WHAT A LONG WAY THE HEART HAS COME!

TAKE CARE OF YOUR HEART FROM THE TIME YOU ARE YOUNG!: That was part of Dr Guruprasad Naik’s talk on cardiology today at the ICG on June 20; a section of the audience and with family friends Sunetra and Mahesh Talaulikar from Siolim

By Special Correspondent

WE are lucky that the treatment of heart disease has come a long, long way in time, and now even if we suffer a heart attack, chances are we may get a new lease of life if treated within what is called the “golden hour.” Heart disease is not something new, it has always been around.

For example, signs of arteriosclerosis or hardening or calcification of the arteries and veins have been found in Egyptian mummies, observed Dr Guruprasad D Naik, head of Department of Cardiology, Goa Medical College (GMC), while speaking on the topic of “Matters of the Heart,” at the International Centre Goa on June 20, 2017. He was the guest lecturer at this year’s Goa Management Association’s Knowledge Series Lectures.

His talk with the aid of a slide presentation pretty much covered the broad spectrum of diseases in which the heart plays a central role (being a key organ of the body). From the most common artery disease (namely atherosclerosis or hardening of the cardiovascular system depending on genes, lifestyle and aging) to heart attacks to degenerated valves to various arrhythmias (abnormal heart rhythms either too fast as in tachycardia or too slow as in bradycardia which can eventually lead to cardiovascular collapse), myopathies, congestive heart failure.

There are several kinds of heart diseases but treating them is much easier now, even hole-in-the-heart babies may be patched up so that they may grow up living a normal life. In the old days, Dr Guru said, nothing could be done for babies born with a malformed or malfunctioning heart where blood flow was obstructed, “We had no resources like prosthetic valves which could be fitted with surgery, and there was a high morbidity in such infants….” Mercifully, those days are over and today there are solutions for tiny hearts in trouble in infancy.

Medical advancement moved quickly once the British Dr William Harvey (1578 to 1657) demonstrated for the first time how blood circulation happened in the body and how it connected with the lungs. For the first time we learned that the heart is basically a pump which relaxes and pumps blood out systematically to reach every part of the cardiovascular system, valves all along regulate blood flow in one direction and there is an electrical system playing a vital role.  Even in Indian medical literature of going back to  600 BC, he quipped, while there was a concept of “pran” or life and the heart’s central role in keeping us alive, nobody quite knew about how blood circulation operated!

The credit for discovering the nitty gritty of how the heart functions goes to the early pioneers of Allopathy and a lot of path-breaking research and contribution also came from the Dutch doctor and physiologist Dr Willem Einthoven who in the early 17th century was responsible for much further progress vis-à-vis heart disease. There used to be a galvanic meter which produced an early version of the electrocardiogram (ECG) which was invented by Dr Einthoven (hence he is the “Father of Electrocardiography”).

The humble ECG or EKG  offers a view of normal/abnormal patterns in blood flow and this has progressed to even more sensitive CT scanners, MRIs, today’s cath labs and state-of-the-art cardiac care units where quick diagnosis may be made, blockages if any unblocked with balloon procedures and the use of stents. There are several tests which confirm various grades of angina pain, narrowing arteries in which blockage occur and there are angiograms and subsequent angioplasties performed as required. There is also bypass surgery which offers a good quality of life to patients.

All in all in today’s times, so advanced is cardiac care that morbidity in heart patients has come down dramatically. In the countries of the West there is considerable consciousness about what lifestyle changes we need to make to better respect the heart and the role it plays in keeping us alive into our senior years.

AN interesting question/answer session followed with various members from the audience asking him about drugs like statins and aspirins used widely in managing heart problems. There were also the questions of fats, which fats/oils to consume in one’s daily eating, with several speaking up on behalf of the virtues of lauric acid-rich coconut oil! But like desi ghee, coconut oil too is a saturated fat, cautioned Dr Guruprasad Naik, so don’t overdo it. Stay with just a teaspoon or tablespoon of desi ghee if you wish, but then skip other fats in fried food. Fish has a good omega-3 fatty acids brief, so by all means eat sardines or tuna twice a week. However, do not go to the extreme of removing all fat consumption from one’s diet, for the good polyunsaturated fats play a vital role in  health!

Heart diseases are complex and overall risk factors need to be taken into consideration, such as family history, genes, hormones, blood pressure, blood sugar, cholesterol, diet, exercise, medicines. Preventive heart care hardly exists in India and it should really begin at a young age, “Diet and exercise play a big role. Encourage children to play and live healthy…spend less time with cell phones and computers!”

He agreed that emergency cardiac care was not up to the mark in Goa and very often the required help does not reach a heart attack patient in time. Here, it would be a big help if more members of the public trained in cardio-pulmonary resuscitation (CPR) to be able to help anyone suffering a heart attack (when a heart attack is on pain may not ebb away for more than an hour), the patient should be rushed to a hospital with cardiac care facilities quickly if life is to be salvaged. Once heart muscles die it is difficult to restore normal circulation.

It was an altogether fascinating insight into the human heart and after the presentation a relaxed Dr Guruprasad Naik greeted some of his teachers in the audience. He is a Siolim born and bred boy who passed out of medical school, went out to the USA to further study interventional cardiology at the Louisiana State University Health Science Center, spend some years at the Marshfield Clinic… returning to Goa in 2014 to be Head of Cardiology Department at the Goa Medical College.

At the GMC he leads a formidable team of doctors which includes cardiac surgeon Dr Borkar, Dr Manjunath Desai, Dr Michelle Viegas Parab, Dr Jaganath Kolwalkar and others. Needless to say the GMC today sees hundreds of patients with matters of the heart to sort out.

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