Heart attack is often the first manifestation of heart disease in young

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Anant Bajaj, MD of Bajaj Electricals dies at 41

Anant Bajaj, managing director of Bajaj Electricals, passed away on Friday after suffering a cardiac arrest. He was only 41.

Coronary heart disease mainly occurs in patients over the age of 40, but younger men and women can be affected. An age cut-off of 40 to 45 years has been used in many studies to define “young” patients with heart disease or acute heart attack.

In the Framingham Heart Study, the incidence of a heart attack over a 10-year follow-up was 12.9/1000 in men 30 to 34 years old and 5.2/1000 in women 35 to 44 years old. The incidence of heart attack was eight to nine times greater in men and women aged 55 to 64 years. In other studies, 4 to 10 percent of patients with myocardial infarction were ≤40 or 45 years of age.

Although heart attacks are uncommon in young patients, yet they pose an important problem for the patient as well as the treating physician because of the devastating effect of this disease on the more active lifestyle of young patients.

Younger patients with heart disease more often have a family history of premature heart disease.

The most common and most modifiable risk factor in young patients is cigarette smoking. Cocaine use, factor V Leiden and oral contraceptive (females) use are other risk factors that are more common in younger individuals. Diabetes and hypertension are less common in young patients with heart disease in comparison to older patients.

The clinical presentation of heart disease in younger patients differs from that in older patients. A higher proportion of young patients do not experience chest pain and often heart attack is the first manifestation of heart disease. Younger patients have a higher incidence of normal coronary arteries, mild luminal irregularities, and single vessel blockage than do older patients.

Mantras

If you can walk 500 meters in six minutes, you do not have significant underlying heart disease.

Everyone should learn the life saving technique of hands-only CPR.

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

Incessant noise can disrupt the body at a cellular level

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Noise is recognized environmental stressor and can exacerbate certain existing health conditions

New Delhi, 16 May 2018: According to a review of the underlying mechanisms that lead to noise-induced heart disease, environmental noise from traffic and aircraft disrupts the body on the cellular level to raise heart disease risk factors. Sound pollution can cause metabolic abnormalities and autonomic imbalance, characterized by dizziness and exercise intolerance. Exposure to this noise can also lead to behavioral issues in children.

Dust mixed with toxic fumes from vehicular exhausts can exacerbate lung and heart diseases and trigger death from heart attack, stroke, chronic obstructive pulmonary disease, lung infections like pneumonia, and cancers of the lung and respiratory tract.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, ” Noise is an unwanted intrusive sound. A loud noise is 85 db or higher, or if a person has to raise his/her voice to speak with someone standing at a distance of 3 feet. Noise is a recognized environmental stressor, which has both physiological and psychological effects. It is associated with anxiety, high blood pressure, increased heart rate, insomnia, annoyance, stress. Progressive hearing loss may result from continuous and repeated exposure to loud noise. The safe limit for sounds at 85 db or less is 8 hours of exposure. Loud noise affects speech intelligibility and consequently work performance and increases chances of errors. Conversation has to be conducted at higher dbs for clear speech communication because of noise interference.”

People living in areas with high traffic noise are also 25% more likely than those in quieter neighborhoods to have symptoms of depression such as sadness, loneliness and trouble concentrating.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “Hospitals are noisy work places. Control of noise levels is very important in hospitals for patient well-being and healing. Noise creates an unhealthy work environment for doctors. It affects concentration and increases the chances of mistakes, which can be costly for the doctors and hospitals. Inability to hear the warning patient monitoring alarm over the general background noise in an ICU may have potentially disastrous outcome. Moreover, doctors too are prone to develop high BP and other negative effects on health.”
Some HCFI tips to reduce noise pollution.
• Traffic flow around schools and hospitals should be minimized as much as possible.
• Signboards displaying ‘Silence zone’, ‘No honking’ must be placed near these areas.
• Efforts should be made to ban the use of horns with jarring sounds, motorbikes with damaged exhaust pipes, and noisy trucks.
• The use of loudspeakers in parties and discos, as well as public announcements systems should be checked and discouraged.
• Noise rules must be stringent and strictly enforced near such silence zones.
• Planting trees along roads and in residential areas is a good way to reduce noise pollution as they absorb sound.

Heart attack with normal angiography or normal post mortem

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Dr KK Aggarwal

Recipient of Padma Shri

The death of actress Sridevi was due to accidental drowning in a bath tub following loss of consciousness in a hotel in Dubai. This was the conclusion of the post-mortem report and foul play has been ruled out. Dubai police said that the case has been closed.

However, the cause of unconsciousness has not yet been conclusively found. Traces of alcohol were found in blood, and it has been suggested that this may have led to the accidental drowning.

Though the post mortem has ruled out heart attack, it still remains the most likely initiating event for loss of unconsciousness or gasping, which may have been due to ventricular tachycardia/fibrillation.

So, can one have a normal angiography or normal post-mortem after a heart attack? The answer is yes.

There are two types of heart attacks: Type I versus type II heart attack.

Most patients with acute heart attack will have obstructive (blockages) atherosclerotic (cholesterol deposition) coronary artery stenoses (narrowing) with acute thrombosis (clot) as the underlying pathology.

However, some patients (up to 28%) will not have significant epicardial coronary artery disease when coronary angiography is performed or post mortem is done. These patients are defined as having a type 2 heart attack, which is defined as a heart attack consequent to increased oxygen demand or decreased supply (coronary endothelial dysfunction, coronary artery spasm, coronary artery embolus, tachy / bradyarrhythmias, anemia, respiratory failure, hypertension, or hypotension).

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

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