Rajiv Agarwal Cardiology Clinic

Hi,

I am Dr. Rajiv Agarwal, Cardiologist. Aaj mai aap se baat karunga heart attack ke baare mein ki aam vayakati ko heart attack ke baarein mein kya jankari honi chaiye. Kyuki jaisa aap sab jante hain ki ye ghatak bimari ho sakti hai. Khas toor se India mein ye bimari badhti ja rahi hai. Humein kaise pata chale ki humein heart attack hai ya humein heart attack hone ki sambhavana hai. Heart attack ka kaise pata chale ye sabhi jaante hain ki agar aap ko tez dard ho sinne mein, crushing type ka pain ho jo baayein haath ki taraf jaaye, pasina aa raha hai toh ye heart attack ho sakta hai.

Aisi condition mein log Dr ki salah lena pasand karenge. Kayi baar heart attack ke symptoms asadharan hote hain. Typical symptoms nahi hote. Kabhi kabhi halka dard ho sakta hai. Jaruri nahi hai ki pain left side ho, right side bhi ho sakta hai. Kabhi kabhi pain neck mein ho. Kabhi kabhi nabhi se upar pain ho. Dard ki location kafi vistirit ho sakti hai. Agar pain hai lekin uska koi karan nahi pata chal raha toh humein heart attack ko sochna chaiye. Kayi baar heart attack bina dard ke bhi aa sakta hai. Kayi baar ye old age, mahilaon mein ho sakta hai. So, 10-20% of people who are elderly diabetic, especially in women can have a heart attack which is completely painless. Aise mein aap ko ek dum se ghabhrahat ho sakti hai, thanda paseena aa sakta hai, dhadkan tez ho jaaye, vomiting ho, chakkar aaye, even behoshi ho sakti hai, aisi situation mein heart attack ye ho sakta hai. Iske liya diagnosis karayein.

Silent heart attack mein aap ko koi symptoms nahi honge. Baad mein ECG karane mein ye pakad mein aa sakta hai. Aisa 5% and diabetics mein bhi hota hai. Heart attack ka pehla lakshan hi sudden death ho sakta hai. Aise cases mein bhi humein prevention ke liya jana chaiye. Isliya agar aap ko lagta hai toh aap ko medical attention immediately lena chaiye. Sabse pehle aap ke ghar mein aspirin ki medicine honi chaiye, paani mein ghol ke use aap lein jis se kayi logon ki jaan bach sakti hai. Dusra aap ko ye pata hona chaiye ki aap hospital kaise pahuchenge. Hospital ka emergency number rakhiye. Aap ek planning kar ke chalien jismein financial planning bhi hoti hai.

Aksar log treatment isliya nahi lete ki kharcha bahut ho jayega. Lekin humein puri tayari rakhani hai. Aaj kal treatment bahut advance ho gaye hain. Agar aap time pe treatment lenge toh aap ka ilaj ache se ho sakta hai. ECG karana bahut jaruri hai. Kayi baar log ye baat nahi samajhate hain aur jis wajah se unka nuksan ho jata hai. ECG ke alwa cardiac enzyme hota hai and vo bhi ek blood test hai. Ye simple test and Dr kabhi kabhi use repeat karenge. Agar confirm hai toh angiography uplabadh hai. Aaj ki date mein humein heart attack plan karna chaiye. Iska sahi upchar karein toh hum apne jeewan ko surakshit rakh sakte hain.

Thank You!

Hello friends,

I am Doctor Rajiv Agarwal. today I am going to talk to you about some advances which are there in the treatment of valvular heart disease and I think the general public should also be aware of this that what new facilities are now available to treat disease which has sometimes been considered to be inoperable and very dangerous to life.

So as you know that the most important heart disease that we keep talking about is a heart attack, which happens because of blockage in blood vessels. In addition the heart also has four valves, which handle the flow of blood which goes to the entire body, two on the right side of the heart and two on the left side of the heart and disease in these valves could be considered to be the second most important heart disease, so these valves can have disease which ranges from a narrowing of the valve opening which leads to back pressure, to severe leakage of the valves. In either case, there is a problem of the forward flow of blood and it leads to problems which might be troublesome to life-threatening.

So the main two valves we will talk about will be mitral valve and the aortic valve and in many cases we are able to treat disease in these valves without surgery, so in regard to the mitral valve, balloon dilatation of the mitral valve has been around now for more than two decades and in fact if there is narrowing of the mitral valve, so-called mitral stenosis then the first treatment which we offer is a balloon mitral valvotomy and this procedure is highly successful.

In some cases where the valve is extremely damaged, often it happens in elderly people, in redo procedures, in that case, we may have to go for an open heart mitral valve replacement, otherwise we are able to handle this in a safe and economical manner by doing balloon mitral valvotomy which is done in the cardiac cath lab.

More recent is the increasing problem of aortic stenosis. Aortic valve is the valve which takes the blood from the heart to the entire body and with increasing age the incidence of narrowing of the aortic valve has been increasing and often these people by virtue of being elderly, by virtue of having many other diseases they are considered to be very high risk for surgery, they may be having associated lung disease or even other associated heart problems which makes it nearly impossible to do a safe open heart surgery for them.

Plain simple ballooning often does not work for the aortic valve because often these valves are highly deformed and calcified, so now help is at hand we have advanced in technology whereby artificial valve can be inserted into the aortic valve in a completely non-surgical method called TAVR (Transcatheter aortic valve replacement) or TAVI(Transcatheter aortic valve implantation). So big catheters are placed usually through an artery in the thigh and under the guidance of X-Ray the catheter is passed up to the patient’s aortic valve position in the upper part of the chest and this valve is deployed under X-ray vision and this is a highly successful procedure.


It is technologically demanding and it requires collaboration between the cardiologist and cardiac surgeon as well as a radiologist. We often have to take the help of our kidney specialist and nephrologist also in order to get a safe procedure with minimum dye usage, but the fact is that something which with open heart surgery carries a risk of 25-30% we are able to do at a risk of hardly 2% by doing this transcatheter aortic valve implantation procedure. Cost no doubt is more than with the surgical procedure but these costs are also coming down with more and more innovation.

So I think many of our no hope valvular heart disease patients should consider this and certain other techniques whereby we can save the lives of many of our patients. So thank you for your kind attention, have a good day.
 

Namaskar,

Me Dr. Rajiv Agarwal, Cardiologist. Aaj me apko btaunga heart disease ke bare me. Me apko btaunga ki kaise pta chal skta hai ki heart disease ke chances hain and ise kaise prevent kia ja skta hai. Heart attack, stroke inse jyada important health issues ho chuke hain. 80% of heart diseases are due to our lifestyle. Aap simple 7 rules follow kren.

1. Physical activities. Regular exercise kren.
2. Blood pressure and blood sugar maintain rkhen.
3. Maintain healthy weight.
4. Avoid smoking, alcohol and tobacco use.
5. Reduce your bad cholesterol level.
6. Maintain you mental health like stress management.
7. Maintain a healthy lifestyle.

Apni family ki health ka bhi dhyan rkhen. Heart disease detect krne ke lia blood test kra skte hain. Echo krva skte hain. Coronary angiography kra skte hain. Angioplasty bhi kra skte hain. Isme hum stent use krte hain. Agar kbhi bhi apko koi health issue dikhta hai to Dr se immediately consult kren.

Thanks!

Namaskar!

I am Dr. Rajiv Agarwal. I am senior director of cardiology at the Max Smart Super Specialty Hospital in Saket New Delhi. I will be talking to you today about heart disease and its prevention. Koi shak nhi hai ki aaj ki tarik me hiredya rog no.1 killer gina jata hai. It is the most dreaded health problem today. It can strike people in the prime of life. Apparently healthy people can suddenly have a problem and har ek ko pta hai ki uske circle me kbhi na kbhi kisiko koi asmik aisa heart attack ho gya ya even nidhan ho gya, to islia har koi iske bare me chintit hai. To sawal ye uthta hai ki kya ye chiz hmari genes me hai. Agar hmari genes me hai to hum kuch kar nhi skte. Hum to kehte hain ki ye to hoga to hoga.

Dusra ye hai ki hmare bhagya me likha hua hai. Ye bhagwan ki den hai. It is an act of God. Lekin vaigyanik tathye ye kehte hain ki aaj ki date me 80% hirdya rog ko hum predict kar skte hain. Hum ankda lga skte hain ki hirdya rog hoga kin hi. Or sath sath simple tarikon se uchit Jeevan shaili se or simple treatment se hum hirdye rog ko rok bhi skte hain. Ye kewal me nhi kehta. Ye kayi anusandhan hue hain. Lot of investigation has been done. World health organization has a position statement on this saying that 80% of disorders like heart attack and stroke can be predicted and prevented by simple measures. So, this is something which is the duty of the medical community to communicate to the public at large. And it is but natural that public would follow if it is effectively communicated.

To hamara daitva hai ki hum apko btayen. Or aap apni jeewan shaili agar achi hai to usko or acha krne ki koshish kren or jo kamiyan hain usko dur kren. Abhi kuch ankade aye the ki hyadatar Hindustan me physical activity ka level bhut hi kam hai. To ye sari chizen hain jinpe humko goor krna hoga. To isko hum ek concept de skte hain jisko kehte hain life simple 7. Ye American Heart Association has started this moment. So, you need to answer 7 simple questions which do not require any special knowledge. And base on that you can predict you risk of heart disease and it tells you what to do to improve it. Not only heart attack but brain stroke, heart failure even cancer and depression are considered o be lifestyle related disorder. So, ye jo jeevan shaili se taluk rkhne vali jo bimariyan hain, non-communicable diseases, ye sari jo hain hum apni jeevan shaili k map dand se inko parkh k keh skte hain ki hum kis level par hain.

To isme sabse pehle point to apki physical activity ka aat hai. Are you physically active. If you are doing at least 15 mins of moderately vigorous activity everyday than you can give yourself 2 points. You are doing none than you can give yourself zero point. Next you can look at you diet. To aap healthy balance diet kha rhen hain ki nhi. Healthy balance diet ka mtlb bilkul fat free nhi hai. Isme apko sare food products lene hain. Khane me protein ki matra achi honi chaiye. Thoda bhut tel or ghee lekin dalda nhi. Sugar or nama ka sewan jhan tak ho apko kam krna hai. Quki ye apki risk ko badhate hain. Fruits, vegetables or nuts, ye sab apko lene hain. Fast food, samosa, kachori ye sab apko avoid krna hai. To aap healthy diet le rhen hain. Teesre apka vajan kaisa hai apki height k mutabik. Iske bhi kayi ankade hain. Isko hum body mass k index ke taur pe dekh skte hain. Apka blood pressure kaisa hai.

Ye to apko napna hi pdega. Apka blood sugar kaisa hai ye bhi napna pdega. Kayi logo ko pta bhi nhi hota ki unhe diabetes hai. Apka cholesterol kaisa hai. Aakhiri jo point hai or abhi tobacco diwas bi hua tha. Jisme btaya gya tha ki duniya bhar me 70 lakh logon ki mrityu har saal preventable mrityu ho rhi hai. To tobacco har rup se apke lia nuksan deh hai or jaan leva ho skta hai. Chahe vo heart disease se ho ya cancer se ho. To tobacco in every form, be it cigarette, be it biddi, gutka, kheni, paan masala or even the latest trend of e-cigarettes is all bad. These are to be avoided at all cost. So, with the 7 simple points, aap bhagya ko kosne ki bjaye aap bhut kuch kar skte hain. Apni life ki quality bhi achi rkhen usi se apki life aage badhti hai. Enjoy the journey which is called life.

Thank You!