This document discusses heart disease and provides information from Dr. V.P. Nair, a cardiologist. Some key points: - Globally, heart disease causes 17.5 million deaths annually. In Singapore in 2009, heart disease caused 23.6% of deaths, or 3933 deaths. - The heart works hard, beating over 100,000 times per day and pumping 10 metric tons of blood. Its energy comes mainly from fats and carbohydrates. - Angina is temporary chest pain or discomfort that occurs during physical exertion. A heart attack is usually caused by a blood clot blocking a coronary artery and treatment is most effective within 1 hour of symptoms starting. -

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

10. 10

11. 11

12. 12

13. Treadmill Stress Test
Treadmil
13

14. Angioplasty (PTCA) and Stending

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

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