Monsoon and Heart Diseases

     Monsoon is a blessing to India. Intolerable summer ends with the rains and worries about the scarcity of water and food for that year vanish. But monsoon comes with its darker side, these are the epidemics. These diseases directly or indirectly affect the heart.

1 Respiratory diseases.

    Repsiratory diseases vary from simple cold to severe pneumonia. Most of us are now familiar with these, thanks to the COVID-19 epidemic. These lead to extra work load on the heart and the patients who are already suffering from heart disease may land up in hospitals with heart failure. To prevent these general hygiene precautions should be followed. High risk patients should use masks outside whenever possible. Elderly patients and patients with high risk should get vaccinated against common respiratory illnesses, take the help of your Doctor regarding this. If patient acquires the infection he/she should get it treated as soon as possible before any complications happen.

2 Gastrointestinal Diseases

   Monsoons comes with the epidemics of gartroenteritis, again it can be milder forms or very severe forms like cholera. Loose motions and vomitings reduce the water in the body and decrease the blood pressure. With doctors advice the patient may need to reduce the dose or stop some of the cardiac medicines temporarily such as diuretics (e.g. Dytor ,lasix). ORS should be taken as recommended to avoid dehydration.High risk patients should better be admitted to hospital ,I.V. fluids can be given in monitored settings.Renal function tests may need to be checked frequently in heart disease patients suffering from loose motions. Gradual restarting of the medication also will require medical professional's help. 

Mosquito born diseases 

    Malaria, Dengue become rampant during rainy season. Heart disease patients shuld take extra precautions to avoid mosquito bites. If get infected immediate investigations and treatment is warranted. High risk patient should get admitted to hospital. As mentioned above precautions should be taken to avoid dehydration. Few people may develop acute heart failure without any previous illness (myocarditis) that requires hospitalisation and close monitoring.

           Take hygienic precautions, drink good quality water, avoid outside food, keep your surroundings clean. Wish you a happy and healthy Monsoon Season.

Mission - Healthy Hearts.

Dr. Tamiruddin A. Danwade

Consultant Interventional Cardiologist,

Mother & Rhythm Clinics,

Kharghar & Seawoods, Navi Mumbai

For Appointments - +919321459928

Online Medical information (Doctor Google 😄)

       Today's era is referred as 'era of explosion of information ' It is perticurly true for medical field. Things which were difficult to read/access once upon a time now are one click away. This has emence implications mostly positive but there are many red alerts also.

       As internet is used by all sorts of people, different views are expressed by everyone. Only few people are authorities in that perticular field many are amateurs and most are quacks for example good medical knowledge is available only on specific internet sites. Geniune literature is provided by high index medical journals ( mind you free journals are rampant now a days which are managed by not so dependable sources) e.g. good cardiology papers and available on JACC, circulation, NEJM, JAPI, Indian heart Journal to name a few there are many others. Some sites compile all the knowledge on a perticular subject, these are UP-TO-DATE, MEDSCAPE , internet sites of Mayo Clinic, Cleaveland Clinic etc. Apart from this many informative videos are available the above rule applies to these also. A well experienced and learned doctor gives true information ( unfortunately some doctors also spread non-scientific information although that is rare).

     For my patients I advise learn about your disease/ illness/ medical condition it helps to treat it in a better way. Having written this I and many of my colleagues face a big issue now a days i.e. patient or a relative who has tremendous amount of information about the disease but who are still unsure 😄. These people become extremely confused and that may hinder the right and scientific decision. If the information is wrong or given by quack situation become more grave. For example in my clinic I see patients who have typical symptoms of coronary artery disease ( disease where hearts blood vessels become blocked causing major or minor heart attacks) I suggest them coronary angiography to check the blockades. Few people unfortunately come across wrong information on internet or see some videos showing non scientific information and take wrong decisions. Few others have genuine information but they are overwhelmed with it and fail to take right decisions.

        My advice for this is believe on your doctor who has painstakingly learned all the medical knowledge for many long years. He/ she is the best person from whom you will get the most scientific information. Take second opinion of another medical expert in same field in case of confusion. Depend only on scientific internet sites as mentioned above. Don't get carried away by emotional videos by quacks. In case of doubts come back to your doctor who is always there to solve them.

Mission - Healthy Hearts.

Dr. Tamiruddin A. Danwade

Consultant Interventional Cardiologist,

Mother & Rhythm Clinics,

Kharghar & Seawoods, Navi Mumbai

For Appointments - +919321459928

Complex Coronary Angioplasties.

 

  Our heart is a natural pump with tremendous efficiency. It supplies blood to the whole body. Coronary arteries are relatively small but vital blood vessels that supply blood to the heart itself. Blockades in these blood vessels mainly due to cholesterol deposition lead to minor or major heart attacks which are potentially life threatening.

  Historically bypass surgery was the only treatment option available for these blockades. This  is a supra-major surgery with its own drawbacks like long recovery time, perioperative morbidity and mortality. In 1977, Dr Andreas R. Grüntzig invented the less invasive treatment option - Coronary Angioplasty. Angioplasty is a percutaneous procedure where the cardiologists pass a balloon over a wire in the coronary arteries through a small tube-like guiding catheter, and blockades are  dilated to improve the blood flow through them. Initially, it was a crude method, nothing else could be done, subsequently, stents  were invented which are metallic scaffolds implanted at the site of the block to prevent re-block. In  the last three decades, stents quality has significantly improved with fewer complications and excellent outcomes.

      Although angioplasty was discovered way back in the 1970s, still till recently, complex cases were managed by bypass surgery. Examples of the complex cases are hard calcified blocks, tortuous vessels, multiple long blocks or blocks at difficult locations of the vessels etc. With cutting-edge techniques manging, these challenging scenarios have become possible via angioplasty. Internal imaging techniques like optical coherence tomography (OCT) or  Intravascur ultrasound (IVUS) made it possible to properly delineate the properties of the blockades like the length of the block, presence of calcium or diameter of the stent to be used etc. So that a stent can be implanted in places like the left main coronary artery with ease. Guide extension catheters are become available for tortuous arteries where passing a balloon or stent is usually very difficult. Calcium cutting techniques like cutting balloons, rota ablation devices and the newest one in kitty intra vascular lithotripsy (IVL) have been introduced  so previously unexpandable blocks now can be tackled. Some technical advances in angioplasty procedures themselves have been  introduced like bifurcation stenting techniques have revolutionised the treatment of vessels with joints (bifurcating vessels). As mentioned previously, stents have become much more advanced and sophisticated so that long length blocks, small diameter vessels or very large vessels can be stented without fear of re-blockades.

  So, with the advent of newer techniques, many complex blockades can be managed with coronary angioplasties now, however, the most important decisions are when to do the angioplasty when to manage medically or when to send the patient for bypass surgery which still has a major role in modern-day cardiology practice. This is decided by a ‘Heart team’ where cardiologists and cardiac surgeons discuss and decide about the best treatment option.

           Dr. Tamiruddin A. Danwade

 Senior Consultant Interventional Cardiologis,

Mother and Rhythm Clinics,

Kharghar and Seawoods, Navi Mumbai.

+919321459928

Stress and Heart diseases

 

   In Modern era stress is independent and probably the most important risk Factor for development of heart related issues especially heart attacks. Stress can be Physical, mental or combination of both.  Today's life of continuous compitition and compulsion for high achievement has increased the stress mutifold.

     Stress can not be measured but there are few signs and symptoms which indicate that the perticular person is stressed out like 1 Continuous feeling of unhappiness without any mental illness 2 Lack of sleep 3 Inability to concentrate 4 Lack of interest in surrounding 5 Burnout stage where people want to give up there jobs or work 6 Body pain , weakness without any disease 7 High heart rate without any heart disease 8 Anger issues. 9 FOMO - Fear of missing out. 

         Stress can lead to high BP, premature development of diabetes, high cholesterol levels and most importantly can lead to development of heart disease and precipitation of heart attacks especially in young people. 

       Many of my patients ask me why they developed heart disease as they don't have any traditional risk factors like high BP, Diabetes, Smoking or obesity. When I take a detailed history I observe their life is extremely stressful. I give these patients following advice.

1. Try to plan and streamline your life in such a way that you are not continuously busy.

2 . Take some time off in every day work. Take afternoon nap if possible.

3 Don't work on weekends keep Sundays ( if possible Saturdays) for yourself.

4 Take regular breaks - Go for vacations.

5 Exercise daily - 30 to 40 of aerobic exercise ( walking/jogging/cycling/swimming) 10 to 15 minutes of streching exercise ( mild gym/ Yogasann like Surya namaskar)

6 Breathing exercises like meditation.

7 Follow your hobbies and take out time for them whatever it may be like reading, listening to music or traveling etc.

9 Take a good refreshing sleep everyday  - 6 to 8 hours.

10. Develope good social support system family and friends. Dine together once in a while.

11. Give a break to social media intermittently, don't see any screens(TV/Mobile/Tablet) 1 hour before going to bed.

12 Experience joy of letting it go sometimes no need to chace the targets every time.

Dr. Tamiruddin A. Danwade

Consultant Interventional Cardiologist.

Mother and Rhythm Clinics

Seawoods and Kharghar

+919321459928