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Welcome Cardiopulse Presents Preventive Health Care Program. Coronary heart disease in India 1990-CVD cause 2.386 Millions Deaths 2015 CVD will cause 4.586 Millions Deaths 60 Million in India Suffering from CAD. Cause of CAD. Atheroscelorosis Smoking Obesity Diabetes Sedentry life style
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Coronary heart disease in India1990-CVD cause 2.386 Millions Deaths2015 CVD will cause 4.586 Millions Deaths60 Million in India Suffering from CAD
Cause of CAD Atheroscelorosis Smoking Obesity Diabetes Sedentry life style Stress
CAD an Epidemic • Is BY-Pass the solution…? • NO
Solution • Life Style Management • Preventive Cardiology • Non- Invasive Methods
Symptoms of Heart Attack • Angina • Chocking Feeling • Sweating • Nausea • Irregular Heart Beat • Heart Burn • Silent Attack
Investigations Opthalmoscopy Lipid profile Uric acid Heart enzyme C P K – 25-130 IU/L AST---8-20 IU/L LDH----45-90 IU/L
INVESTIGATION • ECG • ECHOCARDIOGRAM • TMT • THALLIUM SCAN • CT ANGIOGRAPHY • CORONARY ANGIOGRAPHY • PET SCAN
TREATMENT • MEDICAL • INVASIVE METHODS • CABG • PTCA • NON-INVASIVE • ACT • ECP (External Counterpulsation)
Medicines • NITRATES • BETA BLOCKER • CALCIUM ANTAGONIST • BLOOD THINNER • LIPID LOWRING DRUGS • RESINS • FIBRIC ACIDS • HMG CoA REDUCTASE INHIBITOR • NIACIN
Is By-Pass Necessary • By-Pass V/s Medical Treatment • Veteran administration coperative study group • European Coronary surgery study • Coronary Artery surgery study (CASS) • CASS – 10years follow-up 780 people • Survival of TWO groups is not significantly different
Indications of By-Pass Surgery • Relive angina pain • Prolong Life
When dose By-Pass Prolong Life • Ejection fraction <50% • Blockage of Left main Coronary Artery • Triple Vessel disease
By-pass being over done • JAMA study • 386 patients underwent bypass surgery 44% of the surgery inappropriate • Dr. Thomas Graboys MD-JAMA • 50% of by pass can be avoided
Side effects of By-Pass Surgery • Mortality 1-3% • Brain damage 15-40% • Infection • Internal bleeding
Can Heart Diseases Be Reversed • Dr. Dean Orniesh • Rice University at Houston • 1983 JAMA reversal of Heart Diseases in 82% of Patients • 1995 Showed Reversal of Heart Diseases by PET Scan
Reversal of heart diseases • Reduce Fat Consumption < 10% • Cholesterol Level < 150 • Reduce Stress • Life Style Modification • Regular Exercise • Open Collaterals By ECP • Remove Toxic Metals by ACT
New Risk Factors • CRP (C reactive protein) • Apolipo protein A • Homocysteine • Heart rate variability
Lowering Cholesterol • Recommended – 100-200 mg • Ideal < 150 mg/ml • Water Soluble Fibers – Oats, Barley-brown Rice • Charcoal • Garlic • Gugulipid • Capsaicn • Drugs
ECP (External Counterpulsation) • A Non Invasive Treatment For Heart Patients • Introduction Latest and Very Effective Treatment For Recurrent Angina, Myocardial Infarction, Post MI Angina and CHF. ECP (External Counter Pulsation) Treatment. ECP is an Ingenious Method for Treating Angina it is Non-invasive, Painless, Safe & Inexpensive. It is an Outpatient Treatment.
How ECP Works • Increases Diastolic Pressure – Diastole Augmentation • Decrease After Load – Decompensate Heart • Endothelial Stabilization • VEGF • Collateral Formation
Indication of ECP • Angina and congestive heart failure. • Coronary Heart Disease, Angina Pectoris, Myocardial Infarction. • Cerebral Arteriosclerosis, Cerebral thrombosis, Cerebral Arteries Embolism, Parkinsoism, Cerebral Ischemic, Cerbrovascular Accident Sequelae. • Hypertension For Renal Ischemia, Oliguresis Adnuremina. • Eyeground Arteries Embolism, Centricity Serosity Retina Choroid Pathologic Change Optic Atrophy.
Indication of ECP • Sudden Deafness. • Cerebral Paralysis for Children. • Diabetes for Arteriosclerosis. • Extremities Arteriosclerosis Ischemic of Pancreatic. • Other Ischemic Pathologic Change and Sequelae due to Arteriosclerosis and Disturbance of Blood Circulation. • Hepatitis. • Sports Fatigue. • Use for Sub-Health Care and Test Oration.
Results of ECPEfficacy of Enhanced External Counterpulsation in the Treatment of Angina Pectoris.Lawson WE, Hui JCK, Soroff HS, et al. American Journal of Cardiology 1992; 70:859-862.18 patients with refractory angina
Counterpulsation Protects Coronary Artery Disease Patients from Future Cardiac Events. S. Karim et al 1st International Congress on Heart Disease - New Trends in Research, Diagnosis, and Treatment Enhanced External. The Journal of Heart Disease 1:1 May ’99Karim and associates treated 117 patients with EECP between 1/92 and 12/97.
Total Effective Rate - Symptoms Long-term results were measured in 102 EECP patients; 23, 39, & 53 were followed for 7, 6, & 5 years post EECP respectively. 19, 32, & 52 patients treated solely with medication were followed over the same time periods.
Does Prior Myocardial Revascularization Predict Therapeutic Benefit From Enhanced External Counterpulsation?Lawson WE et al. Biomedicine ’97; April 25-27 1997, Washington DC - Poster #44Dr. Lawson and his colleagues at Stony Brook Medical Center provided EECP to 25 patients with angina due to clogged bypass grafts, and compared their response to that of 35 never bypassed angina patients. Pre-EECP coronary angiograms were carried out in both groups
Psychosocial Effects of Enhanced External Counterpulsation in the Angina Patient.Fricchione GL, et al. Psychosomatics 1995;36:494-97.
Stress Management • Bio-Yoga • Reduces heart rate • Lowers breath rate • Decrease cardiac stress • Improve heart rate variability (HRV)
Reverse Heart Disease/By-Pass Surgery • Choice is yours
Ours programme • 2 days educational programme on reversing heart disease • Age rejuvenation • Healthy aging • Diet counseling • Bio yoga • Lowing cholesterol