Health Talk in Dubai

Dr. Ashok Kumar Kapoor,
MBBS, MD(Int. Medicine), DM (Cardiology), F.card(Germany), FCCP(USA),

Getwell Medical Center

Definitions of Health
“the condition of being Sound in Body, Mind or spirit,
especially freedom from physical disease or pain”
(Webster ) “soundness of body or mind: that condition
in which its functions are duly and efficiently
discharged”


WHO Definition of Health?
WHO definition of Health
“Health is a state of complete physical, mental and social
wellbeing and not merely an absence of disease or
infirmity” + ability to lead a “socially and economically
productive life”


Incidence of Coronary Heart Disease


Incidence of Coronary Heart Disease
• Worldwide 6 to 7 million Deaths.
• In U.S.A, 12 million Americans have CAD.
• 800,000 new Heart Attacks a year and 450,000
recurrent
• UK - 300,000
• INDIA - 2.5 million
• UAE - 10 to 12,000
• Women develop the disease later by 10 years.
• Sudden Death above 35 y-80% are due to Heart attack.


HEART ATTACK (MYOCARDIAL INFARCTION)

• A heart attack is caused by a blood clot
obstructing a coronary artery-muscle death.
• Chest Pain occurs because of the dying muscle.
Electrical instability causes V. Fibrillation and
sudden Death.


Heart Attack Symptoms
• Chest pressure
• Sweating
• Jaw pain
• Heart burn
• Arm pain
• Indigestion
• Back Pain
• Nausea
• Breathlessness


Risk Factors
• Age
• Gender
• Family history
• High Blood Lipids – Cholesterol
• Tri LDL
• Smoking
• Hypertension
• Diet
• Diabetes Mellitus
• Sedentary
• High stress-type A
• Homocys
• Fibrinogen etc


Coronary Angiogram
Digital Image Processing

RCA RCA LCX


Rotabalator and Stenting
 Long standing Hypertension
 Hyperlipidemia
 Chr. Stable Angina
 Twice Balloon Angioplasty

C.S 47, F


DIAGNOSIS OF CHD-EARLY AND ACCURATE

SCREENING FOR CHD:
1. AGE: After crossing 35
2. Family History
3. Smokers
4. Diabetes Mellitus
5. Hypertension
6. Obese
7. High Blood Lipids
8. Stressful, sedentary life.


DIAGNOSIS OF CHD
RESTING ECG:
 Recorded by ECG machine.
 Can be done at home in emergency.
 Any doubtful chest discomfort-do it.
 May be normal in 40% of the cases.
 Chest Pain-ALWAYS DO IT.


STRESS TEST
• Exercise Test-done
on Treadmill or
Bicycle.
• Best screening
test.
• Negative test with
good exercise.
• Tolerance rules out
significant CHD.


ECHOCARDIOGRAPHY

• Evaluates Heart
structure and
function.
• Can localize areas
of heart attack.
• Stress Echo can
improve the
diagnostic value of
stress test.
• Options of color,
Doppler, 2D and
even 3D study.


CORONARY ANGIOGRAPHY
 The Gold Standard for the diagnosis of CHD.
 Invasive procedure.
 A plastic tube passed into the heart and dye is
injected.
 Film taken and studied for coronary Blockages.


HOW TO PREVENT A HEART ATTACK
TIPS:
 Healthy life style,
 Regular exercise: 20 to 30 minutes of Walking,
cycling or on a treadmill.
 Maintain Ideal Weight.
 Open air exercise.


Prevention
Eat Healthy food:
• Plenty of fresh fruits, green vegetables, Salads-
High Fibre diet.
• Avoid oily , Fried foods, cheese butter, ghee and
creams.
• Avoid excess of alcohol.


Life-Style Assessment
 Scoring: Record the number of checkmarks (0 to 5) for
each of the twelve areas. Add up the numbers to
determine your total score.
 48 to 60 Healthier than average life-style
 30 to 47 Average life -style
 0 to 29 Below average: need for improvement
 If you scored less than 3 in any one area, there is a
need for improvement in that area


STRESS & condition, a response to a physical threat or
Stress is a common
ITS MANAGEMENT
psychological distress, that generates a host of chemical and hormonal
reactions in the body. In essence, the body prepares to fight or flee,
pumping more blood to the heart and muscles and shutting down all
non-essential functions. As a temporary state, this reaction serves the
body well to defend itself. However, when the stress reaction is
attenuated, the normal physical functions that have been either
exaggerated or shut down become dysfunctional.


Stress is pervasive, life threatening.
• An estimated 75% to 90% of visits to primary-care
physicians are for stress-related complaints.
• In 2002, people in the United States alone bought
nearly $17.2 billion worth of antidepressants and anti-
anxiety drugs, up more than 10 percent from 2001.
• According the Centers for Disease Control, adult use of
antidepressants almost tripled from 1988 to 1994 and
1999 to 2000.
• A Harvard study showed individuals who lived in a
state of high anxiety were four and a half times more
likely to suffer sudden cardiac death than non-anxious
individuals.


 Take the Stress Test
 See if any of the following symptoms apply to you or someone you know:
 Irritability: Shorter fuse these days, the little things make you angrier?
 Sense of humor: Laughing less, too serious?
 Worry: Reliving or projecting future anxious emotional experiences?
Depressed, resigned over the way things are?
 Excessiveness: Eating, drinking too much, too many mood-altering stimulants?
 Forgetfulness: Can’t remember little things lately, have mental gridlock?
 Aches and pains: Recurring headaches, frequent gastrointestinal distress,
tension in face, jaw, shoulders, back or chest?
 Nervousness: Talking faster, more than in the past?
 Fatigue: Feeling run-down a lot? Tired, but can’t get restful sleep?
 Illness: Suffering allergies, colds, flu and other ailments more often?
 Time pressure: Often feel as if there is not enough time, too much to do?
 If you answered yes to three or more of these questions, there’s a good chance
you are experiencing some degree of chronic stress, but take heart: You can
control your stress and HeartMath will help.


 A HeartMath Tip: Take five minutes several times a
day, whether or not you’re feeling especially stressed,
to try these simple steps adapted from the HeartMath
Attitude Breathing® tool.
 Focus on your heart as you breathe in.
 Concentrate on a positive feeling or attitude as you
breathe out.
 Lock in this new feeling as you continue to breathe it
in and out through your heart.
 As you become adept at using this HeartMath tool,
select new feelings and to help you “de-stress”


Benefits of Stress Reduction
• Improved health, feeling of well-being and quality of life
• Improved intuition, memory and cognitive function
• More energy during the day, restful sleep at night
• More heartfelt feelings like love, appreciation and kindness
• Less impatience, irritability, fits of anger


Smoking - The Facts
 Cigarette Smoking contains the following
 Nocotine
 Tar
 Carbon monoxide
 Many Disease are caused by Smoking.
 Smoking affect other people


 Is it ever too late to quit?
 No, it's never too late to quit. Quit smoking now to start feeling these benefits.

• 20 minutes after quitting:
 Your blood pressure drops back to normal.
 The temperature in your hands and feet returns to normal.
• 8 hours after quitting:
• The carbon monoxide (a gas that can be toxic) in your blood drops to
normal.
• 24 hours after quitting:
 Your chance of having a heart attack goes down.
• 2 days after quitting:
 You can taste and smell things better.
• 2 weeks to 3 months after quitting:
 You have better blood flow.
 Your lungs are working better.


• 1 to 9 months after quitting:
 Coughing, sinus congestion, fatigue, and shortness of breath decrease.
 Your lungs start to function better, lowering your risk of lung infections.
• 1 year after quitting:
 You reduce your risk for heart disease by half.
• 5 to 15 years after quitting:
 Your risk of having a stroke is the same as someone who never smoked.
• 10 years after quitting:
 Your risk of lung cancer is nearly the same as someone who never smoked.
 Your risk of cancer of the mouth, throat, esophagus, bladder, kidney, and
pancreas also decrease.
• 15 years after quitting:
 Your risk of heart disease is now the same as someone who has never
smoked.


CHOLESTROL
• Low fat, low cholesterol diet
• Exercise
• STATINS


Exercise

 Exercise can help your body in many ways. Aside from helping you to keep a healthy body
weight, exercise increases your mobility, protects against bone loss, reduces your stress levels,
and helps you feel better about yourself. And, research has shown that people who exercise are
less likely to develop heart disease, high blood pressure, and high cholesterol levels

 Before you start an exercise program
• You are taking a prescription medicine.
• You have ever had any kind of heart problem, especially a heart attack.
• You have diabetes.
• You have problems with your bones or joints.
• You have high blood pressure and do not take medicine for it.
• You have a family history of coronary artery disease.
• You are a man over 45 or a woman over 50, and you are not used to doing even moderate
levels of exercise.
• You smoke.
• You are very overweight


What kind of exercise should I do?

There are 3 categories of exercises:
 Cardiovascular
 Strength-building
 Flexibility

Cardiovascular exercise is also known as aerobic exercise

For example, walking, jogging, swimming, and cycling are aerobic activities.
Strength-building and flexibility exercises are known as anaerobic exercise.

Cardiovascular Exercise
A simple definition of cardiovascular exercise is any exercise that raises your
heart rate to a level where you can still talk, but you start to sweat a little.


CONCLUSION
 In the conclusion , I can only say that in spite of fast and stressful life the
lifestyle needs to be healthy.
 Prevention is better than cure
 The state of art modern technology and the early diagnosis can make all the
difference in the form of life and death.
 Genetic manipulation and thus producing new coronary artery is the ultimate
goal.


Health Talk in Dubai

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