Heart diseases are product of impaired metabolic activity of body. Imbalance of metabolism and stress gives direct impact on the blood vessels, possibly micro trauma of its very delicate linings. Healing of these linings over years with unorganized manner leads to formation of chunks of fat and other cells forms a big chunk enough to slowly narrow the blood vessel, eventually limiting the passage of blood distally depriving the energy to the distal tissues. Sudden rupture of these fat deposits open into the lining of blood vessel and the blood comes in contact with highly inflammatory material gets clotted and the clot blocks the vessel totally within minutes and causes loss of energy supply to the heart muscle distally eventually it stops contracting, called as heart attack, is a medical emergency. Unless this is opened within minutes or possibly in few hours, significant amount of muscle depend on the vessel dies leaving big scar permanently and significant reduction in the pumping capacity and physical intolerance, at times even to the extent heart acutely loses its ejection force enough to sustain life. So the factors responsible for this are multiple kinds, possibly product of modern lifestyle and civilization. Certain problems like diabetes, some habits aggravate this but not solely responsible to it. So we need to address all aspects our life not only to food and smoking etc. Also, the time of intervention is important, teaching healthy good lifestyle from adolescence might largely prevent these things rather addressing them after middle age by the time plague burden and dispersion may be wide enough to have clean blood vessels, but at any point of time lifestyle modifications and interventions would result in reduced vascular events along with medicines.

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Quite a few of us don’t believe that when they have a chest discomfort during walking, climbing steps or even at rest, it could be a heart attack. They ignore heaviness, tightness, mild pain or stomach discomfort as a normal variant due to muscle spasm or digestion issues. Since time is life in heart attacks, reaching late to a doctor or hospital results in loss of life or life long suffering with limited capacity. They believe that they won’t get heart attacks. The acceptance takes some amount time to decide to consult the expertise. Other common mistake is that people try to reach some of their known contacts far off who may be a doctor or health care personnel to get an opinion on phone or social media. It’s strongly advised to reach a nearby doctor or hospital for help early rather trying to reach other far off contacts. Other mistake is, they consult a doctor but they want a second opinion or they want to reach a higher center for further management not realizing that its time not the level of care or expertise matters in most of the heart attacks. At time in some critical situations the physician himself refers them for a higher center after a necessary emergency care. If you are in a reach of heart center with angioplasty facilities, you can request your nearest family physician for an angioplasty facility referral if the heart attack is diagnosed. The best possible results are by angioplasty comparing injectable medicines if we could reach within an hour or two.

The doctor treats by trying to open the blood vessel by means of medicines which lyse the existing clots or he refers to a cardiologist in angioplasty centers where the cardiologist inserts wire through the clot accessing form one of the accessible blood vessel either from hand or thigh, breaks the clot and applying metal mesh called stents to support the diseased shrunken vessel to keep it open as a one-time definitive measure, called primary angioplasty, which is recommended than clot lysing medicines which may not lyse all the time, if it is in reach by 1 to 2 hours.

Yes. Once we know the vessels are having plaques, we should require few medications to keep the blocks/plaques stable or not to progress along with food and life style modifications. This is even after fixing with stents or bypass surgery, may be at a lower doses. Also we need to take care of the other diseases like diabetes, hypertension, and obesity.

Yes, you will be asked to undergo few laboratory tests, ECG, ECHO and exercise tests like treadmill test to identify significant heart diseases. Negative results do not rule out 100 percent of heart disease, still the definitive diagnostic test called angiogram might be required to rule out heart disease in some cases. Also tests need to be repeated in intervals of every few years or whenever there is suspicion of some symptoms or change in physical tolerance.

Emergency or primary angioplasty fixes the blocked and diseased blood vessel in a real time under vision in a catheterization laboratory. This is a recommended treatment in heart attacks called otherwise myocardial infarction. Comparing with clot lysis with intravenous drugs which only lyse small discrete early soluble clots, it does not address the plaques with tight blocks, the angioplasty gives a complete solution including clot dispersion, widening the vessel and fixing with the stent. This precludes re-occlusion of blood vessels.

Unless the pumping efficiency is significantly low or just few weeks after surgery, no need to restrict any activities, they can have normal occupational or recreational activities after angioplasty or 6 to 8 weeks after surgery but may require medical advice from your doctor on individual basis if you are only on medicines.

You need to undergo few blood tests, and other tests like ultrasound, CT that depends on other associated symptoms and habits. You will be briefed about how you will feel in the icu for few days, like pain, drowsiness due to medicines and nausea, vomiting. You should not take anything by mouth for 6-8 hours before surgery. You have to convey your discomfort to the staff like pain so that the medicines will be given accordingly. You may be having sleep disturbances, may require some interventions. You may feel Anger and restlessness sometimes if it’s bothersome, medicines may be required to calm yourself. You can choose your food as you like but make sure you require good amount of vitamins and minerals to heal the wound. You should have a good share of nuts and fruits in your diet. Walking and aerobic exercises helps you to recover quickly both mentally and physically. Keeping the mind and brain active, boosts overall well-being and recovery that may require activities that stimulate the thought process like reading, chatting, games, puzzles etc, whichever is suitable for the individual. Caring the wound, the wound is kept open after 4 to 5 days of surgery. If any pain, swelling, discharge and gapping in the wound you have to call us or visit our clinic. If you have shortness of breath, giddiness and chest pain, you have to call us or report to our clinic.