Ischaemic heart disease

What is silent Ischaemic Heart Disease

Some times it may happen that you have gone to a doctor for routine heart check up but you do not have any chest pain or previous history of heart disease and after doing ECG your doctor tells you that you are having heart disease. Sometimes ECG may be done for other reasons like preoperative risk stratification or to fill up insurance company protocol or reemployment check up or during annual confidential report time and it is found that your ECG is abnormal. If you do not have any chest symptoms but your ECG reveals abnormality, you must have a thorough cardiac checkup. If you do not have chest pain it does not mean that you can not have block in your coronary artery. Some people in spite of having block in heart circulation do not have chest pain. This means that you have disease but your “warning system” is defective. Silent ischaemia is one of the causes of sudden death. Why some patient get severe pain and other do not is not well recognized. But probably it is due to the variability of individual pain threshold. Pain threshold varies from person to person. Some are afraid of taking a simple injection but some can stitch there own wound him. Possibly some patients do not have angina in spite of having significant ischaemic changes in ECG.

          If your ECG is abnormal it does not always mean that you are having blocked but it is a genuine called normal variant ECG (that means functional deviation from the normal status). Even then if you're ECG is found to be abnormal at routine check up, you must undergo adequate examination to exclude or to establish coronary artery block. You must remember that a fire may remain hidden under ashes for a long time but it may burst at any time. So, beware of it and do not neglect.

Effects of Smoking Cigarettes

Smoking kills the heart

Cigarette smoking is one of the major public health hazards in the developed and developing countries. It has been estimated that a 25 years old male who smokes twenty cigarettes per day will shorten his life by 8-10 years compared to his non-smoking counterpart. Others evils such as cancer and lung diseases aside, smoking are one of the most important risk factors of coronary artery disease (CAD). Epidemiological studies in USA showed that; overall age adjusted 6-year risk of CAD death was 2.3 time higher for cigarette smokers compared to non-smokers. As for the females, smoking and use of oral contraceptives carried a joint impact of a ten-fold increase in CAD compared to their counterparts.

The damage from smoking is ‘dose related’. Pipe and cigar smokers were said to have less propensity to heart disease while use of efficient filters were thought to reduce the risk of smoking. But the only certain way to protect your heart is to quit smoking! Remember, when you quit smoking, you spare the “passive” (involuntary smokers who work in the same office with the smokers, spouses of smoker etc.). Passive smokers are also prone to develop heart attack, lung cancer etc. The good news is that you could reverse many of the adverse effects of smoking by quitting now. Within 2 years of quitting smoking, the heart attack risk is reduced to half that in smokers. Within 10 years, the risk of heart disease is the same as that in non-smokers. Quitting smoking now greatly reduces serious risk to your death.

Kicking out the smoking habit does not come easy. Determination is the most important factor to success. Set an auspicious date to quit smoking and tell your close friends (particularly the smoking ones) and relatives about it to enlist social support. List the long-term health benefits of quitting smoking, and if this seems too remote think of the immediate rewards such as cleaner breath and improved stamina and money saving. Many people who succeeded in kicking smoking began to gain weight. They regained their appetite, and tended to snacks when they carved for cigarettes. So keep a stock of low- calorie snacks on hand when you watch TV or read. Others turn to regular exercises to over come the craving.

The are a variety of interventions to reduce smoking. On an average, about 5 percent of smokers will discontinue the habit for 1 year after receiving a physician’s advice, although the rate of quitting will be higher in more highly motivated cohorts. Nicotine gum or trans dermal patches may increase the 1 –year likelihood of smoking cessation by 30 to 100 percent. Nicotine withdrawal can be managed by tapering cigarette smoking, gradually changing to lower nicotine cigarettes and substituting chewing of nicotine gum. Nicotine gum is prescribed as needed, up to 30 doses per day. The average patient uses 10 doses per day and the frequency of dosing declines over a 1 to 3 month period.

The association between hart disease and smoking is well known to lay public. Myocardial infarction (heart attack) or  by pass surgery is a sufficient impetus for 20 to 60 per cent of patients to stop smoking.

Group counseling can increase rate of quitting. Public programs also are effective, with television advertisements against smoking among the most cost effective.

Stop smoking right now. 

Exercise in the morning for Heart

Exercise but when, Morning or Afternoon?

The time of onset of myocardial infarction (heart attack) and other ischaemic heart events and arrhythmic episodes (irregularities of heart) display a circadian rhythm (variation of time of occurrence) with peak occurrence in the early morning between 6 am and noon. This may be related to morning surges of hormone cortisol, increased blood level of catecholamine and greater platelet agreeability that occurs in the morning as compared with the afternoon. Since exercise may also precipitate ischaemic heart events, it has been postulated that it is safer to exercise in the afternoon than in the morning. But there was no statistically significant difference between the risks of exercising in the morning vs. the afternoon. The risk of untoward cardiac events during regular exercise is low in patients with heart disease, whether they exercise in the morning or the afternoon. Data suggest that the answer to the clinical question of when patients with heart disease should perform regular, sub maximal exercise is clear: AM and PM are both safe.

Health benefits of Exercise

Exercise has got the following health benefits

1.  Caloric expenditure and total time of physical activity are associated with reduced cardiovascular disease incidence and morality.

2. There is a dose-response relationship for this association.

3. Regular moderate physical activity as short as 8 to 10 minutes, totaling 30 minutes or more on most days provide beneficial health and fitness effect.

A number of physical and social environmental factors can affect provide encouragement, or be companions during physical activity. The environment often presents important barriers to participation in physical activity, including a lack of bicycle trails and walking paths away from traffic, inclement weather and unsafe neighborhoods. Excessive television viewing may also deter persons from being physically active.