Dr. K. Sarat Chandra has been invited to inaugurate a new cardiac catheterization lab on 31.10.2021 at Nalgonda Institute of Medical Sciences, Nalgonda. A number of angiographies have been done and patients advised accordingly.
Dr Sarat Chandra, while answering a press meet held the same day said that acute heart attacks are increasing day by day and it is very essential for victims of heart attack to reach a tertiary care centre immediately.
The term heart disease is often used interchangeably with cardiovascular disease. There are many types of heart diseases – each one has its own symptoms and treatment. Coronary Artery Diseases; Heart Rhythm Problems (Arrhythmias); Cardiomyopathy (heart muscle disease); Heart valves disease; Heart failure; Congenital Heart Disease or heart Defects and Heart infections are some of the common heart diseases.
The symptoms of heart disease depend on the type of heart disease a person has. Let us have a look at the signs and symptoms associated with some of these heart diseases.
Symptoms associated with atherosclerotic disease (coronary artery disease) may be different for men and women. While this may be correct to an extent, it is important to understand that any sudden and unexplained complaints above the waistline should always be taken seriously.
Chest pain (prominent symptom)
Chest discomfort (angina)
Pressure in the chest
Chest tightness
Shortness of breath
Pain in the arms
Weakness or coldness in arms and legs
Numbness in the arms
Pain in the neck, jaw, throat, upper abdomen, or back
Symptoms in women
Chest discomfort
Extreme fatigue
Shortness of breath
Abdominal Discomfort
Back pain
Nausea
Abnormal heartbeat or heart arrhythmia is a condition in which your heart may beat irregularly, too slowly or too quickly. The signs and symptoms of heart arrhythmia include the following:
Slow heartbeat or bradycardia
Quick or racing heartbeat tachycardia
Fluttering in the chest
Near fainting or Fainting (syncope)
Dizziness
Shortness of breath
Discomfort in chest or chest pain
Heart disease symptoms caused by heart defects
New-born children with heart defects have the following symptoms if they are born with congenital heart disease:
Pale grey or blue skin colour
Swelling around the eyes, abdomen, and the legs
Shortness of breath – especially during feeding
Poor weight gain
Congenital heart diseases may go unnoticed in some children owing to less serious signs and symptoms. Owing to this reason, children are often diagnosed with heart disease in late childhood or early adulthood. Signs and symptoms associated with such less serious congenital heart diseases include the following:
The signs and symptoms associated with this condition may not manifest during the early stage of heart disease, but as the disease progresses and the condition worsens, the patient may have the following symptoms:
Easily getting tired with little activity or exertion
Breathlessness with exertion or rest
Swelling of feet, ankles, and legs
Fatigue
Dizziness, fainting (syncope), and light-headedness
Rapid, irregular heartbeats
Heart disease symptoms caused by heart infections
Infections of the heart membrane (Endocarditis): Endocardium is the inner membrane of the heart that separates heart chambers and valves. If it is infected, the signs and symptoms may include:
Shortness of breath
Fatigue
Swelling in the abdomen, ankles, and feet
Fever
Abnormal or irregular heart rhythm
Changes in heartbeats
Persistent dry cough
Unusual spots or skin rashes
Valvular heart disease symptoms
Valves in the heart open and close and thus direct blood flow through the heart. Tricuspid, mitral, aortic, and pulmonary are the four valves in the heart – which regulate blood flow. These valves can be damaged by a variety of heart diseases.
In general, the signs and symptoms associated with valvular heart disease depend on the valve which is defective and may include the following:
Chest pain
Irregular heartbeat
Shortness of breath
Fainting (syncope)
Swollen feet or ankles
Fatigue
You must seek emergency medical care if you experience the following signs and symptoms:
Severe chest pain with pressure and heaviness in the chest
Fatigue
Shortness of breath
Dizziness and confusion
Fainting
Heart disease eludes from being detected as it slowly and silently progresses. It rather comes as a big surprise in the form of angina, heart attack, or Heart Failure. One thing you should always remember – your heart’s language is quite difficult to interpret – therefore, when you see even a slight abnormality or symptoms then you must immediately discuss your concerns with your cardiologist. Regular health check-ups, consultation with your cardiologist; a better understanding of your risk factors, and comprehensive heart health evaluation can ensure early detection of heart disease. Your heart is precious, if you love your heart, then take care of it.
Signs and symptoms of heart disease – if you still have doubts pertaining to some of the silently progressing and eluding signs of heart disease – meet Dr. Sarat Chandra to learn about how to detect such signs early and approach a cardiologist to save your heart from potential damage and risks.
Heart attack in young adults in India: Nowadays youngsters at their peak productive age (30s and 40s) are succumbing to heart disease. Even celebrities who are very particular about their diet and exercise are becoming prone to heart attacks and sudden cardiac arrest. This means people in their 30s and 40s are the new high-risk categories for heart attack.
Young Indians are becoming victims of sudden heart attacks – The recent incidence of Siddharth Malhotra is an eye-opener for us.
Let us try to understand the reasons why healthy youngsters who are well aware of physical activity and its health benefits are becoming victims of heart attacks.
The number one reason for heart attack in almost 8 out of 10 cases, is a blockage in the heart – in the other 20% of cases, there could be a different reason.
A clot in the lungs can stop oxygen to the heart and can lead to cardiac arrest.
Intake of toxic drugs in large amounts can stop heart functions suddenly.
Sometimes, even viral infections like COVID-19 can lead to cardiomyopathy (an undetected weak heart muscle can generate an irregular signal).
In some cases, undetected congenital heart defects can manifest abruptly and lead to heart attacks.
Many youngsters don’t realize that they have been living with some blockages in their arteries unless they get sudden heart attacks. Sudden heart attacks in youngsters are due to undetected blockages, a carefree attitude, and lack of symptoms.
Heart problems in young adults’ symptoms: weakness, fatigue, chest discomfort, and breathlessness with moderate physical activity are the warning signs of heart problems in young adults. Many people tend to ignore these signs
Heart-related problems remaining undetected in young people is a very serious problem. The problem has become serious in people who exercise regularly and who never had experienced any heart-related symptoms – such as chest pain, breathlessness, and fatigue. More than 30% of youngsters don’t report any symptoms even with up to 70% of blockages. In some cases, they report only a few vague symptoms – such as fatigue. There are several cases of young people in their 30s being diagnosed with blockages up to 70% in their arteries. A majority of youngsters in these cases are the ones who come for a routine health check and a few others are those who get tested before surgery. This means heart disease detection has now become a chance event rather than a choice event.
If you look healthy and take all sorts of precautions to remain healthy and prevent heart disease, still you should not remain carefree about your heart’s health. I recommend you to take care of your stress levels as you take action to regularly check your cholesterol and triglyceride levels.
Obesity, diabetes, and a high-pressure lifestyle are the major issues to tackle to prevent heart attacks at a young age – these are the major factors responsible for damaging your heart – and also the prominent causes of sudden death in young adults.
Many people regularly ask this question to me: Sir, when should we undergo testing for heart disease. I tell them that Indians are genetically predisposed to coronary heart disease at an early age – so is the case with Asians. Therefore, those who are above the age of 35 should undergo an annual cardiac check-up. In addition, there are some additional tests that can help pick up heart blockage at an early stage – which will help prevent sudden death due to heart attack.
If you still have concerns pertaining to your heart, its health, and the prevention of heart attacks at an early age, then meet me personally for a routine cardiac health check-up and preventive measures. To know more about the rising incidences of a heart attacks in young adults in India, Also Read: ”
Heart Valve Replacement Surgery in Hyderabad
If you are looking for heart valve replacement surgery in Hyderabad by minimally invasive techniques, then the following information is for you.
Aortic Valve Stenosis and TAVR
Aortic valve stenosis results in narrowing of the aortic valve in some people causing the heart valve to open poorly. To correct the failure of the aortic valve, Transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) is performed by interventional cardiologists.
Open heart valve replacement surgical procedure requires the separation of chest bones surgically (the chest is open for the procedure – sternotomy). TAVR or TAVI is a minimally invasive procedure. It is performed through a very small opening in the groin or the chest region – which leaves all chest bones intact. Furthermore, the TAVR procedure is similar to coronary angiogram in terms of recovery.
What is stenosis or aortic valve stenosis?
Aortic stenosis or aortic valve stenosis is a condition of the heart valve in which the heart’s aortic valve calcifies and thickens. Due to this condition, the valve doesn’t open fully limiting the blood flow from the heart to the rest of the body.
What are the symptoms and complications of aortic valve stenosis?
The symptoms of aortic valve stenosis include chest pain, shortness of breath, weakness or fatigue, fainting, and swelling in the legs. Complications associated with untreated aortic valve stenosis include heart failure and sudden cardiac death.
TAVR procedure is suitable for which type of patients?
TAVR procedure is suitable for all risk categories of people. Especially those who have symptomatic severe aortic stenosis.
Who qualifies for the TAVR procedure?
This technique and procedure are particularly effective in people who have limited options of valve repair owing to their health status (kidney disease and lung infections). Such patients are at intermediate or high risk of complications from open-heart surgery (surgical aortic valve replacement).
In such patients, the outcomes are quite promising with improved quality of life.
TAVR Procedure Risks – Are there any risks?
This is a highly recommended procedure for individuals who have not been considered good candidates for aortic valve replacement surgery. Though TAVR is a beneficial treatment option for such individuals, it doesn’t come without risks. The risks are very rare and may include bleeding, infections, blood vessel complications, valve leaking or slipping out of place.
What are the benefits of TAVR?
The risk is minimal when compared to open-heart surgery. In terms of recovery and outcomes, this procedure is quite similar to a coronary angiogram. Patients who undergo this procedure have the least risk of infection, postoperative complications and they are less likely to spend more time in the hospital (hospital stay is short).
TAVR procedure success rate
First of all, TAVR provided an effective treatment approach for people who cannot undergo open-heart surgery. When not a single approach existed for replacing narrowed valves, TAVR first offered the solution.
TAVR procedure is done using any one of the two common approaches. This allows an interventional cardiologist to choose which is the best and safest to access the valve.
How safe is TAVR?
TAVR is effective and safe even in high-risk patients. The outcomes of TAVR are favourable when compared to surgical procedures (surgical aortic valve replacement).
Bottom Line
Your interventional cardiologist makes a decision to treat your aortic valve stenosis condition by transcatheter aortic valve replacement (TAVR). This procedure can effectively relieve the signs and symptoms of aortic valve stenosis and thus reduces the risk of heart failure, complications and sudden cardiac death.
TAVR or TAVI is a boon for patients whose aortic valves have failed. Patients who have lost hope due to inoperable aortic stenosis are suitable for this procedure. TAVI doesn’t require open-heart surgery.
TAVR is the best option if you are looking for minimally invasive heart valve replacement surgery in Hyderabad.
The pulmonary valve is located between the right ventricle and the pulmonary artery. It has three cusps or leaflets or flaps (pieces of tissue arranged in a circle). The valve opens in the direction of blood flow into the pulmonary artery and then closes to prevent backward blood flow. With each heartbeat, the valve opens and then closes.
Obstruction or deformity of the pulmonary valve (one or more cusps become defective, fused or thick) causes narrowing of the opening of the pulmonary valve – which slows blood flow. This condition is known as pulmonary stenosis. (See. Image)
People who have this condition may have symptoms that could be mild or severe. Pulmonary stenosis associated with mild symptoms continues to remain so over time without any worsening symptoms. However, stenosis associated with moderate or severe symptoms may worsen and require intervention.
The good news about pulmonary artery stenosis is that treatment is highly successful as many people can lead a happy life after the treatment. The long-term outlook after balloon valvuloplasty or surgery is excellent.
Pulmonary stenosis murmur – This is the whooshing sound heard by a physician or cardiologist using a stethoscope.
Pulmonary stenosis causes
A cardiologist evaluates a child or an adult by taking into account their symptoms and medical history. The cardiologist during physical examination puts the stethoscope on the chest to listen to the sounds of the heart and lungs. The doctor looks out for the typical heart murmur (an abnormal heart sound). Based on the symptoms and physical examination, the doctor, if suspects any abnormality, may order these tests: chest X-ray, ECG and Echo to diagnose the condition.
Interventional or therapeutic catheterization (balloon valvuloplasty) is a procedure in which a special catheter with a balloon is guided and directed up to the defective valve and then the balloon is inflated to stretch open the valve. Some children may need an advanced interventional procedure or surgery depending on the severity of the condition and symptoms associated with it.
Pulmonary valve stenosis may often be due to congenital heart defects in children. It could also be due to complications from another illness (rheumatic fever) in adults. Therefore, see your cardiologist if you experience or notice chest pain, shortness of breath, and fainting in your child.
I am happy to inform you that our team has performed a very interesting treatment percutaneously implanting a new variant of TAVI (Transcatheter Aortic Valve Implantation) recently in a 74-year-old lady with severe aortic stenosis.
As you are aware, aortic valve stenosis is becoming increasingly common all over the world including India as the population is getting older.
These patients need an aortic valve replacement. While surgical valve replacement is an established procedure, it carries with it the disadvantages like the need for open-heart surgery, need for blood transfusion, complications like wound infection, lung complications, and occasional stroke. For all these reasons percutaneously implanting an artificial bioprosthesis in the place of the native stenosed aortic valve is becoming increasingly popular all over the world.
The procedure involves light conscious sedation, placing a large-sized sheath across the femoral artery, crossing the stenosed aortic valve, and then implant the device that consists of the bioprosthetic valve across the native valve.
This patient came to our attention with acute anterior wall MI in the month of July 2020. We did primary angioplasty at that point in time with a drug-eluting stent to mid LAD.
She recovered very well from the myocardial infarction. In the same admission, we found that she had severe aortic valve stenosis with a history of syncope two months before. The transaortic valve gradient was 70/45 mm hg (peak/mean). In view of her age and recent MI and suitable anatomy as judged by CT scan, we advised the patient to undergo TAVI. CT scan is a very important tool while evaluating the case for suitability of TAVI and the CT, in this case, guided us to choose a 26 mm device.
We used a new TAVI device by the name “HYDRA”. It is a flexible device that tracks along the aorta easily. The procedure went off smoothly. The whole procedure was done by the percutaneous method only. The gradient across the aortic valve has fallen to 28/14 mm hg. The aortic valve area has gone up from 0.9 cm square pre-procedure to 2.1 cm sq. post-procedure. I am here with enclosing some of the pictures.
A blood clot in the vein is known as venous thromboembolism (VTE). When clots form in deep veins, the condition is known as deep vein thrombosis (DVT). If the clot breaks, it travels through the bloodstream to the lungs and causes a pulmonary embolism (PE). If it travels to the heart, it causes a heart attack. Both these conditions are life-threatening and require emergency medical attention.
The risk of DVT increases with the following:
Some temporary situations can also put you at risk of DVT – including the following:
The symptoms of DVT include the following:
The signs and symptoms of pulmonary embolism include:
A general physician will refer you to a hospital if he or she suspects that you may have DVT after an ultrasound scan. The scan shows obstruction in the blood flow through the vein. Further tests including a venogram (X-ray of the vein) may also be recommended. Imaging tests are helpful for the diagnosis of DVT or PE. D-dimer blood test, MRI, CT and duplex ultrasonography are the other tests that are helpful in the diagnosis of DVT.
Pulmonary angiography (PA) is the most accurate test for the diagnosis of pulmonary embolism (PE). A special X-ray test called computed tomographic pulmonary angiography [CTPA] that uses contrast dye provides images of the blood vessels in the lungs. It is a standard imaging test for PE.
Undiagnosed, untreated and serious VTE can become life-threatening and lead to disability and death. Though a serious condition, it is preventable if you consult the best doctor. For deep vein thrombosis, immediate medical care is indispensable.
Anticoagulants: The most common treatment is anticoagulant (blood thinners) medicines. Oral or injectable anticoagulants may be prescribed. The other possible treatment modes may include the use of thrombolytics (clot busters) and inferior vena cava filter. In addition, deep vein thrombosis treatment includes thrombectomy or embolectomy – a surgical procedure is performed to remove the clot.
Myocarditis is an inflammation of the Heart Muscle (myocardium). Myocarditis leads to the reduced ability of the heart to pump blood adequately. It may also lead to weak heart muscles and affect the electrical system of the heart. In addition, myocarditis can also cause arrhythmias or abnormal heart rhythms. Myocarditis gradually weakens the heart and its pumping ability – owing to which the rest of the body doesn’t get enough blood. The condition may lead to a heart attack and brain stroke.
The signs and symptoms of myocarditis include:
The major cause of myocarditis is a viral infection. It can also be due to bacterial and fungal infections, a reaction to a drug and also may be due to an autoimmune reaction.
Microbial Infections
When viruses enter in and cause infections, our body produces cells. These disease-fighting cells enter the heart and release certain chemicals that inflame heart muscles. Some of the common viruses that cause heart inflammation include hepatitis C viruses, cytomegaloviruses (CMV), Epstein-Barr virus (EBV), Coxsackie B viruses, Parvovirus, HIV and herpes. Bacteria that can cause myocarditis include treponema (causes syphilis), staphylococcus, streptococcus (causes strep throat), Borrelia (causes Lyme disease), mycoplasma (causes lung infection), chlamydia (sexually transmitted disease). Parasitic and fungal infections can also cause myocarditis.
Chemicals & Drugs
Certain drugs, lead poisoning, alcohol consumption can also cause heart inflammation. Some other chemicals and allergic reactions to chemicals, drugs and medicines and also to certain toxins can cause myocarditis. Snakebites, wasp stings, bees’ stings and spider bites can also lead to inflammation and myocarditis.
Cancer therapies involving chemotherapy, immunotherapies, drug therapies and radiation therapies can also lead to the heart inflammation.
Autoimmune Disorders
An autoimmune disease that causes inflammation throughout your body, like lupus or rheumatoid arthritis, may also lead to heart inflammation.
Rheumatoid arthritis that affects joints throughout the body and lupus are the autoimmune disorders that may lead to myocarditis due to generalized inflammation throughout the body. The symptoms associated with such conditions may include swollen joints, legs and veins, painful joints, less urine output.
Myocarditis diagnosis: A cardiologist may check for a rapid or abnormal heartbeat if a person is presented with the above signs and symptoms of heart inflammation – such as fatigue, chest pain, shortness of breath and abnormal or irregular heartbeats. The other symptoms may include swollen legs and joints and fluid in the lungs. The cardiologist may also order certain blood tests to check for blood cells count, antibodies and infection. A heart ultrasound, electrocardiogram (ECG or EKG) to measure the heart’s electrical activity and cardiac MRI scans may also be ordered.
Call your cardiologist straight away if you have had an infection and subsequently, your condition got worsen due to severe symptoms such as chest pain, swelling, trouble breathing. Furthermore, if you have been told that you have heart inflammation then seek medical help if you start experiencing the symptoms gradually and if the symptoms are getting worse.
Myocarditis is quite often very disguising as the person who has this condition looks healthy. Which means there are no symptoms at all. In certain cases, some people recover and never know that they once had this condition. Anyway, the best way to prevent it from happening is to treat infections as quickly as possible. One should remain very careful with viral oral and strep throat infections as they are the leading cause of myocarditis.
Angioplasty cost in Hyderabad depends on various factors and components involved in the procedure – such as pre-procedural cost, procedural cost, balloon and stent cost, drugs cost, post-procedural cost, and the cost of a stay in the hospital (day-care cost).
Angioplasty cost depends on several factors including the health status of the patient. Therefore, it may differ from patient to patient. Angioplasty cost in Hyderabad varies depending on the following factors:
The price of Angioplasty in Hyderabad depends upon several factors ranging from the type of procedure, the expertise and experience of an interventional cardiologist, the patient and may range anywhere from Rs. 80,000 to Rs. 200000 in Hyderabad. All these prices are approximate and tentative – the exact cost of the procedure might differ from hospital to hospital.
Angioplasty is a procedure to restore blood flow through the coronary artery. In CAD (coronary artery disease) coronary artery blocks blood flow to the heart.
When this happens, the person having this problem experiences shortness of breath, angina (chest pain), and weakness.
If this problem persists; then, the risk of heart attack increases. In such cases, interventional cardiologists recommend percutaneous transluminal coronary angioplasty (PTCA).
Interventional cardiologists recommend angioplasty to treat worsening chest pain and also to quickly open a blocked artery during a heart attack.
It is also a recommended procedure for those who already have tried lifestyle changes and medications, but none of those measures improved their condition. Angioplasty is often combined with the placement of a stent.
If you are searching for mitral valve replacement surgery in Hyderabad – This is a piece of important breakthrough information for you.
A new treatment without surgery has been given approval by DCGI, Govt. of India in the recent past. This therapy called Mitra Clip has gained momentum recently. The mitral valve that regulates blood flow between the left atrium and left ventricle is a very important valve. There are a variety of diseases which can affect the mitral valve including rheumatic fever. In some cases, after a heart attack, the mitral valve can leak causing breathlessness and other symptoms. The problem can progressively lead to heart failure. In the majority of the cases of mitral valve defect, the patient is usually older and the risk of open-heart surgery is high. Hence an alternative treatment called MITRA CLIP is the latest vogue which is done without surgery.
The procedure involves accessing or going into the heart from the venous side and puncturing the wall that separates the two atria and reaching the mitral valve and then placing the clips on the mitral valve carefully. This clip allows the valve to open normally but prevents it from leaking. Sometimes more than one clip is needed to achieve the desired result. The procedure’s risk is much lower than the surgery. It is expected that with the increasing age of the Indian population, there will be many patients who will require this treatment. Some of the pictures of this procedure are given below to explain this very interesting procedure.
The picture shows the mechanism by which the clip works. While allowing the valve to open in diastole, prevents it from leaking in systole
A diagrammatic representation of how the clip appears in closed position following the completion of the procedure
Fluoroscopy Showing the Clip After Release
If you are planning for Mitral valve replacement surgery in Hyderabad, fix an appointment
Meet Dr Sarat Chandra for a new treatment for heart valve leak