Wockhardt Hospitals Blog

Dr. Venkatesh S, MD, DM,Consultant Cardiologist Wockhardt Hospitals,Bangalore shares his thoughts on the "Risks of heart diseases and stroke for diabetic patients"

To have diabetes mellitus or Pre diabetes (a condition where blood sugar levels are high but not high enough to be labeled as diabetes) increases your risk of heart disease and stroke. According to medical research two out of three diabetic people die form heart disease or stroke.

Diabetes is a condition caused when the body fails to produce enough insulin or when there is resistance to the action of circulating insulin. Insulin is a hormone produced by the pancreas (a gland behind the stomach), that is required by the body to move glucose from the blood stream into the cells of the body where it converted into energy.

The human body converts digested food into energy that sustains the cells in the body. Most of the food we eat is broken down into glucose (a form of sugar) and dispersed into the blood stream to be used as energy. When there is deficiency of insulin the cells in the body fail to get the required energy resulting in a build of glucose in the blood stream and hence the cells starve when there is not energy in the body.

High glucose levels in the blood can lead to several complications and disorders such as heart disease & Stroke. It left uncontrolled there could be several other complications i.e. Blindness, kidney failure and amputations of the limbs caused by damaged arteries.

High blood sugar over a period of time leads to damaged nerves and blood vessels. There is hardening of the blood vessels and increased deposit of cholesterol on their walls – a process termed as atherosclerosis. Atherosclerosis can lead to narrowing of the blood vessels and also causes increased tendency for clot formation within. These two processes are the ones responsible for most heart attacks and strokes.

A Diabetic patent is twice as likely of having heart disease or stroke as compared to a normal person. Diabetic patents tend to develop heart disease and stroke at a younger age than people without diabetics. People with diabetics are also more likely to have a second heart attack as compared to healthy people. Women with diabetes are also at a much higher risk of developing heart disease and stroke. Heart attacks in diabetic patents are generally more serious and complex and are more likely to be fatal.

• Since diabetes is a chronic disease that can only be controlled it is very important to stick to the advice given by the doctor and to take your daily dose of medication at the right times. Go for regular check ups and monitor your pressure and blood sugar regularly.

In Women the symptoms may be very subtle and difficult to diagnose. A regular check up is very essential.

o Sudden severe headache
o Weakness an numbness that comes on suddenly
o Disorientation and confusion or sudden difficulty in recognizing people and speaking
o Dizziness and loss of balance
o Blurred and double vision

If you have the above symptoms it is of utmost importance that you receive treatment at the earliest. Remember the earlier the heart attacks and strokes are recognized the more effectively they can be treated and complications prevented. Delay in treatment can result in loss of life. So, if there is a suspicion that you or someone around you is having a heart attack or stroke, immediately seek medical help. Keep important telephone numbers and emergency numbers always at hand.

Summarizing, diabetes is a chronic disease which can throw up sudden surprises in the form of heart attacks and strokes. Good control of diabetes helps prevent these conditions. Periodic monitoring, regular diet and exercise and strict adherence to the doctors’ treatment is of paramount importance. If symptoms and signs of heart attack or stroke are noticed, getting medical help quickly can make a difference between life and death.

To Do For keeping Heart Risks at Bay

Maintain a healthy blood pressure for people with diabetes, this means less than 130/80.. Medication may be necessary for this

Get your cholesterol tested regularly and, if needed, take medication to lower it. Your LDL-cholesterol levels should be under 100mg/dl.

For consultation with our Doctors at Wockhardt Hospitals, please email us to enquiries@wockhardthospitals.net

An aneurysm is a bulge or "ballooning" in the wall of an artery. Arteries are blood vessels that carry oxygen-rich blood from the heart to other parts of the body. If an aneurysm grows large, it can burst and cause dangerous bleeding or even death.

Most aneurysms occur in the aorta, the main artery traveling from the heart through the chest and abdomen. Aneurysms also can happen in arteries in the brain, heart and other parts of the body. If an aneurysm in the brain bursts, it causes a stroke.

Aneurysms can develop and become large before causing any symptoms. Often doctors can stop aneurysms from bursting if they find and treat them early. Medicines and surgery are the two main treatments for aneurysms.

Aortic dissection occurs when the layers of the wall of the aorta separate or are torn, allowing blood to flow between those layers and causing them to separate further. When the aortic wall separates, blood cannot flow freely, and the aortic wall may burst.

Any condition that causes the walls of the arteries to weaken can lead to an aneurysm. The following increase the risk of an aneurysm or an aortic dissection:

Aneurysms can be detected by physical exam, on a basic chest or stomach x-ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging (MRI), and computed tomography (CT) scanning.

• Aortic dissection may cause sudden and severe pain, and patients often feel like something is ripping or tearing inside of them. The pain is mainly felt in the chest, but it can spread to the back or between the shoulder blades. Aortic dissection may also cause sudden stomach pain, lower back pain, or flu-like symptoms. If blood leaks from the dissection and builds up in the chest, the blood may enter the pericardial space (the sac that surrounds the heart) and prevent the heart from filling properly. This can lead to a life-threatening condition called cardiac tamponade.

Treatment depends on the size and location of the aneurysm and your overall health.

Aneurysms in the upper chest (the ascending aorta) are usually operated on right away.

Aneurysms in the lower chest and the area below your stomach (the descending thoracic and abdominal parts of the aorta) may not be as life-threatening. Aneurysms in these locations are watched regularly. If they become about 5 centimeters (almost 2 inches) in diameter, continue to grow, or begin to cause symptoms, your doctor may want you to have surgery to stop the aneurysm from bursting.

For aortic aneurysms or aneurysms that happen in the vessels that supply blood to your arms, legs, and head (the peripheral vessels), surgery involves replacing the weakened section of the vessel with an artificial tube, called a graft.

For patients with smaller or stable aneurysms in the descending aorta or abdominal parts of the aorta—those farthest from the heart, doctors usually ask patients to come in for regular check-ups so they can follow the growth of the aneurysm. If the aneurysm does not grow much, patients may live with the aneurysm for years. Doctors may also prescribe medicine, especially medicine like a beta blocker that lowers blood pressure, to relieve the stress on the aortic walls. Medicine to lower blood pressure is especially useful for patients where the risk of surgery may be greater than the risk of the aneurysm itself.

For patients with aortic dissection, surgery is usually recommended right away, especially if the dissection is in the part of the aorta closest to the heart. For dissections farther from the heart, patients will be given medicines (such as beta-blockers to lower blood pressure), and the dissection will be watched closely. But, if the dissection begins to leak blood, cause a blockage, or get bigger, surgery is needed.

The NGO Needy Heart Foundation (NHF) has just completed 1000 heart surgeries in eight years. The NGO Needy Heart Foundation is an an initiative of the current NHF chairman O P Khanna, consultant cardiothoracic surgeon of Manipal Heart Institute Joseph Xavier and consultant cardiovascular surgeon of Wockhardt Hospitals,Bangalore Dr N S Devananda.

The NGO last week celebrated this successful milestone while organising`Keep The Beat' on Sunday at The Leela Palace for patients, their families, donors and doctors from partner hospitals.Giving a breakdown on the number of surgeries performed, The NHF chairman said that out of one thousand heart surgeries that has been performed so far, 506 were children and 57 senior citizens.

The NHF has been leading by example for the last few years by treating patients from the lower socio economical background with an objective of preventing finance from being a hurdle in the treatment process.The trusts vision is to eliminate deaths due to heart disease, for lack of money or knowledge.

While the Needy Heart Foundation has been supporting patients from across the country,a majority of them are from Karnataka and neighbouring states.

Over 1.4 million Indians need critical heart surgery annually. Currently about 55,000 surgeries are done, largely because the rest cannot afford it. They die a slow painful death.More than 1,50,000 Indian children are born with congenital heart disease. Only about 5,000 manage to get treated mostly with sponsorships and government aid while the rest are left to die untreated and unheeded.

"We hold our meetings at our partner hospitals at Manipal, Wockhardt Hospitals and Jayadeva Institute of Cardiology. With the support of hospital staff, management and through our website, we coordinate with patients, doctors and donors," Xavier said. "And we don't have a corpus fund either."

He calls the journey a miracle and narrated his experience in working for NHF. "An autorickshaw driver found treatment for both his children. Now, he talks about us and the organization with most of his commuters."

Here is hoping that the Needy Heart Foundation reaches the next one thousand surgeries milestone very soon.

If anyone wish to donate to the NHF or wishes to know more about Needy Heart Foundation,You can check out their website at http://www.needyheartfoundation.org/index.html

This was a first of its kind unique medical breakthrough which the Doctors at Wockhardt Hospitals found themselves to be a part of.The Pediatric Cardiac team at Wockhardt Hospitals, Mumbai at Mulund performed a life saving surgery on a 4 hour old baby gifting a life and in the process creating a new heart.

Pediatric Cardiac Consultants at Wockhardt Hospital have successfully performed a critical 2-hour beating heart surgery to allow the flow of blood from the baby’s heart to her lungs, thereby enabling the child to breathe normal. This life threatening, rare cardiac complication in neonates is called Pulmonary Atresia, that requires to be addressed in a critical window period of just a few hours of the baby’s birth, was accomplished in the state-of-the-art dedicated pediatric cardiac set up of the hospital.

A few minutes after her birth out of a planned caesarian section in a private city hospital the baby was shifted to Wockhardt Hospitals at Mulund .Within four hours of her birth, the baby was wheeled in for a beating heart BT Shunt procedure wherein a synthetic tube (shunt) was inserted to connect a new artery the sub clavian artery -- to the pulmonary artery. The sub clavian artery supplies blood to the arms but is now redirected to share supply to the arms and the lungs.

The child suffered from a rare congenital disorder called 'Pulmonary Atresia" where the the pulmonary valve of the heart which controls blood to the lungs was not developed and no blood was reaching the lungs. The child, however survived for a few critical hours due to ductus arteriosus, a valve that is meant for its fetal existence only. This valve shuts close naturally after birth and the corrective surgery was required within this window.

Pulmonary atresia is a congenital malformation of the pulmonary valve in which the valve orifice fails to develop. The valve is completely closed thereby obstructing the outflow of blood from the heart to the lungs.The only source of pulmonary blood flow is a patent ductus arteriosus. Due to this, the newborn baby is blue in color and pulmonary atresia can usually be diagnosed within hours or minutes after birth.

Foetal Echocardiography is used to diagnose heart defects before a child is born. The diagnosis done through foetal echocardiography helps in treating the heart defect in the child at an early stage especially when many times some interventions needs to be done immediately after the birth. Since foetal echocardiography was done in this case the defect was identified and immediately after her birth the baby was brought to Wockhardt Hospitals for treatment.”

In India, over 2.5 million children are born with heart defects every year and many lives are lost due to lack of proper infrastructure, awareness, and poor planning at time of birth. Some 3 per cent of these cases are of those born with Pulmonary Atresia. Timely detection and early treatment can not only save a child but also help him lead a normal and healthy life.

For more information and scheduling appointments with Doctors at Wockhardt Hospitals write into enquiries@wockhardthospitals.net