Tuesday, April 23, 2024

Cardio Care: New facts

On 4 Mar, 2023, Seniors Today hosted its weekly Health Live Webinar with Dr P K Grant, veteran cardiologist and managing trustee, Ruby Hall Clinic Group of Hospitals. He spoke on and answered questions about ‘What is new in Cardiology’.

About Dr P K Grant

Dr P K Grant is Chief Cardiologist, Chairman of Cardiovascular services and Managing Trustee of the Ruby Hall Clinic group of hospitals. He has three major hospitals in Pune including the well-known Ruby Hall Clinic, Sassoon Road, Ruby Hall Clinic, Wanowrie and Ruby Hall Clinic, Hinjewadi and the latest addition is Ruby Hall Clinic, Satara Road which is in the process of being built.

There are 4000 staff working at Ruby Hall group of hospitals making it one of the largest teaching hospitals in India. In addition, Dr Grant has 26 diagnostic centres all over Maharashtra and Karnataka with MRI and CT scan machines in places like Ahmednagar, Satara, Beed, Karad, Belgaum, Shrirampur, Malegaon, Indapur, Baramati, Gadhinglaj, Daund, Sangamner, Wagholi, Shirur.

Ruby Hall Clinic is the largest cardiac centre in Western India and comes second in India with the number of cases done, an achievement of which Pune city is proud. It has completed more than 3,00,000 Angiographies, 100,000 Angioplasties and 80,000 Open Heart surgeries. Ruby Hall Clinic runs one of the largest Cancer centres in India and treats 130 cancer patients per day in a 10 storey Cancer building.

Dr Grant does nearly Rs 18 crore of free treatment per year to help the poor and needy patients of Western India. In the last one year 100 children have had open heart surgeries done free of charge. Every Thursday Dr.Grant conducts cardiac camps in small towns like

Ahmednagar, Satara, Karad, where he sees patients free of charge. He has been doing this charity work for the last 30 years.

In May 2007 Dr Grant was awarded the FSCAI award by the USA (Fellow of the Society of Cardiovascular Angiography and intervention). In Sept 2008 Dr.Grant was also conferred with the prestigious Fellowship of the American College of Cardiology (FACC). He is also a Honorary Fellow of Cardiological Society of India and Asia Pacific Society of Interventional Cardiology. Because of the work he has been doing Dr.P.K.Grant has been awarded two National awards, one is the Rashtriya Samman award and the other is the Manibhai Desai Rashtraseva  award. He was also given the Lions Yuva Seva Ratna Award by the Lions Clubs International, District 323-D2. Dr P K Grant was nominated as Icon of Pune by the Lokmat group of newspapers. He was awarded the “Shantanurao Kirloskar Puraskar” in May 2016. Ruby Hall Clinic has recently been awarded the first rank in the country for their services in the Cadaver Organ Donation programme for the year 2015-16. This award was given by NOTTO – National Organ and Tissue Transplant Organisation in New Delhi in November 2016. The Clinic has also got last year an award for Excellence in Cardiology by the American College of Cardiology.

In the year 2017, Dr Grant has been awarded the prestigious Dr.Nitu Mandke Award for Excellence in Cardiology. He was also awarded the URJA Awards 2017 for his contribution in Medicine in January 2017. The Ruby Hall Clinic has been nominated as the best hospital for Medical Tourism in India and the President of India gave this Award in March 2012.

Dr Grant has 120 international publications to his name. He has been nominated by the National Board of Examinations India as Chief Examiner in Post Graduate Interventional Cardiology.

The Ruby Hall Hospitals concentrate on the most advanced technologies, and Ruby Hospitals have more equipment than any other hospital in Maharashtra, including Mumbai.

The Ruby Hospital is soon to get a cyber knife, which is going to be the first S7 Model of the cyber knife. It is a machine that is used to treat cancer which a normal linear accelerator cannot achieve. It is a specific market, where about 10-15% of the patients cannot be treated with a linear accelerator and will benefit from the cyber knife.

In the month of Nov-Dec’2023, the Ruby Hall Hospital will also be procuring a linear accelerator based MRI machine. This will also be the first of its kind in the country, or possibly in Asia.

The number of patients requiring angiography and angioplasty has been going up. Heart attacks are occurring/ becoming more and more common in the younger age group as compared to the older age group.

There has been a drift from the older age group, to the slightly younger age group.

Heart Disease/ Coronary Artery Disease causes 12 million deaths every year. There has been an alarming increase, especially in the developing countries, like India.

Indians are more times susceptible than any other ethnic group. 3.4 times more than the Americans, 6 times more than the Chinese, 20 times more than the Japanese. Indians also get the disease 5-10 years before than the average population of all the other countries.

The disease is more severe in the Indian population.

In Coronary Artery Disease (CAD)/ Heart Disease, there are atherosclerotic plaques that keep building up slowly and gradually in the arteries of the heart and as the disease progresses, the atheroma becomes worse, the arteries get blocked and that is why you get a heart attack.

Initially, there are no symptoms for a long time and suddenly, when the blockage is more than 80 %, you start getting chest pain, and when the artery gets completely blocked- Myocardial Infarction or a heart attack can occur.

In some patients, it can lead to sudden death.

Risk factors include:

  • Genetic predisposition
  • Urbanisation- we now live in large towns and cities, which means there is a lot of stress that we have to undergo on a regular basis.
  • Diabetes Mellitus- anyone who is over 60 years of age, nearly 10 % of our population is diabetic. Diabetes affects the arteries of the heart. Patients who are diabetic have smaller coronary arteries due to which they are at a higher risk of CAD
  • High cholesterol- there is good cholesterol- HDL and bad cholesterol- LDL. Normally your cholesterol should be below 200 mg/dL. LDL cholesterol should be less than 100 mg/dL. HDL should be above 40 mg/dL.
  • Obesity
  • Cigarette smoking- it damages the arteries and blood cells and increases the incidence of heart attacks. The chances of heart attack in smokers are nearly 10 more as compared to a non smoker.
  • Small amounts of alcohol is okay, but if you’re drinking more than 4 drinks/ day, you might land up with a gastroenterologist.
  • High blood pressure. Compliance with your antihypertensive medication is very important.

Preventative measures:

  • Keep blood sugar levels under control. Avoid taking mangoes, grapes, sugary food items.
  • Cut down on your cigarette smoking
  • Cut down on fatty foods such as liver, egg yolk, butter, ghee, ice cream. Saturated fats should be reduced as much as possible.
  • Consume more vegetables, fruits, etc.
  • Exercise- walk at least 2 miles/ day. It keeps you fit. It also increases the flow of blood in the coronary artery, increase your heart rate and burns off some of your sugars you might have consumed

10% reduction in cholesterol levels reduces your chances of Coronary Artery Disease by 20%.

The first thing that you do, when you suspect a heart attack, is that you do an ECG to confirm whether it was a heart attack and to locate the site of the heart attack.

The next step is to do the Cardiac enzyme tests to confirm the heart attack.

Once it has been confirmed that it is indeed a heart attack, the patient is taken to a CATH Lab, where the patient undergoes an angiography, where the blockage is localised and a stent is placed to open the blockage- this is called angioplasty.

Dr Noor Gill
Dr Noor Gill, MBBS, deciphers the space between heartbeats, figuratively and literally. Powered by frequent long naps and caffeine, she believes that “knowledge without giving back to society is meaningless” and works to make caring cool again.

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