1510 dr vp nair your heart and you


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1510 dr vp nair your heart and you

  1. 1. Your Heart and You : By Dr. V. P. NairMBBS, BSc, MRCP(UK), MRCP (Ireland), MRCGP(UK),FRCP(Ire), FRCGP(UK), FRCP (Edinburgh), FESC(EU),FRCP (London), FAPSIC(interventional) , FAMS(Cardiology- Singapore), FACC(USA), PBM.Consultant Interventional Cardiologist. Nair CardiacMedical Centre, Mt Elizabeth Hospital #16-08,Singapore. 1
  2. 2. Globally 17.5 million people die of Heart Disease annually.In Singapore, Total death in 2009= 17,101. Total causes ofdeath due to Heart related problems =3933(23.6%.)
  3. 3. The heart Each day, the heart beats about 100 000 times. It pumps approximately 10 metric tons of blood every day.It cycles through about 6 kg of ATP daily—20 to 30 times its own weight—in order to function. O2 ATP Fatty acids Mechanical power Glucose 250 g - 350 gMechanical power of the heart is mainly fueled 3 by fats and carbohydrates
  4. 4. Angina, ( angina pectoris):Temporary chest discomfort fewSeconds or minutes, not hours or all day.Physical exertion, strong emotions, extremetemperatures, or heavy meal increasedemand on heart.Feels pain, pressure, fullness, or squeezing inthe center of the chest or in the neck,shoulder, jaw, upper arm, or upper back.Discomfort relieved by removing the stressand/or sublingual nitroglycerine (GTN) 4
  5. 5. Heart Attack Symptoms• Chest pain• Sweating• Heartburn• Indigestion• General Malaise• Nausea /Vomiting• Shortness of breath• Diziness/light-head• Fainting• Palpitations• Cardiac Arrest• Death 5
  6. 6. Pain of AMI ; (Heart Attack)Lasts 30 mts – hoursconsticting, crushing, oppressing,compressing, something on chest ,squeezing, choking,heavy pain,stabbingboring, burning,Retrosternal-behind chest wall 6
  7. 7. Heart Attack (Myocardial Infarction)Heart Attack is usually caused by rupture of aplaque in a Coronary Artery with evolvingblood clot (thrombus).Treatment is most effective when started within1 hour of start of symptoms 7
  8. 8. Risk factors (causes) for angina andHeart attack are as follows:1. High Blood Pressure (hypertension)2. High fats: Cholesterol and Triglyceride3. Diabetes,4. Smoking5. Male Gender6. Inactive (sedentary) lifestyle7. Family history of heart disease8. Advancing Age9. Overweight & Obesity10. Homocystinemia 8
  9. 9. Lipo Proteins : Serum Cholesterol and Triglycerides: mg/dl mmol/L Interpretation1. Total Cholesterol <200 <5.2 Desirable 200-239 or more 5.2-6.1 or more High <180 < 4.6 Ideal2. LDL Cholesterol <70 <1.8 The best (Bad Cholesterol) <100 <2.6 Optimal 100-129 2.6-3.3 Near optimal 130-159 3.4-4.0 Moderate High >160 >4.1 High3. HDL Cholesterol <40 <1.0 Low (Good Cholesterol) >50 >1.25 Desirable4. Triglyceride (TG) <150 <1.9 Desirable5. LDL / HDL Ratio <3 <3 Desirable 96. Total Cholesterol / LDL <4 Desirable
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  13. 13. Treadmill Stress Test Treadmil 13
  14. 14. Angioplasty (PTCA) and Stending
  15. 15. LAD Before PTCALAD After PTCA 15
  16. 16. Saturday, 23/02/2010 Cardiologists such as Dr Dinesh Nair and his father, Dr V. P. Nair, both from Mount Elizabeth Hospital, who treat patients from Singapore and around the world, say they, have quite a few Indian patients in their 30s and early 40s. A handful are even in their late 20s. They all report that when heart disease strikes Indians, as well as occurring more often and earlier, it also tends to be more severe. Says the senior Dr Nair, who has been in practice for 35 years: ―My Indian patients have multiple blockages – five to six.‖ The average Chinese patient typically has two or three 16Cardiologists blockage.
  17. 17. Which isimportant,Servicingthe Car ?Or Takingcare ofyour ownbody ? Gofor regularcheck up.Dr.V.P.NairStraitsTimesSingapore 17
  18. 18. 1. Maniam, M / 46 collapsed in 1998 - saved by repeated chest Compressions Well @ Age65 2. Peter 68 collapsed @ Bangkok Airport in 1997, Survived with Chest compressions and treatment, though wife initially apprehensive 3. ―With proof from USA and Japan, with survival rate of 300% with CCR, in thousands of victims, this methodology must be seriously considered 4. In my opinion CCR is preferred to all cardiac arrest Victims @ a rate of 100/minute chest Compressions till definite medical help is available, including AED, when again CCR must be continued as long as needed.‖ V P NairThanksdr. Nair 19