How to recognise heart attack early ?

The symptom of heart attack vary from one person to another.Recognition of these symptoms are very important for early detection of heart attack The most common symptoms are

• Chest pain: Patients may experience tightness, heaviness or pain in the chestpain may be felt in arms, neck, jaw, back or stomach: for some people, the pain or tightness is very severe, while some people just feel uncomfortable
• Sweating
• Feeling of light-headedness
• Breathing difficulty
• Feeling nauseous or vomit
• Severe tiredness

If you experience the above symptoms donot hessitate , immediately seek medical help.Emergency ECG and Echo test is required to rule out the myocardial infarction

Read More

Why exercise is advised in diabetic patients

Diabetes mellitus is a condition characterized by elevated blood sugar value. Apart from that there is alterations in blood lipid value and blood pressure. In diabetic patients exercise will help to decrease the blood sugar and also increases the sensitivity to insulin.

Other positive effect of exercise in diabetic patients

1. Decrease the heart attack risk

2. Decrease the blood pressure.

3. Exercise will help to reduce the muscle mass.

4. Reduce the body fat.

5. Produce weight loss.

Recommend exercise in diabetes

Diabetic people are advised exercise 150 minutes/week that is distributed at least over 3 days, moderate aerobic physical activity and resistance training.

Precaution before starting exercise in diabetic patients.

Since  diabetic patients are at high risk for heart disease without pain exercise tolerance test may be done in the following situations.

1. Age  more than 35 yrs

2. Duration of diabetes more than 15 yrs in type 1 diabetes and more than 10 yrs in type 2 diabetes.

3. If the patient has complications of diabetes such as kidney disease ,eye disease

4. Blood vessel occlusion in limbs.

5. Other risk factors for heart disease.

Those patients who have proliferative diabetic retinopathy should avoid vigorous exercise because of the chance of bleeding in to eye. 

Read More

Serum cholesterol testing and its interpretation

Incidence of high serum cholesterol is increasing worldwide. This is due to alterations in lifestyle and food habits. High serum cholesterol is a risk factor for many disease. It increase the risk for heart disease and stroke.The interesting factor is that it is a controllable risk factor. 

Normal value

Total serum cholesterol

Desirable level ­<200mg/dl

Borderline­ level 200 to ­239mg/dl

High risk level > 240mg/dl

Fasting stating is preferred for LDL cholesterol checking. HDL and total cholesterol can be measured non fasting state. Cholesterol level is determined by lipid metabolism. Which in turn is affected by heredity, diet,liver kidney and thyroid disease.

Conditions where you get high serum cholesterol

1. Primary disorders of cholesterol metabolism.

• Polygenic hypercholesterolemia
• Familial hyperlipidemia.

2. Secondary causes of elevated cholesterol.

• Uncontrolled diabetes mellitus
• Hypothyroidism
• Biliary obstruction
• Anorexia nervosa
• Nephrotic syndrome
• Drugs ­corticosteroid
• Conditions with low serum cholesterol
• Severe liver disease
• Hyperthyroidism
• Severe acute and chronic illnesses
• Malnutrition and malabsorption
• Familial causes

Read More

What is sudden cardiac death and its management

Sudden cardiac death is defined as Natural death due to cardiac causes, heralded by abrupt loss of consciousness, within 1 hour of the onset of a/c symptoms. Preexisting heart disease may or may not have been known to be present, but the time and mode of death are unexpected. It is due to direct consequence of cardiac arrest

Risk factors of  sudden cardiac death

Age.elderly at risk.

Male Gender.

Familial factors.Positive family history may be present.

Structural and functional factors.

Heart attack and chest pain - 80%.

Cardiomyopathies - 10 to 15%.

Other causes - 5 to 10 %.

Management of sudden cardiac arrest

Confirm cardiac arrest.

Call for help.

Give Chest compression.

Maintain airway –with  head tilt , chin lift, clear passage.

Look, listen and feel   the breathing.

Hospitalize the patient as early as possible. 

Read More

How will you care heart attack patient ?

Heart attack is a common problem in the community, but majority of the people don’t know what are the precautions we should take after a major heart attack. Understanding of which is very important because it will help us to avoid further attack, and improve the quality of life. Patients and their relatives should take special attention in understanding this aspect. Millions of people are living with heart disease,but it is not easy to live with heart attack.Following are the tip for caregivers and patients.

1.Healthy food - Patient should take a balanced food.Predominantly vegetarian food is preferred,food should be rich in antioxidants.

2.Exercise - Daily exercise will help to protect the heart,only safe exercise is advised.

3.Stop smoking and heavy alcohol intake.

4.Ensure adequate sleep.

5.Patient should not stop drugs without doctors advise.

6.Patients can  take part in cardiac rehabilitation program  after dicussing with the treating doctor.

7.Caregivers should understand the psychological ,cultural and spiritual aspect of health and disease.

8.Avoid mental and physical stress.

9.CPR - Cardio pulmonary resuscitation  is called as chain of survival,it is important that care givers should learn it for their loved one.

Read More

Drugs used for treatment of heart attack patients.

Heart attack occurs when there is reduced blood supply to heart. It is an emergency situation and immediate medical care is required. Here in this article we will tell you some of the drugs and their aims. It is always good to have these in your mind

Following are the aims of treatment.

1.Immediate stabilization of patient.

2.longterm symptom control.

3.Cure of the condition if possible.

Drugs used for the treatment are given below.

1. Antiplatelet drugs –Aspirin and Clopidogrel, it is a group of powerful drugs that will prevent the blood clotting.

2. Nitrates will help to reduce the pain

3. Betablockers decrease the heart rate, blood pressure and improve the oxygen supply to heart.

4. Statin will reduce the blood cholesterol. Stabilize the plaque so prevent further attack.

5. ACE Inhibitors- role is to reduce the blood pressure, dilate the blood vessels and increases the blood supply.

6. Angiotensin II Receptor Blockers will increase the blood supply to heart.

7. Clot lysis with streptokinase give immediate improvement.

8. Diuretics remove excess salt and water from the body so help the heart to work properly.

9. Digoxin improve the function of heart.

Read More

Statin a cholesterol lowering agent - Reduce cholesterol in 4 weeks

The problem of high cholesterol is increasing in the society. This will lead to atherosclerosis and increased risk for heart attack and stroke. Statin's will help to reduce the cholesterol level and thus will help to reduce heart attack and stroke in the community. Statin's are the most efficacious and best tolerated lipid lowering drug. They will reduce both primary and secondary hypercholesterolemia. Statin's can reduce the total cholesterol in 4 to 6 weeks. All the statin's are given at bedtime to get maximum effect.

Statins include the following

1. Atorvastatin­ dose 10 to 80 mg/day.

2. Lovastatin­ 10 to 40 mg/day,this is the first used statin.

3. Simvastatin ­5 to 20 mg/day.

4. Fluvastatin.

5. Pravastatin.

Adverse effects of statins

1. Headache.

2. Nausea and bowel upset.

3. Rash.

4. Sleep disturbance.

5. Muscle pain and rise in CPK level.

6. Increase in serum transaminase,but liver damage is not seen.

Uses of Statins

1.Reduce  cholesterol level.

2.Decrease heart attack rate

3.Decrease  stroke rate.

4.Help in plaque stabilization in atherosclerosis.

Read More

Prevention of recurrent heart attack

Prevention of heart attack is very important because the chance of second attack is high in known heart patient. Repeated attacks are dangerous because it will increase the  risk of death in a given patient. The interesting factor is that the recurrent attack can be prevented with control of risk factors along with certain drugs. This will improve the long term survival.

Following are the measures to prevent recurrent heart attack

1.Drugs

2.Control blood pressure

3.Control blood glucose

4.Regular exercise

5.Balanced diet

6.Control blood cholesterol

7.Stop smoking

8.Avoid excessive alcohol intake

9.Reduce mental and physical stress.

Drugs that will reduce recurrent heart attack

Antiplatelets such as Aspirin and Clopidogrel will produce a 25%reduction in recurrent attack and increase the survival.

ACE inhibitors and ARBS (Angiotensin II receptor antagonists) are also useful in prevention.

Beta blockers will reduce the heart rate and help to  improve the long term survival.

Regular exercise will help to reduce weight ,cholesterol ,control of hypertension and diabetes.

Diet should be low in fat and rich in calories.

Quitting of smoking is very important as it will help to increase the Oxygen supply to heart and decrease the atherosclerosis.

Note : In diabetic patients apart from control of blood glucose control of blood pressure to 120/80 mm of mercury and LDL cholesterol to less than 70mg /dl is advised. 

Read More