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Your Heart and You : By Dr. V. P. Nair
MBBS, 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 Cardiac
Medical Centre, Mt Elizabeth Hospital #16-08,
Singapore.




                                                 1
Globally 17.5 million people die of Heart Disease annually.




In Singapore, Total death in 2009= 17,101. Total causes of
death due to Heart related problems =3933(23.6%.)
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 g
Mechanical power of the heart is mainly fueled
                                                        3
         by fats and carbohydrates
Angina, ( angina pectoris):
Temporary chest discomfort few
Seconds or minutes, not hours or all day.
Physical exertion, strong emotions, extreme
temperatures, or heavy meal increase
demand on heart.

Feels pain, pressure, fullness, or squeezing in
the center of the chest or in the neck,
shoulder, jaw, upper arm, or upper back.

Discomfort relieved by removing the stress
and/or sublingual nitroglycerine (GTN)     4
Heart Attack Symptoms
• Chest pain
• Sweating
• Heartburn
• Indigestion
• General Malaise
• Nausea /Vomiting
• Shortness of breath
• Diziness/light-head
• Fainting
• Palpitations
• Cardiac Arrest
• Death                 5
Pain of AMI ; (Heart Attack)
Lasts 30 mts – hours
consticting, crushing, oppressing,
compressing, something on chest ,
squeezing, choking,
heavy pain,
stabbing
boring, burning,
Retrosternal-
behind chest wall                    6
Heart Attack (Myocardial Infarction)
Heart Attack is usually caused by rupture of a
plaque in a Coronary Artery with evolving
blood clot (thrombus).
Treatment is most effective when started within
1 hour of start of symptoms




                                           7
Risk factors (causes) for angina and
Heart attack are as follows:
1. High Blood Pressure (hypertension)
2. High fats: Cholesterol and Triglyceride
3. Diabetes,
4. Smoking
5. Male Gender
6. Inactive (sedentary) lifestyle
7. Family history of heart disease
8. Advancing Age
9. Overweight & Obesity
10. Homocystinemia
                                             8
Lipo Proteins : Serum Cholesterol and Triglycerides:
                   mg/dl      mmol/L Interpretation
1. Total Cholesterol     <200              <5.2               Desirable
                         200-239 or more   5.2-6.1 or more    High

                         <180              < 4.6              Ideal
2. 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               High

3. HDL Cholesterol       <40               <1.0               Low
 (Good Cholesterol)      >50               >1.25              Desirable
4. Triglyceride (TG)     <150              <1.9               Desirable

5. LDL / HDL Ratio       <3                <3                 Desirable
                                                                              9
6. Total Cholesterol / LDL            <4                     Desirable
10
11
12
Treadmill Stress Test
 Treadmil




                        13
Angioplasty (PTCA) and Stending
LAD Before PTCA




LAD After PTCA

                               15
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
                                                16
Cardiologists                blockage.
Which is
important,
Servicing
the Car ?
Or Taking
care of
your own
body ? Go
for regular
check up.
Dr.V.P.Nair
Straits
Times
Singapore
        17
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 Nair




Thanks
dr. Nair
                                                  19

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1510 dr vp nair your heart and you

  • 1. Your Heart and You : By Dr. V. P. Nair MBBS, 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 Cardiac Medical Centre, Mt Elizabeth Hospital #16-08, Singapore. 1
  • 2. Globally 17.5 million people die of Heart Disease annually. In Singapore, Total death in 2009= 17,101. Total causes of death due to Heart related problems =3933(23.6%.)
  • 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 g Mechanical power of the heart is mainly fueled 3 by fats and carbohydrates
  • 4. Angina, ( angina pectoris): Temporary chest discomfort few Seconds or minutes, not hours or all day. Physical exertion, strong emotions, extreme temperatures, or heavy meal increase demand on heart. Feels pain, pressure, fullness, or squeezing in the center of the chest or in the neck, shoulder, jaw, upper arm, or upper back. Discomfort relieved by removing the stress and/or sublingual nitroglycerine (GTN) 4
  • 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. Pain of AMI ; (Heart Attack) Lasts 30 mts – hours consticting, crushing, oppressing, compressing, something on chest , squeezing, choking, heavy pain, stabbing boring, burning, Retrosternal- behind chest wall 6
  • 7. Heart Attack (Myocardial Infarction) Heart Attack is usually caused by rupture of a plaque in a Coronary Artery with evolving blood clot (thrombus). Treatment is most effective when started within 1 hour of start of symptoms 7
  • 8. Risk factors (causes) for angina and Heart attack are as follows: 1. High Blood Pressure (hypertension) 2. High fats: Cholesterol and Triglyceride 3. Diabetes, 4. Smoking 5. Male Gender 6. Inactive (sedentary) lifestyle 7. Family history of heart disease 8. Advancing Age 9. Overweight & Obesity 10. Homocystinemia 8
  • 9. Lipo Proteins : Serum Cholesterol and Triglycerides: mg/dl mmol/L Interpretation 1. Total Cholesterol <200 <5.2 Desirable 200-239 or more 5.2-6.1 or more High <180 < 4.6 Ideal 2. 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 High 3. HDL Cholesterol <40 <1.0 Low (Good Cholesterol) >50 >1.25 Desirable 4. Triglyceride (TG) <150 <1.9 Desirable 5. LDL / HDL Ratio <3 <3 Desirable 9 6. Total Cholesterol / LDL <4 Desirable
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  • 13. Treadmill Stress Test Treadmil 13
  • 15. LAD Before PTCA LAD After PTCA 15
  • 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 16 Cardiologists blockage.
  • 17. Which is important, Servicing the Car ? Or Taking care of your own body ? Go for regular check up. Dr.V.P.Nair Straits Times Singapore 17
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  • 19. 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 Nair Thanks dr. Nair 19