Dr. Sanjay Rajdev, an accomplished Cardiac & Vascular Interventionist with fellowship training in the USA.
After his fellowships, Dr Rajdev worked at SevenHills hospital, Mumbai for 8 years, this was followed by a stint at the largest healthcare provider in the UAE, the New Medical Center (NMC). Dr Rajdev spent over six years at New Medical Center (NMC) in Abu Dhabi, where he continued to achieve several “firsts” in the hospital and in the UAE.
He then returned home to Mumbai, where he established “Rajdev MediClinic,” a polyclinic featuring state-of-the-art systems for non-invasive cardiology evaluation.
His core interests include all types of Interventional Cardiology treatments including coronary angiography, angioplasty, peripheral angiography and angioplasty, closure of heart defects, treatment of thrombotic vascular disorders and pacemaker implantation.
On the eve of World Heart Day (which falls on September 29), Dr Rajdev will speak on Care for a Healthy Heart for Seniors
Qualifications:: MBBS, MD (Medicine) Gandhi Medical College and Hamidia Hospital, Bhopal; DM (Cardiology) Seth G.S.Medical College and King Edward VII Memorial Hospital, Mumbai
Fellowships in Interventional Cardiology at the University of Alabama at Birmingham & Mount Sinai Medical Centre, New York, USA
The global life expectancy across the world averages to be 71 years. People in European countries and America live longer whereas South Asians and Africans have a slightly lesser life expectancy.
The disease free age/ expectancy of life i.e. the productive number of years in many of the countries across the world is approximately 63 to 64 years.
The difference between life expectancy and healthy life expectancy is almost 9 years. And it is these 9 years which are important. As seniors we need to ensure we take good care of ourselves in these 9 years.
The Lancet Journal suggests that high blood pressure, diabetes and cardiovascular diseases are the most rampant and prevalent acquired diseases in the community causing loss of life.
Hypertension is 4-5 times more common than diabetes; and hypertension is responsible for causing strokes, cerebrovascular accidents and heart attacks.
If you have diabetes at the age of 30/ 40/ 50 years, you will be dying 14, 10 and 6 years respectively, earlier.
Which is why it is important to identify the risk factors and intervene in time, so we can catch up on house 9 years.
Cardiovascular disease is the biggest killer across the globe. It is responsible for approximately 30% deaths in the world.
Risk factors for loss of life attributed a cardiovascular event:
- High blood pressure
- High blood glucose
- Tobacco consumption
- Physical inactivity
- Obesity and overweight individuals
Diabetes starts to affect you at an average age of 25 years, although the incidence of diabetes at such a young age is very small.
Recognisable incidence of diabetes can be seen from and beyond the age of 35 years, thus you should be cautious and careful and start screening yourself around that particular age.
Similarly, cardiovascular diseases mirror the diabetic portfolio and altars to affect you around the age of 35 years.
According to another Lancet Journal study 70% of the urban Indian population is either obese or overweight.
Ideally, your BMI should be below 35 kg/m2
Factors attributable to coronary artery disease in Indians:
- High relative risk burden
- Earlier risk of onset
- Higher case fatality
- Higher premature death
There are reasons which are assigned to the aforementioned factors, most them include:
- Genetic factors that predispose our population to CAD and death
- More inflammatory states are seen in South East Asians
- Abnormalities of liver, lipid and glucose metabolism
- Epigenetic influences that increase our cardio genetic risk
Coronary arteries are small arteries (2- 3 mm) that arise from a bigger artery- the aorta, which supplies the muscles of the heart.
Any problem with the coronary arteries- blocks, clots, etc. can lead to complications of ischemia
Heart is a muscular organ which pumps blood to all the parts and organs of the body but it also needs its own quota of blood supply which it derives from the coronary arteries. Any sudden blockage of these arteries leads to a heart attack.
Individuals who are at a higher risk of developing a heart attack include:
- Individuals with high/ uncontrolled blood pressure
- Hypercholesterolemia
- High blood sugar
- Smokers
- Genetic factors
- Sedentary lifestyle
You can either have a total or a subtotal occlusion of the artery, leading to a heart attack.
A total occlusion heart attack is more severe than a subtotal occlusion leading to a heart attack, nevertheless both of them are life threatening.
Whenever you are suspecting a heart attack, the first investigation that needs to be done is an ECG, and it is for your doctor to interpret the kind of ECG changes that are there. Some changes are severe, others are less severe.
Framingham Risk Score model is the oldest cardiovascular risk score estimator for a heart attack. The risk factors include:
- Age: higher the age, greater the risk
- Systolic Blood Pressure (SBP)
- High Cholesterol levels
- Low HDL levels
- Smoking status
This model gives a 10 year risk of coronary artery disease. Which can be further divided into:
- Low risk: < 10%
- Medium risk: 20- 30%
- High risk: > 30%
Heart failure and kidney failure are the new co-existing conditions which can be prevented by taking the necessary steps to reduce the risk of developing CKM Syndrome known as the Cardiovascular Kidney Metabolic Syndrome.
The Prevent Online Calculator is used to calculate the risk of developing cardiovascular disease and chronic kidney disease. This scoring system not only gives us an estimate of the cardiovascular risk, but also the risk of developing renal and metabolic diseases for the next 10- 30 years.
This score system, apart from the above mentioned risk factors also takes in to account
- BMI (Body Mass Index)
- eGFR (Glomerular Fraction Rate)
- Urinary albumin: creatinine ratio
Symptoms of a heart disease include:
- Chest pain
- Jaw pain
- Pain in the left arm/ back
- Breathlessness
- Excessive sweating
- Palpitation
- Retrosternal burning not relieved on taking medication
- Location: typically below the breast bone (retrosternal) with radiation to the left arm/ jaw/ back, atypically it can also go to the right side of the heart as well. The symptoms are more atypical in females and the elderly.
- Autonomic system activation: this presents as cold sweats, nausea, vomiting, pallor
