A Cardiologist's Web Presence

 
 
FAQ on Coronary Heart Disease

Frequently asked questions (FAQs)

FAQ on Heart Diseases

What causes coronary heart disease?
Coronary heart disease is caused when fatty plaques accumulate along the walls of the coronary arteries, narrowing them and thereby reducing blood flow to the heart. This process is referred to as atherosclerosis. Over time, the heart muscle that is "starved" of oxygen and nutrients carried by the blood, begins to weaken, and parts of it may even die.
Go Top
How many people suffer from coronary heart disease?
Coronary heart disease (CHD) is the most common form of heart disease, affecting approximately 13.2 million Americans. In India prevalence is 0-8% in Rural and 8-12% in Urban Population.
Coronary heart disease is the single greatest cause of death for both men and women in the United States. Every year more than 479,000 Americans die of CHD.
Each year there are more than 1.2 million heart attacks in the United States. Of these 340,000 are sudden, causing the patient to die at home or in an emergency room
Go Top
 Are women affected by heart disease at the same rate as men?
One in ten Indian women and one in six Indian man 45 to 64 years of age has some form of heart disease, and this increases to one in five women and one and three men over 65. Heart disease is the leading cause of death in our country now.
Go Top
Are the symptoms of heart attack different for men and women?
Heart attack symptoms in a man are now fairly well known. A man is likely to experience sudden, intense chest pain that can last for hours. He may also feel pain in the left arm or jaw and have difficulty breathing. These symptoms are obvious to an emergency room staff and immediate action is taken to bring a halt to the advance of heart damage. While a women may have some of the same symptoms, in many cases her symptoms won't fit the traditional heart attack profile. Her pain may be more diffuse, spreading to the shoulders, neck, arms, abdomen and even her back. The pain my come and go or even feel more like a simple heaviness or burning sensation in the chest rather than the red-alert chest pain known to signal a heart attack. More often than not, her primary symptoms may not be chest pain at all but an unexplained anxiety, nausea, dizziness, palpitations and cold sweat. A women arriving at the hospital with these symptoms will often lose precious time while the medical staff test for other conditions or, worse yet, keep her sitting in the waiting room. Women also tend to have more severe first heart attacks and they more frequently lead to death, compared to men.
Go Top

 

Does estrogen protect against heart disease?
It is by now common knowledge that, in general, the female hormone estrogen has a protective effect on the hearts of premenopausal women. True enough, but two conditions that disproportionately affect women - diabetes and high levels of triglycerides in the blood - cancel out the protective affects of estrogen. And while men, on average, develop heart disease ten years younger than woman, once a woman passes through menopause her risk of heart disease rapidly outpaces that of a man her age. One contributing factor is that postmenopausal women have higher levels of the "bad" cholesterol (LDL-cholesterol) that leads to cardiovascular disease than men of the same age. And while hormone replacement therapy seems like a logical step, new studies have suggested that during the first year of estrogen replacement, a women’s risk increases significantly before leveling off. It is important to discuss your medical history, risk factors and family history with a physician to help you weigh the risks and benefits of estrogen therapy.
Go Top
How is coronary heart disease diagnosed?
The only certain way to diagnose and measure the extent of CHD is through the use of coronary angiography, which your physician will order if coronary artery disease is suspected. In this method, a tube is inserted into an arm or leg artery and then navigated up into the main arteries supplying blood to the heart. A dye is then released from the tube, and the blood vessels and heart are then filmed as the heart pumps. The picture taken, or angiogram, will show blockages caused by the thickening of the inside walls of the coronary arteries. This thickening is known as atherosclerosis. Other methods to diagnose CHD include electrocardiograms, stress tests, and nuclear scanning. One new non-invasive tool may replace many of the angiographies in the near future. It is called an ultrafast CT exam. The scan can detect the mineral calcium that is found in plaque, the substance that blocks the arteries.

Go Top

What treatments are available to manage coronary heart disease?
Various medications can also be used to reduce the risk of heart attack or coronary heart disease. Among these are beta-blockers, which reduce the workload on the heart by decreasing heart rate and blood pressure, aspirin and other anti-coagulants, which reduce the tendency for the blood to clot, nitroglycerin and calcium channel blockers, which can increase the blood flow to the heart by helping blood vessels relax and expand, and antihypertensives, used to lower blood pressure.
Surgery is an option for those victims of coronary heart disease who cannot be helped via lifestyle changes or medication. There are several types of heart surgery, including coronary angioplasty and coronary artery bypass. Coronary angioplasty involves inserting a catheter into a leg artery and threading it up into the partially blocked coronary artery. Then, a balloon at the tip of the catheter is inflated, which compresses the plaque against the wall of the artery and allows more blood to flow through. Coronary artery by-pass, on the other hand, allows blood to flow around the blocked artery by grafting a blood vessel (usually, part of a leg vein) to create a alternate route for the blood to flow.

Go Top

How much of an impact can lifestyle changes (exercise, diet, etc.) have on preventing coronary heart disease?
Lifestyle changes can have a significant impact on preventing coronary heart disease; however, they cannot guarantee that you will not be affected. The impact will vary depending on a number of factors, including the degree to which the lifestyle changes are incorporated into one's life, heredity, and if heart-related medications are needed (diuretics for high blood pressure, for example). The following are the most important heart-healthy lifestyle changes:

  • Engage in frequent aerobic exercise
  • Eat a diet low in total fat and saturated fat
  • Stop smoking
  • Avoid excessive use of alcohol
  • One third of diet should be vegetables and fruits

Go Top

What does a heart-healthy diet mean?
Heart-healthy means eating a diet that is low in sodium, cholesterol, and fat. Foods that best meet this requirement are whole grains, fruits, and vegetables. A diet high in sodium, fat and cholesterol is associated with higher blood pressure, increased weight, and elevated blood cholesterol levels, all of which increase the chances that atherosclerosis will occur. Atherosclerosis is the hallmark of coronary artery disease and consists of the build-up of fatty deposits on the inside of the artery walls.

Go Top

Are Herbal Supplements Safe?
There are very few well-designed studies examining the safety and effectiveness of herbal treatments, and many herbs have not been studied at all. "Natural" is not synonymous with safe. There can be serious and even fatal interactions between prescription heart medications and herbal treatments. If you are considering the use of herbal remedies, discuss the issue first with your physician. The following are a just a few examples of serious interactions that can occur:

  • Ephedra: can increase blood pressure and heart rate to dangerous levels.
  • Garlic: taken in combination with blood thinning medications, such as Coumadin, can cause excessive bleeding.
  • Ginkgo biloba: this supplement can also cause bleeding to become excessive when it is taken with blood thinning medications.
  • Ginseng: can be problematic for people with hypertension.
  • Ginger: can hinder blood clotting mechanisms.

Go Top

When to do TMT (Treadmill Test) and Echo for early detection of Coronary Artery Disease (CAD)?

Since our country is going through an epidemic of Coronary Artery Disease (CAD) early detection assumes great importance as early treatment by PTCA or other measures is cheaper and less risky .

Any one with age of forty years and above should have TMT (Treadmill Test) especially if risk factors like diabetes or smoking or positive family history is present.

IF ITS NORMAL IT SHOULD BE REPEATED EVERY 3 - 5 YEARS DEPENDING ON THE PRESENCE AND SEVERITY OF RISK FACTORS.

However it picks up only 80 - 85 % of cases and about 20% are falsely positive.

Go Top

  
 
           
©2007 Designed and Developed by Roshan Singh, Web Developer, roshan1972@rediffmail.com
  
Content Provided by Dr. Niraj Prasad (Senior Interventional Cardiologist)