AN INTERVIEW WITH DR. PRASANT KUMAR SAHOO, SR. CONSULTANT CARDIOLOGIST & DIRECTOR, INTERVENTIONAL CARDIOLOGY, APOLLO HOSPITALS, BHUBANESWAR ON THE OCCASION OF WORLD HEART

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29-09-2016

AN INTERVIEW WITH DR. PRASANT KUMAR SAHOO, SR. CONSULTANT CARDIOLOGIST & DIRECTOR, INTERVENTIONAL CARDIOLOGY, APOLLO HOSPITALS, BHUBANESWAR ON THE OCCASION OF WORLD HEART

By;Prasant Patnaik,Sr.Media Associate and Patron,odishabarta

 

What is the purpose of celebrating ‘world heart day’(?).

World Heart Day is a campaign established to spread awareness about the health of heart among common people all through the world. This initiative was founded in the year 2000 to inform people to take care of their heart. A huge percentage of common public in the society is suffering from the heart diseases like stroke, heart attack, heart failure, etc. Heart problems are the leading causes of death in the world.It is celebrated annually all over the world on 29th of September. A particular theme is decided for the each year celebration in order to focus on the main subject and make it effective. Theme is prepared by keeping in mind the key issues of heart health. 

How is it celebrated(?).

World Heart Day is celebrated throughout the world every year by organizing variety of events and activities related to the heart health for more awareness in the common public. The aim of this campaign is to motivate people for active participation in huge number to make this campaign successful and world free of heart diseases. There are many ways people can be involved in the celebration such as planning their own ways, sharing healthy heart selfies on Twitter, Facebook pages and other social media sites to boost the campaign, keep an eye on the website of world heart federation regularly for current updates and information. 

The main aim of world heart day is to improve global heart health by encouraging people for lifestyle changes and gain knowledge about ways to be good to the heart. There is a target by WHO to reduce non-communicable disease mortality rate by 2025 by reducing the premature deaths because of cardiovascular disease.

AN INTERVIEW WITH DR. PRASANT KUMAR SAHOO, SR. CONSULTANT CARDIOLOGIST & DIRECTOR, INTERVENTIONAL CARDIOLOGY, APOLLO HOSPITALS, BHUBANESWAR ON THE OCCASION OF WORLD HEART

The World Heart Federation motivates the health care professionals, medical societies, policy makers, patients, organizations and other healthy individuals to come forth and participate actively in the campaign to reduce the fear of heart disease and stroke as well as ensure people for longer and better lives. 

What is the theme of ‘world heart day’ this year(?).

The theme of world heart day this year is ‘‘Power Your Life’

 

Can you explain what is the meaning of this theme(?).

Your heart powers your whole body. It lets you love, laugh and live your life to the full. Heart health is at the heart of all health. When you look after your heart it means eating and drinking well, exercising, stopping smoking. all the things that make you not only healthier, but also feel good and able to enjoy your life to the fullest. That’s why it’s so important to look after it. If you don’t, you’re putting yourself at risk of cardiovascular disease (CVD), which includes heart disease and stroke. 

Why are we so worried about heart disease(?).

Heart attacks are the world’s number one killer. Each year, it’s responsible for 17.5 million premature deaths, and by 2030 this is expected to rise to 23 million.India is no exception. Our country is the ‘capital’ of heart attacks for the world. Maximum number of patients who have heart attacks are from India. Our resources are limited and usually heart attacks strike Indians almost a decade earlier than our western counterparts. Families have been ruined when heart attacks strike at the ‘prime time’ of ones life. Treatment of heart attacks are costly and as a result in is a big burden for the middle class families when the sole bread earner of the family dies due to a heart attack. So every Indian should be aware about what a heart attack is and try to prevent such incidents by taking simple measures. 

 

Is heart disease in ‘males’ different from ‘females’ (?).

Heart disease is no longer considered a disease that affects just men. In the past, women usually received less aggressive treatment for heart disease and were not referred for diagnostic tests as often. As a result, when many women were finally diagnosed with heart disease, they usually had more advanced disease and their prognosis was poorer. We now know that cardiovascular diseases affect more women than men and are responsible for more than 40% of all deaths .Women have different symptoms of heart disease than men do, and those differences can make for deadly mistakes .Despite stunning improvements in cardiovascular deaths over the last decade, women still fare worse than men and heart disease in women remains underdiagnosed, and under treated. 

 

What are the common complains that a person has when he/ she gets a heart attack(?).

Know the warning signs: the sooner assistance is sought, the greater the chances of a full recovery.Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

 

Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath with or without chest discomfort. Other signs may include breaking out in a cold sweat, nausea or light headedness

 

What should the person do if he / she suspects a heart attack(?).

 

AN INTERVIEW WITH DR. PRASANT KUMAR SAHOO, SR. CONSULTANT CARDIOLOGIST & DIRECTOR, INTERVENTIONAL CARDIOLOGY, APOLLO HOSPITALS, BHUBANESWAR ON THE OCCASION OF WORLD HEART If you suspect you’re having a heart attack: 

  • DO call for help ; call for an ambulance; Inform your family doctor.
  •  
  • DO try to stay calm until help arrives.
  •  
  • DONT delay calling for help
  •  
  • DON’T dismiss your symptoms as the flu / stress/ gas .
  •  
  • Do chew a tablet of Aspirin and if available, put a tablet of Nitroglycerine under your tomgue.
 
  • DON’T drive yourself to the hospital
  •  
  • Before reaching the Emergency room of the nearest hospital, try to give them a call and inform that you are reaching- so that the doctors attend you fast and see that a bed is available in the ICCU for further treatment.

 

Is it true that heart attacks are getting more common in younger age group these days(?).

When the afflicted individual is under the age of 40, the tragic consequences for family, friends, and occupation are particularly catastrophic and unexpected. Indians are prone as a community to CAD at a much younger age. In the Western population incidence of CAD in the young is up to 5% as compared to 12-16% in Indians. The percentage of patients below the age of 45 years suffering from heart attacks is reported as high as 25-40%. Indians have 15 times higher rate of CAD than Chinese and 10 times higher rate than local Malays below the age of40 years. The prevalence of CAD is two-times higher(10%) in urban than in rural India. South Indians have higher prevalence, 7% in rural and 14% in urban areas. 

 

What is the reason for this(?).

The vulnerability of urban Indians to CAD is possibly related to different nutritional, environmental and life-style factors. Life style factors mainly contribute to a steep rise in heart attacks . People adopt sedentary life styles, do not exercise, take fatty food- especially the much sought after ‘ fast food’ and smoke a lot. These factors have played an important role in the steep rise in heart attacks in our country.

 

How can we prevent oneself from getting a ‘heart attack(?).

It is very important to stop smoking, to keep optimal weight, to take regular exercise like walking and to adhere to medical advice seriously. In the industralised countries there has been a continuing decline of heart attacks during the last three decades. This has been possible by focussing on public education programmes for modifying the known risk factors and by targeting high risk individuals and emphasising on healthy life-styles. This achievement of the industrialised nations must become an example for the people, for physicians and policy-makers in India.

 

What all tests do you advise for persons suspected to have heart disease(?).

First of all one has to calculate as to how much risk is involved. For example people who have diabetes or hypertension , or smoke a lot and arte overweight are more prone to heart attacks. Basic tests like a Serum lip[id profile, ECG, exercise ECG ( TMT) and an echocardiogram are essential for detecting the presence of heart disease. To investigate further, a coronary angiogram may be essential to pin point the diagnosis of a heart problem.

 

How are heart attacks treated(?).

A heart attack is a medical emergency. Delaying treatment can mean lasting damage to your heart or even death. The sooner treatment begins, the better your chances of recovering.  

Restoring blood flow to the heart is vital to prevent or limit damage to the heart muscle and to prevent another heart attack. The main treatments are the use of thrombolytic (‘clot-busting’) drugs and procedures such as angioplasty. 

Thrombolytic drugs (‘clot-buster’) are used to dissolve blood clots that are blocking blood flow to the heart. When given soon after a heart attack begins, these drugs can limit or prevent permanent damage to the heart. To be most effective, they need to be given within 1 hour after of the start of heart attack symptoms. 

Angioplasty & Stenting procedures are used to open blocked or narrowed coronary arteries. This form of treatment is widely picking up and is definitely preferable in certain subset of cases. 

Coronary Artery Bypass Surgery uses arteries or veins from other areas in your body to bypass your blocked coronary arteries. 

 

Could you highlight something about ‘primary angioplasty(?).

If heart attack occurs, patient can undergo immediate angiography and stenting ( called as Primary Angioplasty). Primary angioplasty is the best form of treatment available, as of date to save a heart from getting damaged further .In these procedures the patient is taken to the cardiac catheterisation laboratory, where a coronary angiogram is done. Based on the angiogram, the block is identified. If there is a ‘clot’, then it is sucked out with help of a catheter ( thrombosuction), so that blood flow to the artery is restored.. After this a ‘stent’ is deployed to keep the blocked artery open. Best results are obtained, if this procedure is done within 6-12 hours of a heart attack. A stent, which is a tiny metal mesh tube, may be placed in the artery to help keep it open. Results have shown that Primary angioplasty is the best form of treatment that is available for acute heart attack.

 

How safe are these procedures(?).

Angioplasty procedures are extremely safe these days, if performed by experienced hands. Regarding the hospital set up one should go to a hospital, where there is expertise in performing Primary Angioplasty and according to the US regulations the operator (Cardiologist) should have performed at least 75 Angioplasties per year (and the team should perform 200 Angioplasties and 36 primary angioplasties per year)..By performing primary angioplasty immediately following an acute heart attack it has been possible to reduce the chances of death and to salvage lot of heart muscle so that the quality of life of the patient in future does not deteriorate.

 

What are the different types of ‘stents’ available for use (?).

Indian market has been flooded with hordes of stents either produced abroad or in India. Discuss about the ‘merits’ & ‘demerits’ of the type of stent you select for your heart with your treating cardiologist.It is always safe to use an US FDA ( Food & Drug Authority) approved third or fourth generation drug eluting stent (which is approved for use in USA and is time tested).Certain stents are approved foruse in diabetics, and have shown good long term results.. The newer generation of ‘Bioabsorbable scaffolds’ (melting stents) are good as within 3-4 years there is no metal in the heart. And the artery gets back its natural shape. These have been recently approved in USA and is freely available in our country. 

 

What is better for the patient in a case of acute heart attack – angioplasty or Bypass surgery(?).

During an acute heart attack, the primary aim is to restore blood supply to the occluded artery. If multiple blocks are there, then the artery causing the heart attack has to be opened first, so that blood flow is restored and heart muscle death does not occur. This is known as the ‘infarct related artery’. The best way to open the infarct related artery is by angioplasty and stenting. Once this is done , thereafter in a second stage one can go for further angioplasty to other arteries or go for a bypass surgery. Hybrid procedures ( angioplasty of the infarct related artery in the initial stage , followed by bypass for other arteries) are commonly done these days, to save heart muscle. In rare situations ‘em,ergency Bypass surgery’ is required, as angioplasty may not be feasible in some cases. The main aim is to salvage as much of heart muscle as possible, as we have only ‘ONE’ heart.

 

What tips would you suggest to our readers to have a ‘healthy heart (?). 

Get active;30 minutes of activity a day can help prevent heart attack and stroke. Try to make exercise a regular part of your life: use the stairs instead of the lift, get off the bus a few stops earlier and walk the rest of the way. Being active is also a great way to relieve stress and control your weight, which are both risk factors for cardiovascular disease.Stop smoking and protect yourself from tobacco.If you stop smoking, your risk of coronary heart disease will be halved within a year and will return to a normal level over time. Avoid smoke-filled environments: exposure to second-hand smoke significantly increases the risk of heart attack.

 

3. Eat healthily 

Eat plenty of fresh fruit and vegetables, a variety of whole grain products, lean meat, fish, peas, beans, lentils, and foods low in saturated fats. Be wary of processed foods, which often contain high levels of salt. Try to avoid drinking alcohol or if you do drink, make sure it is in moderation. Drink lots of water!

 

Maintain a healthy weight 

Keeping a healthy weight and limiting your salt intake will help to control your blood pressure and lower your risk of heart disease and stroke. A good way to keep track of a healthy weight is to use BMI (Body-Mass Index) which is a measure of how much body fat is on a person based on their height or weight. To calculate your BMI, you divide your weight (in kilograms) by your height squared (in meters). A healthy adult should keep his or her BMI between 18.5 and 24.9 kg/m

 

In other words, take measures to ‘POWER YOUR LIFE’ by protecting yourself from heart attacks !!!

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