Sir Ganga Ram Hospital

Hi,

I am Dr. M Wali. Internal Medicine Specialist. Lybrate is serving to the doctor who is practicing in their various specialty as well as helping patients to reach to the best doctor. I congratulate Lybrate for doing this great job which is the need of the hour. Today I would like to discuss about the biggest killer of the mankind which is called heart disease. Heart is an organ of the body which never goes on leave. In one minute, it beats 72 times on an average. This is such a beautiful organ which nature has given to the heart. It never gets tired like we go to the gym and our muscles gets tired. When the whole heart pumps the blood to the whole body, it doesn't get blood for itself. It only gets the blood for itself when it relaxes and that is called coronary flow. Heart also gets influenced by different nerves, hormones, when you are running or in a fast mode. Heart is also controlled by various endocrine gland. Most of the time when we see the patient as cardiologist patient, we forget upon these lines, that is why I am talking about these. It is under influence of sleep, the day and night cycle. Those who have thyroid, their heart works double the rate of normal. Hypothyroid patients' heart works slow. Heart is also controlled by the blood pressure. We insult our heart in many ways.

We create a biggest disastrous for the heart. First of all we do not do any exercise. This is one of the major factor to prevent heart attack. We get the heart attack by feeding ourselves with high cholesterol diet and not controlling uric acid. 50% of the population doesn't know that they are suffering from hypertension. 50% go for the treatment and 50% maintain their blood pressure. Very rarely doctor talk about high blood pressure. They do not act very intelligently on blood pressure. Like orthopedic surgeons never check blood pressure. Eye doctor sends the patient to some other doctor ENT doctor highly check. First we will talk about heart diseases. Before talking about coronary artery diseases, I will tell that heart has 4 valves also. They open at the every beat of the heart. They get wear and tear. They get infected by bacteria, fungus which is very common known disease. Later on it bites the heart. Now we have congenital diseases which by birth either deformed or infected. It may also get infected by drugs addict. Heart valves are very sensitive and sometimes they also work under pressure. Heart valve gets affected by a common person ways either they get stenosed or dilated. One can have the complication and it puts the load to the lungs. So, it affects the system like kidney, heart and lungs.

Most of the cases of these valve diseases are also preventable if they are detected in the early life. So, now it can be treated in very advanced way also. When I was studying in school, I never heard that we can also treat the patient of damaged valve at the age of 90-96. We can replace these valve by transvessel technique. We just put an additional valve and we come out. So, these techniques are evolved over the period of decade and they are recent part of valve diseases. 2nd, when valves get infected, we have to give medicines for a long time. Pregnancy is another condition where valves get affected. Valves can also rupture during the heart attack. There is a septum of the heart which keeps the pure and impure blood separate. When they have heart attack then septum also gets ruptured. Similarly, I will mention about the membrane which covers the heart and i.e. called pericardium. It gets involved very commonly in India because of a common infection tuberculosis. Sometimes, membrane gets as hard as stone. It doesn't give space to the heart to beat. Many other conditions which affects the heart. Then other pipes of the heart also gets diseases. Aorta can get the disease by birth, by the genetic disorder. Aorta can get dilated. The patients who are very tall, can get this disease. The blood starts flowing within the vessels with separate paths. This is a very fatal condition. Sometimes aorta gets dilated which we call ballooning of the heart. I am talking about these conditions because surgically it is possible to replace the aorta. These are the advancement in the heart disease treatment. We can replace valves, we can even replace valves from outside without opening the heart. So, there is a huge intervention which a cardiologist can do or a vascular surgeon can do rather sending a patient for an open heart surgery. Now, coming to the heart attack. It is very dangerous. The heart stops getting a blood supply in one or 2 vessels. Usually, it is one vessel at a time.

Left coronary artery divides into 2 coronary branches. In India, when I see the angiogram there is a disease in the left and left circumference. One of the common cause that it is related to the frequent infection. The basic crux of the disease that it damages the inner lining of the membrane or inner lining of the coronary arteries. Mainly, we talk about the cholesterol, heart attack. It can bleed, swell, platelets can deposit, acute heart attack can occur. And this can harm in many ways because coronary obstruction does not develop overnight. This develops slowly and one day it gets rupture or gets bigger or sometimes, one can have a heart attack. The coronary artery goes into the spasm. It is very commonly seen in ladies and in those who smokes. The artery gets thin and more sensitive. I am talking about smoking because it is the major prevention in stoppage of the heart attack. Smoking, high blood pressure, obesity, high uric acid, diabetes are the things which makes the person prone to heart attack. We can prevent smoking, we can reduce weight, we can control the blood pressure, uric acid and cholesterol. So, this topic is to emphasis that heart disease can be prevented. So, more focus should be done on prevention. Nowadays, everyone knows that how heart attack takes place. Everybody knows that heart attack causes death. We all know that smoking, tobacco, sleep deprivation, stress causes heart attack. So, these all can be prevented. These al can be prevented with lifestyle modification, primary or secondary prevention which can make us live healthy. And escape death from heart attack. I also get obese patients, and everyone knows that when we talk about diet and exercise, they say we will start very soon. That next day and from tomorrow never comes. We have to start right now. Heart attack sometimes does not give us time to go to the hospital. But if it can be diagnosed on time then we can do sudden interventions. We can open the blocked artery by procedure called ballooning and angiography. Sometimes, it is not feasible to put the stents if the lesions are multiple or they belong to some artery. We have to do surgery. These days a lot of money wasted on surgeries. So, what is important for the person who is seeing this video. How can we prevent the heart disease. Very simple, regulate your sleep. There should be no light in the bedroom when you are sleeping,

TV should be off and your bed should be very comfortable. And minimum 8 hours sleep is very important. We are creating a fatal thing in our heart by not sleeping well. 2nd is distress yourself by anything which you like. Relax and when I say relax, this means yoga. I would say adequate sleep, a balanced diet. I would say swimming, golf, playing cricket or whatever you like. One can relax in many ways. Or just do meditation. Next is technical expect of these. First is blood pressure. At least we should know the blood pressure number of ours. We should know when blood pressure is high and when is it normal and low so that we can take remedies. Diabetes control is again a big topic. This we will discuss next time in the video. Glucose is good for our nutrition. Glucotoxicity makes the cells age faster. It damages kidney, heart vessels, brain vessels. From head to toe, it damages everything. So, control you blood pressure and sugar. If you have high uric acid, control that also. Now smoking is the enemy of the heart. When someone has heart attack, heart ruptures. Smoking does more damage to the heart then the clotting of the blood. We don't realize it. These days the pattern of the smoking is changing. Our children starts smoking at the very early age even when they are in school. Girls do smoke. Smoking becomes habit that it becomes difficult to de-addict. And we do not get to know when are we going to heart attack. So, this is a duty to stop smoking. And young people and children should stop smoking immediately otherwise, they are going to have quick death. Then adequate exercise. When you go to the gym, your gym instructor says to do cardio. What is it? Cardio is the exercise which strengthen your heart muscles. Now, I am sitting so my heart beat is 70 and when I will go to the treadmill, it will go 140. When it goes beyond 70 then it becomes the meter of the car. So, while doing cardio exercises, we achieve the cardiac results.

This is very simple to understand and we are prepared for the war when we are resting. Armies do the exercises regularly and if they do not do, they can not handle a war. If we do not do exercises, we cannot remain healthy. What exercises means which starts from walking, running, cycling, gyming. So, do exercises not philosophy. Some people buy treatmills and 90% of them lie at home. So, we should actively do exercises. We should do yoga, pranayams, deep breathing, at the same time our lungs should be healthier. So, when we do cardio exercises, it also makes our lungs strong. Those who do exercises becomes active and intelligent and those who do not becomes lazy, tired. It also prevents hypertension, thyroid. We should prevent heart disease. Million of dollars are wasted on heart treatment. Because India is the capital of diabetes similarly we will become the capital of heart disease. Pollution is directly related to the lungs health. I see children breathing the same polluted air which we do. I feel very sad. India is the most top polluted country. Drinking water is also important. People think that RO water is good for health which is not. Many a times when we drink less water, body gets dehydrated. And then there are more chances of blood getting thicker. 10 years back we were very excited about refined oil but if you try to learn how is it made, you will hate it. Use olive oil, desi ghee. Then other thing which causes problem is food adulteration and water pollution. Because of this a lot of bad things are going in our body.

We used to have copper utensils and zinc which was healthy then it changed into stainless steel which is far better than aluminium. Sue to advancement we are also losing healthy things. So, we should be health conscious. We should be sleeping adequately. We should do exercise, yoga, pranayam, cycling, gym. We should control diabetes, blood pressure. Most importantly stop smoking as it is the biggest enemy of heart and lungs. Not only it causes cancer, it causes heart attack. I am telling you the ways how not to reach the doctor. How to stay healthy which is in your hand not in any doctor hand. You can win over on all these enemies. That is how you can have a healthy heart, blood pressure and sugar. Thank you for watching this video. The message is stop smoking, control your blood pressure, control your diet, cholesterol, have a healthy eating, do exercises regularly in whatever the form you like. These all things are in your hand. Now I say good bye to you with these golden points that if you practice this, you would not need any doctor You will have a healthy heart. Thank You.

Hello,

I am Dr. M Wali, greetings to all the viewers of lybrate.com. Lybrate is doing for the benefit of Drs and mankind. Medical work is under watch, what the doctors are doing for the patients. India is one of the best countries as far as doctors are concerned. We have lots of setups. Sometimes, it becomes difficult for patients to find a suitable doctor. Now people choose their doctors online. We are concerned about preventing diseases. If the disease cannot be cured, at least we can treat the patients. India is under the threat of various diseases. Diseases which threatened the Indian population are coronary artery disease, hypertension, diabetes, cancers, bone diseases, osteoporosis. Doctor's goal always should be to do work with perfection, dedication, devotion and should produce the best results. Sometimes I find something hidden in the diagnosis, I relocate the diagnosis. I give the treatment for lifestyle diseases as well. The beauty of the medical profession is that we can prevent these diseases. Treatment can be done if they are fully blow off. We do some modification in our diet, daily routine, avoid stress management and most of it can be prevented. My present stress is on preventing these diseases.

This is related to our lifestyle. As far as heart disease is concerned, nowadays we don't get regular heart disease. We get the more cardiac disease, heart failure, hypertension which takes a back seat. Hypertension multiplies the risk of sudden death due to coronary artery disease. So, we have to be very careful in treating blood pressure. 2/5 do not know till the time it produces complications that they are going to have diabetes. In fact, when diabetes develops, 30% of pancreas gets destroyed. We need more holistic care these days. Very important thing is that the patient walks in our chamber and he is not concerned about what I am doing as a specialist. He is concerned to get a solution to all his problems. We should give care under one roof. Holistic care is missing. My stress remains that every patient comes to my clinic or Sir Ganga Ram Hospital, I should treat patient holistically.

I take the help of a specialist and my colleagues. If anything encountered an emergency, I get them admitted. India has a great burden of communicable diseases also. We have recently have reduced the instances of tuberculosis. We have made the India polio-free. At times, when patient has very severe diabetes, they are infected, kidney damage, they have other complications like stroke, these are all preventable as I mentioned. A great deal goes for improvement in our lifestyle through yoga, exercise, regulation of eating a good diet. Avoid 3 whites like salt, sugar and ghee. Regular exercise, at least 30 minutes a day or 5 days a week can also prevention towards non-communicable disease. Yoga is a very important aspect of holistic healing. Through yoga and pranayama, we can prevent lots of lifestyle-related diseases. Apart from that, there is another epidemic which is creeping into a society which is depression.

There are various things happening in our day to day life which leads to depression. Depression makes the disease worst. So, some questions are mandatory to ask the patient while treating depression. While practicing, a thorough history is mandatory to take. Communication with the patient is mandatory. Through communication, we can treat the patient better. Poor coronary artery disease patient can be treated with counseling, yoga, exercise to save their money also. Practice the profession diligently, holistically with full dedication and become part of the patient's problem. Try to solve them. We always should be very humble, productive and patient ourselves.

Thank you very much.