Sudden cardiac death

  A young executive in his 50 s avid marathon runner and a staunch diet fellow was found dead on one morning. What is responsible for so many young deaths. The family he supports is in a shock.

Can this be prevented ? 

A lot of studies carried out point out that blood pressures  diabetes are silent kilers. These are lifestyle modification diseases which are like an iceberg.  

The maincauses of sudden cardiac death are aortic stenosis, arrhythmia .  The family members of patient who has sudden cardiac death must be screened thoroughly for underlying disease. 

The family members should be  screened for underlying heart  issues . Aneurysm of aorta is known to recur in family. 

Patient need to be aware of frequent rythm disturbances manifestation as missed beat. Can be precurser of an underlying valcano waiting to burst open . 

Many causes of sudden cardiac death . Sleepless night, strenous work pattern make a perfect receipe. 

Modern wearables such as wrist watches can detect atrial fibrillation. Atrial fibrillation accounts for most common cause for stroke . 

Silent killer

 Why Blood Pressure Monitoring Matters: A Simple Habit That Saves Lives

High blood pressure, often called the “silent killer,” affects millions of people worldwide. Unlike many medical conditions, hypertension usually has no obvious symptoms, yet it significantly increases the risk of heart attacks, strokes, kidney disease, heart failure, and vision problems. This is why regular blood pressure monitoring is one of the simplest and most effective ways to protect your health.

What Is Blood Pressure?

Blood pressure measures the force of blood pushing against the walls of your arteries. It is recorded as two numbers:

• Systolic pressure – the pressure when the heart contracts.
• Diastolic pressure – the pressure when the heart relaxes between beats.

A healthy blood pressure is generally considered to be below 120/80 mmHg, although individual targets may vary depending on age and medical conditions.

Why Regular Monitoring Is Important

Monitoring blood pressure helps to:

• Detect hypertension before symptoms appear.
• Assess the effectiveness of lifestyle changes and medications.
• Reduce the risk of cardiovascular complications.
• Encourage patients to become active participants in managing their own health.

Early diagnosis allows timely treatment, preventing long-term damage to the heart, brain, kidneys, and blood vessels.

How to Measure Blood Pressure Correctly

For the most accurate reading:

• Rest quietly for at least five minutes before measurement.
• Avoid caffeine, smoking, and exercise for 30 minutes beforehand.
• Sit comfortably with your back supported and feet flat on the floor.
• Keep your arm supported at heart level.
• Use a properly fitting upper-arm cuff.
• Take two readings one minute apart and record the average.

Home blood pressure monitoring is especially useful for tracking trends over time and reducing the effects of “white coat hypertension.”

Lifestyle Changes That Help

Healthy habits can make a significant difference:

• Maintain a healthy body weight.
• Reduce salt intake.
• Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Exercise regularly.
• Limit alcohol consumption.
• Avoid smoking.
• Manage stress through relaxation techniques and adequate sleep.

The Role of Digital Health and Artificial Intelligence

Advances in digital healthcare are transforming blood pressure management. Smart blood pressure monitors can automatically store readings, while mobile applications help patients track trends and share results with healthcare professionals.

Artificial intelligence is increasingly being used to:

• Identify patients at higher cardiovascular risk.
• Detect abnormal patterns in blood pressure readings.
• Improve medication adherence through reminders.
• Support clinicians with personalised treatment recommendations.

These technologies have the potential to improve outcomes while reducing the burden on healthcare systems.

Final Thoughts

Blood pressure monitoring is a simple habit that can have a profound impact on long-term health. Whether performed at home, in a pharmacy, or during a healthcare visit, regular monitoring enables early detection, informed treatment decisions, and better prevention of serious cardiovascular disease.

Remember: You cannot always feel high blood pressure, but you can measure it. A few minutes spent checking your blood pressure today could help prevent a life-changing event tomorrow.

Why Blood Pressure Monitoring Matters: A Simple Habit That Saves Lives

High blood pressure, often called the “silent killer,” affects millions of people worldwide. Unlike many medical conditions, hypertension usually has no obvious symptoms, yet it significantly increases the risk of heart attacks, strokes, kidney disease, heart failure, and vision problems. This is why regular blood pressure monitoring is one of the simplest and most effective ways to protect your health.

What Is Blood Pressure?

Blood pressure measures the force of blood pushing against the walls of your arteries. It is recorded as two numbers:

• Systolic pressure – the pressure when the heart contracts.
• Diastolic pressure – the pressure when the heart relaxes between beats.

A healthy blood pressure is generally considered to be below 120/80 mmHg, although individual targets may vary depending on age and medical conditions.

Why Regular Monitoring Is Important

Monitoring blood pressure helps to:

• Detect hypertension before symptoms appear.
• Assess the effectiveness of lifestyle changes and medications.
• Reduce the risk of cardiovascular complications.
• Encourage patients to become active participants in managing their own health.

Early diagnosis allows timely treatment, preventing long-term damage to the heart, brain, kidneys, and blood vessels.

How to Measure Blood Pressure Correctly

For the most accurate reading:

• Rest quietly for at least five minutes before measurement.
• Avoid caffeine, smoking, and exercise for 30 minutes beforehand.
• Sit comfortably with your back supported and feet flat on the floor.
• Keep your arm supported at heart level.
• Use a properly fitting upper-arm cuff.
• Take two readings one minute apart and record the average.

Home blood pressure monitoring is especially useful for tracking trends over time and reducing the effects of “white coat hypertension.”

Lifestyle Changes That Help

Healthy habits can make a significant difference:

• Maintain a healthy body weight.
• Reduce salt intake.
• Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Exercise regularly.
• Limit alcohol consumption.
• Avoid smoking.
• Manage stress through relaxation techniques and adequate sleep.

The Role of Digital Health and Artificial Intelligence

Advances in digital healthcare are transforming blood pressure management. Smart blood pressure monitors can automatically store readings, while mobile applications help patients track trends and share results with healthcare professionals.

Artificial intelligence is increasingly being used to:

• Identify patients at higher cardiovascular risk.
• Detect abnormal patterns in blood pressure readings.
• Improve medication adherence through reminders.
• Support clinicians with personalised treatment recommendations.

These technologies have the potential to improve outcomes while reducing the burden on healthcare systems.

Final Thoughts

Blood pressure monitoring is a simple habit that can have a profound impact on long-term health. Whether performed at home, in a pharmacy, or during a healthcare visit, regular monitoring enables early detection, informed treatment decisions, and better prevention of serious cardiovascular disease.

Remember: You cannot always feel high blood pressure, but you can measure it. A few minutes spent checking your blood pressure today could help prevent a life-changing event tomorrow.

Yoga and meditation can be valuable additions to a healthy lifestyle and may help support blood pressure control, particularly when combined with medication (if prescribed), regular exercise, a healthy diet, and weight management.

Benefits for Blood Pressure

Research suggests that regular yoga and meditation may:

• Reduce stress and anxiety

• Lower sympathetic (“fight-or-flight”) activity

• Improve sleep quality

• Promote relaxation

• Lead to modest reductions in blood pressure in some people

They should not replace prescribed treatment for hypertension but can complement it.

Recommended Yoga Poses

Gentle poses that are generally suitable include:

• Mountain Pose (Tadasana) – improves posture and breathing

• Child’s Pose (Balasana) – promotes relaxation

• Cat-Cow Stretch – improves flexibility and breathing

• Legs Up the Wall (Viparita Karani) – encourages relaxation (avoid if your healthcare professional has advised against it)

Avoid prolonged inverted poses (such as headstands) if you have uncontrolled high blood pressure.

Simple Meditation Routine

• Sit comfortably with your back straight.

• Close your eyes.

• Breathe slowly through your nose.

• Inhale for about 4 seconds and exhale for about 6 seconds.

• Focus on your breathing or silently repeat a calming word such as “peace.”

• Practice for 10–20 minutes daily.

Lifestyle Tips

• Aim for at least 150 minutes of moderate exercise each week.

• Eat a diet rich in fruits, vegetables, whole grains, and low-fat dairy, while limiting salt.

• Maintain a healthy weight.

• Avoid smoking and limit alcohol.

• Sleep 7–9 hours each night.

Given your previous interest in blood pressure, incorporating 20–30 minutes of gentle yoga followed by 10 minutes of meditation each day is a practical routine that may help reduce stress and support overall cardiovascular health. If you have heart disease, severe hypertension, or other medical conditions, check with your healthcare professional before starting a new exercise program.

A new lease of life

 A young gentleman operated for Avr

 .to appraisal 2023 

dated 25.07.2023 

I had joined my night duty that day. patient age 50 operated for AVR today was extubated and stable in bed .

he had taken some bread slices to eat along with water. suddenly he developed breathlessness and saturation fell down . prompt decision taken by anaesthesiologist on call, re intubate patient. Urgent TOE showed collection of fluid around left ventricle and flexible bronchoscopy was some secretions without any solid food residue. otherwise tracheal tree was normal. Chest x ray was congested. Family update was done.

haemodynamically patient was unstable and saturations were not climbing up. decision was made to open the chest and review. 

on opening the chest there was no collection causing tamponade . serous fluid 1000 ml drained from left pleura. 

serous fluid kept recollecting in left pleura. 

heart contractility was good . 

decision taken to put patient on bypass and aortic and venous bypass was established after giving heparin. patient kept on bypass while partial ventilation was done. 

secretion from endotracheal tube were kept on pouring secretions. Lactate were climbing up. 

contacted help at Papworth hospital for veno venous ecmo . 

helped arrived at 7 am and patient shifted to Papworth hospital for further management . 

learning lessons: quick decision taken to reintubate patient.

decision to shift patient to theatre was quick. In theatre free discussion with everyone lead to conclusion that we need to put patient on bypass giving rest to lungs. 

Team ECMO contacted and decision made in the best interest of patient. sometimes wait and watch is the best policy 

Patient was stabilised and sent back to basildon to recover and discharge home 

heart matters: DUSSEHRA 2020

heart matters: DUSSEHRA 2020:  This year has seen a lot of pitfalls and tragedy for each and everyone . Let us celebrate the victory of all good over evil on this pious o...

DUSSEHRA -DIWALI 2020

 This year has seen a lot of pitfalls and tragedy for each and everyone . Let us celebrate the victory of all good over evil on this pious occassion of Dussehra and Diwali . 

Let us unite together to eliminate vices from ourselves . Become fit and have a healthy life in future . Let us all plant a seed of good healthy habits today to reap the benefits later . 

For those who have undergone a heart surgery to even people who look forward to a healthy life . Let us join forces to eliminate obesity , hypertension and diabetes from our midst . Just 30 minutes of workout today and your body will thank you in future for the steps you have taken today . 

Almost all life style diseases have encompassed our beings . The time of need is to adhere to good healthy habits and good thoughts . 

The pandemic of Corona has not left us yet . Small changes made to life style can result in lot of benefits . the positive outlook towards life and need for frequent handwash can give grand results . 

the victory of good over evil is manifested . loosing weight is good that gains victory over obesity evil . all lifestyle diseases have been shown to respond to changes we actively take .diabetes can be brought undercontrol, so also hypertension . this shift of paradigm has to take place now . let the new life begin .

Thoughts can be like dormant valcano .it affects the subconcious and manifests as disease . thoughts can be controlled and we can soft tune our subconcious . 

the mind association of disease is very well documented .

heart matters: post operative rehabilitation post cardiac surgery

heart matters: post operative rehabilitation post cardiac surgery: post cardiac surgery rehabilitation is a poorly addressed phenomenon in India . patients will have dry cough. coughing will make the pati...

stroke

a stroke . anyone can be affected .
formation of plaque in carotid artery disloges to result in stroke . the patient can be maimed for life , with loss of speech and inability to move limbs .
a devastating episodes usually resoves if thin small plaques rupture and emboli shower distally into the brain .
ct scan and mri scan can delineate the injury to the underlying brain . at times repeat scans can be required to assess the injury .
stroke can present as haemorrhagic or emboli
emboli shower can further diseminate to clear the injury .  the good part of stroke is brain is supplied by 2 branches on either side of neck and in the brain too circle of willis is there to steal blood from its brother branch .

clots in lung

very common occurance in prolonged flight patients complaining of breathlessness sudden onset . reduced fluid intake and stasis of blood in legs prone to develop blood clots in calf veins which migrate to the heart thence to lungs . if the clot is massive and causing a big filling defect in central pulmonary artery , the case should be operated immediately . if the clots are peripheral then it. other  is managed medically . othe r causes of clot formation is patient on contraceptive pills .

left atrial clot

few patients present with left atrial clot. the size of same can vary from miniscule to large as a tennis ball . it can be fixed to left atrial appendage or mobile .usual patients with left atrial clot can present as stroke resulting in Cerebro vascular episode.on evaluation by doing a echo cardiography usually the clot is noticed . the ecg rythm of such candidates can be in fibrillation.
the eddy currant in flow of blood in the left atrial chamber will result in a clot formation .
operation is recommended for removal of such clot , at a same time correcting additional deformities  in mitral valve.

Post cardiac surgery life

Life presents suprises at every turn and a significant turn was having a cardiac arrest . Many patients return to their previous life style and face the same challenges head on that they faced before having a heart attack . Almighty has given a second chance to them to make a difference .

Experiencing happiness is the ultimate goal . Can witness of such a feeling . Exercise causes causes happinness to flow. So studies have revealed atleast a half an hour of exercises doing releases dopamine the feel good factor .

Indulging in an activity to do something for which you are not paid causes a surge in happiness within you .the joy of giving has been documented to achieve happiness . All have tuned happiness by giving. Giving doesnot include only money , but giving a compement , a smile

Mindful ness has been associated with happiness .

Keeping gratitude diary helps . All people who have helped you and indirectly helpful. We should be thankful for a new life and purpose . Find your goal .

Leave a lasting impression on those people who donot have access to facilities you enjoy .
subtle changes to Diet what we put in our body and what we take out forms a very circle of our existance. 

tumours in heart

as the tumours are forming in other parts of body similarly they occur in heart . the incidence is less . the most common tumors of heart is MYXOMA .
It can be presented in a patient as a polyp , at times it is large as the complete left artial cavity . at times it moves in and out of the left ventricle . easily detected on echocardiography.
choice of treatment is urgent surgery and removal of the mass from its base stalk . usually the base is at fossa ovalis , artificial ASD is created and further closed using a pericardial patch . 

as the tumours are forming in other parts of body similarly they occur in heart . the incidence is less . the most common tumors of heart is MYXOMA .
It can be presented in a patient as a polyp , at times it is large as the complete left artial cavity . at times it moves in and out of the left ventricle . easily detected on echocardiography.
choice of treatment is urgent surgery and removal of the mass from its base stalk . usually the base is at fossa ovalis , artificial ASD is created and further closed using a pericardial patc

pannus

formation of pannus in the post operative period after mitral valve replacement or aortic valve replacement is suggestive of a ongoing disease process and the new pannus formed interacts with the normal valve function . explantation of artificial valve or just removing the pannus is the treatment of choice .
patient can present with gradually increasing shortness of breath after few months of implantation of artificial valve .

artificial intelligence in cardiac surgery

plenty of patient database is available in the hospital . can we analyse the data and predict the onset of heart disease ?
the pathway followed by patient is more or less the same , we can curtail the onset of disease and identify the patient before hand . the implications of such a pathway could be utilized by the insurance sector and lot of money can be saved . the predictors of morbidity can be found before hand and disease onset can be annihilated .a new dawn in cardiac surgery .

world heart day

another year dawns , celebrate world heart day . camps to drive people to exercise, and remind once more that we have a body to care for . incidences of heart attack is rising so is the population having more precusor of diabetes and hypertension .
both are precusor of having a heart attack in future . the warning sign is a reminder once again that we have a body to be cared for .establishing a new routine to exercise at least for 45 minutes a day and undertaking extra efforts to eat healthy will go a long way .

post cardiac surgery rehabilitation

immediately after discharge patient will notice dry cough which irritates them while going to sleep . it is a common occurance after open heart surgery . taking nebulization of normal saline will help the patient . if the cough doesnot stop medical advise should be taken .
very rarely cough can extend to more than 15 days and ent surgeon consultation is required