Prventvie health care program


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  • Primus hospital offers a range of specialized cardiac treatments using the latest diagnostics, treatments and surgical techniques recognized for providing high quality clinical expertise, rapid assessment and customized care. Primus Super Speciality Hospital Chandragupta Marg, Chanakyapuri New Delhi-110 021, India +911166206630, 40
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Prventvie health care program

  1. 1. Welcome Cardiopulse Presents Preventive Health Care Program
  2. 2. Coronary heart disease in India 1990-CVD cause 2.386 Millions Deaths 2015 CVD will cause 4.586 Millions Deaths 60 Million in India Suffering from CAD
  3. 3. Cause of CAD <ul><li>Atheroscelorosis </li></ul><ul><li>Smoking </li></ul><ul><li>Obesity </li></ul><ul><li>Diabetes </li></ul><ul><li>Sedentry life style </li></ul><ul><li>Stress </li></ul>
  4. 4. CAD an Epidemic <ul><li>Is BY-Pass the solution…? </li></ul><ul><li>NO </li></ul>
  5. 5. Solution <ul><li>Life Style Management </li></ul><ul><li>Preventive Cardiology </li></ul><ul><li>Non- Invasive Methods </li></ul>
  6. 6. Result of heart disease
  7. 7. Symptoms of Heart Attack <ul><li>Angina </li></ul><ul><li>Chocking Feeling </li></ul><ul><li>Sweating </li></ul><ul><li>Nausea </li></ul><ul><li>Irregular Heart Beat </li></ul><ul><li>Heart Burn </li></ul><ul><li>Silent Attack </li></ul>
  8. 8. Investigations <ul><li>Opthalmoscopy </li></ul><ul><li>Lipid profile </li></ul><ul><li>Uric acid </li></ul><ul><li>Heart enzyme </li></ul><ul><li>C P K – 25-130 IU/L </li></ul><ul><li>AST---8-20 IU/L </li></ul><ul><li>LDH----45-90 IU/L </li></ul>
  9. 9. INVESTIGATION <ul><li>ECG </li></ul><ul><li>ECHOCARDIOGRAM </li></ul><ul><li>TMT </li></ul><ul><li>THALLIUM SCAN </li></ul><ul><li>CT ANGIOGRAPHY </li></ul><ul><li>CORONARY ANGIOGRAPHY </li></ul><ul><li>PET SCAN </li></ul>
  10. 10. TREATMENT <ul><li>MEDICAL </li></ul><ul><li>INVASIVE METHODS </li></ul><ul><li>CABG </li></ul><ul><li>PTCA </li></ul><ul><li>NON-INVASIVE </li></ul><ul><li>ACT </li></ul><ul><li>ECP (External Counterpulsation) </li></ul>
  11. 11. Medicines <ul><li>NITRATES </li></ul><ul><li>BETA BLOCKER </li></ul><ul><li>CALCIUM ANTAGONIST </li></ul><ul><li>BLOOD THINNER </li></ul><ul><li>LIPID LOWRING DRUGS </li></ul><ul><li>RESINS </li></ul><ul><li>FIBRIC ACIDS </li></ul><ul><li>HMG CoA REDUCTASE INHIBITOR </li></ul><ul><li>NIACIN </li></ul>
  12. 12. Is By-Pass Necessary <ul><li>By-Pass V/s Medical Treatment </li></ul><ul><li>Veteran administration coperative study group </li></ul><ul><li>European Coronary surgery study </li></ul><ul><li>Coronary Artery surgery study (CASS) </li></ul><ul><li>CASS – 10years follow-up 780 people </li></ul><ul><li>Survival of TWO groups is not significantly different </li></ul>
  13. 13. Indications of By-Pass Surgery <ul><li>Relive angina pain </li></ul><ul><li>Prolong Life </li></ul>
  14. 14. When dose By-Pass Prolong Life <ul><li>Ejection fraction <50% </li></ul><ul><li>Blockage of Left main Coronary Artery </li></ul><ul><li>Triple Vessel disease </li></ul>
  15. 15. By-pass being over done <ul><li>JAMA study </li></ul><ul><li>386 patients underwent bypass surgery 44% of the surgery inappropriate </li></ul><ul><li>Dr. Thomas Graboys MD-JAMA </li></ul><ul><li>50% of by pass can be avoided </li></ul>
  16. 16. Side effects of By-Pass Surgery <ul><li>Mortality 1-3% </li></ul><ul><li>Brain damage 15-40% </li></ul><ul><li>Infection </li></ul><ul><li>Internal bleeding </li></ul>
  17. 17. Can Heart Diseases Be Reversed <ul><li>Dr. Dean Orniesh </li></ul><ul><li>Rice University at Houston </li></ul><ul><li>1983 JAMA reversal of Heart Diseases in 82% of Patients </li></ul><ul><li>1995 Showed Reversal of Heart Diseases by PET Scan </li></ul>
  18. 18. Reversal of heart diseases <ul><li>Reduce Fat Consumption < 10% </li></ul><ul><li>Cholesterol Level < 150 </li></ul><ul><li>Reduce Stress </li></ul><ul><li>Life Style Modification </li></ul><ul><li>Regular Exercise </li></ul><ul><li>Open Collaterals By ECP </li></ul><ul><li>Remove Toxic Metals by ACT </li></ul>
  19. 19. Heart Disease Reversal <10 % OF Calorie 10-30% of calorie Total Fat <100 mg/dl 80-110 mg/dl Blood Sugar (F) <100 mg/dl 30-130 mg/dl LDL BANNED PUFA, MUFA Visible Fat >40 mg/dl 30-60 mg/dl HDL <120 mg/dl 60-160 mg/dl Triglyceride <150 mg/dl 130-200 mg/dl Serum Cholesterols Reversal Recommended
  20. 20. New Risk Factors <ul><li>CRP (C reactive protein) </li></ul><ul><li>Apolipo protein A </li></ul><ul><li>Homocysteine </li></ul><ul><li>Heart rate variability </li></ul>
  21. 21. Lowering Cholesterol <ul><li>Recommended – 100-200 mg </li></ul><ul><li>Ideal < 150 mg/ml </li></ul><ul><li>Water Soluble Fibers – Oats, Barley-brown Rice </li></ul><ul><li>Charcoal </li></ul><ul><li>Garlic </li></ul><ul><li>Gugulipid </li></ul><ul><li>Capsaicn </li></ul><ul><li>Drugs </li></ul>
  22. 22. ECP (External Counterpulsation) <ul><li>A Non Invasive Treatment For Heart Patients </li></ul><ul><li>Introduction </li></ul><ul><li>Latest and Very Effective Treatment For Recurrent Angina, Myocardial Infarction, Post MI Angina and CHF. </li></ul><ul><li>ECP (External Counter Pulsation) Treatment. ECP is an Ingenious Method for Treating Angina it is Non-invasive, Painless, Safe & Inexpensive. It is an Outpatient Treatment. </li></ul>
  23. 23. How ECP Works <ul><li>Increases Diastolic Pressure – Diastole Augmentation </li></ul><ul><li>Decrease After Load – Decompensate Heart </li></ul><ul><li>Endothelial Stabilization </li></ul><ul><li>VEGF </li></ul><ul><li>Collateral Formation </li></ul>
  24. 24. Indication of ECP <ul><li>Angina and congestive heart failure. </li></ul><ul><li>Coronary Heart Disease, Angina Pectoris, Myocardial Infarction. </li></ul><ul><li>Cerebral Arteriosclerosis, Cerebral thrombosis, Cerebral Arteries Embolism, Parkinsoism, Cerebral Ischemic, Cerbrovascular Accident Sequelae. </li></ul><ul><li>Hypertension For Renal Ischemia, Oliguresis Adnuremina. </li></ul><ul><li>Eyeground Arteries Embolism, Centricity Serosity Retina Choroid Pathologic Change Optic Atrophy. </li></ul>
  25. 25. Indication of ECP <ul><li>Sudden Deafness. </li></ul><ul><li>Cerebral Paralysis for Children. </li></ul><ul><li>Diabetes for Arteriosclerosis. </li></ul><ul><li>Extremities Arteriosclerosis Ischemic of Pancreatic. </li></ul><ul><li>Other Ischemic Pathologic Change and Sequelae due to Arteriosclerosis and Disturbance of Blood Circulation. </li></ul><ul><li>Hepatitis. </li></ul><ul><li>Sports Fatigue. </li></ul><ul><li>Use for Sub-Health Care and Test Oration. </li></ul>
  26. 26. Results of ECP Efficacy of Enhanced External Counterpulsation in the Treatment of Angina Pectoris. Lawson WE, Hui JCK, Soroff HS, et al. American Journal of Cardiology 1992; 70:859-862. 18 patients with refractory angina
  27. 27. Counterpulsation Protects Coronary Artery Disease Patients from Future Cardiac Events. S. Karim et al 1st International Congress on Heart Disease - New Trends in Research, Diagnosis, and Treatment Enhanced External . The Journal of Heart Disease 1:1 May ’99 Karim and associates treated 117 patients with EECP between 1/92 and 12/97. 1010 958 Mean # Event Free Days 1.7% . 5% Revascularization 1.7% 4.5% Heart Attack 4.3% 9.6% Cardiac Death EECP Group Drug Group
  28. 28. Total Effective Rate - Symptoms Long-term results were measured in 102 EECP patients; 23, 39, & 53 were followed for 7, 6, & 5 years post EECP respectively. 19, 32, & 52 patients treated solely with medication were followed over the same time periods . 21.3% 73.9% 7 year follow-up 48.1% 67.9% 6 year follow-up 33.3% 55.8% 5 year follow-up Drug Group EECP Group Long-term:  Symptoms
  29. 29. Cardiac Death Rate 30.3% 8.8% Overall 30.3% 7.7% By Eighth Year 13.5% Group4.9% First Year Drug Group EECP Cardiac Death
  30. 30. Does Prior Myocardial Revascularization Predict Therapeutic Benefit From Enhanced External Counterpulsation? Lawson WE et al. Biomedicine ’97; April 25-27 1997, Washington DC - Poster #44 Dr. Lawson and his colleagues at Stony Brook Medical Center provided EECP to 25 patients with angina due to clogged bypass grafts, and compared their response to that of 35 never bypassed angina patients. Pre-EECP coronary angiograms were carried out in both groups
  31. 31. Psychosocial Effects of Enhanced External Counterpulsation in the Angina Patient. Fricchione GL, et al. Psychosomatics 1995;36:494-97. 100% 0% 0% Energy level 100% 0% 0% Ability to work  67% 33% 0% Social life 100% 0% 0% Sense of well-being  100% 0% 0% Health condition  67% 33% 0% Family life  33% 67% 0% Sexual activity    Improved Unchanged Worsened Parameter   
  32. 32. Stress Management <ul><li>Bio-Yoga </li></ul><ul><li>Reduces heart rate </li></ul><ul><li>Lowers breath rate </li></ul><ul><li>Decrease cardiac stress </li></ul><ul><li>Improve heart rate variability (HRV) </li></ul>
  33. 33. Reverse Heart Disease/ By-Pass Surgery <ul><li>Choice is yours </li></ul>
  34. 34. Ours programme <ul><li>2 days educational programme on reversing heart disease </li></ul><ul><li>Age rejuvenation </li></ul><ul><li>Healthy aging </li></ul><ul><li>Diet counseling </li></ul><ul><li>Bio yoga </li></ul><ul><li>Lowing cholesterol </li></ul>
  35. 35. Thanks a Lot