Published On : Mon, Feb 25th, 2019

Cardiologist Dr Archana Jain on what ails the heart!

Dr Archana Jain Md, MED, DNB Cardiology a specialist from Orange City Hospital and research Institute highlighted the major points involved in treatment of heart patients.

1. What is Heart Attack?
Heart attack is sensation of pain or pain that patient notices after a reduction in blood to heart or inadequate supply of blood to heart in
relation to its requirement. It is called chest pain but that is not always a chest pain. It can be any abnormal sensation of chest squeezing or just tightness felt at level of
heart i.e. midline of chest. Many times it can be just sudden breathlessness, abdominal fullness or jaw pain, neck pain, back pain. Many patients miss it and take it as gas.


2. What are types of heart attack?
We divide it in three types

ST elevation Myocardial Infarction(STEMI) or conventional heart attack
Non ST elevation myocardial infarction and unstable angina (NSTEMI or UA)
Stable angina
STEMI -severest type of heart attack

Portion of heart does not receive blood and patients symptoms and presentation is acute severe. In this patient usually has prolong chest heaviness that is unbearable, seating or vomiting, he is restless, may develop acute breathlessness, may be unable to sit. But some heart attack can go unnoticed.
If blood supply is not restored in 20 minutes, part of heart supplied by that blood vessel becomes dead. Patient can develop arrythemia, abnormal rhythm .if not relived in
time patient can die. For ventricular fibrillation time is less than 3 minutes. If he does not develop arrthymia, still patient can survive but with always with defect in heart pumping or heart function.

3. What are the effects on Heart in STEMI ?
How much the effect will be depends on amount of heart muscle involved. If vessel having block is proximal part of artery, effect will be more severe,
as large part of heart is involved. Blood not pumped out acuumultes in lungs ,patient develop pulmonary oedema, lungs flooded with blood but
oxygen can not be extracted.
This can produce low BP, Hypotension, shock, reduction in blood supply to all vital organs, producing even kidney failure. Some times proximal part of artery also supplies heart rhythm producing centre of heart, therefore slows and again can produce low bp, syncope, secondary kidney failure etc

The STEMI type are dangerous of all as the risk involved is high. Some STEMI can have late complications like heart rupture,
ventricular septal defect, or valve leakage, Even if patient survives , normally with timely diagnosis and treatment, he will face complications and even permanent damage.

4. How is NSTEMI or Unstable angina different from Stable Angina ?

In NSTEMI the hearts blood supply is reduced. The patient can also have complications like STEMI, but if diagnosed at right time, heart function can be preserved.

If treated adequately the heart can function back to normal with the help of angioplasty.

In Stable Angina, patient suffers with a blockage in heart vessels, 70, 80 or 90% but patient can maintain his life style without gross discomfort

Patient could suffer with transient heart pain or discomfort if involved in some strenuous activity, while the pain reduces with rest or with tablets.
These patients also can have heart attack in stress or strain or can have gradual deterioration of heart function.
These patients also need long term monitoring and appropriate advises

5. What are tests available to diagnose Heart Attack ?
ECG , ECHO, TMT,Angiography

ECG Electrocardiogram is basic thing . Usually picks up STEMI or NSTEMI. Angina picked up only during pain in 20- 25% patients. ECG also picks up arrytemias or abnormal heart rhythm.

ECHO is next common test, picks heart muscle damage, area of damage, valve function, leaks and heart function. Even heart function can deteriorate over time.

TMT Tread mill test or stress test is to see ECG during stress to heart. It can pick up about 40 to 70 % of heart patients

Angiogram is test to see actual blocks in blood vessels. Site and size of blocks are determinant of further procedure

6. What are the Current Treatment methods involved?

Doctors recommend Aspirin to everyone, Clopidogrel or other drugs as per cardiologist, Control of BP, Sugar, prescribed Medicines for heart failure /pump failure, Medicines to relieve chest pain or angina.

7. What are the Risk Factors of suffering Heart Attack?

Non modifiable
Family history of Heart disease
Smoking or tobacco

8. Any tips on coping with the disease?

Have a healthy lifestyle
Eat healthy food
Timely checkup
Control your blood pressure
Control your cholesterol levels
Check for diabetes
Control your stress level