have high blood

pressure and:

Ÿ Your blood pressure is much higher than

normal (such as 180/110 or higher).

Ÿ You think high blood pressure is causing

Make lifestyle change

When should you call for help?

symptoms such as:

Ÿ Severe headaches.

Ÿ Blurry vision.

Ÿ Your blood pressure is 140/90 or higher on

two or more occasions.

Ÿ You think you may be having side effects

from your blood pressure medicine.

Ÿ Your blood pressure is usually normal and

well controlled, but it goes above the

normal range on more than one occasion.

Make an appointment to see your doctor if

you have never been diagnosed with high

blood pressure but you have a high blood

pressure reading.

Call a doctor if:

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HIGH CHOLESTEROL

Cholesterol is a type of fat. Your body needs it

for many things, such as making new cells. You

get cholesterol from the foods you eat and

your body makes it.

Having too much cholesterol does not make

you feel sick. But it raises your risk of a heart

attack and stroke.

Your cholesterol levels can help your doctor

find out your risk for having a heart attack or

stroke.

LDL (low-density lipoprotein) is the "bad"

cholesterol. High LDL can raise your risk for

heart disease, heart attack, and stroke. HDL

(high-density lipoprotein) is the "good”

cholesterol. High HDL is linked with a lower risk

for heart disease, heart attack, and stroke.

But it's not just about your cholesterol. Your

doctor uses your cholesterol levels plus other

things to calculate your risk. These include:

Ÿ Your blood pressure

Ÿ Whether you have diabetes or not

Ÿ Your age, sex, and race

Ÿ Whether you smoke or not

Understanding your cholesterol levels

Treating high cholesterol

Lifestyle changes

The goal of treatment is to reduce your

chances of having a heart attack or stroke. The

goal is not to lower your cholesterol numbers

only. The two types of treatment are:

Ÿ Lifestyle changes

Ÿ Medicines called statins

The way you choose to lower your risk will

depend on how high your risk for heart attack

and stroke is. It will also depend on how you

feel about taking medicines. Your doctor can

help you know your risk. Your doctor can help

you balance the benefits and risks of your

treatment options.

Lifestyle changes are always important, even if

you take medicines to lower your risk.

Your doctor may suggest that you make one or

more of the following changes :

Ÿ Eat heart-healthy foods.

Ÿ Lose weight if you need to, and stay at a

healthy weight.

Ÿ Be active on most, if not all, days of the

week.

Ÿ Don't smoke.

Some people take medicines called statins, in

addition to making lifestyle changes. This

medicine can lower the risk of a heart attack or

stroke.

Statins reduce the body's natural production

of cholesterol. So they lower the amount of

cholesterol in your blood.

Statins don't cause side effects in most people.

When side effects happen, they tend to

include minor problems such as muscle aches

and tiredness. Serious side effects are rare. If

you can't take a statin, your doctor may

recommend another type of cholesterol

medicine.

Talk with your doctor about your risk of a heart

attack and stroke. Together you can decide if

medicine is right for you. Your doctor may

recommend that you take statins if the

benefits outweigh the risks.

For some people, the chance of having a heart

attack or stroke is high. These people may

decide to start taking a statin because statins

can reduce this risk.

For other people, it's not as clear if they need

to take a statin. You and your doctor will need

to look at your overall health and any other

risks you have for heart attack and stroke.

Take the sheet with you to your next doctor

visit. You may want to ask your doctor these

questions:

Ÿ What is my risk for heart attack and

stroke?

Medicines

Deciding about medicine

Talk to your doctor

Ÿ Should I do something to help lower my

risk?

Ÿ What lifestyle changes can help me stay

healthy? How can I make changes that

will last?

Ÿ Should I think about taking medicine?

Do you have any questions or concerns after

reading this information? It's a good idea to

write them down and take them to your next

doctor visit.

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HEART DISEASE: ANGINA

Angina is a symptom of heart disease.

Angina happens when your heart does not get

enough blood. This is caused by heart disease,

also called coronary artery disease. Heart

disease can narrow the arteries that bring

blood to the heart muscle. Heart disease

increases your risk for a heart attack.

Symptoms of angina include chest pain or

pressure, or a strange feeling in the chest.

Some people feel pain, pressure, or a strange

feeling in the back, neck, jaw, or upper belly, or

in one or both shoulders or arms. Other

symptoms of angina include shortness of

breath, nausea or vomiting, light headed

nessorsudden weakness, or a fast or irregular

heartbeat.The different types of angina include:

• Stable angina: This type has a typical

pattern. People who have it know when it

may happen, such as when they exercise or

do activities. It goes away when they rest or

stop the activity, or when they take a

medicine such as nitroglycerin.

• Unstable angina: This is a change in the

usual pattern of stable angina. The

symptoms happen at rest or with less

activity. They do not go away with rest or

nitroglycerin.

• Angina caused by coronary artery spasms:

This type of angina happens when a

coronary artery suddenly contracts (or

spasms). The spasm reduces blood flow to

the heart.

Variant angina (Prinzmetal's angina) is one

type caused by a spasm. It has a typical

pattern. It usually occurs when you are

atrest and lasts 2 to 5 minutes. It happens

more often at night, in the early morning,

or at the same time of the day.

With both a heart attack and angina, part of

your heart muscle is not getting enough

oxygen because of reduced or blocked blood

flow in your coronary arteries. With angina,

the lack of oxygen is temporary. Permanent

heart damage doesn't occur. But during a

What is the difference between angina and

a heart attack?

Unstable angina is an emergency

because you might be having

a heart attack.

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heart attack, the lack of oxygen lasts longer

and damages the heart.

With stable angina, you may notice the

problem only when your heart is working

harder and needs more oxygen, such as during

exercise. The pain goes away when you rest,

because your heart no longer needs as much

oxygen.

With unstable angina, a clot may be partially

blocking your coronary artery, or it completely

blocks it for a short time.

Most people who have stable angina can

manage their symptoms. This includes taking

medicines as prescribed.

If your doctor has given you nitroglycerin, keep

it with you at all times. If you have angina

symptoms, sit down and rest, and take a dose

of nitroglycerin as directed.

Staying active and knowing when to rest during

activity is also important. You can try these

tips:

Ÿ If an activity causes angina, stop and rest.

Be active at a level that does not cause

symptoms.

How can you manage angina?

Ÿ Ease into your day. Warm up slowly before

activity.

Ÿ Give yourself time to rest and digest right

after meals.

Ÿ Change the way you eat. Eat smaller meals

more often during the day instead of two

or three large meals.

If angina is more severe and you are having a

hard time managing it, you can:

Ÿ See if family members or hired help can

assist with heavy chores such as shoveling

snow or mowing lawns.

Ÿ Try taking nitroglycerin before you start a

stressful activity that can cause angina,

such as walking uphill or having sex.

Ÿ If you are not taking a medicine for angina,

ask your doctor if one could help you.

Call 108 if you have symptoms of a heart

attack. These may include:

Ÿ Chest pain or pressure, or a strange feeling

in the chest

Ÿ Sweating

Ÿ Shortness of breath

Ÿ Nausea or vomiting.

Ÿ Pain, pressure, or a strange feeling in the

back, neck, jaw, or upper belly or in one or

both shoulders or arms

Ÿ Lightheadedness or sudden weakness

Ÿ A fast or irregular heartbeat

If you use nitroglycerin and one dose has not

relieved your symptoms within 5 minutes, call

108. Do not wait to call for help.

After you call 108, the operator may tell you to

chew 1 adult - strength or 2 to 4 low-dose

aspirin. Wait for an ambulance. Do not try to

drive your self.

Ÿ There is a sudden change in your angina

symptoms.

Ÿ You begin to get angina at unexpected

times.

Ÿ You get angina when you are resting.

When should you call for help ?

Call your doctor now or seek immediate

medical care if:

If you have angina, pay attention

to your symptoms.

Know what is typical for you,

learn how to control it, and understand

when you need to get treatment.

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Angioplasty is a way to get more blood flowing to the heart muscle. Your doctor may call it percutaneous coronary intervention (PCI).

It is a procedure that widens a coronary artery that was narrowed or blocked by plaque. Coronary arteries are blood vessels that provide blood and other nutrients to the heart muscle. Plaque is a fatty buildup that can block your arteries.

If you have a heart attack, an emergency angioplasty might be done to prevent more damage to your heart.

Or, you might choose to have this procedure if you have angina symptoms that do not go away with medicine and healthy life style changes. An angioplasty can improve blood flow to your heart. But it is not a cure for heart disease.

Before angioplasty, the doctor will do a test called a coronary angiogram. For this test, any tube called a catheter is threaded through an artery in your arm or groin and up to the coronary arteries. A dye is then sent through the catheter. The dye makes your coronary arteries show up on a screen so the doctor can see them. If one is narrowed or blocked, your doctor will do angioplasty.

How it is done ?

During angioplasty, the doctor threads a catheter into the narrowed or blocked artery. At the end of the catheter is a tiny balloon. The doctor inflates the balloon inside the artery to open the blocked or narrow area.

The doctor may put a stent in your artery

during angioplasty. A stent is a small tube that

expands against the walls of the artery. The

stent can keep the artery from closing again.The doctor may use a type of stent called a drug-eluting stent. These stents are coated with medicines that keep scar tissue from forming inside the stent. This helps keep the artery open.

Angioplasty doesn't require a large cut

(incision). You'll get medicine to help you relax,

but you'll be awake during the procedure.

What to expect after the procedure ?

Ÿ You will have a large bandage at the site

where the catheter was inserted.

Ÿ Nurses will check your heart rate and

blood pressure and check the insertion

site for bleeding.

Ÿ If the insertion site is at your groin, you will

need to keep your leg straight for a few

hours.

Ÿ If the insertion site is in your arm, you will

need to keep your arm still for at least one

HEART DISEASE: ANGIOPLASTY

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hour.

Ÿ You will probably go home in a day or two.

Once you are home:

Ÿ Gently wash around the insertion site with

clean water 2 times a day unless your

doctor gives you other instructions. Other

cleaning products, such as hydrogen

peroxide, can slow wound healing.

Ÿ Check the insertion site every day for signs

of infection: redness, swelling, pus, or

fever.

Ÿ You will probably be able to return to your

normal activities in a few days.

Ÿ Do not smoke. Smoking raises your risk of

having the artery close after angioplasty

or stent placement.

Ÿ Keep all your follow-up appointments.

Angioplasty is not a cure. You still need to

see your doctor and take your medicines.

Ÿ Take your medicines as directed. If you got

a stent, you'll take blood-thinning

medicines, including aspirin, to help

prevent a heart attack. Don't stop these

medicines unless you've checked with

your doctor first. If you got a drug-eluting

stent, you will probably take both of these

medicines for at least 1 year. If you got a

bare metal stent, you will take both

medicines for at least 1 month but maybe

up to 1 year. Then, you'll likely take daily

aspirin long-term. Your doctor might

recommend cardiac rehab for you. In

rehab, you'll get education and support to

help you recover and make lifestyle

changes to keep your heart healthy.

Risks

When to call your doctor Call your doctor if:

The rate of problems after angioplasty is very

low. But like all medical procedures, it does

have some risks. The most common are:

Ÿ Bleeding from the blood vessel where the

catheter was inserted.

Ÿ Damage to the blood vessel in your groin

or arm, which may need to be repaired.

Ÿ Damage to the coronary artery, which can

cause a heart attack.

Ÿ Infection.

Ÿ An allergic reaction to the dye used during

the procedure

Ÿ An allergic reaction to the dye used during the procedure

• You have any signs of infection.

These include:

¡ Increased pain, swelling,

warmth, or redness at the

insertion site

¡ Red streaks leading from the

insertion site

¡ Pus draining from the

insertion site

¡ Fever

Ÿ You have pain or bleeding at the insertion site

Ÿ You have any questions or concerns

MERA HRIDAY 09

When you have heart disease, it is very

important to get regular exercise. Exercise can

help your heart get stronger and work better.

Your doctor can suggest a safe level of

exercise based on your condition and the

stage of your disease. Even if you can only do a

small amount, exercise will help you have

more energy and manage your weight and

your stress

Your heart is a muscle. When you use a muscle

during exercise, it gets stronger and more

efficient. A more efficient heart can pump

more blood with each heartbeat and deliver

more oxygen and nutrients to the rest of the

body. Getting regular exercise is important

because even a short period of inactivity can

weaken your heart.

Ÿ Reduce angina symptoms, such as chest

pain or discomfort

Ÿ Improve cholesterol

Ÿ Lower your blood pressure

Ÿ Reduce or control your weight

Exercise: Why does it matter?

Regular exercise also helps :

Ÿ Reduce stress and lift your mood

Before you start an exercise program:

Ÿ See your doctor for a complete physical

exa m . Yo u r d o c t o r m ay d o a n

electrocardiogram (EKG or ECG) and a

stress test to see what level of activity

your

Ÿ heart can handle.

Ÿ Before your visit, make a list of questions

to discuss with your doctor.

Ÿ Learn how to check your heart rate. Your

doctor can tell you how fast your heart

rate should be when you exercise.

Your doctor can help you make an exercise plan. Or your doctor may suggest a cardiac rehab program at a local hospital or clinic. Cardiac rehab is a medically supervised program for people who have heart problems. It includes exercise, lifestyle changes, education, and emotional support. A team of doctors, nurses, dietitians, and physical therapists can design a program to help you improve your quality of life.

Getting ready to exercise

Making an exercise plan

HEART DISEASE: BEING ACTIVE

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Most exercise programs include:

Once you have started:

Ÿ Stretching for 10 to 15 minutes helps

warm up your muscles.

Ÿ Activities that raise your heart rate

(aerobic exercise). Walking, riding a

stationary bike, and swimming are all

aerobic exercises.

Ÿ Strength training. Exercises using light

weights can help tone and strengthen

your muscles.

Ÿ A cool-down period.

Once you start exercising, try to stick with it. Here are some tips that can help you succeed:

Ÿ Start slowly, and set realistic goals. If you

expect too much too soon, you may get

discouraged and give up.

Ÿ Find a partner. One of the best ways to stay

motivated to exercise is to include other

people. Ask a friend or coworker to join

you. Join a health club or walking group.

Ÿ Choose a type of exercise that you enjoy.

Walking is a great exercise that most

people like and can do. You may want to

set a goal of walking briskly for at least 30

minutes a day.

Ÿ Keep a daily record of your exercise. It is

okay to skip a day once in a while or to cut

back if you are too tired or not feeling well.

Ÿ Give yourself time. It can take months to

get into the habit of exercising. After a few

months, you may find that you look

forward to it.Ÿ Reward yourself. Build in rewards along

the way that help you continue your program.

Keep in mind It is important to:

For safety:

Ÿ Take your pulse often. Check your pulse

when you walk up hills or stairs. Make sure

it stays in a safe range.

Ÿ Watch for signs that your heart is working

too hard. You are pushing yourself too

hard if you cannot talk while you are

exercising.

Ÿ If you become short of breath or dizzy,

stop, sit down, and rest. If these

symptoms do not go away, call your

doctor.

Ÿ If you think you might be having a heart

attack, call 108 right away. Symptoms

include pain, pressure, or a strange

feeling in your chest, back, neck, jaw,

upper belly, arm, or shoulder.

Ÿ Ask your doctor about continuing your

exercise program if your medicines

change. New medicines can affect how

you feel when you exercise.

Ÿ Adjust your exercise program if it is

interrupted for more than a couple of

days. Gradually increase to your regular

activity level.

If you feel "wiped out" the day after you

exercise, walk slower or for a shorter distance

until you can work up to a better pace.

Ÿ Do not exercise outdoors when it is very

cold, very hot, or very humid. When the

weather is bad, exercise indoors or walk at

a mall.

Ÿ Avoid exercises that require or encourage

holding your breath, such as push-ups and

sit-ups. Also avoid heavy lifting.

Do not take hot or cold showers or sauna

baths right after you exercise. Very hot or

very cold temperatures can be dangerous

Ÿ

.

MERA HRIDAY 11

If you have heart disease, one of the things you

can do to help your heart is to take medicine

that helps prevent your blood from clotting.

This is called antiplatelet therapy.

Aspirin is the most common antiplatelet

medicine. Your doctor may suggest that you

take aspirin, another antiplatelet medicine, or

both.

Antiplatelet medicine helps prevent heart

attacks. Heart attacks occur when blood flow

to the heart is blocked. This usually happens

because fatty deposits called plaque have built

up inside the coronary arteries, which supply

blood to the heart. If a plaque breaks open, the

body tries to fix it by forming a clot around it.

The clot can block the artery, preventing the

flow of blood and oxygen to the heart and

causing a heart attack.

Blood clots also can form on stents, which are

small expandable tubes that are put in your

coronary artery during angioplasty. They keep

the artery open. Blood clots on a stent block

blood flow and can cause a heart attack.

Antiplatelet medicine helps prevent blood

clots in the arteries and on stents. This reduces

Why take antiplatelet medicine?

the chances that you will have a heart attack.

These medicines make bleeding more likely.

Talk to your doctor about your risk for

bleeding, especially if:

Ÿ You have stomach ulcers or have had

bleeding in your stomach or another part

of your digestive tract

Ÿ before.

Ÿ You had a stroke caused by bleeding in the

brain.

Ÿ Limit alcohol. Ask your doctor whether

you can drink alcohol and how much you

can drink. Drinking 3 or more alcoholic

drinks a day while taking antiplatelet

medicine increases your risk for liver

damage and stomach bleeding.

Ÿ Do not take prescription or over-the-

counter medicines, vitamins, herbal

products, or supplements without talking

Is the medicine safe?

Things to avoid when you take antiplatelet

medicine :

HEART DISEASE: ANTIPLATELET TREATMENT

MERA HRIDAY12

to your doctor first. Before you take any

over-the-counter medicine, read the

label. Many contain aspirin and could

cause you to take too much aspirin.

Ÿ Do not take prescription blood thinners

(anticoagulants) unless your doctor has

told you to.

Ÿ Do not stop taking aspirin or another

antiplatelet medicine without talking to

your doctor first. Call your doctor if you

think you are having a problem with your

medicine.

Ÿ Talk to your doctor before having a

medical procedure, surgery, or dental

work that may cause bleeding. Your

doctor can tell you if and when you should

stop taking your antiplatelet medicine

before the procedure. Make sure you

understand exactly what your doctor

wants you to do.

Ÿ Talk to your doctor before taking aspirin or

another antiplatelet medicine if you are

pregnant, are breast-

Other concerns :

When to call your doctor

feeding, or plan to

become pregnant.

Ÿ If you need to take a pain reliever, talk to

your doctor about which one you should

take.

Call 108 anytime you think you may need emergency care. For example, call if:

Ÿ You pass out (lost Consciousness).

Ÿ You have a sudden, severe headache that

is different from past headaches.

Ÿ You have symptoms of a heart attack.

These may include:

v Chest pain or pressure, or a strange

feeling in the chest

v Sweating

v Shortness of breath

v Nausea or vomiting

v Pain, pressure, or a strange feeling in

the back, neck, jaw, or upper belly, or in

one or both shoulders or arms

v Lightheadedness or sudden weakness

v A fast or irregular heartbeat

After you call 108, the operator may tell you to

chew 1 adult-strength or 2 to 4 low-dose

aspirin. Wait for an ambulance. Do not try to

drive yourself.

Call your doctor now or seek medical care

right away if:

Watch closely for changes in your health, and

be sure to contact your doctor if:

v You have any abnormal bleeding, such as:

¦ Nosebleeds

¦ Vaginal bleeding that is different (heavier,

more frequent, at a different time of the

month) than what you are used to

¦ Bloody or black stools, or rectal bleeding

¦ Bloody or pink urine

v You have:

¦ Ringing in your ears

¦ Problems with your vision

¦ Nausea

¦ Dizziness

¦ Rapid or deep breathing

v You have an upset stomach

v You have questions about aspirin or other

antiplatelet medicines

MERA HRIDAY 13

HEART DISEASE: LIFESTYLE CHANGES TO LOWER RISK

If you have heart disease, you can help lower

your risk of a heart attack and stroke with

healthy lifestyle changes. A healthy lifestyle

can also improve the quality and length of your

life.

You can lower your risk for heart attack and

stroke by making lifestyle changes and taking

medicine.

To be heart-healthy, eat healthy foods, be

active, stay at a healthy weight, and don't

smoke.

It's not easy to make changes. But taking the

time to really think about what will motivate or

inspire you will help you reach your goals. Also,

the more support you have for making a

lifestyle change, the easier it is to make that

change.

Ask your doctor if a cardiac rehabilitation

(rehab) program is right for you. In cardiac

rehab, you will get support to help you build

new, healthy habits.

Making lifestyle changes

Getting active

Before you start a new activity, talk to your

doctor about how much exercise is safe.

Start slowly, and go at a pace you can manage.

Try to do at least 2½ hours of moderate

exercise a week. One way to do this is to be

active 30 minutes a day, at least 5 days a week.

Walking is an easy, low-cost way to be active.

Walking with a partner helps you keep up a

routine. Try using a pedometer to count your

steps and set walking goals.

Here are some other ideas for getting active:

Ÿ Work in the yard or garden.

Ÿ Swim or go for a bike ride.

Ÿ Join a health club or walking group.

No matter what you do, the key is making

physical activity a regular, fun part of your life.

Healthy eating starts with learning new ways

to eat, such as adding more fresh fruits,

vegetables and whole grains and cutting back

on foods that have a lot of saturated fat,

sodium, and sugar.

Heart-healthy eating

Heart-healthy foods include:

Ÿ Lean meat, poultry, fish, and beans

Ÿ Fruits and vegetables

Ÿ Whole grains and cereals

You can work with a dietitian to make a healthy

eating plan.

Getting active and eating a healthy diet can

help you lose extra weight.

You'll have more success getting to a healthy

weight if you first change the way you think

about certain things:

Ÿ Don't compare yourself to others.

Healthy bodies come in all shapes and

sizes.

Ÿ Pay attention to how hungry or how full

you feel. When you eat, pay attention to

why you're eating and how much you're

eating.

Ÿ Decide that you're going to improve your

health and plan exactly what you'll do to

reach that goal.

Healthy weight

Quit smoking

Quitting smoking may be the best thing you

can do for your heart and your body. It is hard

to quit. But there are many things that can help

you. Ask your doctor about:

Ÿ Medicine.

Ÿ Support groups and quitting smoking

programs

Ÿ Internet programs and smartphone or

tablet apps

Tips for getting support

Partner with someone who is also making

lifestyle changes.

Ÿ Get friends and family involved.

Ÿ Join a class or workout group.

Ÿ Give yourself positive reinforcement.

You will also take medicine that lowers your

risk for heart attack and stroke. This includes

medicine to:

Ÿ Lower risk of blood clots.

Ÿ Lower blood pressure.

Ÿ Lower cholesterol.

Even though you are taking medicine, it is

always important to make lifestyle changes

that keep your heart and your body healthy.

Do you have any questions or concerns after

reading this information? It's a good idea to

write them down and take them to your next

doctor visit.

Taking medicine

MERA HRIDAY14

MERA HRIDAY 15

HEART DISEASE: HOW TO MANAGE YOUR LIFE AFTER A HEART ATTACK

After a heart attack, you probably have

concerns about your health. But you can start

doing things now to improve your health and

prevent another heart attack.

Medicines and healthy lifestyle changes can

help you prevent another heart attack. A

healthy lifestyle means being active, eating a

heart-healthy diet, and controlling your blood

pressure and cholesterol.

Your doctor may recommend a cardiac

rehabilitation program. This will help you

recover and improve your health. You will learn

how to exercise safely, change your diet, deal

with stress, and return to your daily activities.

Certain medicines can lower your risk of having

another heart attack. These include:

Ÿ Beta-blockers and ACE inhibitors to lower

your blood pressure and reduce the

workload on your heart

Ÿ Aspirin and other antiplatelet medicines

to help prevent blood clots

Ÿ Statins to lower your cholesterol

Take your medicines exactly as prescribed. And

Medicines

don't stop taking them unless your doctor tells

you to. If you stop taking your medicines, you

can increase your risk of having another heart

attack.

Call your doctor if you think you are having a

problem with your medicine.

You can help lower your chance of having

another heart attack by managing other health

problems you might have. Health problems

such as high blood pressure, high cholesterol,

and diabetes can increase your risk of a heart

attack.

If you have any of these health problems,

healthy lifestyle changes, such as quitting

smoking, eating better, and being active, can

help. You also may need to take medicines to

manage these conditions.

Healthy lifestyle changes can help prevent

another heart attack:

Ÿ Quit smoking, and avoid secondhand

smoke. This is one of the best things you

can do for your heart and your overall

Manage other health problems

Lifestyle changes

health.

Ÿ Be active. Get at least 30 minutes of activity

on most days of the week. Physical activity,

like walking, can help you lose weight,

lower your blood pressure, and improve

your cholesterol. Before starting activity,

talk to your doctor to find out how much is

safe for you. Increase your activity a little

bit at a time, as your doctor approves.

Ÿ Eat a heart-healthy diet. This includes

plenty of fruits and vegetables, fish, and

high-fiber grains and breads. Eat foods low

in sodium (salt), saturated fat, trans fat, and

cholesterol.

Ÿ Lose weight if you need to, and stay at a

healthy weight.

Ÿ Cut down on stress. Stress may damage

your heart, and it can trigger a heart attack.

Ÿ Avoid colds and flu. Get the flu vaccine

every year. Get a pneumococcal vaccine

shot. If you have had one

Ÿ before, ask your doctor whether you need

another dose.

Ÿ Ask for help if you think you are depressed.

A medical team can design a cardiac

rehabilitation (rehab) program to fit your

needs. This type of program helps you recover

from a heart attack. It also helps you take steps

to prevent another one.

In the program, your doctor and other

specialists will give you education and support

to help you build new, healthy habits. You will

learn how to manage your heart disease and

any other health problems you might have.

Working with your team, you'll decide what

lifestyle choices are best for you.

If your doctor hasn't already suggested it, ask

him or her if cardiac rehab is right for you.

Take part in cardiac rehab

When to call for help Call 108 if:

Ÿ You have symptoms of a heart attack.

Ÿ You have signs of a stroke, such as:

Ÿ Sudden numbness, paralysis, or

weakness in your face, arm, or leg,

especially on only one side of your body.Ÿ New problems with walking or balance.Ÿ Sudden vision changes.Ÿ Drooling or slurred speech.Ÿ N e w p r o b l e m s s p e a k i n g o r

understanding simple statements, or feeling confused. A sudden, severe headache that is different from past headaches.

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There are many steps you can take to feel

better and improve your health if you have

heart failure. Medicine and lifestyle changes

can slow heart failure in some people. Learning

all you can about your condition can help you

get the best results from your treatment.

Heart failure occurs when your heart does not

pump as much blood as your body needs.

Failure does not mean that the heart has

stopped pumping. It means it is not pumping

as well as it should. Anything that damages the

heart and its ability to pump can lead to heart

failure. This includes coronary artery disease,

heart attack, high blood pressure, and heart

valve problems. You may not know you have

heart failure until you have had it for years. This

is because your heart can make up for not

being able to pump well by getting bigger and

beating faster. But it can only do this to a

certain point. In time, your heart gets worn

out. You have symptoms, such as feeling weak,

lightheaded, and very tired. Fluid builds up in

your lungs and other parts of your body. This

causes you to be short of breath and have

swelling in your body.

What is heart failure and what causes it?

What are the types of heart failure?

What increases your risk for heart failure?

Ask your doctor what type of heart failure you

have.

Most people get heart failure because of a

problem with the heart's left lower chamber

(ventricle). During the resting phase of your

heartbeat, the left ventricle fills with oxygen-

rich blood. This phase is called diastole. Then

the ventricle squeezes and pumps the blood to

your body. This pumping phase is called

systole.

Ÿ When the left ventricle cannot pump

well, it is called systolic heart failure.

Ÿ When the left ventricle cannot fill

properly, it is called diastolic heart

failure.

Heart failure is generally caused by another

disease, such as CAD, heart attack, and high

blood pressure. Anything that increases your

risk for getting one of those diseases also adds

to your risk, or is a risk factor, for heart failure.

For example, diabetes increases your chance

of having CAD, so it is also a risk factor for heart

failure.

HEART FAILURE

Some risk factors exist because of who you are.

Some result from your lifestyle choices. Others

come from your environment. Some risks that

you cannot control include:

Ÿ Your age: The risk of developing heart

failure rises sharply as you age.

Ÿ Your sex: Overall, men are at a higher risk

for heart failure than women. But this

difference narrows as women get older.

Your family history: If any of your close

relatives have or had heart failure, you

may have

Ÿ

inherited a risk for heart failure.

You may be able to control many things

that increase your risk for heart failure.

Examples include:

Ÿ Using tobacco: Smoking increases your

risk of heart disease.

Ÿ Drinking large amounts of alcohol, which

can raise your blood pressure, trigger

uneven heartbeats, and damage your

heart muscle.

Ÿ Not getting enough physical activity: Lack

of exercise can increase your risk of high

blood pressure, high cholesterol, high

blood sugar levels, blood clots, obesity,

and stress.

Ÿ Poor eating habits, which can cause

obesity and lead to high blood pressure,

diabetes, and high cholesterol.

Having a risk factor does not mean that you will

develop heart disease. Even if you have no risk

factors, you still may develop heart failure.

Your doctor's goal is to relieve your symptoms

and prevent more heart damage. Your doctor

will also need to treat the problem that caused

your heart failure. You will probably take

several medicines to reduce blood pressure

and fluid buildup and decrease your heart's

How is heart failure treated?

workload.

It is very important to take your medicines

exactly as your doctor tells you to and to keep

taking them. If you have any problems with the

medicines, tell your doctor. You may be able to

take different ones to get the same benefit.

Your doctor will also recommend some

lifestyle changes. Taking these steps can help

you feel better and might help slow the

progression of heart failure:

Ÿ Eat less sodium. Sodium causes you to

retain water and makes it harder for your

heart to pump.

Ÿ Get regular exercise, which will help keep

your heart healthy.

Ÿ Lose weight if you are overweight. Even

small changes can make a difference.

Ÿ Stop smoking.

Ÿ Limit alcohol. Ask your doctor how much,

if any, is safe.

Ÿ Control your blood pressure. Exercise,

limit alcohol, and control stress to help

keep your blood pressure in a healthy

range. You may also need to take

medicine.

Ÿ Watch your fluid intake if your doctor

advises it.

Ask your doctor if a cardiac rehab program is

right for you. Rehab can give you education

and support that help you learn self-care and

build new healthy habits, such as exercise.

Heart failure often gets worse over time and

requires more treatment to manage

symptoms and control complications. Take

your medicines as prescribed, make some

lifestyle changes, and work closely with your

doctor. These give you the best chance to

co nt r o l h e a r t fa i l u r e a n d p r ev e nt

complications.

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Dr. Shaunak Shah (M) +91-98250 44502

Dr. Manan Desai (M) +91-96385 96669

Dr. Dhiren Shah (M) +91-98255 75933

Dr. Dhaval Naik (M) +91-90991 11133

Dr. Chintan Sheth (M) +91-91732 04454

Dr. Niren Bhavsar (M) +91-98795 71917

Dr. Hiren Dholakia (M) +91-95863 75818

CARDIOVASCULAR, THORACIC &

THORACOSCOPIC SURGEON

CARDIAC ANAESTHETISTS

PAEDIATRIC & STRUCTURAL

HEART SURGEONS

CARDIOTHORACIC &

VASCULAR SURGEONS

Dr. Pranav Modi +91-99240 84700(M)

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Dr. Divyesh Sadadiwala (M) +91-82383 39980

Dr. Milan Chag (M) +91-98240 22107

CARDIOLOGISTS

CONGENITAL & STRUCTURAL HEART DISEASE SPECIALIST

CARDIAC ELECTROPHYSIOLOGIST

Dr. Ajay Naik (M)

Dr. Vineet Sankhla (M) +91-99250 15056

+91-98250 82666

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