Thursday, March 30, 2023

All you want to know about heart care

On December 21, 2021, Seniors Today hosted another one of its weekly Health Live webinars. This week we had Dr Tilak Lall  speak on Heart Care for Seniors.

Dr Tilak Lall is a very senior, experienced and well-respected Coronary Interventional Cardiologist in Mumbai. He is attached to the Saifee hospital, Sir HN Reliance and Wockhardt hospital in Mumbai.  He also visits Breach Candy Hospital. He has been voted amongst the “Top Doctors in Mumbai’ annual listing of 2020,  published by India Today and Outlook magazine.

Dr Lall has an experience of about 25,000 independent coronary angiographies and about 5000 independent coronary angioplasties.Since the last 10 years, most of his procedures are being done via the Radial approach. His primary area of interest is the treatment of acute myocardial infarction by primary angioplasty as well as CTO Angioplasty.

Coronary artery disease or heart disease as you might understand  it as, is blockage of these small arteries that supply blood to the pumping muscles of the heart. These are fine arteries about 2-3 mm in diameter which are present on the surface of the heart and from there they interdigitate and go into the heart and supply the blood to the muscle that pumps the blood out of the heart.

A small, unstable, ruptured plaque can lead to a clot to sit over there/ dislodge and this can completely block the artery and that is what usually causes a heart attack.

Risk factors for heart diseases:

  • Hypertension: a benchmark blood pressure of 150/90 mm of Hg is not okay. Regular monitoring of blood pressure is important. Hypertension also leads to target related organ damage.
  • Diabetes mellitus: high carbohydrate diet is not healthy for you and can cause diabetes and obesity. A blood sugar level more than 110 mg/dl (fasting) or more than 140 mg/dl (post prandial) is not healthy.
  • Cigarette smoking: it is one of the easiest modifiable lifestyle changes.
  • High blood cholesterol: also known as hyperlipidemia. Your cholesterol should be less than 200 or your LDL should be between 70-100
  • Family history of heart disease
  • Obesity- which Dr Lall calls a pandemic worse than covid
  • Physical inactivity

And a few other factors

An ECHO is a sonography of the heart which tells you about the structure of the heart, the valves and pumping of the heart. It cannot however tell about the obstruction.

Typically the chest pain associated with a heart disease/ heart attack is typically a tightness or heaviness over the centre of the chest associated with radiation of pain to the arm. Both the arms, though it is more commonly in the left one; neck, back, jaw.

This pain usually, initially occurs on exertion but a heart attack may not necessarily be due to exertion, it can also occur at rest.

Typically this exertion pain can get relieved by taking rest or tablets under the tongue, which is nitroglycerine.

It can also cause difficulty in breathing, tightness in the chest, and headache.

You can take aspirin if you’re suspecting a heart attack, but make sure you’re not empty stomach.

You can also take nitroglycerine sublingually till you reach a hospital and get an ECG done as soon as possible.

With age, the aortic valve tends to thicken and does not open adequately. So basically, there is an issue of obstruction of the aortic valve, this leads to increased pressure in the heart with less blood going forward. This is a serious problem that needs to be dealt with.

There are 3 blood pressure readings- home blood pressure monitoring, doctor’s office blood pressure monitoring and ambulatory blood pressure monitoring.

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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