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