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Expert guidelines on treatment and management of cardiovascular diseases

Expert guidelines on treatment and management of cardiovascular diseases

Introduction

Every 06 seconds one person in India succumbs to cardiovascular disease. This is because annually the number of deaths in India from CVD is 4.77 million. It is possible to reduce the risk of this dreaded disease through a simple approach, including detection and treatment. Let’s take a look at specialists endorsed guidelines for the timely treatment and management of cardiovascular disease.

What are the various cardiovascular disease treatment options?

Treatment of cardiovascular disease after it has been diagnosed includes the following standard options. This typically involves the use of medications, changes in lifestyle and for some people, it could also require surgical procedures.

An important aspect of treatment and management of CVD is changes to lifestyle. This is known to have a strong impact on outcomes and also help to reduce risks from the disease. Changes to lifestyle include:

  1.  Diet – consumption of a diet that is labelled as heart healthy. For instance, fruits, vegetables, whole grains, lean proteins, and healthy fats. Additionally, intake of salt is to be lowered, while intake of unhealthy fats is also to be reduced considerably.
  2.  Physical activity – Individuals diagnosed with some form of CVD are to ensure a fitness regimen of 30 minutes every day.
  3.  Weight – this is to be managed in such a manner so as to regulate blood pressure levels, bad cholesterol, and control blood sugar levels.
  4.  Smoking and drinking – are to be stopped, as this is a major factor or contributor to increased risk.

Apart from lifestyle changes, you will also be recommended medications to manage the condition, including:

  1. Antiplatelet agents and anticoagulants – to prevent blood clots.
  2. Statins and similar medications – to lower cholesterol levels.
  3. Antihypertensive medications – to control blood pressure levels.
  4. Diabetes – to manage blood sugar levels.

As outlined above, in certain instances, it may be necessary to undergo procedures to fix problems. This could be a procedure to treat a problem that has already progressed, including:

  1. Angioplasty and positioning of stents – to open blocked coronary arteries.
  2. Coronary Artery Bypass Grafting – to improve blood flow by bypassing blocked arteries.
  3. Use of devices – like pacemakers to manage irregular heartbeats.
  4. Valve repair – these procedures are required when heart valves are damaged.

What is the treatment for cardiovascular disease when it is in an advanced stage?

Before we look at the treatment and management of cardiovascular diseases in an advanced stage, it is important to know what happens in that stage. Advanced stage CVD is also known as congestive heart failure. This happens when the heart is unable to pump enough blood and in turn makes the heart to work harder. This condition has certain tell-tale symptoms that can be used to identify the disease. 

  1. Heart beat changes – in this stage, you may experience faster heart beats. Alternatively, you may feel that your heart is beating abnormally hard. 
  2. Profuse sweating, difficulty breathing and unusual tiredness may be experienced in this stage.
  3. Increased anxiety – the sudden changes may make you increasingly anxious about your health.
  4. Sudden weight loss, unusual changes in the color of your skin, swelling, and pain in the abdomen are other possible symptoms.

What are the treatments for cardiovascular disease in advanced stage?

It is necessary to note that presently there is no cure for heart failure. The whole idea of treatment and management is to relieve symptoms and reduce the possibility of more damage. The actual treatment will depend on various factors, including the extent of failure, type of heart failure, and underlying conditions. 

  • Treatment involves changes in lifestyle such as reduced intake of salt. This is because fluid retention can cause complications. Similarly, you will be asked to go off caffeine due to heartbeat irregularities. Additionally, your intake of fluid intake will also be controlled.
  • Medicines are an important part of the treatment plan. This will include vasodilators to ensure relaxed blood flow, diuretics and aldosterone inhibitors to regulate fluid retention. Other medicines include ACE inhibitors, ARB drugs to enhance the functioning of the heart. Similarly, digitalis glycosides help to improve the contractions of the heart. Finally, you may also be recommended medications like tranquilizers to bring down your anxiety. Standard medications given during initial stages of CVD will also be recommended – anticoagulants, antiplatelets, and beta-blockers. 
  • Surgical procedures are often relied upon in severe cases. This is mainly to bypass blocked arteries, or in some instances to fix or replace heart valves. Devices like pacemakers help both sides of the heart to work in unison. Other implants include defibrillators, that send shock impulses to manage heart rhythm

What is the ideal approach to cardiovascular disease treatment and prevention?

The best approach to treatment and management of CVD is early detection and preventive, remedial measures. There are various factors that cause CVD, and it is possible to understand future or lifetime risk of the disease through proper screening. This includes laboratory tests to look for conditions that are known to cause CVD. These are simple tests that can help determine if a person has diabetes, high blood pressure or high cholesterol levels. These conditions are known to contribute to risk of CVD. Other conditions that could also cause CVD include sleep apnea.

One of the reasons for certain cardiovascular disease is known as the genetic component. You may inherit certain conditions from your parent, like hypertension, cardiomyopathy and arrhythmias. This passes from the parent to offspring in DNA. Similarly, a person belonging to a family that has a history of heart attack is also prone to higher risk.

This genetic component of cardiovascular diseases can be detected much earlier, unlike other disease factors. A simple blood sample or saliva sample is all that is required to check if you are at risk of CVD in the future from the genetic angle. Advanced genetic testing facilities are presently available in Tamil Nadu, and this can help you screen for the disease.

This is a huge advantage considering that you will learn of any possible risk, well in advance. This is unlike other factors such as high cholesterol levels or diabetes or hypertension, wherein you will know, only if the condition has progressed to levels where it can be detected as borderline or above.

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Why You Need To Start Understanding Cardiovascular Disease (CVD)

Why You Need To Start Understanding Cardiovascular Disease (CVD)

Introduction

Some diseases do not presently have a cure, but can only be managed with treatment and lifestyle changes. One such disease is cardiovascular disease. The whole idea of treatment is to mitigate the risk of cardiovascular disease (CVD) and to reduce the effects when the disease gets you. One of the reasons to start understanding cardiovascular disease better is to detect, identify symptoms and seek timely medical assistance.

One of the reasons for seeking early detection are non-modifiable risk factors. We will look at these factors in a subsequent paragraph. But before that, lets get to understand cardiovascular disease from expert opinion.

What is the main information about cardiovascular disease?

Cardiovascular disease is also famously known by its acronym CVD. This refers to various conditions that affect the heart and blood vessels. Some of the different types of conditions that comprise CVD are as listed below. The first step to start understanding cardiovascular disease is by knowing the difference between each of the following conditions.

  •  Coronary Artery Disease – Also known as CAD, this is due to buildup of plaque in the coronary arteries. This causes a reduction in flow of blood to the heart.
  •  Heart attack – Also known as myocardial infarction, this is due to blockage of blood flow to a part of the heart for an extended period. This either causes damage to the heart muscle or the heart muscle dies.
  •  Heart failure – This is when the heart is unable to pump sufficient blood to the body. This deprives the body of the its need for nutrient rich blood.
  •  Arrhythmias – This refers to conditions when the heart has abnormal or irregular heart rhythms. This could be either too fast or too slow or irregular heartbeats.
  • Stroke – This occurs when there is some interruption or stoppage of blood flow to the brain. This could be due to a blockage, or a rupture of specific internal blood vessels.
  •  Peripheral Artery Disease – Also known as PAD, this refers to a condition where there is reduced flow of blood. This is due to narrowing of the peripheral arteries, typically in the legs. 
  • Hypertension – This is the commonly experienced high blood pressure levels, referring to an increased pressure of blood on the artery walls. This causes various health complications, including heart disease.

What causes cardiovascular disease?

As part of understanding cardiovascular disease, lets now look at the causes of cardiovascular disease. This is mainly due to a combination of factors, that are classified broadly into lifestyle reasons, genetic reasons, and medical conditions, as explained below:

Lifestyle reasons

  • When your diet is high in saturated fats, trans fats, cholesterol, sodium, and sugar, you may develop atherosclerosis. This causes a buildup of plaque in the arteries, and an contribute to high blood pressure, apart from obesity.
  •  When you are physically inactive, you may end up with obesity, hypertension, and high cholesterol levels.
  •  Smoking will damage blood vessels, and bring down the blood oxygen levels. It also causes high blood pressure and heart rate, which will put you at risk of CVD.
  •  Alcohol can raise blood pressure, and also spike your triglyceride levels, contributing to heart disease.

Genetic reasons

  • If you have a family history of cardiovascular disease, you will be increased risk. Additionally, some genetic disorders can also predispose you to higher risk of CVD.

Medical conditions

  • Hypertension damages the arteries and heart, causing heart disease and stroke.
  • High cholesterol levels of low-density lipoprotein can cause plaque buildup in the arteries. This increases risk of heart attack and stroke.
  • Diabetes damages blood vessels and nerves that regulate the heart. This increases your risk of heart disease.

In addition to the above, there are other risk factors, such as advancing age and gender. Factors that are considered as contributing include chronic stress, sleep apnea, and chronic inflammation in the body. CVD is mostly due to a combination of multiple reasons.

Can cardiovascular disease be cured?

No, as mentioned earlier, as part of understanding cardiovascular disease, these conditions presently do not have a cure. The only possibility is to manage the condition through medications, and lifestyle modifications. The best approach is to go in for periodic tests to check for risk of the condition and to detect the condition early in life. It is important to note that there are two types of risk factors that contribute to the condition – modifiable and non-modifiable.

As the names suggest, you can do something about the modifiable risk factors and reduce the risk of heart disease. This will ensure that you will reduce your lifetime or future risk of the condition, apart from considerably reducing the impact of the disease, if it eventually gets you. The best way to deal with non-modifiable risk factors is by early detection. By detecting non-modifiable risks, you can seek treatment to reduce the effects and outcomes of the genetic components.

Modifiable risk factors

The following are the modifiable risk factors of heart disease.

  •   Wrong diet
  •   Sedentary lifestyle, obesity
  •   Smoking and alcohol  
  •   Hypertension
  •   High cholesterol levels
  •   Diabetes

Non-modifiable risk factors

The following are the non-modifiable risk factors of heart disease.

  •   Advancing age
  •   Gender – men are known to be at higher risk of heart disease than women
  •   Family history  
  •   People of specific ethnic categories are at higher risk

How cardiovascular disease occurs? ​

As mentioned above, cardiovascular disease is due to a combination of multiple factors. As part of efforts to start understanding cardiovascular disease, it is important to note the symptoms of these conditions.

  •   Chest pain or some form of discomfort, known as angina
  •   Difficulty breathing
  •   Pain or weakness in the limbs
  •   Pain that radiates to the neck, the upper abdomen or your back
  •   A fluttering sensation in the chest
  •   Abnormal rapid heartbeats
  •   Overall tiredness
  •   A lightheaded feeling or dizzy feeling
  •   Unexplained swelling in the legs

How will genetic testing help with non-modifiable risk factors?

With genetic testing, you can learn of any genetic component that may put you at risk of heart diseases. These could be a congenital mutation or it could an inherited condition. With advanced genetic testing facilities in Tamil Nadu, you can quickly receive comprehensive screening. Based on the results, you can seek medical treatment and mitigate the risk of heart disease. 

Medically Reviewed by

Dr.Rajasekar Cardiologist

Dr. Rajasekar is a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).

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What are the Common Heart Attack Signs and Symptoms in Women?

What are the Common Heart Attack Signs and Symptoms in Women?

Introduction

Sex-specific tests are now a major consideration for assessing heart attack risk in men and women. For example, certain threshold values in a few diagnostic tests are now different for men and women. The average size of the heart and blood vessels are different in men and women.  Similarly, cholesterol buildup occurs differently in men and women. This makes it necessary to identify heart attack signs and symptoms in women accordingly. Here is useful information about how to identify these symptoms in women.

What are the signs of heart attack in women?

Heart attack symptoms are mostly the same for women and men, for instance, chest pain, pressure and short term discomfort. However, in women, chest pain is not as severe and the type of pain is best explained as some kind of pressure or tight feeling. Women may also not necessarily have chest pain to as a symptom during a heart attack. 

Commonly experienced heart attack signs and symptoms in women include the following:

  • Discomfort or unease in the neck, jaw, shoulder.
  • Pain or discomfort in the upper back or abdomen.
  • Difficulty breathing.
  • Pain in either arm; this could sometimes be experienced in both arms.
  • Feelings of nausea.
  • Urge to vomit.
  • Profuse sweating.
  • Lightheaded feeling.
  • Overall tiredness.
  • Indigestion due to heartburn.

The above symptoms are mainly be because women end up with blockages in the small arteries or blood vessels apart from the main arteries. This condition is medically known as small vessel heart disease or coronary microvascular disease. Some of the heart attack signs in women are often experienced during rest.  Due to the changes in the symptoms, women often do not get diagnosed on time.

For a woman early warning signs of a heart attack could be different than that of men

There are distinct differences between men and women – in various organs, and in the cardiovascular system. Women have smaller hearts with blood vessels that are narrow when compared with men. As a result of this, the manner in which heart disease progresses, is different among men and women. One of the reasons for heart attack is build-up of cholesterol plaque on the walls of arteries that damage major blood vessels. In men, this plaque buildup happens in the bigger arteries. However, in women, this buildup happens in smaller blood vessels. 

What is the ApoB Test?

In addition to understanding the different heart attack signs and symptoms in women, it is also important to know more about certain tests. This will help detect certain conditions on time. The ApoB Test refers to the Apolipoprotein B protein that is partly responsible for lipid metabolism, including low-density lipoprotein and very low-density lipoprotein. The test calculates the amount of this protein in the blood. This helps to understand about the inherent risk of developing heart disease in the particular person. The test offers a clear cardiovascular risk assessment, as high levels indicate a potential to buildup of plaque in the arteries.

When should I take the ApoB test?

  • If you have a family history of certain conditions, the test is recommended. For instance, a family history of heart disease, hypertension, diabetes puts you at risk. 
  • If you have high lipid levels.
  • If you have been diagnosed with some heart disease.

What genetic components of heart attack are inherited?

One among the many reasons for heart attack is the genetic component. In such eventualities, some genetic factors are inherited and this increases your risk of heart attack. An understanding of these conditions will also help to be on the look-out for heart attack signs and symptoms in women. The following is a list of possible genetically inherited conditions.

  • Familial hypercholesterolemia – This is a genetic disorder arising from high levels of low-density lipoprotein cholesterol. This increases the risk of heart attack and is caused by certain genetic mutations – LDLR, APOB, and PCSK9.
  • Lipoprotein(a) – Higher levels of lipoprotein(a) is an identified risk factor of heart disease. This is due to a genetic component or genetic variant of the LPA gene.
  • Polygenic risk scores – A combination of different genetic variants can put you at risk of heart attack.
  • Apolipoprotein – As outlined earlier, genetic variants – APOE, APOA5, and APOC3 – can affect lipid metabolism. This can increase your risk of cardiovascular disease. 
  • Genes that are linked to inflammation – Certain genes are linked to inflammation, and this affects your body’s inflammatory response. For example, genes like IL6 and CRP impact inflammatory response.
  • Genes that impact blood pressure – Certain genetic variants linked to blood pressure regulation, can put you at risk of hypertension and heart attack. For instance, AGT, ACE, NOS3 may add to your risk of hypertension. 
  • Thrombosis – There are genes related to blood clotting, and this can contribute to heart attack risk. For instance, changes in the F5 and F2 genes could put you at risk of thrombosis.

How do these genetically inherited conditions progress or manifest?

There are certain patterns in which these genetically inherited conditions manifest. Here is a quick look at some patterns.

  • Monogenic – This refers to specific genetic conditions, wherein a single copy of the gene that is changed can put you at increased risk.
  • Polygenic inheritance – This refers to heart attack due to multiple genetic variants. In such conditions, the different genetic mutations add to the overall risk.  
  • Family history – If a member of your family has had some heart disease in the past, it could mean that you are at risk. In such circumstances, it would help to be aware of heart attack signs and symptoms in women.

Will genetic testing help understand this risk of genetically inherited conditions?

Yes, genetic testing can help unearth your risk of heart attack due to any inherited conditions. The tests, that are presently available in Tamil Nadu can identify specific mutations or genetic variants linked with heart attacks.

Medically Reviewed by

Dr.Rajasekar Cardiologist

Dr. Rajasekar is a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).

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How You Should Start Recognizing Early Warning Signs of a Heart Attack?

How You Should Start Recognizing Early Warning Signs of a Heart Attack?

Introduction

A recent study by Lancet has revealed that heart diseases are now turning into a leading cause of fatalities in India. Important findings include heart attacks at an earlier age, and more fatalities. Various risk factors were evaluated, and threw up interesting findings on lipid metabolism, and genetic predisposition. The study recommended a multi-dimensional approach to prevent cardiovascular diseases. Lets look at the importance of recognizing early warning signs of a heart attack.

What are the early warning signs of a heart attack?

There are certain signs that can be considered as an indication or forewarning of a heart attack. However, it is very important to note that these signs are also common to other conditions or circumstances. This means that when you experience such signs, it does not automatically mean that you are having a heart attack. It should be viewed in the context of other symptoms and needs to be assessed medically.

It is best to be aware of symptoms and signs in such a manner to help you in recognizing early warning signs of a heart attack. This will help you from raising a false alarm or panicking that you are having a heart attack, even when the symptoms could mean something else. For instance, vomiting is a sign of heart attack in women; however, this does not mean that anyone who vomits is having a heart attack. There are other signs and conditions that need to be understood before assuming that a heart attack has occurred.

Here are some of the early warning signs that you need to be aware.

  • Discomfort in the chest – You may experience some kind of pressure, or a squeezing sensation. A feeling of fullness or pain bang in the middle of the chest may also be an early sign. These symptoms are typically known to last for a few minutes, and in some cases may be intermittent. 
  • Upper torso discomfort – Another sign is some kind of pain or unexplained discomfort in either of the arms or both arms. This may sometimes extend or radiate to the back, the neck, your jaw, or your stomach.
  • Difficulty breathing – One particular sign is shortness of breath that may be experienced either with chest discomfort or without any discomfort. Note the fact that this refers to situations even when there is no physical activity.
  • Common symptoms – Some of the other common symptoms include a possible cold sweat, or feelings of nausea. You may sometimes feel lightheaded without any particular reason.

Apart from the above commonly experience symptoms, women are sometimes likely to experience certain symptoms that are not commonly experienced.

  • Overall tiredness, without any reason.
  • Feelings of anxiety.
  • Sudden indigestion or heartburn.
  • Dizzy feelings.

Common heart attack sign and symptoms

The above section was more about early warning signs that could indicate that you are in high risk of a heart attack in the near or not too distant future. However, there are some signs and indications of a heart attack, when it occurs. It is important to know all about recognizing early warning signs of a heart attack. Some of the symptoms may be common or overlap, and the intensity could be the major difference between the two.

  • Pain in chest or unease – You may experience some kind of pressure, or squeezing sensation. This is similar to early warning signs, and includes a feeling of fullness. The pain may be experienced in the middle of the chest and could last for a few minutes. This may sometimes feel like it has resolved naturally and will return shortly. This alternating pain and pain-free phase could be a good indicator of an impending or heart attack in progress.
  • Upper body unease – As mentioned in the previous section, you may experience unease in the upper part of your body. 
  • Difficulty breathing – A sign of heart attack is shortness of breath. This could be separate from discomfort or could be experienced along with discomfort. 
  • Sweating – There is a difference between a cold sweat and normal sweating. A cold sweat, as the name suggest is cold to the touch, while a normal sweat is warm and moist. You sweat normally after some kind of physical activity or if you have a fever, or if you are in some warm or hot place. A cold sweat, is the result of some kind of internal stress, fear, or pain or the result of a medical condition. This could be an infection, or it could also be a heart attack. A normal sweat usually occurs gradually, unless there is heavy physical exertion.
  • Feelings of nausea – If you have vomiting sensations or if you are experiencing nausea, it could also be an indication of a heart attack. However, heart attack is not the only reason for vomiting, therefore it is wrong to assume that the only reason for vomiting is a heart attack.
  • Other symptoms – There are other symptoms that will help you in recognizing early warning signs of a heart attack. These are a lightheaded feeling, or dizziness.

Main heart attack signs in men

As can be seen from the above sections, the symptoms of heart attack are mostly common to men and women with some differences. There are only a few symptoms and signs that are considered as exclusive or gender specific. Some of the signs of a heart attack in men include the following: An understanding of this will help you in recognizing early warning signs of a heart attack.

  1. Men experience pain the chest or discomfort differently – Among men, this is mostly felt as some kind of heavy pressure, or tight feeling. This could also be felt as a squeezing sensation in the chest. This symptom is considered as the very common and an easily identifiable symptom. 
  2. Men feel the pain radiating across the upper body – Among men, the pain usually begins in the chest and slowly radiates. This could spread to the left arm, or the neck, jaw, or back.
  3. Breathing difficulty is sudden and is usually experienced along with pain in the chest. However, shortness of breath without pain is also a possible symptom. The common condition is the sudden onset of breathing difficulty.
  4. Cold sweats – This is usually experienced by men during a heart attack.
  5. Dizzy feeling – Men experience this in combination with other symptoms. For instance, dizzy feelings, when experienced along with chest pain or difficulty breathing, can be considered as a symptom of heart attack in men.
  6. Unease in the torso – Discomfort or unease could be in either of the arms or both the arms. This could stretch to the back, the neck, jaw, or even the stomach.

Which heart attack signs in women are different?

The symptoms experienced by women are only slightly different, with just a few exclusive gender-specific symptoms. The symptoms are more subtle, and this actually poses a health risk.  The subtle nature of the symptoms make it harder identify and distinguish. It is therefore necessary to have a clearer understanding for recognizing early warning signs of a heart attack.

Overall tiredness that is abnormal – Women experience tiredness that is abnormal and this could be experienced for many days. A distinct nature of this symptom is that rest will not offer any relief. 

Difficulty breathing – This is somewhat common to that of men; however, the difference is the subtle nature of this symptom.  

Vomiting – This is more experienced in women than men. In most situations, there is every possibility of this being mistaken as due to other conditions. 

Pain in the jaw or the back – This pain may radiate to the back or to the jaw. This is different from the pain typically experienced by men, where the pain extends to the chest or the arm. 

The pain in the chest is different – Though chest pain is itself common to both genders, there is a difference in the nature of pain in women. It could be felt as some sharp pain, or a burning sensation, instead of the heavy pressure or heaviness felt by men. 

Women may wake up from sleep with pain in the neck or the shoulder. 

Indigestion – This symptom is likely to be confused as a gastrointestinal condition, but could also be due to a heart attack.

Women may experience many symptoms together, and due to the subtle nature, it could be misread. It is important to learn recognizing early warning signs of a heart attack and to seek emergency medical assistance.

Is vomiting a sign of heart attack?

Yes, vomiting could indicate that you are having a heart attack. However, heart attack is not the only reason for vomiting. This symptom is more commonly reported in women and could also be experienced other symptoms such as nausea, dizzy feelings and difficulty breathing. You may also experience some chest pain or unease with vomiting. Women are to look at these symptoms along with other symptoms to distinguish it as signs of a heart attack. In the event of other symptoms, it is necessary to seek medical assistance.

Is this true - pain early warning signs of a heart attack?

Yes, pain is known to be an early warning sign of a heart attack. As part of your understanding of recognizing early warning signs of a heart attack, you need to identify the distinct pain of a heart attack. It is almost always experienced as some kind of pressure being felt on the chest. Some may feel it as a squeezing sensation, while others experience it as a full feeling in the chest. The location of the pain is mostly in the middle of the chest. This pain could at times be experienced in the left arm, or also both arms.

Women may experience pain in the back, while there could be pain in the neck or the jaw also. Men may experience pain in the shoulders and the stomach also. The nature of the pain is slightly different from that of pain due to other reasons. It is not persistent, but intermittent, lasting for a few minutes. This pain goes away for a short while, only to return for a similar duration. These phases of pain can be a good way in recognizing early warning signs of a heart attack.

Are there any signs before heart attack?

There are signs before a heart attack, listed out earlier. Some signs not mentioned above include a sense of impending doom. When this is experienced with other symptoms, it means you definitely need to do something about it. 

The faster you react to the symptoms, the better are your chances or the chances of the person who is experiencing the symptoms.

How will genetic testing help?

Genetic testing helps in many ways in preventing or mitigating the effects of a heart attack. There are many reasons that cause a heart attack, and one of the reasons is genetic predisposition through inheritance and genetic mutations. Genetic testing, presently available in Tamil Nadu, helps to uncover these reasons and help you understand your future or lifetime risk of a heart attack. Based on the assessment, you can then take suitable remedial measures.

Apart from an understanding of recognizing early warning signs of a heart attack, it would help be undergo genetic testing. In addition to the ability to uncover your risks, you can also receive better treatment, because genetic changes affect the way each person responds to medicines. For instance, some people respond better to medications, while some do not. This could be even when everything is similar – age, gender, overall health, underlying medical conditions etc. The difference is the genetic dissimilarities between people. Understanding this will help receive better treatment. Personalized medications and genetic testing go hand in hand for better medical outcomes.

Medically Reviewed by

Dr.Rajasekar Cardiologist

Dr. Rajasekar is a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).

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What are the Primary Reasons for Heart Attack?

What are the Primary Reasons for Heart Attack?

Introduction

One of India’s finest cricket players, former Indian cricket captain Sourav Ganguly had to undergo a procedure due to blocked coronary arteries. There are countless examples of people who have received timely treatment and now lead a near normal life with some changes. Understanding the reasons for heart attack and detecting risk of heart ailment can go a long way in preventing hospitalization.

Detecting could be from identifying early symptoms or undergoing necessary clinical or genetic tests. ApoB tests also help to determine risk of heart attack. Here is how you need to approach this all important and possibly life saving decision.

What are the reasons for heart attack?

Multiple reasons can contribute to a heart attack. In many cases, different reasons build up or contribute to a heart attack, while in some instances, a single reason could be the cause. Heart attacks, known medically as myocardial infarctions, are due to blockage of the blood flow to the heart. When this blockage of blood flow is long enough it damages that part of the heart muscle. Let’s look at some of the reasons for heart attack:  

  1. Coronary Artery Disease – Buildup of plaques in the coronary arteries is identified as one of the most common causes. This eventually causes a rupture, forming a blood clot and blockage of the artery.
  2. Age – The probability of a heart attack increases with age. Among genders, men are more at risk, while in women, the risk of heart attack increases after menopause.
  3. Family – If you have a family history of heart disease, that could also be a reason. 
  4. Smoking – This habit causes damage to the lining of the arteries, increasing the possibility of atherosclerosis and blood clots.
  5. Hypertension – High blood pressure levels can cause damage to the arteries over a period of time. This will facilitate the buildup of plaque.
  6. Cholesterol – If you have high levels of low-density lipoprotein, this may end up with plaque buildup.
  7. Diabetes – High blood sugar levels damage blood vessels and nerves related to the heart.
  8. Weight – Excessive weight increases some of the above risk factors. For example, you are more likely to end up with high blood pressure, cholesterol, and diabetes.
  9. Medical conditions such as metabolic syndrome, pre-eclampsia and autoimmune conditions, increase your risk of heart attack.  Though these are not direct reasons for heart attack, they are indirect causes.
  10. Other reasons – In addition to the above, there are other conditions that could trigger a heart attack. For instance, excessive physical exertion, stress, extreme cold weather, coronary Spasm, drug abuse, and blood clotting disorders are possible risk factors.

Sudden heart attack reason that you should know

A category of heart attacks is sudden heart attack, or sudden cardiac arrest. This happens when the heart unexpectedly stops, and totally cuts of flow of blood to the brain and organs. There are multiple reasons for heart attack that occurs suddenly, as outlined below:

  1. Ventricular fibrillation – This is a life endangering condition when the functioning of the heart to pump blood effectively is severely affected. 
  2. Ventricular tachycardia – This is another serious condition due to rapid heart rate that begins in the ventricles of the heart. 
  3. Dilated cardiomyopathy – In this condition, the heart’s pumping chamber becomes enlarged, and as a result it impacts the pumping of blood.
  4. Stenosis or regurgitation – This causes sudden cardiac arrest due to heart valves that suddenly malfunction. 
  5. Congenital heart disease – Defects in the heart that are structural in nature and congenital (from birth), can cause sudden cardiac arrest.
  6. Electrolyte – An imbalance of potassium, magnesium, calcium can impact electrical impulses in the heart. 
  7. Genetic component – Genetic disorders that impact the electrical activity in the heart can cause conditions that result in sudden cardiac arrest.
  8. Other reasons – This includes, respiratory failure due to lack of oxygen, extreme physical stress, drug abuse, severe Infections like sepsis, myocarditis.

How can I detect the reasons for heart attack?

It is possible to carry out certain tests and detect the possible reasons for heart attack. This includes clinical evaluations and observations of symptoms that can help in opting for additional tests to confirm certain conditions. Let’s look at the right combined approach to understand the reasons that trigger a heart attack.

  1. Individuals with a family medical history of heart disease, hypertension, diabetes, or high cholesterol need to periodically check for these conditions.
  2. Carrying out ApoB (Apolipoprotein B) tests will help detect risk of atherosclerotic cardiovascular disease and also reveal possible underlying conditions.
  3. Tests to ascertain levels of blood pressure, blood sugar and cholesterol.  Cholesterol levels include LDL cholesterol, HDL cholesterol, and triglycerides.
  4. Blood tests can also look for troponins, that are markers of heart muscle damage.
  5. Blood tests to ascertain C-Reactive Protein levels that help identify inflammation linked to heart disease.
  6. Stress tests and pharmacologic tests help to understand the effects of exercise on the heart.
  7. Coronary calcium scan – This measures the calcium in the coronary arteries, which help to evaluate possible risk of coronary artery disease.
  8. Genetic testing looks for inherited risk factors by identifying your predisposition especially if there is family history.
  9. Assessment of your lifestyle will also help understand or predict possible reasons for heart attack. For example, if you are a smoker, or if you consume alcohol heavily.
  10. Evaluation of certain medical conditions like autoimmune disorders and metabolic syndrome. These conditions increase your risk of heart attack.

Tests that help to predict future and lifetime risk of heart attack

Some of the tests mentioned above help to identify present, elevated risk of heart attack. There are tests that can also tell if you are at future risk of heart attack. This includes any lifetime risk of heart attack. The first category is genetic testing to look for any inherited genetic component of heart disease risk. This could be a direct risk or reasons for heart attack or indirect risk. These tests will also look for any genetic mutations in you that can pose a risk of heart attack. Genetic testing facilities are available in Tamilnadu, and these are simple tests that require you to give a sample of your saliva or blood.

Another type of test is the ApoB test that looks for the levels of a protein that is responsible for transporting LDL and VLDL. Levels more than 90 mg/dL may necessitate certain modifications in lifestyle to reduce the risk.

Medically Reviewed by

Dr.Rajasekar Cardiologist

Dr. Rajasekar is a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU).

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Standard Diagnosis And Cardiovascular Test For Disease

Cardiovascular Disease

Introduction

Every fourth death in India is due to cardiovascular diseases. This statistic is even more alarming considering that this development began after the year 1990. From 1990, the number of cases has more than doubled, and an early onset of the disease is now affecting younger people. This makes it all the more important for early Cardiovascular Test for cardiovascular diseases. Here are details on how you can do that easily.

What are the tests for cardiovascular disease diagnosis?

Various tests are presently available as part of diagnosis and testing for cardiovascular disease. The most common approach includes a clear understanding of family history apart from the following tests:

  •       Blood tests.
  •       Chest X-ray
  •       Electrocardiogram.
  •       Holter monitoring.
  •       Echocardiogram.
  •       Stress tests.
  •       Cardiac catheterization.
  •       Heart CT scan.
  •       Heart MRI scan.  

What are the preventive or screening Cardiovascular Test for disease?

While diagnosis and testing is as listed above, the main screening for cardiovascular disease includes the following:

  1. Blood pressure – This is considered as a mandatory test, as high blood pressure may not present symptoms normally. The best option is to undergo tests to screen. Normal blood pressure is below 120/80 mm Hg, and you need to check this yearly. When the values are higher, you will need to control it through medication and lifestyle modifications. 
  2. Cholesterol – This is checked through blood tests that check your total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides levels. Based on the results it is possible to roughly estimate your future risk of cardiovascular disease.
  3. Weight/obesity – Your waist circumference and/or body weight helps to measure body mass index. Obesity increases the risk of heart disease and stroke.
  4.  Blood glucose –Untreated diabetes can indirectly cause heart disease and stroke.
  5.  Lifestyle – If you happen to be a smoker, if you are physically inactive, or if you follow a poor diet, you are at risk.
  • Blood pressure level is considered normal if it is below 120/80 mm Hg.
  • The normal cholesterol levels for adults are as given below:
  • Total cholesterol for adults is considered normal if it is less than 200 mg/dL. If it is between 200–239 mg/dL it is borderline high, and above 240 mg/dL is considered high.
  • LDL cholesterol is considered as normal if it is less than 100 mg/dL. If it is between 100–129 mg/dL it is borderline, and between 130–159 mg/dL is labelled as borderline high. Levels between 160–189 mg/dL are high, and above 190 mg/dL are very high. 
  • HDL cholesterol is considered best when it is 60 mg/dL or more. When the levels are below 40 mg/dL it is considered as poor (in this context it is bad).
  • Normal triglyceride level is below 150 mg/dL.
  • Normal body mass index (BMI) for adults is between 18.5 to 24.9. Levels between 25 and 29.9 are regarded as overweight, levels between 30 and 39.9 are considered as obesity. When the levels are above 40, it is regarded as severe obesity. 
  • Fasting blood glucose levels between 70–99 mg/dL are considered as normal. Levels between 100–125 mg/dL is regarded as prediabetes, and above 126 mg/dL is diagnosed as diabetes.

What is the best approach to test for cardiovascular disease?

The best approach to diagnosis and testing would be to undergo tests and assessment for modifiable risk factors as well as non-modifiable risk factors. For instance, by checking for blood pressure, cholesterol, diabetes you can work on reducing the effects. You can bring about changes in lifestyle and also rely on medications to mitigate the effects.

There are other factors that pose a risk of heart attack or other cardiovascular diseases. This is the genetic component – such as an inherited condition or some genetic mutation. By undergoing genetic tests, you can uncover these risks and work towards mitigating them. The tests, presently available in Tamilnadu, involve analyzing your saliva or blood sample. This looks for genetic mutations or changes that could predispose you to certain conditions.

Based on the genetic test reports, your cardiologist will recommend lifestyle changes, and medications, wherever necessary. This will considerably reduce your future or lifetime risk of heart attack. Therefore, the best approach is to check for all possible risk factors of cardiovascular disease and take appropriate remedial measures.

What are the traditional risk factors for cardiovascular disease?

Multiple factors are considered as traditional risks for cardiovascular disease. The most common among these include the following:

  • High blood pressure – Cardiovascular Test is medically labelled as a silent killer, as it develops undetected for a significant percentage of people. The warning signs are usually detected after the condition has progressed to an advanced stage. This makes it essential to periodically opt for diagnosis and testing to check for the condition.
  • Overweight – Obesity will indirectly cause cardiovascular diseases, when left untreated. The numbers clearly explain this – 8 out of ten people who have CVD are either overweight or obese.
  • Diabetes – People with diabetes may end up with CVD at some point, if the condition is left untreated. This is because diabetes may cause (i) nerve damage and (ii) damage to blood vessels resulting in build up of fatty deposits.
  • Smoking – Multiple effects are attributed to smoking. For instance, smoking reduces the amount of oxygen in the blood, casing damage to tissues. Similarly, fibrinogen levels increase due to smoking, which contribute to increased blood clotting factors. Another effect is damage to blood vessels, that result in build-up of plaque, eventually resulting in atherosclerosis.
  • High cholesterol levels – This causes build-up of fatty deposits in the blood, and this eventually results in atherosclerosis.
  • Alcohol – Consumption of alcohol can cause an increase in blood pressure levels, and also weaken heart muscles. Additionally, drinking also brings about oxidization of LDL cholesterol, resulting in the formation of blockages.
  • Stress – This causes release of excessive hormones such as adrenaline and cortisol that will cause an increase in blood pressure and heart rate. Stress is also responsible for increased inflammation, and blood clotting, that increase the possibility of stroke.

    Medically Reviewed by

    Dr. Rajasekar Cardiologist

    Dr. Rajasekar is a cardiologist in Chennai, with extensive experience in the field. He completed his MBBS from Madurai Kamaraj University, followed by an MD in General Medicine and a DM in Cardiology from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU)

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