Basic Questions by the Heart Patients
1. Why Heart disease should be treated without
Bypass surgery or Angioplasty?
Reason 1: Body should be least
disturbed
Ans : Body is the best reaction
of nature. We can make computer fridge, Television but cannot make fruit,
plant, flower and other things made by God. We can repair a computer after it
is broken but cannot join a fruit when it is cut, or cannot save a fruit or leaf
after they are detached from the tree. Disturbing the nature is never a good
thing to do. It causes more harm than good. The packing of god should not be
disturbed. This is why these operations do not last long. Many patients die
after these operation or repeated operations are required. It is best to allow
the nature to heal by itself.
Reason 2: Non invasive lifestyle
treatment is more logical, more scientific
When a problem comes- it is not good to bypass it. We should look at the
cause of th problem and try to solve the causes. Unlike the man made machines,
our body can heal itself. You scratch on a Mercedes car and on your body – the car
cannot heal but our body will. When a bone breaks, the doctors just put them
together under a plaster and wait for the body to heal the broken bone. The lifestyle
treatment is non invasive and provides the
correct atmosphere for the body to remove the blocks or at least stop the
growth of blockages. So, lifestyle treatment is more logical and scientific. Cutting
the body is non scientific and less logical; if an alternative is available,
why not to avail it.
Reason 3: Most surgeries occur due
to panic which is mostly artificially created.
There is no need to panic/fear after the diagnosis of heart disease. Most of the operations of Bypass surgery and angioplasty is done due to fear, panic of an impending heart attack. This unnecessary panic is induced by the heart hospital doctors who want to pressurize the patients in favour of a bypass surgery or angioplasty. The patient needs to know what is heart attack, why it may happen and what can be done to avoid a heart attack. Lack of information and education make the patients more vulnerable to the fear of exploitation of the heart hospital doctors whose primary aim is to make more money by doing large discourage lifestyle based treatment though they cannot refuse the good effects of lifestyle changes.
2. What is heart disease?
Ans. Heart disease is the gradual built up of excess fats inside the (blood flowing) tubes to the heart muscles. These blocks built up very slowly and when close more than 70 – 80% of the tubes heart cannot get adequate blood leading to chest pain, choking, suffocation or breathlessness. These symptoms happen more when the patient/heart requires more blood while walking or running. There are more than 10 crore (100 million) heart patients in India out of them 98% of heart disease fall into this category, rest two percent have valve defects , hole in the heart.
3. What is heart attack and how does it
happen?
Heart attack happens when the
heart tubes (the tubes which supply blood to the heart muscles) have 100%
blockage.
Ans. Most of the heart attacks occur suddenly and without any warning when a blood clot lodges in the space between the blockage and the wall of the tubes. The cause of the blood clot is the chemicals released by the rupture of the membrane which cover the blockages (which break due to continuously accumulating fats inside the blockage). It is like a breaking of the rubber band on the band on the bundle of note-as you keep on adding notes inside the rubber band. It takes about two minutes to clot the blood, which was flowing through the tube.
During heart attack patients get severe chest pain, breathlessness at
rest. The portion of the heart muscles which do not get blood due to this 100%
blockages start dying immediately. If the area involved is big the patient may
also die. About 40-50 lac people die in India every year due to heart attack.
4. What are the causes of Heart Attack?
Ans. If we analyze more deeply, the membrane that covered the blockage (called Intima in medical language) was being stretched due to gradual accumulation of fats inside it. Heart Attack occurs when eventually the membrane reaches its last stage and rupture. The broken or injured membrane releases chemicals and clot forms.
When the membrane will break depends on the strength of the membrane in some patients it may not break till 90% blockage but in some it may break at 50% blockage.
So, the basic cause was the gradual accumulation of fats namely the Cholesterol
and Triglycerides. These two types of fats are the main criminals.
5. How to prevent or stop heart attack?
Ans. The simple answer is – by preventing further accumulation of these two fats. If we can stop the supply of these two types of fats to the body and keep their blood levels at the lowest (cholesterol below 130mg/dl and Triglycerides below 100mg/dl) heart attack cannot happen ever.
So the aim of the patients should be to educate themselves about these two kinds of fat and avoid them.
6. When does the patient come to know about
heart disease?
Ans. The tubes which take blood to the heart muscles (called Coronary arteries LAD, RCA and LCX) have 70-80% extra blood than the heart’s need. Heart needs only 10-30% but the supply is 100%. This 70-80% is in reserve. So, the heart patient only will come to know about the shortage when the blocks cross 70-80% level. It usually takes 30-40 year to built up so much blockage, but some people with bad lifestyle can complete the job in 10-15 years.
The complaint of the heart patient after the blockage of 80% or so is called Angina. This can be chest pain or heaviness feeling on the left side of the chest increasing while walking or on exertion and are relieved on taking rest. Some people with angina may not have pain but may complain of breathlessness, uneasiness, burning sensation in the middle of chest or just palpitation.
Many people come to know about heart disease when they have 100% blockage following rupture of the membrane covering the blockage. These people will have the sever angina symptoms even at rest. Perspiration, sinking feeling or even collapse may happen during severe heart attack.
7. How to identify heart disease before a
heart attack?
Ans. Heart attack (medically known as Myocardial Infarction) may occur anytime after the patient grows the blockage above 50% level. The membrane can rupture at 50-70% level if it is weak. Such patient will not know that he had any blockage before the heart attack-as less than 70% blockage does not give any symptom. But these blockages can be easily detected by a non invasive test called CT Coronary Angiography in two minutes. This test is now widely available in India and is becoming popular.
But after the block crosses 70-80% angina may happen and can be detected with TMT (Exercise stress test) or again by CT angiography.
If we can detect heart blockage before the heart attack, we can remove the causes of the blockages and prevent the heart attack.
8. What to do when heart disease is detected
only after a heart attack?
Ans. At the time of the heart attack the blockage was 50-90% but the clot has formed which has blocked the tube by 100%. Immediately the area of the heart will start dying. The patient will have severe chest pain or breathlessness in most cases. The patient should be immediately moved to a hospital within few minutes and the doctors should try to break the blockages as soon as possible. If that is successful the area of the heart can be saved from dying.
So, the aim would be to shift the patient to a hospital as soon as possible. Before that a sorbitrate tablet can be given below the tongue and a tablet of Despirin can be given as a precaution to the patient. Early recognition of the heart attack is very important and can save the heart muscles and death from a heart attack.
So, people are advised to prevent heart attack and not to take a risk of heart attack.
9. Most ideal treatment of heart attack in a
hospital?
Ans. As soon as a heart attack patient reaches a hospital the diagnosis can be confirmed with an ECG and a troponin I test (a slide test for heart attack like pregnancy test). If the heart attack has happened within 15 minutes to one hour a immediate injection of a clot busting drug (like Streptokinase urokinase) can be given to the patient which may break the clot and save the heart muscles from drying. The hospitals should also perform cardiac enzyme tests, echo cardiogram to assess the severity of the heart attack. Oxygen, continues heart monitoring can be started and other appropriate drugs should start to make sure that the heart does not stop and keep on working smoothly.
In some cases if the patient reaches within one hour or so an emergency angioplasty (called Primary angioplasty) can be tried by an experienced cardiologist.
10. What are the main causes of heart disease?
Ans. The two major items that cause the blockages and Cholesterol and Triglycerides. Increased blood level and increased consumption of both the items increase the speed of blockages. The blood level cholesterol (serum cholesterol) levels above 150mg/dl and Triglyceride level of more than 130mg/dl would lead to speedy increase of blockages. These two kinds of fats can be called mafia-as they lead to death of millions of people by heart attacks every year in the whole world.
Despite this, many cardiologists allow the Cholesterol levels above 180mg/I and Triglycerides above 160mg/dl.
All these questions are answered by Famous Heart Doctor (Dr. Bimal Chajjer)
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