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Heart Talk

Heart maybe just the size of your fist, but it controls your life. Dr. K.K.Aggarwal throws light on a few most important heart facts which everybody should be aware that nobody is caught unawares when it strikes!

The 20 heart facts you ought to know!

1. What is the function of heart?
Heart is a muscular organ the size of a fist, beating one lakh times a day (60 beats per minute). It supplies oxygenated (pure) blood to the whole body.

2. What is heart attack?
Heart is dependent for its own nutrition on the coronary flow (3 channels supplying blood to the heart). Blockages in any of these arteries (the channels) will reduce the blood supply to the heart-causing angina. Patient at this stage will get chest pain on exertion. When the blood supply through one of the arteries is totally blocked by a clot, it is called heart attack.

3. What are the warning signals of heart attack?
Patient often presents with pain, burning or discomfort in the centre of the chest with or without sweating, breathlessness and/or pain radiating to the left arm. Pain often persists for more than 20 minutes.

4. What should be done when is suspected to have a heart attack?
Chewing a tablet of aspirin reduces the chances of death by 20%. Rushing to the hospital without delay and receiving a clot dissolving medicine within 3 hours of the onset of chest pain can reduce the chance of sudden death by another 20%. Irrespective of whether medicines are available or not, the patient must be calmed and arrangements made for rushing him to a hospital.

5. What are the conventional risk factors for development of heart attack disease?
Uncontrolled blood pressure and diabetes, high cholesterol, active and passive smoking and unmanaged stress.

6. What is a Cardiac Metabolic Syndrome?
It represents a number of reversible life style induced metabolic abnormalities typically seen in Indian population. If not managed in time, these abnormalities can cause heart attack and liver damage.

7. What are the abnormal parameters in cardiac metabolic syndrome?
1. Fasting blood sugar more than 110 mg%.
2. Fasting triglyceride levels in the blood more than 150mg%.
3. HDL (good) cholesterol levels less than 40mg% in men and 50mg% in women.
4. Blood pressure more than 130/85 mmHg.
5. Waist circumference more than 40 inches in men and 35 inches in women.

8. What is potbelly obesity?
When the fat is abnormally deposited in the abdomen, it is called potbelly obesity. Here, the overall weight of the person may be normal. It is also called couch potato obesity or central obesity. These patients do not metabolise fat in the vessels supplying blood to the heart or to the liver.

9. What are other associated abnormalities with a cardiac metabolic disorder?
Abnormal levels of liver enzymes (SGPT) and a high uric acid level in the blood.

10. What is the significance of high uric acid?
A high uric acid level in the blood may lead to a disease called gout in which there is painful swelling and redness in the base of the great toe. Often these patients are without symptoms and do not suffer from clinical gout. A level of upto 10 mg% may require drug treatment. If the levels are high, person will need to reduce consumption of spinach, tomato, alcohol and fermented food.

11. What is the significance of raised SGPT level?
It indicates some damage to the liver cells. If SGPT is high then detailed liver functions will need to be done including ultrasound of the liver for fatty infiltration. Often these patients (with cardiac metabolic syndrome) are non-alcoholics.

12. What is the cause of raised SGPT in patients with cardiac metabolic syndrome?
Raised levels of triglycerides are responsible for deposition of fat in the liver. It is similar to the fat deposition in the abdomen. This causes an inflammatory reaction, causing damage to the liver cells. If the liver enzymes are persistently raised, the person can develop a condition called NASH (Non Alcoholic Steato Hepatitis). It is a serious condition and can end up with permanent damage to the liver leading to cirrhosis.

13. What is cholesterol?
Cholesterol is a wax like substance essential for the body. However, if the levels of cholesterol are high, it can cause deposition of fat in the channels supplying blood to the heart and other organs. One percent increase in the levels of cholesterol can increase the chances of heart attack by 2%. The levels of cholesterol should be kept below 200 mg% in the blood.

14. What can cause increased cholesterol?
Elevated cholesterol levels can be caused by several factors, including hereditary, a diet high in saturated fat, being overweight, being sedentary, advancing age and male sex. Of these causative factors, heredity, age and gender cannot be controlled. The other causative factors can be controlled.

15. What are the types of cholesterol?
Cholesterol or lipid profile measures five different types of cholesterol. These are total cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol and triglycerides.

16. What is HDL cholesterol?
HDL stands for high density lipoprotein and is a good cholesterol. More the level, less the chance of heart attack. Anyone whose HDL level is below 40 mg/dl should consider taking steps to increase their HDL. This is the case even if total cholesterol and LDL cholesterol levels are within the normal rage. HDL acts as a "vehicle". It "scours" the walls of blood vessels and cleans out excess cholesterol. Thus, the cholesterol being carried by HDL is actually "bad" cholesterol that has just been removed from blood vessels and is being transported back to the liver for further procession. Apparently, unlike some bad humans, bad cholesterol can be rehabilitated.

17. What measures can be used to increase HDL levels?
Regular aerobic exercises (any exercise, such as walking, jogging or bike riding, that raises your heart rate for 20-30 minutes at a time) increases the HDL levels. Obesity results not only in increased LDL cholesterol, but also in reduced HDL cholesterol. If you are overweight, reducing your weight should increase your HDL levels. If you smoke, giving up tobacco with result in an increase in HDL levels. If you take alcohol, one or two drinks per day can significantly increases HDL levels. More than one or two drinks per day can lead to substantial health problems including heart failure. Monounsaturated fats such as canola oil, avocado oil or olive oil and in the fats found in peanut butter can increase HDL cholesterol. Soluble fibres are found in oats, fruits, vegetables and legumes and result in both a reduction in LDL cholesterol and an increase HDL cholesterol. For best results, at least two servings a day should be taken.

18. What is triglyceride?
It is a type of cholesterol. The level should be kept below 150 mg%. Indian typically have high levels of triglycerides and low levels of HDL.

19. What is LDL cholesterol?
LDL or low-density lipoprotein is a type of bad cholesterol. Lower the levels better the heart protection. In Indian population, the level should be kept preferably less than 100 but definitely less than 130. When LDL cholesterol levels are too high, the LDL tends to stick to the lining of the blood vessels, leading to the stimulation of "atherosclerosis," or hardening of the arteries. Atherosclerotic "plaques" causes narrowing of the arteries and lead to heart attacks and strokes. Therefore, elevated LDL cholesterol levels (and since most cholesterol is from LDL, elevated total cholesterol levels) is a major risk factor for heart disease and stroke.

20. What about the association between triglycerides and HDL cholesterol?
It is evident that whenever triglycerides increases, HDL cholesterol decreases. Recent evidence strongly suggests that an elevated triglyceride level is a significant risk factor for cardiac disease - especially when it is elevated as part of the "metabolic syndrome," sometimes called Syndrome X.

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