heart disease prevention

1. Heart disease
Heart disease
prevention and treatment
prevention and treatment
Dr Jamshed J Dalal
Dr Jamshed J Dalal
Kokilaben Dhirubhai Ambani
Kokilaben Dhirubhai Ambani
Hospital
Hospital

4. Treatment of
Treatment of
Coronary Artery Disease
Coronary Artery Disease
Early Diagnosis
Early Diagnosis
Early Recognisation of Risk Factor
Early Recognisation of Risk Factor
& Modification of Risk Factor
& Modification of Risk Factor
Early Treatment
Early Treatment
- Medical Management
- Medical Management
- Coronary Angioplasty
- Coronary Angioplasty
Bypass Surgery (CABG)
Bypass Surgery (CABG)

6. Family History and IHD
Family History and IHD
 Genetic factors
Genetic factors
 Environmental factors
Environmental factors
 Psychological social factors
Psychological social factors

7. WHAT IS CHOLESTEROL ?

8. Management of Hypercholesterolemia :
Management of Hypercholesterolemia :
1)
1) Education
Education
2)
2) Diet
Diet
3)
3) Exercise
Exercise
4)
4) Drug therapy
Drug therapy

9. PINCH TEST

11. Diabetes Mellitus and heart
Diabetes Mellitus and heart
disease
disease
 Diabetes is well established risk factor
Diabetes is well established risk factor
 Increases risk Two to four times
Increases risk Two to four times
 Metabolic syndrome-
Metabolic syndrome- big stomach, high
big stomach, high
trigycerides, high BP, diabetes.
trigycerides, high BP, diabetes.

12. Type A - Personality
Type A - Personality
Ambitious
Ambitious
Aggressive
Aggressive
Very Active
Very Active
■ Unsatisfied
Unsatisfied
■ Non-adjustable
Non-adjustable
A

13. Diagnosis of CAD
Gold Standard
ECG
ECHO
Stress Test

14. Coronary Angiography
Coronary Angiography
Routes
Routes
1. Femoral artery approach
1. Femoral artery approach
2.
2. Radial artery approach
Radial artery approach
Procedure Time
Procedure Time
≈
≈ 10 minutes
10 minutes
OPD – Day Care Procedure
OPD – Day Care Procedure
4-5 hrs Hospitalisation
4-5 hrs Hospitalisation
CT angiography
CT angiography

15. ANGIOPLASTY
ANGIOPLASTY
 Arm or leg
Arm or leg
 One hour procedure
One hour procedure
 24 to 48 hr stay
24 to 48 hr stay
 No anesthesia
No anesthesia
 Back to work immediately
Back to work immediately

17. Medicated stents
Medicated stents
 Special drug coating on the stent which
Special drug coating on the stent which
gets liberated at the site of blockage and
gets liberated at the site of blockage and
reduces the chance of recurrence.The
reduces the chance of recurrence.The
drug is liberated over six weeks. Reduces
drug is liberated over six weeks. Reduces
reblockage chances to only 5-6%
reblockage chances to only 5-6%

18. TREATMENT
TREATMENT
 Non drug
Non drug
 Medical
Medical
 Angioplasty
Angioplasty
 Bypass surgery
Bypass surgery

19. Medical Management
Medical Management
 Aspirin
Aspirin
 β
β-blocker
-blocker
 Ace Inhibitors
Ace Inhibitors
 Lipid Lower Agents
Lipid Lower Agents
 Statins
Statins

20. BYPASS SURGERY
BYPASS SURGERY
 More traumatic, needs general anesthesia
More traumatic, needs general anesthesia
 Useful when there are too many blocks
Useful when there are too many blocks
 One month to recover
One month to recover
 Long lasting if arterial grafts used -
Long lasting if arterial grafts used - total
total
arterial grafting
arterial grafting
 Beating Heart Surgery Bypass surgery
Beating Heart Surgery Bypass surgery
is done without stopping the heart – no
is done without stopping the heart – no
heart lung machine
heart lung machine

21. W
H
E
R
E
Y
O
U
E
A
T

22. Type A – Personality :
Type A – Personality :
Treatment
Treatment
 Stretches
Stretches
 Relaxation
Relaxation
 Meditation
Meditation
 Yogic Behavior
Yogic Behavior
 Psychotherapy
Psychotherapy

23. 20
minutes

24. Control
Stress-yoga
Control
Obesity
Control
Diabetes
Control
Fats
Control
Blood Pressure
Relaxation
Avoid Smoking
Regular
Exercise
Prevention of Coronary Artery Disease
Prevention of Coronary Artery Disease

25. Prevention is better,
Prevention is better,
cheaper, and
cheaper, and
easier, than treatment
easier, than treatment
& remember there is
& remember there is
no real cure
no real cure