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Will I develop blockages in my arteries over time?
Q. I underwent angiography three years
back. My cardiologist told me that there are no blocks in my heart
and my heart as good as that of 25 years old. At that time I was 51
years old and had just developed type II diabetes. My blood sugar
levels are under control. I am on hypertension treatment and take
drugs for high blood pressure, diabetes, high cholesterol, etc. My
question is, with this background, what is the time frame to
develop blockages in arteries? I exercise and practice yoga
regularly.
A. I don't think we have any mathematical scale on which we can
define the time frame for development of blockage. We all know,
Churchill smoked till the age of 90 but he never developed cancer and
there are people who have never smoked and they have fallen victim to
cancers. Similarly there are a lot of people who are diabetic,
hypertensives, with high cholesterol level, who never developed
blockages of the arteries of the heart and vice-e-versa is also true.
However, if you will keep your sugar and cholesterol under check and
you continue to exercise and practice yoga regularly then I am sure, there
is no reason, why you should develop the blockage and if it ever
comes, then we will talk about it; but do not anticipate things
because it may add another risk factor to your profile - that of
stress.
How serious is
an atherosclerotic block?
Q. What is atherosclerotic block in
the heart? What are its symptoms, the seriousness of the case and
do I need any diet restrictions? Can a person suffering from this,
smokes a cigarette everyday?
A. I think you mean atherosclerotic block. Atherosclerosis means
cholesterol deposition in the tubes carrying blood, leading to
gradual narrowing at that site. Smoking even one cigarette /day can
be extremely dangerous. Unlike alcohol, there is no safe limit for
smoking. You have to eat less fast foods /fats and oils and take more
fresh fruits & vegetables. The seriousness of the problem depends
upon where these blocks are (heart tubes, brain tubes) and how severe
these blocks are & if they are producing any symptoms like chest
pain.
What
precautions are required after a bypass surgery?
Q. What precautions should be taken
for the heart patients who have undergone open heart bypass
surgery?
A. After bypass surgery, one has to take care of all the risk
factors, which originally led to blockages of the arteries of the heart.
For example, if one has diabetes then the blood sugar has to be
controlled well. The blood pressure has to be kept within normal
limits. Regular exercises in form of walking for 4-5 kilometres in 30
minutes every day should be carried out. One should avoid smoking and
also keep away from passive smoke. Stress also needs to be curtailed
and in this yoga and transcendental meditation play an important
role. One should also take care of the calorie and fat intake and
keep the blood lipid profile under control. Nowadays, ‘lower is
better’ is the dictum and the bad cholesterol (that is LDL) should be
kept below 70 mg% and triglyceride closer to 100 mg%. The HDL
cholesterol, which is good cholesterol, should be kept as high as
possible and certainly above 40-45 mg%. One should also keep a check
on the weight and abdominal obesity in form of potbelly is a poor
prognostic sign for future recurrence of disease and therefore one
should avoid potbelly. Besides this, one should have regular medical
check up done and any specific factor, which is applicable in an
individual, would obviously be communicated by the treating
cardiologist.
Can I live a
normal life with an artificial mitral valve?
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Q. I am 31 years old. I have an artificial mitral valve
(metallic). I was operated 7 years ago. I am healthy now and
I work and play TT, cricket, and badminton. Will there be any
problem in getting married? How much strain and hard work can I
manage? What precautions should I take? What is the life of the
metallic mitral valve? What are the symptoms of it failing or
malfunctioning?
A. 1. Artificial valve lasts
virtually a life time as long as you look after it carefully. One
has to keep taking the blood thinning tablets and get the blood
test (INR) done regularly to control the INR levels between 3.0 -
3.5) or as specified by your treating cardiologist.
2. Mechanical valve does not interfere in marital functions and
you can safely get married and have a normal and blissful married
life.
3. You can work and strain as much as you would like and there
are no restrictions on this aspect.
4. Symptoms of a failing valve are usually sudden onset breathing
difficulty, blood in sputum or sudden loss of consciousness of
thinking sensation. If any breathing of this sort is ever
noticed, then you must report to your nearest physician.
I hope I have answered all your queries to your satisfaction, but
if you any doubts, please feel free to contact me and it shall be
my pleasure to answer them.
Why
is my pulse rate so high?
Q. I am 28 years old. I got married 6 months back. I take
non-vegetarian food but do not smoke or drink. Neither do I have
any addiction. For the last 3 months, I have routinely got my
blood pressure (systolic/diastolic/pulse) checked and found that
– systolic: 100-115; diastolic: 65-75 and pulse rate: 100-110. I
feel that my pulse rate is quite high from normal. These
readings were taken when I was calm. Why is the pulse rate so
high? What regulations or medicines should I take to make my
pulse level drop to the normal level? Is there a possibility of
any disease? I feel fine otherwise.
A. Your blood pressure is normal
but as pointed out by you your pulse rate is not normal. It
certainly is reassuring that you feel well. Nevertheless, I
recommend you see a physician so that a determination can be made
if the heart rate is regular (which it normally should be) or
irregular. Once that determination has been made several medical
conditions need to be excluded. I have listed some of these
below:
1. Hyperthyroidism - overactive thyroid - this is a fairly common
condition and its presence can be detected by examination and
blood tests.
2. Anxiety - this is self explanatory
3. Pheochromocytoma - this gives rise to episodic rapid heart
beat and is a tumour of the adrenal gland - rare
4. Anaemia - if your haemoglobin is low.
5. Atrial fibrillation - is irregular heart rate because the
atrial chambers of the heart are not beating regularly.
6. Exposure to stimulants (nicotine, caffeine) or illicit drugs.
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Why do I get extra heart beats?
Q. I am 35 years old and have been taking
10 mg Atenolol daily since a year. I want to stop it now
but if I discontinue, I have observed that I get chest pain.
Should I continue this drug?
A. Some people have extra beats
of their heart in between normal beats, which is not dangerous
but you may feel them. If the Echo (heart ultrasound) is normal
there is not much to worry about. If it’s irritating,
beta-blockers (including atenelol) are good drugs, which can be
taken life long. Of course, if you don't mind an occasional
'skipped beat' you don't need to take it. 10 mg is a small dose
& I am surprised it’s working so well for you.
What
is the cause for a heart murmur?
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Q. My baby
is 3 months old and the doctor says that there is a murmur
sound in his heartbeat. What is the reason for this
murmur sound in the heartbeat? The baby's health is
otherwise good. There is no sucking problem and the baby
sleeps well for about 16 hours. He has also gained 2 kgs in
the past 2 months (from 2.5 to 4.5 kgs).
A. Most
murmurs in babies are normal (innocent) and will disappear
with age. Sometimes your doctor is so sure that the murmur
is normal that he or she may not even suggest an
echocardiogram; but otherwise an echocardiogram is a safe
test that will totally rule out any major causes for the
murmur.
Heart attack
Q. What
are the indications of a heart attack?
A. The
signs may be difficult to identify and may mimic other
conditions. Typically there is pain in the chest with
tightness and difficulty in breathing. Sweating, nausea and
feeling faint may be other symptoms. The pain may be in the
front of the chest or behind the breastbone. From there it
may go to the neck or left arm. In severe cases, the
patient may look pale due to a fall in blood pressure rapidly
leading to death.
To diagnose a problem related to heart, you must consult a
physician or a cardiologist. He will do a physical
examination and may also suggest certain tests such as ECG,
X-ray of the chest, and certain blood tests. He will also
check your pulse rate and the blood pressure. The diagnosis
will be based on the outcome of these investigations and
tests.
Hole in the heart
Q. I have
VSD problem and have a 4mm hole in the heart. I am
now 30 years old. I want to know what type of precautions we
should take. If the hole increases what is the remedy? or
any other suggestion or guidance, please let me know.
A. Ideally
every hole in the heart should be surgically closed because
of two reasons.
1) The hole in heart can lead to infection (infective
endocarditis) in a small subset of patients and which could
be a serious matter.
2) Clot from the right side of the heart can travel in to
the left side and produce, what we medically call
paradoxical embolism, which again is a serious problem.
However, if for some reason or in your own wisdom, you do
not want the hole in the heart to be closed, then the only
precaution that you could take is that every infection in
the body, specially upper respiratory infection like common
colds, cough and sore throat, should be adequately treated
by competent doctor. Apart from that, I do not think you
can take any precautions at your level what so ever. The
hole is very unlikely to increase in size and it tends to
remain stationary but even a small hole can create serious
complications as I have mentioned earlier. Therefore, I
would very sincerely advise you to consider operation for
closure of this hole in heart which is a very safe
operation and would make you 100% medically fit
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