Good food for a healthy heart

 

Although you might know that eating certain foods can increase your heart disease risk, it's often tough to change your eating habits. Whether you have years of unhealthy eating under your belt or you simply want to fine-tune your diet, here are eight heart-healthy diet tips. Once you know which foods to eat more of and which foods to limit, you'll be on your way toward a heart-healthy diet.

Read more from Mayo  Clinic

Posted on September 4, 2015 .

Innovator Lab Consultants India: small step ahead

Every once in a while we find ourselves stuck while working; and it takes a sheer moment of inspiration to come up with a way to solve it. I have been in medicine for over three decades now; and I find recognising medical problems and searching for their engineering solutions very exciting.  Over the last couple of decades I have patented a couple of medical innovations and tried to bring them to market, realising very quickly thereafter that this is a very complicated business indeed.

I now have a firm belief that while medical doctors are able to identify problems at their workplace and may even venture into finding engineering or other solutions for them; most of these concepts would remain just that. I know because I have struggled for a decade with one such idea. Each step along the way is complicated and fraught with delays and disenchantment.  To help medics and allied people along that path, I set up Innovator Lab Consultants India.

At Innovator Lab we strive to create technologies that improve the quality of patient care, speed of recovery, and the general patient experience. The emphasis is on providing the initial infrastructure, funding, manpower, and medical resources for projects that we partner with. Innovator Lab was founded to ensure good ideas formed at the bedside don't die off. Over the years I have established an extensive network with engineers, students, advisors and consultants both in India and abroad. 

Today we are at a position where we have an advanced cardiac prosthetic project underway supported by external funding, and a few other areas of active interest. With the established network we now have in this industry, we are confident that we can push forward the development of any further projects. I encourage you to read more about this endeavour at www.innovatorlabindia.com.

Posted on December 30, 2014 .

Is Heart surgery risky?

Lets start with this: Heart Surgery is safe. 99.4% of patients survive the surgery & live a better longer fruitful life.

Decades ago in 1953, simple heart operations often times led to about 66% deaths. Research was mounted in a big way across the western hemisphere, and monumental advances were made in cardiac surgery over the decades as a direct result. This led to a steep decline in death rates and better post-operative practices.

By 1995, the death rates for cardiac surgery fell to 8%. Knowledge, science, technology and techniques have improved once again and in the last 10 years we have come a long way once again with the average death risk of about 2% for most cases. However, the most complicated patients with multiple other problems obviously have higher risks invovled.

Major risks include Death (as above), paralytic stroke and other major organ system failure. Paralytic stroke is a devastating complication that has troubled cardiac surgery over the years. The risk of stroke is significantly lower now that what it was even 2 decades ago, the recent studies reflect an incidence of 2.0-2.3%.

Why a stroke:
The heart almost never develops narrowing in its arteries in isolation, atherosclerosis is a whole body process affecting arteries of the brain, spinal cord, kidneys, liver, bowel and also the arms and legs. Should a patient develop a low blood pressure or go in shock, anytime during or after an operation, all these organs are at risk of temporary or permanent dysfunction. There are some operations when we operate upon the aorta at the root of neck, such operations especially carry a higher risk of stroke.

Kidneys can similarly fail after an operation. Provided heart resumes adequate function rapidly, renal failure following surgery should also recover. Some patients with preexisting chronic kidney disease could end up becoming dialysis-dependant following surgery. In general if the kidneys were healthy before a heart op, they would regain function. However, for patients where kidneys fail secondary to heart failure, the chances of survival reduce significantly.

There are a group of patients where heart surgery itself might reverse kidney failure. These are patients with right heart failure or with constrictive pericarditis. I have seen individuals treated by kidney and liver specialists, who had this condition that precipitated organ failure; cured not only of their heart condition, but also of kidney or liver failure after heart surgery. Patients with heart failure are often given large doses of pills called diuretics, that can often aggravate renal dysfunction and cause frank failure. If the underlying cause of heart failure can by treated effectively such patients can have miraculous recoveries.

The worst complication for the elderly heart patients is gangrene of the intestine. Quite possibly in India we operate upon a slightly younger population that is not so much at risk for bowel gangrene.

My observation is that though cardiac surgical techniques have been fine tuned, no major surgical innovations can take credit for reducing risks of heart surgery. My belief is that the treatments, drugs and monitoring as well as personnel available nowadays for a patient undergoing Cardiac Surgery is much more definitive and reliable. That clearly would be the reason why all surgeons working in a particular hospital get almost similar results and why also some hospitals continue to get poor results when rest of the world has marched ahead.



We challenged ourselves a few years ago to see if we could improve upon the readily acceptable figure of 2%. At Sir Ganga Ram Hospital, we aimed to have 99% survival but kept our mission close to our chests. We have been blessed, our team has been successful 1194/1200 times. That is a 99.5% survival rate. This result is truly remarkable for we do some of the most complex and riskiest operations including mechanical complications of heart attacks, aortic dissection surgery, surgery for HOCM as well as Heart Transplantation.


The patients undergoing heart surgery nowadays are more of a challenge; patients are older and operations more complex. Looking at the rate of improvement in cardiac surgery however, we can finally start thinking about 100% survival rates - something unthinkable only 15 years ago.

Posted on October 17, 2014 .

Heart Attack and Angina

1) The heart muscle requires a certain amount of energy just to survive; it requires increasing amounts of energy to perform more and more work.

2) When you are resting the heart is still pumping blood in your body, however when you start exerting like walking to the bathroom body requires more blood to be pumped by the heart i.e. more work for the heart.  Lets say you go upstairs that requires more blood flow than previously and finally when you start jogging or sprinting the blood flow in the body can easily go up from almost 5 litres per minute to 15 -20 litres per minute. 

3) To perform the work (pump the blood) the heart also requires increasing amounts of energy, nutrients and oxygen that comes to it via the blood supply of the heart: coronary arteries

4) Even when the coronary arteries are narrow by as much as 60% there may not be significant trouble for a patient.  However, as the narrowing progresses in severity- the blood flow and energy supply to the heart progressively turns critical and the patients suffer from angina at severe exertion, at moderate exertion and then even at rest.

5) And if the energy supply is cutoff completely then the heart can not even survive: portions of the heart actually die.

Posted on March 9, 2014 .

Caring and Curing

Both of us separately decided that she was more or less inoperable, her tumour was surgically incurable.  It was magical when we sat down together and sought to find a solution.  I could readily operate upon areas not approachable by the liver team and Suresh could operate the rest.

Posted on February 9, 2014 .

Matters of the Heart

Students of DAV school Rohini interviewed me few weeks ago, and I connected with them instantly one because of Alumnus connection and secondly they were just the same as my son

Posted on February 4, 2014 .

Bypass Surgery

Quick introduction:

In very simple terms, Coronary artery bypass surgery is performed when the coronary arteries are fully or partially blocked. Coronary arteries are the blood vessels that supply the heart itself. The narrowing/blockage of these arteries may lead to a heart attack. Hence it is essential to keep the heart well supplied with blood.

Posted on August 15, 2013 .

Angina and Heart Attack Basics

One should be aware of heart attack symptoms since this knowledge can make a life and death difference.  Two broad symptom groups exist that is angina and heart attack.

Should these symptoms come about upon exertion or stress and be relieved by rest and relaxation; one can be pretty sure that this has to do with and abnormal heart.  Angina is caused by reduction of blood flow in the heart muscle; almost always due to  narrowing in coronary arteries that develops over time, and so is frequently seen in older individuals.

Posted on February 12, 2013 .

Inheritance patterns and basics of Hypertrophic Cardiomyopathy

Hypertrophic Cardiomyopathy is a genetic disorder because often a single gene change creates the cardiac muscle hypertrophy.  While initially there would be negligible or little obstruction to blood flow from the left ventricular outflow, a small percentage of patients would progress to increasing obstruction.  A further small subset of these patients ultimately develop symptoms of breathlessness, palpitations, dizziness, chest pain or even death.

The link below provides clear information about genetics of HCM and is a worthwhile read.

Posted on February 3, 2013 .