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The secret to having a healthy heart

September 09, 2015 12:00 IST
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"Untreated hypertension is a slow killer giving rise to cardiac failure, stroke, vision loss, kidney problems eventually"

"Occasional skipped beat is a common finding. Make sure you limit your intake of beverages/ colas and avoid smoking."

Dr Praveen Kulkarni, consulting cardiologist, Global Hospitals, Mumbai shares advice on how to have a healthy heart.

How to have a healthy heartA healthy diet that is low on fat and sugar combined by regular exercise can improve the life of your heart.

In an online chat with readers on September 8, Dr Praveen Kulkarni, consulting cardiologist, Global Hospitals, addressed queries related to heart problems and offered advice.

For those who missed the chat, here's the unedited transcript:

SHASHANK GANDHI: Dear Sir, I have palpitation problem since last 8 years, I was diagnosed with mild systolic prolapse what precaution should be taken and is it dangerous?

Praveen Kulkarni: Your condition is called mitral valve prolapse.

It occurs in 2 to 5 per cent the world's population. As long as there is no significant valve leak you need not worry.

Sanjay Goyal: Sir, I take Telma 20 twice a day. I feel exhausted while climbing stairs, my age is 47. Is this a negative signal for heart. My resting heart rate ranger 81-87. Sometimes I get clinching sensation in lower jaw area.

Praveen Kulkarni: Without knowing your age I would suggest a stress test in you to rule out angina.

PABOLU VSS-KUMAR: Dear Dr, I am having triglycerides > 1000; with Cholesterol-387; LDL Chol-Uncountable; VLDL Chol-Uncountable. When using satins - these ranges are coming to "normal". Once I stop taking these satins, try, chol, hdl are going up abnormally.

Is there any other treatment (instead addressing the symptom) . Have I to take satin on daily basis?

Praveen Kulkarni: Your lipid profile is grossly abnormal. It warrants aggressive medication and regular follow up

Harpreet kaur: Is this necessary to take medicine for hypertension on daily basis?

Praveen Kulkarni: Yes. Untreated hypertension is a slow killer giving rise to cardiac failure, stroke, vision loss, kidney problems eventually.

Atul-Hol: I'm 33 yrs having normal hypertension 130/ 80 and sometimes 140/ 80, please suggest. Is it required to go for medication.

Praveen Kulkarni: Relax. They seem normal.

Dheeraj Ajwani: I'm 42yrs. following are results. glucose fasting: 87.2 hba1c - 5.3 per cent b12- 315d3- 36 total chl - 228.9 tri - 78.9 hdl 52.6 ldl - 167 vdl - 8.5 chdl/hdl ratio - 4.4 ldl /hdl - 3.2 uric - 7.2 Advice for me please. thks

Praveen Kulkarni: Dheeraj, Clearly your cholesterol is on the higher side.

Start aggressive lifestyle measures from today and recheck your cholesterol after three months.

kp--haran: My brother 66 years old had a minor attack a week before. Angio result shows right side of heart is 100 per cent block and left side has 70 per cent.

Is it ok to go in for Chelation therapy or any other method for cure. Thanks in advance. Regards, Haran

Praveen Kulkarni: "Alternate therapies" are not scientifically tested and are hence not standard of care.

kishore deshpande: I am 48 years, male and my BP generally is 145/95, but after jogging for around 40 minutes, it comes to 110/70. Is this normal?

I am preparing for Half Marathon. What tests do you suggest I should take. Regards.

Praveen Kulkarni: Exercise usually causes systolic BP to go up and Diastolic BP to come down.

However, you must keep normal BP fluctuation in mind before getting worried. If you are planning to participate in marathon suggest a detailed cardiac assessment.

mk saxena: 65 F, 5'1", Diabetic 3 yrs. 18 months ago undergone CABG. Currently on Glimy M, Carbophage XR 500, Prolomet R-50, CTD 12.5, Ecosprin gold20.

I am told to walk as much as I can but I am not having energy for it. Frequent Coughing bouts are troubling me a lot, could it be due to Prolomet R-50. If so what can I do to get relief from coughing. Please advice.VS

Praveen Kulkarni: Do a pulmonary function test and a 2d echo and see your cardiologist.

Amit Adhikari: I am 40 yrs old having hypertension and anxiety issue, taking Ciplar LA 40 and Amodep 5 once a day for the last 10 yrs and maintaining systolic pressure of 130 with these medicines.

My doctor has recently changed my medication to Metosartan 50 twice a day bcz my systolic went to about 140.

I feel Metosartan 50 twice a day is little higher, What is your opinion ?

Praveen Kulkarni: It will be difficult to advise regarding dosages without examination

namrata malani: I am 33 yrs old women, BP is perfectly fine. Height 5.6 and weight 74. I am having chest pain followed by pain in arms and hands.I was in lot of stress.This is happening frm last 1 month. I have 2 kids. I am a working woman.

Praveen Kulkarni: Symptoms don't seem like heart related. Adopt de-stressing measures like yoga, meditation etc.

Nayan Sheth: Dear Doctor,I m Nayan Sheth, age 62 years and under supervision of cardiologist since last 3 years as I'm getting tired fast more particularly while climbing staircase.

I have no chest pain whatsoever and all other related blood tests are normal. Nuclear Stress Test is also negative.

Taking BP and cholesterol medicines for three years. Pl advise how to reduce tiredness.

Praveen Kulkarni: Your heart seems to be normal. look for other medical causes for tiredness.

Suhail Khan: Dear Doctor I sometimes feel my heart is beating very fast .. After some time it becomes normal. It happens mostly after taking the meals .. Please advice

Praveen Kulkarni: Try getting an ECG during your palpitations.

Lourdes Baptista: I am 62 years of age. Have suffered a heart attack when I was 60 because of two blocks and have now two stents. I was informed that my heart is functioning at 35 per cent.

Recently I did an ECHO and was informed that my heart is functioning at 20 per cent and that I may have suffered another episode. Any way of improving the heart functioning especially the left ventricle. Thanks

Praveen Kulkarni: This situation is called as post MI heart failure. Series of measures including optimization of medicines, salt and water restriction is advised.

Usually we recommend ischemia testing in the form of stress nuclear imaging/ stress echo to see for any potential reversible element.

laxman-s-rapolu sattayya: Hi, I am 33 years, i drink twice a week, whenever i drink same night I feel vibration in my chest and some time conjection in chest . what is exact cause for the same?

Praveen Kulkarni: Alcohol. Good time to stop it.

gopal singh: I am 34 years old and my BP is very high in this age. My weight 85 KG and height 5.6''.How i am control it?

Praveen Kulkarni: You are clearly overweight for your height with a BMI of around 31kg/mt. sq.

You begin by losing weight and keeping a tab on your blood pressure readings. target a BMI of less than 25.

Chander Malhotra: Is it advisable to undergo an Angioplasty every 5 years or so whether or not there are any symptoms of any feeling related to the heart and not going through other prior procedures like stress test etc.

Praveen Kulkarni: Angiography is a minimally invasive test.

It is done by trained cardiologists at equipped centres only at the discretion of the cardiologist. All and sundry are not required to undergo "routine" angiography.

kamala jain: good morning doctor I have done my angioplasty in 2010 but yet my ecg and stress test show the ischemia from 2010 till date the cardiologist says its o k the ecg is stable do I need further investigation and why does this happen

Praveen Kulkarni: As you have no new symptoms stick to your cardiologists's advise.

SANJAY PATIL: Hello doctor, I am 44 yrs old had angiography and angioplasty with one stent. I have reduced my weight around 13 kg and working out for some more kgs.

I am curious to know will this stent have any problem with the normal life span or any health problem in future,do i have to be on medication whole life ?

Praveen Kulkarni: Medications are for your life. With increasingly better quality stents and the technical know how, the chances of re-blockage within the stent is around 3 per cent. But the risk of a new blockage will always be looming large and this warrants regular meds and life style measures.

Srinivasan Venkataraman: Doctor I am taking dplatt 75 mg in the afternoon, astin 5 mg in the night, telpress 20 mg in the morning.

How long i should take this because i have skin white spots some say it is autoimmune due to in take of deplatt. please clarify sir. I am 66 yrs old. regardz venkat

Praveen Kulkarni: Visit your doctor / dermatologist to confirm whether the drugs are causing this.

pradeep sipani: I have 40 to 50 per cent blockage in rca it is advicable to go for stents

Praveen Kulkarni: Stenting or intervention is usually advised for blockages more than 70 per cent in a major coronary artery.

Border line or inconclusive angiography usually demand advanced imaging like IVUS or FFR.

vineet sharma: hi, I had an angiography and angioplasty I have a query is there any procedure to check how much blockage is there in the stent.

I am very young and out curiosity wants to know. Moreover, any thing which I can do to prevent any further destruction. Please guide

Praveen Kulkarni: In asymptomatic patients post angioplasty/ bypass surgeries we usually advise some form of stress testing e.g. treadmill test, stress echo etc.

Rabinarayan Mishra: hi, I'm 42 year female, height 5'6'', weight-65kgs. I've varying blood-pressure from normal of 120/80 to 160/100.

I do aerobics and walking everyday. What needs to be done further to control my BP?

Praveen Kulkarni: For marked fluctuations in blood pressure readings I would suggest a 24 hour ambulatory bp monitoring.

This will confirm the exact pattern of your readings and guide further management. This facility is available at most of the cardiac centres.

mahesh chavan: hello sir I'm 39 my BP is normal but there is one extra heart beat after 7 to 8 heart beat, my local Dr. told me its normal dont worry just do regular walk and ur work

Praveen Kulkarni: Your doctor is right, occasional skipped beat is a common finding. Make sure you limit your intake of beverages/ colas and avoid smoking.

LALIT KUMAR: I am feeling a dry throat and in the night sometimes my breathing gets obstruct which cause me to sleep. Are these symptoms indicating towards any problem related to heart??

Praveen Kulkarni: These symptoms do not seem to be associated with the heart. However, do visit your doctor for complete evaluation.

Tanmaya Panda: Good morning doctor. There was a RFA done on slow path way in 1996 when I was 24 years old.

After that I do not have any heart related problem and a healthy man.

Since it is already 20 years and I am getting older what would you suggest to keep my health well.

Praveen Kulkarni: RFA is done for the rhythm problem of the heart.

You do not otherwise stand at a higher risk for "heart attack."

However mentioned in the previous queries do ensure to take care of the potential risk factors.

Sandeep Naik: Hi doc,had my angiography and plasty done before 8 years. Wat are the chances of blockage reoccurring and precautions to be taken. Am 47 years of age.

Praveen Kulkarni: Sad to hear you had to undergo intervention so early in your life.

You need to continue blood thinners (anti-platelets) and cholesterol lowering meds (statins) for the rest of your life.

Good control of cardiac risk factors like smoking, physical inactivity, diabetes, high BP and cholesterol must be ensured.

Srinivas Donkada: Hi Sir, is it true eating garlic daily will help in reducing the chances of getting heart attacks.

Praveen Kulkarni: There are many dietary factors that have proven to reduce cholesterol among them garlic is one of them.

saurabh savant: Good Morning Doc. Please advise routine heart health checkups for my father who is 68 yrs old.

Praveen Kulkarni: The following basic tests are usually advised in this age group -- blood sugar, lipid profile, renal profile, ecg, 2d echo, stress test, after a detailed evaluation by cardiologist.

jaishankar mishra: How to control cholesterol without use of medicine!

Praveen Kulkarni: Lifestyle modification is the broad term used for this.

It includes strict dietary restrictions including limiting trans fatty acids, regular exercise (30-40 mins each day), weight control and regular health-checks should help you in keeping it under check.

Mahima Das: Pls share some tips on how to prevent a stroke.

Praveen Kulkarni: We refer to stroke when someone has sudden occlusion of blood supply to the brain. It's different from heart attack.

The risk factors for stroke however overlap with those of heart disease.

Nitin Joshi : Is it true that cholesterol leads to heart attack?

Praveen Kulkarni: Cholesterol is one of the strongest risk factors for heart disease.

High cholesterol levels are asymptomatic. Regular check-ups usually picks high chol. levels.

Untreated, it gives rise to progressive blockage in the blood vessels of the heart. This causes heart attack eventually.

Riyaz Sheikh: How to identify a cardiac arrest and what first aid should one give before getting an expert?

Praveen Kulkarni : Cardiac arrest refers to sudden stoppage of the heart which is usually due to heart attack.

Any chest pain, breathlessness, sweating, radiation of pain in the shoulders and arms, loss of consciousness should make us think of cardiac involvement.

Rush the patient to immediately to a equipped tertiary care centre.

Aspirin commonly available as disprin (1/2 tablet) should be popped up immediately. Good morning doctor. I am 48 and have high blood pressure. How can I take care of my heart? Pls advice.

Praveen Kulkarni: High blood pressure is one of the commonest cause for heart failure and stroke.

It is usually asymoptomatic in its early stages. regular checks targeting BP< 140/90 mm Hg must be ensured.

If on medications, do not stop without doctors orders. regular exercise, weight reduction and salt restriction will help in the long run

Lead image used for representational purposes only. Image: Gabriela Pinto/Creative Commons

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