On 17 February, Health Live@Seniors Today hosted Dr Kaushal Chhattrapati. He spoke on and answered questions about Preventive Cardiology and Medication Management.
Dr Kaushal Chhatrapati is a senior interventional cardiologist based in Mumbai. He completed his MBBS in 1997 from KJ Somaiya Medical College, University of Mumbai. And his MD in Internal Medicine from Grant Medical College & Sir JJ Group of Hospitals, University of Mumbai in the year 2001. He then pursued his DM in Cardiology passed out in the 2005 from Bombay Hospital Institute of Medical Sciences, University of Mumbai
He has many International Society Fellowships to his name:
– Fellowship of American College of Cardiology (USA)(FACC)
– Fellowship of Society of Coronary Angiography & Intervention (USA)(FSCAI)
– Fellowship of European Society of Cardiology (FESC)
And Post Doctoral Fellowships/Courses like Fellowship in Advanced Interventional Cardiology, Mount Sinai Hospital from New York, (USA). He has also been trained in Advanced Heart Failure Therapies and Transplantation from the Ohio State University, Columbus, Ohio (USA).
The number of cases with heart disease have increased over the past few years. This is because we have been a little casual in our attitude towards our health, we do not exercise enough and our diet includes junk food.
And this is not the only reason, another reason is also that with the increased lifespan, the elderly population is also increasing.
The key principle to preventing cardiac diseases is taking good care of your body and being respectful of it. Other principles include:
- Regular health check ups
- You should be cognisant of what you eat. Avoid fast and junk food. It provides no nutrition, it is high in salt and trans fats which are all bad for our heart
- Physical activity needs to be incorporated in your daily routine. 35 mins of moderate intensity exercise should be embodied in our schedules. 6000 to 8000 daily steps is an achievable goal for all ages
30 is the age where you need to preemptively start checking your health data, because 60 is when the diseases have already set in. It is thought that since the individual is not symptomatic, he does not need to do anything. Now, take diseases such as hypertension and diabetes, these do not produce symptoms until the disease has progressed and caused complications- we do not want our first intervention to be at such a late stage. This makes it important to intervene in the primordial stages of the disease.
Everyone over the age of 30 should get:
- Their blood pressure measured routinely
- Get your HbA1c checked every 3 months
- Fasting lipid profile should be done once a year
If you do the above said things, the disease can be caught and treated early on and you can do all the things you need to do right to prevent further progression of the disease.
After the age of 50, loss of muscles (sarcopenia) ensues. This is a natural process which occurs as age advances, the body tends to lose muscle and become weak. In order to counter that, we have to exercise and have a protein rich diet.
Exercise can be of many forms. The American Heart Association and American College of Cardiology recommends a healthy mix of aerobic and anaemic exercises which includes some amount of weight training.
Aerobic exercise can be easily adopted by everybody.
Weight training should be adapted in your exercise routine, with proper cardiac clearance, you should be sure that you do not have any untreated blood pressure or incipient Coronary Artery Disease.
Walking is one of the most underrated exercises. 10,000 steps are good for a healthy adult. And even for someone in their 60s/ 70s, it is not difficult to achieve the 6000 – 8000 steps per day goal. Climb a few stairs, if you can.
Keeping your muscles well strengthened and toned helps avoid falls.
Yoga cannot be substituted for aerobic exercises such as walking. It is a stretching exercise which keeps your joints well lubricated, and also helps in maintaining flexibility and balance.
Meditation is underrated. It helps you combat stress. Meditation has incremental benefits:
- Calms your mind
- Decreases the stress
- Decreases the sympathetic drive
- Relaxes the body and blood vessels, lowering the blood pressure and further reducing the chances of cardiac events
If you meditate for even a couple of days, and check your heart rate variability (HRV), it would have increased significantly, and this is a marker of longevity.
Stress is a very important cause of cardiac mortality today.
To meditate, you can start with 2 mins and then increase it slowly to 5-10 mins.
Sit in a dim, comfortable room and try to actively avoid any thoughts from entering your mind. It is difficult in the beginning, but as you practice, you can increase from 2 mins to 10 mins, gradually.
The internet is a democratic resource which provides all kinds of information, ranging from pathetic to state of the art. But, no one knows what is really right. You need to be educated in a field to know which information is useful and which needs to be filtered out.
Every chest pain above a certain age needs to be looked at with suspicion. If you experience chest pain, manage the pain and immediately go to a tertiary care hospital and get an ECG done. If the ECG is abnormal, call for the cardiologist and he will make the call for the next step in the course of management.
If it is an acute heart attack, you will require an angioplasty immediately. This is called Primary Angioplasty in Myocardial Infarction (PAMI).
Smart watches have a limited usefulness, as on date to detect heart diseases. But for guiding your fitness journey, these play an important role. They can prompt you to get up, walk, track and keep a record of your workouts.
Coronary Artery disease remains the No. 1 killer out of all the cardiac diseases in India today. As age increases, the incidence of Coronary Artery Disease also increases exponentially.
The angioplasty which is done in young people is very different from an angioplasty done in an 80 year old individual- because their arteries are more hardened due to the presence of calcium and they require expert management and special devices such as rotablation, intra vascular lithotripsy.
As age progresses there is a tendency that the natural pacemaker of the heart starts failing, this requires the need to put an artificial pacemaker.
With the life span of humans increasing and people living well into their 80s and 90s, the aortic valve also started to become hardened due to calcium deposition and therefore leading to the increasing need for an aortic valve replacement.
Open heart surgery has a lot of morbidity and mortality and not all 80- 90 year old patients can withstand anon heart surgery. In many cases, open heart surgery is associated with 5 % mortality and in some others it even a high as 30%
Dr Kaushal Chhatrapati can be reached at SoBo Heart Clinic, Gamdevi, Mumbai: 400 007. For appointments, call 9820740204
