1. Dr. Ashok Kumar Kapoor,MBBS, MD(Int. Medicine), DM (Cardiology), F.card(Germany), FCCP(USA), Getwell Medical Center

2. Getwell Medical Center 3. Definitions of Health the condition of being Sound in Body, Mind or spirit, especially freedom from physical disease or pain (Webster ) soundness of body or mind: that condition in which its functions are duly and efficiently dischargedGetwell Medical Center 4. WHO Definition of Health?WHO definition of HealthHealth is a state of complete physical, mental and socialwellbeing and not merely an absence of disease orinfirmity + ability to lead a socially and economicallyproductive life Getwell Medical Center 5. Incidence of Coronary Heart DiseaseGetwell Medical Center 6. Incidence of Coronary Heart Disease Worldwide 6 to 7 million Deaths. In U.S.A, 12 million Americans have CAD. 800,000 new Heart Attacks a year and 450,000 recurrent UK - 300,000 INDIA- 2.5 million UAE- 10 to 12,000 Women develop the disease later by 10 years. Sudden Death above 35 y-80% are due to Heart attack. Getwell Medical Center 7. HEART ATTACK (MYOCARDIAL INFARCTION) A heart attack is caused by a blood clotobstructing a coronary artery-muscle death. Chest Pain occurs because of the dying muscle.Electrical instability causes V. Fibrillation andsudden Death.Getwell Medical Center 8. Heart Attack Symptoms Chest pressure Sweating Jaw pain Heart burn Arm pain Indigestion Back Pain Nausea BreathlessnessGetwell Medical Center 9. Risk Factors Age Gender Family history High Blood Lipids Cholesterol Tri LDL Smoking Hypertension Diet Diabetes Mellitus Sedentary High stress-type A Homocys Fibrinogen etc Getwell Medical Center 10. Coronary Angiogram Digital Image Processing RCARCA LCX Getwell Medical Center 11. Rotabalator and Stenting Long standing Hypertension Hyperlipidemia Chr. Stable Angina Twice Balloon AngioplastyC.S 47, F Getwell Medical Center 12. DIAGNOSIS OF CHD-EARLY AND ACCURATESCREENING FOR CHD:1. AGE: After crossing 352. Family History3. Smokers4. Diabetes Mellitus5. Hypertension6. Obese7. High Blood Lipids8. Stressful, sedentary life.Getwell Medical Center 13. DIAGNOSIS OF CHDRESTING ECG: Recorded by ECG machine. Can be done at home in emergency. Any doubtful chest discomfort-do it. May be normal in 40% of the cases. Chest Pain-ALWAYS DO IT. Getwell Medical Center 14. STRESS TEST Exercise Test-doneon Treadmill orBicycle. Best screeningtest. Negative test withgood exercise. Tolerance rules outsignificant CHD. Getwell Medical Center 15. ECHOCARDIOGRAPHY Evaluates Heartstructure andfunction. Can localize areasof heart attack. Stress Echo canimprove thediagnostic value ofstress test. Options of color,Doppler, 2D andeven 3D study.Getwell Medical Center 16. CORONARY ANGIOGRAPHY The Gold Standard for the diagnosis of CHD. Invasive procedure. A plastic tube passed into the heart and dye isinjected. Film taken and studied for coronary Blockages.Getwell Medical Center 17. HOW TO PREVENT A HEART ATTACKTIPS: Healthy life style, Regular exercise: 20 to 30 minutes of Walking,cycling or on a treadmill. Maintain Ideal Weight. Open air exercise. Getwell Medical Center 18. PreventionEat Healthy food: Plenty of fresh fruits, green vegetables, Salads-High Fibre diet. Avoid oily , Fried foods, cheese butter, ghee andcreams. Avoid excess of alcohol.Getwell Medical Center 19. Life-Style Assessment Scoring: Record the number of checkmarks (0 to 5) foreach of the twelve areas. Add up the numbers todetermine your total score. 48 to 60 Healthier than average life-style 30 to 47 Average life -style 0 to 29 Below average: need for improvement If you scored less than 3 in any one area, there is aneed for improvement in that area Getwell Medical Center 20. STRESS & condition, a response to a physical threat or Stress is a commonITS MANAGEMENTpsychological distress, that generates a host of chemical and hormonalreactions in the body. In essence, the body prepares to fight or flee,pumping more blood to the heart and muscles and shutting down allnon-essential functions. As a temporary state, this reaction serves thebody well to defend itself. However, when the stress reaction isattenuated, the normal physical functions that have been eitherexaggerated or shut down become dysfunctional.Getwell Medical Center 21. Stress is pervasive, life threatening. An estimated 75% to 90% of visits to primary-carephysicians are for stress-related complaints. In 2002, people in the United States alone boughtnearly $17.2 billion worth of antidepressants and anti-anxiety drugs, up more than 10 percent from 2001. According the Centers for Disease Control, adult use ofantidepressants almost tripled from 1988 to 1994 and1999 to 2000. A Harvard study showed individuals who lived in astate of high anxiety were four and a half times morelikely to suffer sudden cardiac death than non-anxiousindividuals. Getwell Medical Center 22. Take the Stress Test See if any of the following symptoms apply to you or someone you know: Irritability: Shorter fuse these days, the little things make you angrier? Sense of humor: Laughing less, too serious? Worry: Reliving or projecting future anxious emotional experiences?Depressed, resigned over the way things are? Excessiveness: Eating, drinking too much, too many mood-altering stimulants? Forgetfulness: Cant remember little things lately, have mental gridlock? Aches and pains: Recurring headaches, frequent gastrointestinal distress,tension in face, jaw, shoulders, back or chest? Nervousness: Talking faster, more than in the past? Fatigue: Feeling run-down a lot? Tired, but cant get restful sleep? Illness: Suffering allergies, colds, flu and other ailments more often? Time pressure: Often feel as if there is not enough time, too much to do? If you answered yes to three or more of these questions, theres a good chanceyou are experiencing some degree of chronic stress, but take heart: You cancontrol your stress and HeartMath will help. Getwell Medical Center 23. A HeartMath Tip: Take five minutes several times aday, whether or not youre feeling especially stressed,to try these simple steps adapted from the HeartMathAttitude Breathing tool. Focus on your heart as you breathe in. Concentrate on a positive feeling or attitude as youbreathe out. Lock in this new feeling as you continue to breathe itin and out through your heart. As you become adept at using this HeartMath tool,select new feelings and to help you de-stress Getwell Medical Center 24. Benefits of Stress Reduction Improved health, feeling of well-being and quality of life Improved intuition, memory and cognitive function More energy during the day, restful sleep at night More heartfelt feelings like love, appreciation and kindness Less impatience, irritability, fits of angerGetwell Medical Center 25. Smoking - The Facts Cigarette Smoking contains the following Nocotine Tar Carbon monoxide Many Disease are caused by Smoking. Smoking affect other peopleGetwell Medical Center 26. Is it ever too late to quit? No, its never too late to quit. Quit smoking now to start feeling these benefits. 20 minutes after quitting: Your blood pressure drops back to normal. The temperature in your hands and feet returns to normal. 8 hours after quitting: The carbon monoxide (a gas that can be toxic) in your blood drops tonormal. 24 hours after quitting: Your chance of having a heart attack goes down. 2 days after quitting: You can taste and smell things better. 2 weeks to 3 months after quitting: You have better blood flow. Your lungs are working better.Getwell Medical Center 27. 1 to 9 months after quitting: Coughing, sinus congestion, fatigue, and shortness of breath decrease. Your lungs start to function better, lowering your risk of lung infections. 1 year after quitting: You reduce your risk for heart disease by half. 5 to 15 years after quitting: Your risk of having a stroke is the same as someone who never smoked. 10 years after quitting: Your risk of lung cancer is nearly the same as someone who never smoked. Your risk of cancer of the mouth, throat, esophagus, bladder, kidney, andpancreas also decrease. 15 years after quitting: Your risk of heart disease is now the same as someone who has neversmoked. Getwell Medical Center 28. CHOLESTROL Low fat, low cholesterol diet Exercise STATINSGetwell Medical Center 29. Exercise Exercise can help your body in many ways. Aside from helping you to keep a healthy body weight, exercise increases your mobility, protects against bone loss, reduces your stress levels, and helps you feel better about yourself. And, research has shown that people who exercise are less likely to develop heart disease, high blood pressure, and high cholesterol levels Before you start an exercise program You are taking a prescription medicine. You have ever had any kind of heart problem, especially a heart attack. You have diabetes. You have problems with your bones or joints. You have high blood pressure and do not take medicine for it. You have a family history of coronary artery disease. You are a man over 45 or a woman over 50, and you are not used to doing even moderatelevels of exercise. You smoke. You are very overweightGetwell Medical Center 30. What kind of exercise should I do?There are 3 categories of exercises: Cardiovascular Strength-building FlexibilityCardiovascular exercise is also known as aerobic exerciseFor example, walking, jogging, swimming, and cycling are aerobic activities.Strength-building and flexibility exercises are known as anaerobic exercise.Cardiovascular ExerciseA simple definition of cardiovascular exercise is any exercise that raises yourheart rate to a level where you can still talk, but you start to sweat a little.Getwell Medical Center 31. CONCLUSION In the conclusion , I can only say that in spite of fast and stressful life the lifestyle needs to be healthy. Prevention is better than cure The state of art modern technology and the early diagnosis can make all thedifference in the form of life and death. Genetic manipulation and thus producing new coronary artery is the ultimategoal. Getwell Medical Center