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On 11th September 2007, most of the Mumbai newspapers have published news about a senior citizen undergoing third time bypass surgery in Bombay Hospital. How many times a patient can undergo bypass surgery? Is bypass surgery the final solution for coronary artery disease? Why there is no guarantee that the re-clogging of arteries will not take place after the bypass? Is bypass, angioplasty or stent are the only solution for coronary artery disease?  
On 20th June 2008 Friday 47-year-old Thane resident, Harwanshlal Panchotara, suffered a heart attack during rush hour on a local train His fellow commuters carried the man and took him to Rajawadi Hospital in an autorickshaw but it was too late and the man was declared dead soon after.
India will have 60% of world’s heart cases by 2010
A 2004 study had estimated 60 per cent Indians would be at risk of heart diseases by 2010. On Friday, medical journal The Lancet took it a step further saying it would hit them younger and harder. “The crux of the study is that Indians get heart disease at a much earlier age than the rest of the world and many more die of it here because their illness will be more severe and they don’t get treatment in time,” said Dr Srinath K. Reddy, one of the authors of The Lancet study and president of the Public Health Foundation of India.
Angioplasty 25 hours after heart attack no good, says new study
New York Times
Posted online: Wednesday, November 15, 2006 at 0000 hrs IST NEW YORK, NOVEMBER 14
Opening a blocked artery with balloons and stents can be lifesaving in the early hours after a heart attack, but a new study concludes that it often does no good if the heart attack occurred more than 25 hours ago.

The findings should change medical practice, researchers say. The researchers say that doctors should stop trying to open arteries in people who had heart attacks days or weeks ago and who are stable and free of chest pain. Currently, the balloon procedure, called angioplasty, is often used in those patients, along with stents, devices that are implanted to prop an artery open.
The Indian Express dated July 12, 2007.
DIABETIC and hypertensive patients are now exposed to new risks. In a Pune study on 300 diabetic patients above 50 years, doctors found 104 (38 per cent) had coronary artery narrowing, 150 (50 per cent) had Peripheral artery narrowing and almost 192 (64 per cent) showed evidence of cholesterol deposits in coronary or peripheral vascular arteries.
Press Releases
COLUMBUS, Ohio – With as many as 20 million Americans living with hearts that aren’t as strong as they should or could be, cardiologists at Ohio State University Medical Center recommend adding another measurement to the list of risk factors for heart disease: the ejection fraction. The ejection fraction provides a relative measure of the strength or weakness of the heart by indicating the amount of blood the heart squeezes out to the rest of the body with each beat. A normal ejection fraction is 55 to 60 percent, meaning that much of the total blood in the main pumping chamber is ejected with each beat. An ejection fraction below 50 percent indicates increased risk for congestive heart failure, the most rapidly growing form of heart disease in the country, said Dr. William Abraham, director of cardiovascular medicine at Ohio State’s Medical Center.
Don't rush into heart procedures: Study
Combo of lifestyle changes, drugs found as effective as angioplasty in less severe cases Mar 27, 2007 04:30 AM
Joseph Hall
Health Reporter
Angioplasty procedures performed on millions of North Americans are no more effective at preventing many heart attacks than aggressive medication, diet and exercise regimens, according to a major new study led by Hamilton researchers. In less threatening cases, the use of angioplasty and stents to open up partially blocked arteries should be considered only after rigorous medication and lifestyle changes have been tried, says a McMaster University cardiologist who helped lead the study.
Hindu dated July 01, 2008
Of all the causes of illness and death below 65 years of age including that of India, 48% is due to heart attack, 22% due to cancer, 4% due to accidents and 26% include infections of various kinds. However, heart disease and stroke top the list.The trend today is to have frequent simple check ups even when the person is in apparently in good health. It is even more relevant in persons in the high risk group i.e., those with a family history of heart disease, diabetes and high blood pressure Between the age of 20 and 25, there should be comprehensive physical check up as the person is now an adult, to determine basal data on height, weight, blood pressure levels and biochemical parameters of blood sugar, lipids, renal function etc. After this a regular check up once in two to five years is desirable. From the age of 40 onwards, an annual check up is recommended.
Mumbai Mirror September 17, 2008
BPO shifts give man a heart attack at 23 .Doctors suspect it was triggered by his odd working hours and poor eating habits. The case of Prashant Nawalu, a 23-year old BPO worker who suffered a heart attack on Saturday, illustrates how the average age of people with heart disease is dropping fast.

Prashant was admitted to Balaji Hospital at Byculla after complaining of severe chest pain. An angiography test revealed that he had suffered a heart attack due to 100 per cent blockage in his left coronary artery. He underwent angioplasty on Monday.
A study recently published in the Indian Health Journal says that by 2015, the number of Indians with coronary artery diseases will increase to 6.2 crore, a growth of 114 per cent in just 15 years. Of these, 2.3 crore will be younger than 40 years of age. Changes in lifestyle and stress are blamed for the worsening health scenario.
DNA.SUNDAY
Dated 5th October 2008
Briton dies at airport
The 38-year-old was waiting to board a Jet Airways flight to the UK when he had a cardiac arrest
Navita Singh
A British national who was to board a Jet Airways flight to London, died of cardiac arrest on Thursday evening, in the security hold area of Mumbai airport. His body has been sent for a post mortem, and will be flown to his family in the UK next week.
Dryan Kitchner, 38, died in Terminal 2B in Chhatrapati Shivaji International Airport. He was to board the Jet Airways Mumbai-London flight, 9W120. After completing all immigration and other formalities, he was sitting in the security hold area waiting for his flight, says a Mumbai International Airport Limited (MIAL) official. At 11.10pm, he suddenly found that he was short of breath. The airport manager then called up the airport directors for help, who rushed doctors to the security area. They found Kitchner sitting on a chair, gasping for breath.
DNA dated 22nd October 2008.
Western diet blamed for 35% of heart attacks globally
Washington: Diets worldwide those are rich in fried and salty foods increase heart attack risk, while eating lots of fruit, leafy greens and other vegetables reduces that risk, a groundbreaking study showed.

The study, called INTERHEART, looked at 16,000 heart attack patients and controls between 1999 and 2003 in countries on every continent, marking a shift from previous studies which have focused on the developed world.

The patients and controls filled in a “dietary risk score” questionnaire based on 19 food groups, which contained healthy and unhealthy items and were tweaked to include dietary preferences of each country taking part in the study.
DNA dated 7th June 2009.
Study reveals a definite co-relation between chronic kidney disease and cardiovascular problems. Apart from being genetically predisposed to cardiac problems, research suggests that the increasing incidence of chronic kidney diseases could also mean more people dying of heart problems. The correlation between chronic kidney disease (CKD) and cardiovascular problem, though rarely highlighted, has become a point worth taking note. Patients with chronic kidney disease are more likely to die from premature cardiovascular death even before reaching the end stage of renal disease.

"Excess calcium and phosphate presence combines to form bony deposits in tissues and organs and go on to block blood vessels in the heart leading to a condition called cardiac calcification." "In such cases, mortality is very high and patients die of heart damage even as they are fighting a chronic kidney disease,"
 
Dizziness can be an early symptom of heart attack
Cardiac chest pain is often vague, or dull, and may be described as a pressure or band-like sensation, squeezing, heaviness, or other discomfort.

Heart attacks frequently occur from 4:00 A.M. to 10:00 A.M. due to higher adrenaline amounts released from the adrenal glands during the morning hours. Increased adrenaline in the bloodstream can contribute to the rupture of the plaque that causes the formation of the clot and the eventual heart attack.

Studies have found that, at least in northern regions, heart attacks may occur more often in the winter months.

Heart attacks do not usually happen during exercise, although exercise is commonly associated with exertional angina.
Approximately one quarter of all heart attacks are silent, without chest pain. In diabetics, the incidence of "silent" heart attacks may be much higher.
 
Typical Symptoms
The typical symptoms of a heart attack are similar to those of angina, but more severe and longer lasting. The victim feels a pain that is usually squeezing or burning or feels a terrible pressure in the middle of chest. This pain may also travel up to the neck, jaw, or shoulder or down the arm and into the back.
Sweating, dizziness, weakness, and shortness of breath often accompany the pain of a heart attack. If you have chest pain that lasts longer than 15 minutes and is not relieved by rest (or by a dose of nitroglycerin), get immediate medical attention.
Immediately after you call for medical help, chew and swallow an aspirin and drink a glass of water. (Don't take aspirin if you are allergic to aspirin.) Aspirin is known to thin the blood, which helps the heart get more blood if you are, indeed, having a heart attack.
In some cases, a heart attack may cause a sensation that feels like indigestion: you get a sick, aching feeling high in the middle of your abdomen. It can cause a feeling of great weakness, or a sense that you are about to faint. (Many of the people who had heart attacks thought that they had intestinal problem instead of associating it with a heart attack.)
 
Silent Heart Attack
Heart attacks can occur without any warning symptoms. These are called silent heart attacks. Some heart attacks may be associated with "atypical' symptoms, symptoms such as heartburn, nausea, or sudden light-headedness and sweating. These are more common in women, diabetics, and people older than 65.

The primary symptom of heart attack is a consistent deep, often severe, pain in the chest that can spread to the left arm, neck, jaw, or the area between the shoulder blades. The pain may be present for up to twelve hours.

Many people who have had heart attacks describe it as a heavy, substernal pressure that makes it feel as if the chest is being squeezed. Other symptoms may include shortness of breath, sweating, nausea, and vomiting. Heart attack can also cause abnormal heartbeat rhythms called arrhythmias.
 
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