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09/Oct/2021

The topic for discussion today is myth versus reality heart disease, inflammation. And we’re extremely honored to have with us Dr. Aparna Jaswal leading senior consulatant interventional Best Cardiologist in Delhi at Fortis escorts hospital daily. Thank you so much, mam. Once again for accepting our invitation to address this cause. And now I would like to hand out the session to you to guide us further around heart disease in women.

Thank you very much. At the outset, I would like to thank you, Ben, for giving me this opportunity to be amongst your there could be no better opportune day and moments than today, considering today is the world heart day. And we are seeing a lot of activity and buzz around this day in media, today’s newspapers all around. And I think it’s vital. We discussed this because heart diseases continue to remain a very big burden of disease across the globe.

 Even more so in India, there could be no better day than today to be discussing heart disease in women. I think a lot of attention in 2021 is being given to heart disease in women in general. And today is a special day. So I think I would like to take you along with me trying to understand why we need to discuss this. The reason the most important reason is that people have this myth that heart disease is generally a man’s disease. It was always believed that women do not die of heart diseases. However, the glaring reality and unfortunate one is that heart disease continues to remain the leading cause of death in women. It is important to remember that women develop cardiovascular disease about a decade later than men. But the outcomes for women are often worse. Women do not remember themselves, that heart disease is the number one killer in them.

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Read Also:- Are Women Also At The Equal Risk Of Sudden Cardiac Death (SCD)?

This brings us to the point to discuss today that awareness is lacking. We can only achieve what we wish to if we are aware of the problem. So I will make an attempt to take you through to understand why we need to remember that heart disease in women is a big burden. Women carry the traditional as well as non-traditional risk factors. The traditional risk factors being what we see in men, diabetes, smoking, obesity, sedentary lifestyle, hypertension, and abnormal cholesterol. However, in women, they should be aware that women undergo hormonal, emotional, the drug problem that they undergo with hemodynamics when they are pregnant, all these together become even more troublesome for women. As you can see, there are issues around delivery time during the pregnancy, hypertensive disorders, diabetes during the pregnancy, there is something called autoimmune disorders, breast cancer, and of course depression. Hyper hypertension, high blood pressure is a leading cause of cardiovascular disease worldwide. This is to be remembered that women have higher mortality than men when they are hypertensive. under the age of 45, men are more likely, however, as women get older women to develop hypertension more than men. And it’s important to remember this only 1/3 of elderly women have adequate blood pressure control. Often patients come to us and ask us, doctor, will I have to take the pill every day? Well, we must understand and remember, if you have high blood pressure, it’s important to keep your blood pressure under control. Because blood pressure is a silent killer and it destroys our other organs. And the most dramatic and devastating complication of high blood pressure is stroke. Diabetes confers a greater cardiovascular risk for women than men.

Diabetic women have a higher incidence of heart disease as well as stroke. Thus, diabetes correlates most strongly with Cardiovascular Disease mortality in women than men. High cholesterol, dyslipidemia, as it is called, has the highest population-adjusted risk among women, compared with all other known risk factors for heart disease, obesity. Now, this is a problem that is more specific to low and middle-income nations, there is double the amount of obesity in women than in men, the reason being the low and middle-income nations. Because the diet, the diet is rich in carbohydrates. As a result, it makes people obese. Hence, it is important that we control obesity as a risk factor for women in the developing world. Physical inactivity, we have to remember that we must get out of our beds and hit the box and walk for at least 30 to 45 minutes every day, we must take a pledge upon ourselves as women that we must take out that much time for our own activity. pregnancy. This is something that is unique to women. And it is important that we must assess the pregnancy history for women of all ages.

The problem of pregnancy is that during the pregnancy, they can develop high blood pressure, they can develop diabetes, they can be preterm delivery, all of these put the woman at a higher risk of heart disease, depression. I think depression is something that is a universal phenomenon that can affect men and women. But surely, women have more psychosocial problems. As a result, they are more inclined to go into depression. Depression is associated with increased cardiovascular mortality, because people will not exercise, they will eat unhealthily, they will eat out of time hence there is a problem. And why do women tend to delay care? This is important. They misinterpret their symptoms. They believe that I cannot have heart disease, there is a state of denial, minimizing the perception of risk. Competing obligations don’t want to impose their problem on the family and sometimes can be embarrassed about their symptoms. Thus, it’s important that women know their symptoms. Women don’t experience heart disease the same way as men do. They have less angina, they can present very differently. What is Heart Attack: Symptoms, Warning, and Treatments. Have heart attacks among women usually are more sudden and come on with less warning. As a result, women are less likely to take that they’re having a heart attack and to seek medical care. So what are the unusual symptoms? So typical symptoms one must remember is chest pain in the center, which is constricting as somebody has kept awake and paying and go to the job or to the shoulders, at least in our arms. But women can come even differently. They can be unusual upper body discomfort, they can be shortness of breath, break out of a cold sweat, unexplained fatigue, lightheadedness, or nausea. If you have any of these symptoms, and you have risk factors you must not ignore and you must seek medical care. It is time to tell the women that we must be increasingly aware and we must remain ready to be screened so that they have knowledge of lowering the chances of getting heart disease. Rule number one look before you eat. Eat a variety of fruits and vegetables every day. Eat a variety of great products. Choose nonfat and low-fat products, less fat meats, more chicken fish, and lean guts. Switch to fat-free and skimmed milk. Dietary Guidelines as I told you, you must limit the number of carbohydrates you must limit the number of calories you must not try to drink too much of soft drinks, candies and junk food, saturated fats trans fats and this is what comes in your pizzas, burgers, pastries, cakes, chips, so this is some more sauce. This is what is saturated and trans fats. You must remember you must eat less than six grams of salt today means a small teaspoon is five grams. It should be less than that all your day. exercises. Rule number two, maintain a level of physical activity exercises daily for 30 minutes. This is extremely important. It reduces your risk of obesity increases your good cholesterol, lowers your bad cholesterol helps keep lifestyle diseases such as diabetes and hypertension at bay. Walking for a healthy heart. It has been known that those people who walk live the longest and amongst all the exercises daily walk is one exercise which has shown to last the longest. So it is a good thing if you can go to the go to gym and do it every day. However, walking is something all middle-aged women must adapt because it lasts the longest stress management manage your stress well. A very good way to do that is by doing yoga. Take a daily sleep of seven to nine hours, but must attempt to sleep on time and wake up on time. Know your numbers. This is important when we deal with cholesterol. Total cholesterol should be less than 200. LDL should be less than 100 and HDL should be more than 40 triglycerides less than 200. Get these levels tested routinely after especially once you achieve middle-aged and keep them under control. They are not difficult to get under control. If you exercise well. eat healthily seek the help of your doctor and take the right medications. Benefits of reducing cholesterol. But 10% reduction of blood cholesterol produces a 20 to 30% decline in deaths because of heart disease. So you must remember that if you are an adult, get your levels tested 20 years and above, get it tested five years later again get it tested, one must not worry about drugs, one must not worry about the result, one must test it and get it treated. Control your blood pressure. We must try to achieve a blood pressure in the majority of the time to be between 120 and 80.

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If your blood pressure is more than 130 by 90, you are labeled as hypertensive, so you must try to achieve optimal levels. How can you keep your blood pressure at bay if you don’t want to eat medicine is diet, exercise solid restriction controlling your weight? And if you need medication as per your doctor, you must take the blood pressure medications. Do not stop your medications without consulting your doctor. Do not think that I’ll have to eat for a lifetime. Because most important is to keep your blood pressure controlled. Control your blood sugar. You must remember a fasting blood sugar has to be less than 100. Post means less than 140. modify your lifestyle, diet, exercise, and weight. These are the most important things. Do not stop your medications for diabetes without consulting your doctor. Remember, if you’re a diabetic once, you will need medications for blood pressure control. You can reduce your doctor can reduce your blood pressure medications. If you exercise well eat healthily and control your weight.

I think I would like to conclude here and open the house for the discussion. And I will be happy to take some questions. Yeah, thank you so much, man, for such an informative session. We have a few questions in the chatbox man. Would you like to take those questions first?

How Can I Keep My Cholesterol Levels in Check? 

Well, the most important thing is if you’re an adult, you’re more than 30 it’s a good idea to at least get your blood cholesterol checked once. If your cholesterol is on the higher side. The simplest thing is to exercise to eat healthily. If these don’t work, you may need a pill to discuss with your Best Heart Specialist in India or your physician. And if they think it is important, you must take a pill, exercise, and die. Bring your levels down. The doctor may think that you can stop your pill. That’s how you do it. The next is our pregnant women are at risk of heart disease. It’s not that pregnant women are at risk of heart disease.

How can I keep my cholesterol levels in check

It is the hemodynamic the autonomic, the hormonal, the emotional imbalances which come with pregnancy, which can put you at risk. You can develop gestational diabetes, you can develop hypertension. So hence you can be at risk. So does my menopause have anything to do with heart disease? Yes, menopause in women has a lot to do with heart disease. When you achieve, you know, cause you are now at risk of heart disease just as your male counterparts. So if you are in a menopausal age group, you must work aggressively to take care that you don’t develop high blood pressure. You do not develop diabetes, you take care of your cholesterol levels, you work aggressively on them because now your risk of heart disease is as much as men because the protection offered by the hormones when you were pre-menopausal has gone away. 

So The Next Question is My Father Aad A Heart Attack A  Few Years Back, Am I At Equal Risk To Get it? 

This is a very good question. Strong family history puts you at risk of developing heart disease. So you should remember that if you have a family history, you need to work over zealously over aggressively to make sure that your risk factors are very well controlled. 

The Risk Factors Are High Blood Pressure 

Diabetes, smoking, cholesterol levels, and exercise. If you take care of these five things, you can push your genetics and make sure that even your genetics do not allow you to develop heart disease. The lifestyle measures that you need to adapt to avoid heart attack on exercise every day. I often tell my patients that exercise nine days a week, it implies on some days, do twice a day, eat healthily, do not have transplants, have less salt, make sure your diet is not cholesterol-rich, do not have trans fats. So if you look into these things, do not smoke. I think that’s important. Do good stress management, sleep well do not remain essentially, these are the measures that are very simple and should be incorporated in our daily lifestyle, which can keep you healthy. Are women more vulnerable in heart disease as they lack vigorous exercise? Yes. So after menopause, if women don’t look after themselves, they will be at Risk of Sudden Cardiac Arrest, because as I told you, postmenopausal women are at equal risk as men. So to think in our homes, we have our mothers, we have our grandmothers who think that they will not develop heart disease, because they’re protected by hormones, is a bit postmenopausal, they must look after themselves, too. Young hypertension, has young hypertension become more common and women when hypertension has stepped into our lifestyles, and we are seeing more and more of high blood pressure, even in school-going children. What is the reason is inactivity. So being on the computers, being on their mobile phones, not going out to exercise, eating unhealthy foods, eating junk foods, all of these, remember the food that you get from outside, a very high inside preservatives, saturated fats, and trans fats. All these things together, combined with lack of exercise, push us to develop heart diseases. So it’s a combination of all of these factors, which pushes us to develop heart disease.

Right, thank you so much, ma’am. I think we have Thank you so much, first of all, for pretty much covering all the questions which our audience has asked. And this session has been really wonderful for us. We got to know a lot of facts about heart disease in women which is really a pressing need to understand at this point in time. We would like to thank you once again for sparing your valuable time to address this noble cause of heart disease in women thank you so much from local India. And that’s it from our side.

Thank you very much. I think it is it is activities such as these that will actually bring around awareness and all of us will make a concerted effort for a healthy life in this world hearty Thank you very much.


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21/Jun/2021

 Sudden cardiac arrest(SCA) is an electrical disturbance of the heart rhythm that causes the heart to beat very rapidly, chaotic & subsequently may result in death. It generally occurs due to blockage in the blood vessels of the heart. These blockages may result in a decrease in the pumping ability of the heart (left ventricular ejection fraction). As a result of the above, or in some cases even with preserved pumping of the heart, it can cause sudden, chaotic& rapid rhythm – wherein the heart begins to fibrillate. This results in Sudden Cardiac Arrest. Quick and appropriate medical intervention can increase the chances of survival from SCA and prevent Overview Sudden Cardiac Death (SCD). Some people may experience a racing heartbeat or may feel dizzy, alerting them that a potentially dangerous heart rhythm problem may have occurred. In most cases, however, sudden cardiac arrest occurs without prior symptoms.

While the common risk factors for an SCA include coronary heart disease, smoking, consumption of alcohol, high blood pressure, high cholesterol, obesity, diabetes, and a sedentary lifestyle, SCA and SCD affect men and women differently. According to the American Heart Journal, the incidence of SCD in women is significant, but lower than in men, particularly in the premenopausal and early postmenopausal years. SCD in women is associated more with decreased heart function and myocardial fibrosis (a condition in the later stages of the cardiac disease which can be a factor for SCD) as compared to their male counterparts. There is also a recent study by the Heart Rhythm Center, USA which highlights that women at higher risk for death by nighttime cardiac arrest than men, especially in those suffering from lung disease, COPD, and those taking stress medication or anti-depressants.

How Sudden Cardiac Death Heart Diseases Affect Men And Women Differently:

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The biology and physiology of men and women are significantly different, which determines the effect of heart disease on both groups:

Cholesterol Blockages: The deposition of cholesterol in the case of men occurs in the large arteries while in women, it is in the smaller vessels. Since these vessels are small, the symptoms may not be as significant when compared to deposits in the large arteries. Hence SCA can be a silent killer in women.

Read Also:- Things To Do Every Day To Keep Your Healthy Heart

Lifestyle: Lifestyle changes have increased the incidence of heart diseases in women owing to factors such as stress, unhealthy diets, smoking, consumption of alcohol, obesity, and consumption of oral contraceptives. This has also led to younger women developing heart conditions.

Stress coping mechanisms: Men and women have different stress coping mechanisms. The presence of higher levels of oxytocin in women enables them to cope with stress hormones which increases blood pressure and sugar levels. Also, women cope with stress by emotional responses, as compared to men who often display fight or flight responses.

Experiencing symptoms differently: Men and women experience some of the heart disease-related symptoms differently. Men typically get the classic pattern of angina (chest pain by reduced blood flow to the heart) with pain in the left side of the chest, while women are more likely to have atypical angina, wherein they experience discomfort in the shoulders, back, and neck.

Prevention:

  • Leading a healthy lifestyle with a well-balanced diet and adequate physical exercise
  • Quit Smoking
  • Limit alcohol intake
  • Undergoing regular medical check-ups to monitor your heart health
  • Keep your BP & Blood sugar under control
  • Keep a check on your blood cholesterol levels
  • Avoid stress
  • Those with a strong family history of heart disease must ensure regular follow-ups
  • If you have heart disease with a lower pumping of your heart, discuss with the Best Cardiologist in Delhi about your risk of SCA since it can be prevented by timely action.

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14/Dec/2020

I’m today with you again. I’m Dr. Aparna Jaswal and from Fortis Escorts Heart Institute New Delhi. And the topic that we chose for today was that we will discuss heart attack.

At the outset, I hope you and your families are safe. And please remember that we have to learn to live with this virus. Please ensure that when you leave your home, you have a good mass, keep social distancing, and keep your hands safe.

So to begin with the topic of interest today, the topic we chose today, as we had discussed last time, was a heart attack. So before we begin to speak about heart attack, let me tell you…

 What Is It That Happens Inside The Heart Normally?

So this is the structure of the heart, the heart has four chambers, two upper chambers, and two lower chambers. We are all aware, that heart is the pump, which pumps the blood outside of the body to enter the entire body and supply blood to the entire body. It’s very interesting to know that the heart itself does not receive blood from here, but the heart has its special blood vessels.

Must Read:-

Best Overview of Sudden Cardiac Death 2020 (Part-1)

The blood vessels of the heart arise from here, and They go like this. So you can see that the heart has its special blood supply. These blood vessels of the heart run on the surface of the heart and supply rich, oxygenated blood to the heart muscle, the heart muscle is a very important pump. This heart muscle pump is the pump that is responsible for the pumping of blood to the entire body.

As a result, it must receive very good blood to itself. As you can see, it receives the best blood. As soon as the blood leaves the heart, the first blood vessels to arise are the heart blood vessels. So, the heart blood vessels received the Best blood. So, you can see these other blood vessels of the heart. As you can see on this drawing, we have three blood vessels of the heart; there is one lung vessel on the right.

And we have two blood vessels on the left. So, these are the three main blood vessels of the heart. These vessels further have small branches, but they are not as important for you to understand, you should know that there are three blood vessels of the heart and they supply blood to the heart.

So, what happens when you get a heart attack is what you need to understand.

So, if we were to open up this blood vessel, there are the numbers

The blood vessel is a smooth more structure, it is very smooth, and the black does not stick to it at all. It smoothly flows inside in one direction. What happens is as we get older or if we eat diet, which is a very high fat, or if we are genetically inclined, or if you are a smoker, and you have lifestyle diseases, such as high blood pressure and diabetes, what happens in that is that there is a breather within this blood vessel, which should be very smooth, there can be a buildup of fat and cholesterol. There as you can see, there is a buildup of fat and cholesterol as you keep leading an unhealthy life or smoker or are genetically inclined.

What is on Discarded Black?

Now, these are the blockages that form inside the blood vessel of the heart. How does a heart attack happen? What happens and can happen at any time? If you have some blockages inside your blood vessels.

What Happens to These Blockages They Can burst Why?

Divorced, they burst because it can happen at times if you have intense stress or if a back pressure suddenly increases or they can be a myriad of reasons, where this blood vessel is, this block can burst as soon as this block bursts, you should remember these small timid blood vessels, they are about three mm full mm wide.

So, when this block bursts, this whole blood vessel gets blocked, no, why does this get blocked, this gets blocked, because you are aware if you get a cut on your finger of blood clot forms. Similarly, when they cut on this, I told you the blood clot bursts, there is a clot inside whenever this clot falls, the blood which was going here, through this blood vessel is unable to go ahead, the blood vessel is cut off, there is a certain cutoff. So, what happens, you have to understand, I showed you this is the heart. This heart I told you when receiving blood, if the blood clot drops here, there is no blood, which can go and supply this muscle. As they design what happens.

You Have Phases These Types of Problems 

Supposing there is a sudden blockage of this blood vessel, you must understand we will present with sudden onset of symptoms. So understand again, that this is the heart which has four chambers, two upper chambers, and two lower chambers. And the blood vessel was supplying the heart, the blood vessels of the heart.

Now, this vessel if gets blocked, this part of the heart was receiving blood from this nervous because there will be no blood supply, there will be a sudden cry from the heart that I need help. How will the heart tell us the heart tells us a sudden onset, which is excruciating, it can be excruciating pain, sudden onset in the center of the chest, where the patient complains as if somebody has tied a band. This pain can go over your shoulders, it can come up to your jaws, it can go to the inner side of your left arm.

It can present in this way typically, it can also present in different ways, as the patient ages complained of nausea, vomiting, success and sweating or just some job a Remember, if you are faced with any such symptoms, which you have never experienced before, it is telling you the hardest telling you that I need medical attention. So let me let you again if you present with symptoms such as retrospect right in the center of the heart as if somebody has put a weight on your chest, or a band is tied across your chest wall, or the pain is relating to your shoulders, to your jaw bone on the inside of your arm. And if it lasts for more than 30 minutes, it means it could potentially be a heart attack because the heart is crying for help, it needs help, it is telling you that you should seek medical attention.

In such cases, the intervention of a heart specialist like a Best Heart Specialist In Delhi is recommended.

Consult Today! Dr. Aparna Jaswal is an Acknowledged Expert in Cardiology at Fortis Escorts Heart Institute

With more than 22 years of experience, Dr. Aparna Jaswal is a renowned cardiologist and electrophysiologist.

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She has been actively involved in the Department of Cardiac Pacing and Electrophysiology.

She has attained fellowship from Heart Rhythm Society and American College of Cardiology, the USA as well as training in Cardiac Electrophysiology at St. Luke’s Hospital, Milwaukee, USA.

Dr. Jaswal has won many accolades, including Dr. Wazir Gold Medal; Pinnamineni Venkateswara Rao Gold Medal, and Prof DP Basu Memorial Award.

So if you see any centers, which are or which you have never been faced before, you must go to your doctor and have an ECG done.

he has the tag of being the first electrophysiologist to start an EP program in Mauritius in November 2010.

For Emergency: Call us:-  +91 9818797594 ,  +91 8130762838

24×7 Online Appointment:- https://www.draparnajaswal.in/contact-us/

[To be continued…]




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Additional Director Cardiologist and Electrophysiologist at the Escorts Heart Institute and Research Centre in New Delhi.




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