ARTICLES ON Heart Care

Minimal invasive cardiac surgery is usually done in patients with a better heart function and those with 3-4 blockages inside the heart Cases of heart attacks among young people are increasing dramatically. Experts say that the number will only continue to grow and blamed it on poor lifestyle choices such as lack of exercise and a bad diet, which is also increasing the incidents of type 2 diabetes. Earlier heart problems were primarily seen in the 50-plus population. However, recently more people in their 30s and 40s are getting affected. As per WHO, cardiovascular diseases (CDV) account for about 45 percent of deaths in the case of Indian adults aged 40 to 69. Disorders in the heart and blood vessels lead to most CVDs and often these patients need to undergo surgery. Creating awareness of cardiac health is very crucial and is the need of the hour. In an exclusive interaction with TheHealthSite, Dr. Mangesh Kohale, Consultant Cardiac Surgeon, Wockhardt Hospitals in Mumbai spoke about the advantages of minimally invasive cardiac surgery over open-heart surgery. Preference for Minimally Invasive Cardiac Surgery is on the Rise There are several ways to treat a person with cardiac problems with advanced technology. Patients prefer shorter hospital stays and fewer postoperative complications, hence opt for Minimal Invasive Surgeries (MIS) over open-heart surgery said Dr. Kohale. He mentioned a case of a 76-year-old man from Madhya Pradesh who recently suffered from a heart attack. The man got the angiography done in his state, where the doctors also suggested a bypass, but he was not ready to opt for it considering his fear about the surgery. Within a week, he was admitted to Wockhardt Hospitals, where Dr. Kohale and his team did his bypass via minimally invasive surgery. Dr. Kohale recalled, “In his case, the heart pumping was at 25 percent which is a risk factor for the outcome of any procedure, but the only option was bypass surgery. We did his bypass via minimally invasive surgery. We usually do MICS (Minimal invasive cardiac surgery) in patients with a better heart function and those with 3-4 blockages inside the heart his surgery was successfully done with a small incision via the breastbone. The patient got discharged on the 5th day and doing well by performing his daily routine without any problems.” Benefits of Minimally Invasive Cardiac Surgery Dr. Kohale explained that while doing minimally invasive surgery, a small incision is made on the chest to reach the heart between ribs, rather than cutting via breastbone. This procedure is safe, and the success rate is high with less risk. A doctor will suggest MIS depending on a few factors such as the type of heart disease one is diagnosed with, how severe it is; the patient’s age, medical history, lifestyle; and results of tests done before surgery. As compared with the open-heart surgery, this type of surgery is less painful and has a quicker recovery in patients Minimally Invasive Heart Surgery Has Various Benefits Procedures for Minimally Invasive Heart Surgeries Coronary Artery Bypass Grafting (CABG) This is a surgical procedure used to treat coronary heart disease. It helps divert blood around the clogged or narrowed parts of the major arteries to improve the oxygen supply and blood flow to the heart. Dr. Mangesh KohaleConsultant Cardiac SurgeonWockhardt Hospitals, Mumbai To book an appointment call: +918291101001 Source: https://www.thehealthsite.com/diseases-conditions/heart-disease/advantages-of-minimal-invasive-cardiac-surgery-over-open-heart-surgery-881990/

The legendary Australian cricketer Shane Warne passed away at 52, on Friday due to a suspected heart attack. Although Erskine talked about Warne’s weight loss stories, no direct correlation was found between his crash diet and his sudden death. Unfolding the details, Warne’s manager, James Erskine, has told that the cricketer was on a ‘ridiculous diet’ before his untimely death. According to Erskine, Warne was on a 14-day liquid diet where he consumed nothing but fluids. He further stated that the legendary spinner had also previously followed such crash diets. Essentially, a crash diet involves diets that have you consuming a minimal amount of food. This diet may seem effective, but the moment you start to eat normally again, you will gain back the weight you lost during your crash diet. Due to the small portions, you are consuming, you will miss out on vitamins and nutrients that your body needs. Dr Manjari Chandra, told that fasting and diets are a “way to heal our bodies.” However, these terms are now being used to lose weight in a quick fashion these days. She said, “Fasting is part of our systems, so we should fast because that’s the easiest way of resetting the human body in every way. But this way of dieting to lose quick, quick weight is not the right way to do it.” What Does the Research Say? Even though crash dieting can have some positive outcomes, it can also have some potentially harmful effects on the heart as a result of an increase in heart fat level. A study published earlier stated that “Crash diets can cause a transient deterioration in heart function.” The study included 21 obese volunteers and the average age was 52 years. According to the study, after a week, the researchers noticed that the heart fat content had risen by 44 per cent. This was associated with a deterioration in heart function, 3 including the heart’s ability to pump blood. Experts’ remarks: Crash diets not advisable Experts have cautioned that a crash diet may lead to electrolyte imbalance, in turn leading to a sudden heart attack. A drastic alteration in diet and extreme weight loss measures could be dangerous even for apparently healthy individuals without a history of the cardiac ailment. Tina Sapra, RD MPH CLE, Doctor Diet, said that if someone is on a liquid diet, then the individual is lowering the blog pressure and blood sugar levels. She said, “Lower BP places the heart in the most crucial state.” Experts’ remarks: Crash diets not advisable Experts have cautioned that a crash diet may lead to electrolyte imbalance, in turn leading to a sudden heart attack. A drastic alteration in diet and extreme weight loss measures could be dangerous even for apparently healthy individuals without a history of the cardiac ailment. Tina Sapra, RD MPH CLE, Doctor Diet, said that if someone is on a liquid diet, then the individual is lowering the blog pressure and blood sugar levels. She said, “Lower BP places the heart in the most crucial state.” She explained that crash dieting involves lowering the intake of nutrients, which means missing all the three macronutrients, carbohydrates, fats, and proteins. “Since, the blood sugar drops, it leads to cardiac arrests.” “Heart mostly fails due to aerated cholesterol which is diet-related or low BP, hence, crash diets can lead to heart attacks,” she added. She, relating crash diets to heart attacks, also said, “If you are on a 14-day liquid diet, the liver has to work harder leading it to higher cholesterol level”, which can increase the chance of heart attack. Dr Amreen Sheikh, a renowned Dietitian in Mumbai and is currently practising at Wockhardt Hospitals, elaborates that it also depends on the other activities is been followed with the diet as it directly affects cardiac activity. She said, “Crash diets are not advisable because it lacks the nutrients a human body needs on a daily basis.” She also said that a crash diet and medications along with it, is a dangerous cocktail for a cardiac arrest. “Individuals who follow this diet, usually end up taking a lot of supplements and steroids to cover up for the nutrient deficiency which can also be a reason for heart attacks. So, it is not only the diet but also, what an individual adds to it,” she added. Dr Amreen Sheikh, Dietitian Wockhardt Hospitals Source: https://www.news9live.com/health/crash-diet-and-weight-loss-supplements-are-dangerous-cocktail-for-cardiac-arrest-experts-157635

Are you in your 40s? Then, you need to beware of heart problems. Yes, Heart problems can strike-in at any stage. Hence, taking preventive measures can help you reduce the risk of heart disease and improve your quality of life. Read on to know about keeping your heart healthy in your 40s. Also, don’t forget to follow the vital tips listed in the article below. The cases of heart attack in youngsters are increasing at a rapid rate, and many are losing their precious lives. A sedentary lifestyle like lack of physical activity, stress, unhealthy eating habits, and even comorbidities can double the chances of heart problems. Yes, you have heard it right! Diabetes can give a tough time to your heart. Did you know? High blood sugar levels can lead to atherosclerosis that is the build-up of fats, cholesterol, and other substances in and on the artery walls. Hence, you will suffer from chronic health problems and fall prey to a heart attack. Even high blood pressure tends to make your heart muscles thicken, harms the blood vessels, and invites a heart attack. Have you gained oodles of weight? Then, you will immediately have to embrace a healthy lifestyle to battle the bulge. Being overweight or obese can lead to a heart attack. Moreover, smoking can raise blood pressure and narrows them, making you prone to a heart attack. Thus, once you turn 40, you need to pay attention to your health in order to lead a healthy life. Know what you can do to keep your heart healthy It is a no-brainer that quitting smoking can do the trick. So, opt for a smoking cessation program and try to limit your alcohol intake too. Try to get active by exercising daily. You can walk or do aerobics. Do not indulge in intensive workouts that can strain your heart. It is better to speak to your doctor before starting any fitness routine. Exercise for at least 5 days a week for half-an-hour. Moreover, you will also have to stay healthy and maintain an optimum weight. Eat more fibre and avoid sugar, salt, and trans fats. Include fresh fruits, vegetables, nuts, pulses, legumes, oats, and whole grains in the diet. Say No to pizza, pasta, cake, pastries, donuts, desserts, sweets, namkeens, and colas. Eat food in controlled proportion. Check food labels before buying anything to make sure you are not having too much salt. Maintain appropriate cholesterol and blood sugar levels as recommended by the doctor. Do not ignore symptoms such as chest pain, palpitations, breathing problems, and even unusual sweating. Stress can be problematic for your heart. So, try to stay happy and calm down by opting for relaxation techniques such as yoga or meditation. Invest time in doing what you like. Paint, listen to music, dance, or cook. By Dr. Chetan Bhambure, Consultant Interventional Cardiologist, Wockhardt Hospitals, Mira Road. Source: https://health.economictimes.indiatimes.com/news/industry/how-to-take-care-of-heart-in-your-40s/86608986

Dhiren Sevak, a 42-year-old tax consultant based out of Mumbai, had the shock of his life when he found out that the discomfort in his chest was actually a heart attack. Sharing his ordeal, he said that he never thought he would end up in such a situation since he is not overweight. According to experts, Indian men in the age group of 40-45 are more susceptible to heart failure. The World Health Organization says India reported 63 per cent of the total deaths due to non-communicable diseases, of which, 27 per cent were attributed to cardiovascular diseases, which also account for 45 per cent of deaths in the 40-69 age group. According to Dr Ashish Agarwal, Indians are already predisposed to heart failure due to genetic reasons. Now, with smoking habit being more rampant in younger people, including women, cardiovascular diseases are becoming more common. Besides this, sedentary lifestyle and stress also lead to weight gain, which, in turn, increase the risk of heart disease. Diabetes is also a major cause of heart diseases. ‘A major defect’ “Our genes have a major defect, because of which young people in our country are facing heart attacks. The other reasons are diabetes and increasing stress levels. Thirty per cent of people die within one hour of the heart attack,” said Dr Ravi Gupta, Consultant Cardiologist at Wockhardt Hospitals, Mumbai Central. According to experts, although the genetic predisposition cannot be prevented, other contributory factors that lead to heart failure could be controlled. “Brisk walk and a good diet may help in preventing heart failure. Stress management is very important, and people need to be aware about their health. They should avoid smoking,” said Agarwal. “Knowledge of cardiopulmonary resuscitation is extremely important till one receives medical assistance. Young people above 30 who have hypertension, diabetes, obesity or family history of the above or even if they do not have any problem, routine basic tests such as ECG, 2D Echo test, A stress test are extremely important,” Gupta added. Meanwhile, Sevak, who is now on the road to recovery, said: “Young people need to learn to strike a balance in their personal and professional life. Taking time out for one’s health is extremely important. Anything extreme is not good. Physical activity, meditation and yoga must become an integral part of one’s life.” Source: https://www.thehindubusinessline.com/news/national/indians-predisposed-to-heart-failure-due-to-genetic-reasons/article36721988.ece

Cardiovascular Diseases (CVDs) are one of the leading causes of deaths across the globe and the most common complication is a heart attack or stroke. While medicine experts have managed to formulate several advanced procedures to treat CVDs, it is still hard to predict when one might suffer from a heart-related complication. In recent years, studies have shown that heart-related conditions are on the rise among young people. Television actor Sidharth Shukla’s demise in September at age 40 due to a heart-attack brought the focus back on this subject. Risk Factors Dr. Chetan Bhambure, consultant interventional cardiologist, Wockhardt Hospitals says people with comorbidities such as high blood pressure, cholesterol and diabetes during their 30s or 40s need to be extra vigilant about their heart health as their chances of suffering from a heart disease is higher than their non-comorbid counterparts. Lack of physical activity, obesity, uncontrolled diabetes, cholesterol, and high blood pressure only enhances the risk. Excessive smoking, drinking and a sedentary lifestyle can also prove to be damaging. He adds that stroke, heart failure, and heart attack are a common occurrence in people with comorbidities.  Also, to avoid the risk of a heart attack or stroke in the later part of life, it is imperative to take care of the heart in the younger years, adds Dr. Narayan Gadkar. Therefore, on the occasion of World Heart Day, Mid-day online has combined the insights of experts to collate a list of lifestyle changes that could reduce the risk of heart-related complications in young people. Dr. Bhambure says powerful nutritional strategies can be beneficial for the heart. Regular consumption of the right foods can help curb the risk factors such as high blood pressure, cholesterol, abnormal blood sugar levels, triglycerides, and obesity which may give rise to a heart disease in later life.  He adds, avoid saturated fats and trans fats and choose monounsaturated and polyunsaturated fats. Eat more fibrous foods and switch on to plant protein from animal protein. Go for low-fat dairy products and control your portion size. Higher cholesterol levels in the body can lead to atherosclerosis (plaque builds up inside arteries) which can, in turn, increase the risk of a heart attack or stroke.  Dr. Gadkar says eat fresh fruits like apples, berries, cherries, avocados and kiwis. Opt for legumes like beans, lentils, nuts, seeds, olives, herbs, paneer, tofu and whole grains. Go for oily fish like salmon, mackerel, tuna, sardines, which will increase HDL, i.e., good cholesterol, and reduce the risk of blood clots. Eat corn, soy, pumpkin seeds, sunflower seeds, flax seeds, sesame seeds, and chia seeds. Cut down on processed, junk, oily, frozen and canned food. Limit salt and sugar intake. Cut down on colas, sodas, artificial sweeteners, and colors. Even alcohol and smoking should be avoided. Get the Body Moving As a young adult, regular exercise is the best gift that you can give your heart, says Dr. Bhambure. Staying fit and maintaining optimum weight will help cut down the chances of coronary artery disease and vascular disease. Exercising will help control abnormal blood sugar levels, and also lower stress that could lead to heart problems. Being physically active also slows down the heart rate and lowers blood pressure. Brisk walking, swimming, yoga, running, aerobics, cycling can help burn calories and enhance the functioning of the blood vessels. Dr. Gadkar also recommends resistance training, push-ups, pull-ups, chin-ups, stretching. However, it is advisable to consult your doctor before taking up a fitness regime and practice it under the guidance of an expert. Manage Stress Dr. Gadkar says stress can contribute to heart disease and stroke. Particularly for working professionals, stress causes overeating, smoking, increased alcohol intake and disinterest in fitness-related activities, among other things. All these factors can block the blood vessels. Lack of physical activity and weight gain can raise blood pressure. Thus, a heart attack is common in those who are stressed. Regular exercise, eating a well-balanced diet, avoiding emotional eating, and addressing issues like depression and anxiety can help manage stress. Create a structured routine of activities you like doing, Dr. Bhambure adds. So, listening to music, dancing or gardening can help beat the stress. For working professionals, practicing deep-breathing exercises, dividing work into smaller tasks and setting smaller goals can help. Source: https://www.mid-day.com/lifestyle/health-and-fitness/article/world-heart-day-lifestyle-changes-to-improve-heart-health-in-people-under-40-23194288

Many of us would think twice before saying no to a delicious, hearty meal any time of the day. Only thing is, we tend to overlook an important aspect the moment we lay our eyes on a sumptuous spread- the harmful effects food can have on our health and more specifically, our heart. The food you eat has an impact on your heart and unhealthy eating, coupled with a sedentary lifestyle can damage your health.  Eating healthy will keep your heart fit and fluttering flawlessly for a longer time. A heart-healthy diet can diminish the risk of heart disease or stroke by almost 80%. Follow the Tips Below to Help Prevent Heart Disease: Cut Down on your Fat Intake: To prevent or reduce heart ailments, you need to choose the right type of fats and eat less fat in general. Our diet comprises a large amount of fat in general, regardless of the source. So cutting down on the fat and oil intake can be a good first step. Avoid fats that elevate cholesterol levels; saturated fats and trans fatty acids, which are present in bakery products, fried foods, butter, cream, margarine. Use healthier oils like olive, ricebran or soyabean Eat Green Leafy Vegetables, Fruits and Low Fat Dairy Products: All meals should comprise an adequate amount of vegetables and fruits because they have a high satiety index and therefore regulate appetite. They are low in fat and high in fibrous content and power-packed with vitamins and minerals, which are beneficial for the heart. Make sure to consume fresh fruits and vegetables at least 5 times a day. Eating fresh produce can keep you full for a longer period and may prevent you from eating unhealthy snacks. Regulate the Consumption of Sugar, Sugary Products, and Salt: High intake of sugar leads to high insulin levels in the body and inflammation and damage of the arteries. Not just that, excessive sugar consumption also leads to weight gain, further increasing the risk of cardiovascular diseases. Thus avoid fast foods as they contain starch, sugar, and trans fat. Excess salt in your diet can cause blood pressure elevation, which increases the development of heart problems. Reduce your daily salt intake to not more than 5gms a day. You can cut off your excess salt intake by using less salt for cooking, avoiding table salt while eating, cutting down on processed and canned foods, and avoiding crackers and snacks which are high in salt. Indulge in Whole Grains: Whole grains are excellent sources of carbohydrates and fiber and help in regulating blood pressure and heart health. Try to add whole grains as much as you can to your meals and refrain from eating refined flour products. Substitute white bread and pasta with brown bread and whole wheat pasta, add coarsely grounded flaxseed ion salads/cereals and make chapatis with a combination of grains. Choose a Low-Fat Protein: Eating protein is a healthy start. But many good-quality proteins are also high in fats. Opt for chicken and fish and cut down on meat, beef, and pork, use leaner cuts that trim down the fat. Use methods like grilling, baking, and barbecuing rather than frying and making gravies. Maintain a Healthy Body Weight: Being overweight can increase the risk of heart disease. Maintain an ideal body weight for your height and age. A lifestyle change, balanced diet, and moderate physical activity can help you attain your desired weight. Keep a 5 Hour Gap in Between Each of the Three Meals: Frequently eating does not allow the insulin levels of the body to decrease which in turn, results in more cholesterol and fatty acids or lipids production in the system. High cholesterol is the root cause of many chronic diseases. Drink Adequate Water Throughout the Day: It is important to drink at least 8-10 glasses of water every day. Water keeps the body dehydrated and flushes out the toxic remnants of the body. Consume These Secret Superfoods: Foods that have antioxidant properties reduce inflammation, “bad” cholesterol and increase the “good” cholesterol, keep your blood pressure in the desirable range and boost your immunity. Foods like garlic, onions, berries, oranges, flaxseeds, and nuts are vital for a healthy heart. Control the Portion Size While Eating: ‘How much you eat is as important as ‘ What you eat’. Making heaps of food on the plate, taking second helpings, and eating until you feel stuffed will end up consuming excessive, fat and cholesterol than you actually should be having. The smart way not to waste and eat enough is to take small quantities in the first go itself. You can also try eating on a smaller plate than the usual dinner plate. This psychologically will give you a feeling of a fuller plate and satiated appetite. Say No to Processed Foods: Processed foods are high in calories, high in fats, have easily digestible carbohydrates, do not give satiety, are low in fiber, and possess an array of health hazards. Cut down on consumption of ready-to-eat, ready-to-cook, instant foods, reduce your intake of packaged snacks and say no to processed foods for a healthier heart. Avoid Smoking & Use of Alcohol: Smoking consistently is known to be a major cause of heart disease. Smoking increases your heart rate and disrupts your blood pressure and also causes oxidative damage to your body. Try to kick the habit if you want a healthy heart. Alcohol also affects your heart rate and causes weight gain. Excess drinking for a consistent period can elevate your blood pressure and affect your good cholesterol. Do Regular Exercise: A sedentary lifestyle is a major cause of developing heart diseases. Physical activity must be maintained regularly along with diet, that is, at least 30 minutes of exercise daily. It will keep your weight in check, improves your heart rate, and keeps your heart healthy. Avoid Stress: Stress and an unhealthy lifestyle can lead to a number of health issues. Try to get rid of tension and aim for a healthier

Various reports and studies have confirmed that people who work for long hours are at a higher risk of cardiovascular disease. People who have been working from home in the last 16 months of the pandemic have been putting in much more hours than they would if they were at the office premises. And heart specialists say that these long hours of non-stop work can put pressure on one’s heart inviting a heart attack. Dr Narayan Gadkar, consultant cardiologist from Zen Multispecialty Hospital says, “You will be shocked to know that working at least 55 hours per week is linked to a higher risk of both ischemic heart disease and stroke when compared to those people who work for around 35-40 hours a week. Working long hours can increase mortality and morbidity from ischemic heart disease and stroke via psychosocial stress.”With the lockdown slowly being lifted and people started to going to work in offices is another reason for longer work hours. Some are working for more than 14 to 15 hours a day, are always glued to chairs in offices or at home and fail to get that much-needed break. Dr Bipeenchandra Bhamre, cardiovascular surgeon, Sir H N Reliance Hospital, and Lilavati hospital, says, “All this should be a strict no-no as doing so can take a toll on your heart. We are not kidding here. Working for longer hours invites various health risks along with heart problems. The people who already have risk factors like hypertension and diabetes and high cholesterol may develop ischemic heart disease, heart attacks, strokes, and heart rhythm problems owing to extended working hours.” Dr. Anup Taksande, consultant interventional cardiologist, Wockhardt Hospitals, Mira Road says, “People with hypertension and diabetes and high cholesterol are at a higher risk of developing ischemic heart disease, heart attacks, strokes, and heart rhythm problems because of erratic and long working hours. It is the need of the hour to keep heart disease at bay and adhere to a healthy lifestyle.” DOCTORS SHARE SOME HEART-FRIENDLY TIPS THAT YOU NEED TO FOLLOW… Don’t ignore check-ups and telemedicine In these times, staying in touch with your doctor through video consultation or calls or even WhatsApp is needed. Regular check-ups are essential. Make use of technology to avoid delays if you have any health issues. Manage your cholesterol levels Do not eat processed or deep-fried foods that can lead to abnormal cholesterol levels. Cholesterol is one of the potential causes of heart disease. Hence, it is the need of the hour to check on your cholesterol levels. Stick to a schedule You will have to follow a proper routine, every day. Slot time for your exercise. Stick to your diet chart. Maintain a good sleep routine of seven to eight hours a day. Try to take out some time for yourself. Stay physically active This is super essential! Just walking for 40 minutes every day has been shown to improve heart health. So if you can swim or run or do bicycling it’s great for your heart. If you are already a heart patient then don’t go overboard while exercising. Just keep moving at home, maybe walking or even doing aerobics in order to increase blood circulation. Do it after speaking to the doctor. Take medication as prescribed by your doctor If you are on high blood pressure medications or diabetes medications take them on time. Don’t miss your doses. REMEMBER TO CHOOSE HEART-FRIENDLY FOODS Opt for foods that enhance your immunity, say doctors. Eat a well-balanced diet that includes all the essential nutrients and minerals. Have foods with a lot of green vegetables and fruits, for non-vegetarians once in a week chicken and fish is fine. Food like walnuts, beans, flax seeds, avocado, berries, nuts, carrots, sweet potatoes, capsicum, spinach, asparagus, tomatoes, broccoli, oranges, nuts, and papaya are great. Avoid eating spicy, oily, canned, salty, and sugary foods that have artificial sweeteners and a lot of salt. Eliminate carbonated drinks from the diet. Reduce alcohol consumption and quit smoking or using tobacco in any form, as doing so can take a toll on your heart. FACTORS BEHIND HEART DISEASE: Source: https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/tired-of-long-working-hours-heres-how-to-manage-your-heart-health/articleshow/85059379.cms

Once diagnosed with a heart condition, monitoring your heart health is critical and integral. Here is how you can monitor your heart health from the comfort of your home. 45-year-old, school teacher, Lakshmi was not new to heart problems. In June 2019, she was diagnosed with cardiac arrhythmia (palpitation, racing heart) a condition that leads to irregular heartbeats as a result of the heart pumping too fast or too slow. However, Lakshmi ignored the condition as regular medical consultations helped ensure that her condition was under control. She was managing fine until the pandemic broke out. Lakshmi started experiencing increased symptoms earlier and was unable to step out and consult a cardiologist due to concerns around her health and safety. The symptoms gradually impacted her routine chores including her professional life. When her condition worsened, she was compelled to visit the hospital after 4 months and was recommended to undergo a cardiac ECG, a medical test that helps detect heart abnormalities by measuring the electrical activity generated by the heart. Continuous Monitoring of the Heart Since it was essential that her heart rhythm be monitored for a few more days, she was put on an external loop recorder which is a small and convenient diagnostic tool for at-home continuous monitoring of the heart while carrying out daily activities. The sustained monitoring revealed that she was suffering from a fatal arrhythmia called ventricular arrhythmia (abnormal heartbeats that originate in the lower heart chambers) and had to undergo minimally invasive surgery to monitor her heartbeat and for keeping it under control. The implanted ICD device helped her to overcome a life-threatening condition like ventricular arrhythmia amidst the pandemic through timely medical intervention and treatment. The latest ICDs are equipped with advanced technologies like remote monitoring. This feature allows for Lakshmi’s heart to be monitored remotely from the comfort of her home by her doctor, thereby ensuring peace of mind for both the patient and doctor. What is a Remote Monitoring Technology, and How Does It Work? There is an increasing burden of heart diseases in India due to factors such as sedentary lifestyle, increasing stress, obesity, smoking and consumption of alcohol among others. These factors combined with a low level of awareness of the various heart conditions and their management through new-age technologies leads to high mortality rates. While prevention is important, once diagnosed with a heart condition, monitoring your heart health is critical and integral. This is where technologies like remote monitoring can help in detection and treatment much earlier as compared to a situation without constant surveillance. It can be used for patients who have undergone device implantation such as ICD (implantable cardioverter-defibrillator) or CRT-D (cardiac resynchronization therapy defibrillator) devices for managing their heart condition. The technology involves syncing the transmitter with the ICD/CRT-D to acquire data on the heart’s rate and rhythm. The computer then transmits this data to the cardiologist through a secure website. The syncing and transmission can happen 24×7, even while one is asleep and enables the cardiologist who has the medical history of the patient to offer the best medical advice, remotely. How Does This Technology Benefit Patients? According to the European Heart Journal, in the case of remote monitoring, there is a greater than 65% reduction in hospitalization and nearly 80% reduction in the time taken to detect fatalities and initiate timely action. Remote cardiac device monitoring is a game-changer that’s more important than ever because patients can be monitored from the safety and comfort of their homes. The Latest technologies such as smartphone-enabled remote monitoring help personalize and customize the approach to cardiac care by enabling patients to be in complete control of their heart health and be involved in their treatment. The technology also has user-friendly features such as simplified programming and enhanced detection and treatment capabilities to ensure safer care and improved quality of life for patients. Source: https://www.indiatoday.in/information/story/how-to-monitor-your-heart-health-from-home-1798612-2021-05-04

Reviving the doctor patient relationship – Dr. Nitin Tiwari, Cardiologist, Wockhardt Hospitals, Nagpur. Heart attack is the leading cause of death in the world with India being the epicenter of it. Even younger people in their 20’s and 30’s nowadays are getting heart attacks said Dr. Nitin Tiwari (Sr. Interventional Cardiologist) working in Wockhardt Hospitals in Nagpur for the last 15 years. The youngest patient he has done angioplasty is a 23 years old student. Primary angioplasty is an emergency angioplasty which if done within the first 90 minutes of a heart attack (door to balloon time less than 90 minutes)  can save the heart muscle from getting damaged permanently and save a precious life.   Dr. Tiwari emphasized “I do not treat a heart or an artery, but a sick human being.  There is an art to medicine:  Warmth, sympathy, and understanding may outweigh the surgical knife or the chemist’s drug.” So what are the feelings that the patient undergoes after a heart attack? Dr. Nitin Tiwari said, in my experience of 20 years. During a heart attack, the patient has feelings of denial (why me?), anger, frustration, fear, and anxiety. Then there are common questions like Will I survive? Will I be able to work again? Will I be able to play my favorite sport? How much life do I have? Will I have a second heart attack?  And so on. He said that just by doing an angioplasty you are just healing the heart but not the patient. Here comes the role of a good doctor–patient relationship. This unique relationship encompasses 4 key elements: mutual knowledge, trust, loyalty, and regard. Knowledge refers to the doctor’s knowledge of the patient as well as the patient’s knowledge of the doctor. Trust involves the patient’s faith in the doctor’s competence and caring, as well as the doctor’s trust in the patient and his beliefs and report of symptoms.  Loyalty refers to the patient’s willingness to forgive a doctor for any inconvenience or mistake and the doctor’s commitment not to abandon a patient. Regard implies that the patients feel as though the doctor likes them as individuals and is “on their side”. These 4 elements constitute the foundation of the doctor-patient relationship. Dr. Nitin Tiwari said there are 4 types of patients: The first ones are ignorant who have 100% faith in the doctors and go by their decision. The second one has informed patients with some science background. They are aware of illness and wellness and need proper counseling. Third, are google friendly ones who not only like to be counseled but also want to be a part of shared decision making. Fourth are the most important and enlightened patients who believe in taking multiple opinions both nationally and internationally and believe more on Google than on an individual opinion. All categories may get hurt if their respective trust is lost. Their expectations are also different. Trust is the most important element of any doctor-patient relationship. But unfortunately, it is on the ebb. Dr. Tiwari recalled the old song of Oscar awardee writer and singer Bob Dylan. “The Times they are changing “. In a study by Bennett et.al, it was found that the patients who trust and “like “their doctor had higher levels of satisfaction. Ratings of doctor’s friendliness, warmth, emotional support, and caring have been associated with patient satisfaction. Dr. Tiwari also added that giving adverse comments about other doctors (professional jousting) is also rampant and it benefits neither the doctor nor the patient. In fact, a study found that 2/3 rd of the patients didn’t like it if the doctor criticized his previous doctor, and only 1/3 rd approved of it.So in today’s changing world what are the key points which any patient should remember- 1) Trust your doctor. He is not God But trust and prayers have been shown to improve healing. 2) Give yourself time to absorb the bad news, create a support system, educate yourself, take a deep breath and look ahead. 3) Be positive, be optimistic as studies have proven that people with serious diseases like cancer, heart disease, and AIDs recover faster and cope better if they have a positive attitude. 4) Don’t fall into the trap of quacks that give you a 100% guarantee for recovery to the extent of removing blockages without angioplasty. Don’t fall prey to fake news on Whatsapp and other social media. 5) Use your pain for good. Many people with heart attacks say that they consider their illness to be “a gift”.  The illness taught them to value each day, appreciate the moment,  and get their priorities right. “ There is an end to life, but not to the greed for money ! ”. 6) An Australian nurse had interviewed  end stage disease  patients  and found the top regrets they had in their lives were : So to conclude, Dr. Nitin Tiwari said “ We fall, we break, we fail. But then we rise, we heal we overcome”. As written by the famous poet John Keats,” What is this life if full of care, we have no time to stand and stare !”. So live life to the fullest, but a healthy one!

What is a Stroke? One of the most prevalent conditions among all neurological disorders is brain stroke. A stroke occurs when blood flow to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. This condition typically affects the elderly, but it has recently started to impact younger people as well. The risk factors associated with a stroke include high blood pressure, diabetes, cardiovascular disease, smoking, and alcohol consumption. Stroke Symptoms The importance of time needs to be understood when symptoms of a stroke start or if you think that you or someone you know has suffered a stroke. Early intervention following a stroke is necessary for timely management. The following are stroke symptoms: Causes of Stroke Hemorrhagic and ischemic strokes are the two main types of strokes, with distinct causes of stroke and effects on the brain.Ischemic strokes – Usually, blood clots cause ischemic strokes, which can be triggered by various factors, including: Hemorrhagic strokes – Compared to ischemic strokes, hemorrhagic strokes are  less common. They occur when a blood artery within the skull ruptures, leading to blood seeping into and around the brain. Hemorrhagic strokes can also be caused by various factors, including: The risk of stroke can also be influenced by several other diseases and factors. These include: Stroke Treatment The course of therapy for an emergency stroke varies depending on whether it is hemorrhagic or ischemic.  Ischemic Stroke The brain’s blood flow needs to be promptly restored in order to treat an ischemic stroke. This might be done using: Hemorrhagic Stroke The goal of emergency treatment for hemorrhagic stroke is to stop the bleeding as soon as possible and lower the pressure that extra fluid is putting on the brain. If the stroke was caused by an aneurysm, arteriovenous malformation (AVM), or other blood vessel disease, your doctor may suggest one of these procedures:  Even today, there is not enough awareness in our society about stroke. Most important thing is to recognize the symptoms. Accurate and early detection of symptoms helps the patient to get early treatment and consequently reduces the risk of permanent disability. For this, we ask everyone to remember the formula of “BE FAST”. B stands for Balance, E stands for Eye, F stands for Face, A stands for Arm, S stands for Speech and T stands for Time. Always remember that a stroke is a sudden onset of paralysis, which is recognized by the sudden loss of balance, squinting of the eyes, crookedness of the face, loss of strength in the limbs, and difficulty in speaking. When the blood supply to the brain is disrupted for some reason brain cells do not get enough oxygen supply through the blood, as a result, these cells start to die (almost 36,000 neurons die every second) and this affects the functioning of the body. This condition is called a stroke.  The most important thing in this situation is “Time”. Such patients should be immediately rushed to a hospital where CT scans, MRI facility, and Neurologists are available within the first 4 ½ hours of symptoms got noticed. This 4 ½  hour period is called the ‘Golden Hour’, during which if the patient receives immediate and appropriate treatment, the effect of stroke can be prevented which results in the preservation of brain cells. In medical terminology, there is a saying ‘Time is a neuron’. In a stroke, time is a neuron. Failure to do so may possibly make the patient permanently disabled.  If the patient arrives at the hospital within 4 ½ hours, he/she can be diagnosed and can be given a TPA injection, which dissolves the clot & improves the blood supply to the affected part of the brain. This is called thrombolysis. Before giving this medicine, the doctor makes sure that there is no bleeding in the brain. Sometimes within six to twelve hours, a test called DSA (Digital Subtraction Angiography) can accurately identify a blockage in a blood vessel and the blockage can be removed by a ‘Mechanical Thrombectomy’ procedure.  At Wockhardt Hospital, Nashik, we have implemented a ‘Code White’ system for immediate treatment of paralyzed patients. In this, the paralyzed patient is thrombolysis with a proper diagnosis within 30 minutes of admission to the hospital. For this, Neurologists, Radiology Technicians, Nursing supervisors, and Pharmacists all come together immediately and TPA injections are made available just as quickly. Due to all these measures, numerous paralyzed patients have survived at Wockhardt Hospital, Nashik, and are doing well.  In the end, all I can say is that by accurately identify the symptoms of a stroke and move the patient to the hospital within four and a half hours without fear in such a situation, the rest of the patient’s life will surely be happy. Thanks! Dr. Vishal Sawale PatilMD, DM (Neurology)Consultant – NeurologyWockhardt Hospitals NashikFor Appointment, Call – 02536624444 FAQs on Stroke Q. What happens after stroke? A stroke can alter your thoughts, memories, and senses, including hearing, seeing, and the perception of the environment. Different degrees of physical and cognitive disability, such as weakness, paralysis, difficulty speaking, and memory loss, can occur after a stroke. Q. Can stroke be cured? Thrombectomy is an emergency treatment that can be used to treat some severe ischemic strokes. In order to fix the ruptured artery in the brain, an extensive surgery is necessary after a hemorrhagic stroke. A long-term, continuous rehabilitation programme is the key to recovering from a stroke. Q. Can I be normal again after stroke? Although recovery from a stroke varies, many people manage their medical condition, undergo therapy, and go back to a substantial degree of normality. The degree of recovery relies on a number of factors, including the severity of the stroke and the efficacy of the treatment. Q. What are good signs after a stroke? Immediately after a stroke, achieving a quick recovery or regaining skills is often encouraging. For example, the ability to cross your legs during the initial stages of recuperation may serve