Heart

Will I develop blockages in my arteries over time?

How serious is an atherosclerotic block?

What precautions are required after a bypass surgery?

Can I live a normal life with an artificial mitral valve?

Why is my pulse rate so high?

Why do I get extra heart beats?

What is the cause for a heart murmur?

Heart attack

Hole in the heart

 

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?

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.

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?

 

  

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