admin Blog, Health

What is Coronary Artery Disease?

Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Because of presence of some irritative substance in blood, the (endothelium) innermost layer of blood vessels gets damaged and cholesterol (lipid – LDL) and sometimes calcium gets deposited (plaque) in your artery (mainly coronary artery) which causes inflammation in coronary artery.

When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

Coronary artery disease often develops over decades; you might not notice a problem until you have a significant blockage or a heart attack. But there’s plenty you can do to prevent and treat coronary artery disease. A healthy lifestyle can make a big impact.

 

Symptoms

If your coronary arteries gets narrow, they can’t supply enough oxygen-rich blood to your heart — especially when it’s beating hard, such as during exercise. At first, the decreased blood flow may not cause any symptoms. However, as plaque continues to build up in your coronary arteries, you may develop signs and symptoms, including:

Chest pain (angina): You may feel pressure or tightness in your chest, as if someone is crushing or as if someone has put some heavy weight on your chest. This pain, referred to as angina, usually occurs on the middle or left side of the chest. Angina is generally triggered by physical or emotional stress. The pain usually goes away within minutes after stopping the stressful activity. In some people, especially women, this pain may be felt in the neck, (left) arm or back.

Shortness of breath: If your heart can’t receive enough blood, it can’t pump out enough blood to meet your body’s needs. In such condition, you may develop shortness of breath or difficulty in breathing on exertion or extreme fatigue with exertion.

Heart attack: A completely blocked coronary artery will cause a heart attack. The classic signs and symptoms of a heart attack include crushing pressure in your chest and pain in your shoulder or arm, sometimes with shortness of breath and sweating. Sometimes a heart attack occurs without any apparent signs or symptoms.

Age: Simply getting older increases your risk of damaged and narrowed arteries.

Sex: Men are generally at greater risk of coronary artery disease. However, the risk for women increases after menopause.

Family history: A family history of heart disease is associated with a higher risk of coronary artery disease, especially if a close relative developed heart disease at an early age. (Your risk is highest if your father or a brother was diagnosed with heart disease before age 55 or if your mother or a sister developed it before age 65)

Smoking: People who smoke have a significantly increased risk of heart disease. Exposing others to your secondhand smoke also increases their risk of coronary artery disease.

Alcohol use: Heavy alcohol use can lead to heart muscle damage. It can also worsen other risk factors of coronary artery disease.

High blood pressure: Uncontrolled high blood pressure can result in hardening and thickening of your arteries, narrowing the channel through which blood can flow. High blood cholesterol levels. High levels of cholesterol in your blood can increase the risk of formation of plaque (atherosclerosis). High cholesterol can be caused by a high level of low-density lipoprotein (LDL) cholesterol, known as the bad cholesterol. A low level of high-density lipoprotein (HDL) cholesterol, known as the good cholesterol, can also contribute to the development of atherosclerosis.

Diabetes: Diabetes is associated with an increased risk of coronary artery disease. Type 2 diabetes and coronary artery disease share similar risk factors, such as obesity and high blood pressure. Overweight or obesity. Excess weight (especially around waist) typically worsens other risk factors.

Physical inactivity: Lack of exercise also is associated with coronary artery disease and some of its risk factors, as well. High stress. Unrelieved stress in your life may damage your arteries as well as worsen other risk factors for coronary artery disease.

Unhealthy diet: Eating too much fatty food, salt and sugar can increase your risk of coronary artery disease.

 

EECP Treatment for Coronary Artery Disease.

Enhanced external counterpulsation (EECP) is a mechanical form of treatment for angina. While several clinical studies appear to show that this treatment can be helpful in reducing symptoms of angina in patients withcoronary artery disease (CAD). EECP was approved by the US Food and Drug Administration in 1995 for the treatment of coronary artery disease (CAD).

Several studies suggest that EECP can be quite effective in treating ischemic heart disease. EECP significantly improved both the symptoms of angina (a subjective measurement) and exercise tolerance (a more objective measurement) in patients with CAD. EECP also significantly improved “quality of life” measures, as compared to placebo therapy.

admin Blog, Health

Food and Fruits that Benefit Heart

A healthy diet helps in keeping us fit and away from metabolic disorders. In fact, certain foods can influence blood pressure, triglycerides, cholesterol levels and inflammation, all of which are risk factors for heart disease.

 

Here are certain foods the help in keeping the heart healthy:

  1. Green vegetables Consumption of at least one cup of green leafy vegetables can significantly reduce their risk of cardiovascular diseases.
  2. Broccoli and asparagus are filled with mighty nutrients such as vitamins C and E, potassium, folate, calcium and fiber.
  3. Almonds lowers your LDL cholesterol, or bad cholesterol, which is involved in creating plaques in your coronary arteries that can cause heart attacks.
  4. Walnuts are the only ones with a significant amount of a certain type called alpha-linoleic acid. Alpha-linoleic acid acts as an anti-inflammatory agent and has actually been shown to help reduce plaque buildup in coronary arteries
  5. Fruits such as oranges, cantaloupes and papaya are rich in beta-carotene, potassium, magnesium and fiber.
  6. Dried beans and lentils ― such as garbanzo, pinto, kidney or black beans, are high in fiber, B-vitamins, minerals
  7. Flaxseeds contain omega-3 fatty acids, fiber and phytoestrogen to boost heart health.
  8. Berries are full of heart-healthy phytonutrients and soluble fiber.
  9. Oats They’re a gluten-free whole grain and a great source of important vitamins, minerals, fiber and antioxidants
  10. Bell peppers: Bell peppers contain folate, another nutrient that reduces homocysteine.
admin Blog, Health

What is EECP treatment?

For those who have heart disease and have been advised Bypass surgery or Angioplasty, there is an alternative treatment available. EECP (Enhanced external counter pulsation) treatment is a non-surgical treatment for coronary artery disease.

For those patients, who are not willing for surgery or not fit for surgery, EECP is an excellent option. EECP (Enhanced external counter pulsation) has been approved by the United States Food and Drug Administration (FDA) for management of angina (chest pain) and Hear failure.

EECP treatment is totally safe, painless and doesn’t require hospitalization.  In EECP treatment 3 sets of cuffs are tied at calf, thigh and hip region, these cuffs are inflated during every Diastole (relaxing phase of heart) and deflated just prior to Systole (Heart contraction).The  Inflation and deflation are electronically synchronized with the heartbeat. This treatment is given 1 hour daily for 35 sessions.

 

Hoe does EECP works?

With inflation of cuffs, blood is pushed back in to the heart arteries with force and volume and it helps in creating network of small arteries (Collateral circulation) thus creating “Natural Bypass” and increasing the blood supply to the heart muscles and relieving the chest pain. The cuff deflates just prior to the contraction of the heart so heart can pump the blood with more ease thus reducing pressure from heart.

 

Benefits of EECP

No need of surgery or any other painful treatment.

No hospitalization, no recovery time needed, patients can continue their normal activities.

EECP increases the blood and oxygen supply to heart muscles and reduces chest pain / discomfort.

EECP improves exercise tolerance and quality of the life.

admin Blog, Health

Frequently Asked Questions On EECP

DOES THE BLOCKAGES GO AFTER TAKING EECP?

 

 One of the most asked questions about EECP treatment is does the blockage go after the taking the EECP treatment? No, the blockage that is there in the major arteries of the heart doesn’t go after the EECP treatment.

 

WHAT IS THE BENEFIT OF TAKING THE EECP TREATMENT?

 

The next question that arises in the patient mind is that when the blockage doesn’t go with EECP treatment then what is the benefit of this treatment.

The one thing that patient needs to understand that EECP treatment acts on the micro circulation of the heart. EECP helps in creating collateral circulation within the heart which helps in supplying blood to the area of the heart which was receiving less blood due to blockages in the major arteries.

Even when the patient undergoes a bypass surgery the objective of the surgery is to provide blood supply to the area of the heart affected by the blockage. So what the surgeon will do is take a blood vessel from a distal part of your body and create a diversion for blood to flow around the blocked vessel. So even after undergoing the knife in a major surgery cabg the blockage doesn’t disappear.

 

HOW MANY DAYS DOES THE EFFECT OF EECP LAST?

 

The benefit of EECP treatment last from 3 to 5 years but this benefit will vary from patient to patient. Some patients may require repeat 10-15 sessions every one or two years.

 

DOES EECP HELP IN HEART FAILURE PATIENTS?

 

Yes EECP does benefits heart failure patients. In some cases the ejection fraction also increases of the patient but this increase is also from patient to patient.

 

WHAT IS THE DURATION OF THE EECP THERAPY?

 

EECP treatment is a 35 days duration treatment in which patient has to come daily for one hour of EECP session. Some patients may require extra 5-10 sessions as per improvement noted in the patient.

 

admin Blog, Health

Diagnostic Test Done For Heart Functioning And Their Significance

Heart disease patients or those suspected of having a heart disease are advised a number of test to determine the functioning of heart in various parameters. Various diagnostic test like ECG, Holter monitoring, Stress test and Echocardiogram have different significance when he comes to determine the heart functioning.

 

 

 

ELECTROCARDIOGRAM

     ELECTROCARDIOGRAM measures the electrical activity of the heart. ECG is the first line of diagnostic test to be done when patient has severe angina (chest pain) at rest or heaviness feeling in the chest.

ECG helps in following ways

1) First line of test to determine if patient is having a heart attack.

2) It helps to monitor changes in heart rhythm

3) helps to predict if heart attack is developing.

 

ECHOCARDIOGRAM

In echocardiogram sound waves are used to see how your heart is beating and also to see how your blood is moving through the heart chambers.

It basically helps us to determine the following

1) The heart pumping percentage i.e. how much percentage of volume the heart is pumping at each systole

2) Determine the cause of heart murmur

3) Helps in assessing functioning of heart valves

4) Helps in assessing the heart chamber size and functioning

 

TREADMILL STRESS TEST

In this test the patient is made to walk on a treadmill while ECG is being recorded while the patient walks on the treadmill.

Treadmill stress test help is assessing following things

Determine the cause of chest pain, shortness of breath and weakness

1) Assess the health of the heart

2) Assess safety of exercise

3) Identify heart rhythm changes with activity

4) Find evidence of inadequate blood flow to the heart muscle during exercise

 

HOLTER MONITORING

The cardiologist may request a Holter monitor ECG if you have symptoms, such as dizziness, fainting, low blood pressure, ongoing fatigue (tiredness), and palpitations and a resting ECG doesn’t show a clear cause. The Holter monitor is a type of portable electrocardiogram (ECG). It records the electrical activity of the heart continuously over 24 hours or longer while you are away from the doctor’s office. Following assessment can be made from holter test

1) To evaluate chest pain that can’t be reproduced with exercise testing

2) To evaluate other signs and symptoms that may be heart-related, such as tiredness, shortness of breath, dizziness, or fainting

3) To identify irregular heartbeats or palpitations

4) To assess risk for future heart-related events in certain conditions, such as hypertrophic cardiomyopathy (thickened heart walls), after a heart attack that caused weakness of the left side of the heart, or Wolff-Parkinson-White syndrome (where an abnormal electrical conduction pathway exists within the heart)

5) To see how well a pacemaker is working

6) To determine how well treatment for complex arrhythmias is working

admin Blog, Health

DIAGNOSIS AND PREVENTION OF HEART ATTACK

PREVENTION OF HEART ATTACK

Heart Attack is the leading cause of death worldwide. In India people about 25-30% dies due to heart attack. Heart is supplied by three major blood vessels, RCA, LAD & LCX. When one of the blood vessels get 100% blocked due to thrombus the area supplied by the vessel starts to die. During this the patient experiences severe chest pain, breathlessness and heaviness in chest.

Heart attack happens when the lining of the plaque in the blood vessel rupture and causes thrombus formation. The percentage of heart blockage doesn’t determine when the plaque will rupture. A blood vessel having 60% blockage can also rupture and cause heart attack.

Patient having heart blockage has symptoms of chest pain and heaviness and subsides when he takes rest or takes Tab sorbitrate. When heart attack takes place chest pain is usually at rest and doesn’t get relieved by taking tab sorbitrate. Another presentation of heart attack could be burning in epigastric falsely diagnosed as gastric problem. If you have any one of the following symptoms, one should get an ECG and Trop T done to ascertain whether the chest pain is of heart attack or no.

Prevention of Heart Attack:

Once the blockage has been detected, treatment should be done for the heart blockage. If the person doesn’t know whether he has blockage or no ascertain whether his risk factors for heart disease like high cholesterol level, smoking, diabetes, obesity or family history of heart disease. He should undergo a CT coronary angiography and ascertain how much blockage he has in the heart. Patient should modify the risk factor like quit smoking, reducing weight keeping blood pressure cholesterol levels diabetes in check.  For treatment of heart blockages we at CORDIS HEART INSTITUTE provide EECP treatment which is a non-invasive treatment which helps in increasing the blood supply to the deficient areas of the heart through collateral circulation.

admin Blog, Health

Are All Heart Blockages Harmful?

 

Arterial supply of the heart

There are three arteries that run over the surface of the heart and supply it with blood (see the diagram above). There is one artery on the right side, and two arteries on the left side. The one on the right is known as the right coronary. On the left side, which is the main side, we have the left anterior descending (LAD) that runs down the front of the heart and supplies the front and main wall, and then the left circumflex that supplies the sidewall. If you look carefully, a major artery called the left main artery supplies the LAD and the circumflex.

 

Mild coronary artery disease

Heart blockage less than 40% is classified as mild coronary artery disease. Such blockages are clearly not causing restriction to blood flow and therefore very unlikely to be causing symptoms. It is important to note, however, that there is clear evidence here of progressive coronary artery disease and such patients need aggressive attention paid to risk factors for coronary disease (cholesterol, diabetes, smoking, blood pressure etc.), appropriate medicines, and healthy lifestyle changes such as exercise, weight loss and dietary modification. Paying close attention to these things can prevent progression of heart blockage and help to stabilize it.

 

MODERATE CORONARY ARTERY DISEASE

A moderate amount of heart blockage is typically that in the 40-70% range. Usually, heart blockage in the moderate range does not cause significant limitation to blood flow and so does not cause symptoms. Moderate coronary artery disease is treated much in the same way as mild disease, basically attention to risk factors, medications, and healthy lifestyle modification. Occasionally, heart blockage at the higher end of the moderate range (50-70%) may require additional testing to see if it is significant or not and may be responsible for symptoms.

 

SEVERE HEART BLOCKAGE

Severe heart blockage is typically that in the greater than 70% range. This degree of narrowing is associated with significantly reduced blood flow to the heart muscle and can underlie symptoms such as chest pain and shortness of breath. The severe heart blockage causes symptoms and are treated with placement of a stent  or sometimes bypass surgery is required in the setting of multiple severe blockages.

 

TOTALLY HEART BLOCKAGE.

 

100% blockage in coronary artery stopping blood flowing any further and, of course, leading to a heart attack. Such a heart blockage is typically accompanied by major symptoms, and treatment needs to be given in a very timely manner.  If the treatment for this isn’t done within good time (usually the first few hours, the sooner the better), then the heart muscle may die, and once dead, cannot usually recover, which results in reduced heart pumping function and heart failure.