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29 Feb 2020 ---- Successful Complex challenging radial angioplasty - done Live from Jaipur national university hospital to IndiaLive2020, in Delhi. operator: Dr Sanjay Chugh DM Cardiology AIIMS New Delhi. CLICK for Videos


  • What is Radial Angiography and Angioplasty?

    Radial Angiography is an X- Ray of the artery supplying the heart to look for blockages. When done through the wrist artery it is called Radial Angiogram.
    Radial Angioplasty is opening of the blocked heart artery using a wire, balloon , a spring like metallic structure called stent is deployed to keep the artery open . When done through the wrist artery it is called Radial Angioplasty.

    What are the advantages of Radial Angiography and Angioplasty ?

    i) Improved survival especially in patients with Heart Attack.
    ii)Less risk of bleeding and Vascular complications during Angioplasty hence better survival.
    iii)Patient can get up and walk soon after the procedure and go home early ( 3 our after Angiogram and 12- 18 hours after Angioplasty )
    iv)Patient friendly because patient can sit up and eat immediately after the procedure while after Femoral Angiography / Angioplasty ( procedure done through the groin ) patient has to lie flat for 6 -12 hours.
    v) Prolonged recumbency is not there therefore no back pain.
    vi) Patient can use the washroom immediately hence no need for urinary catheter. There for lower risk of Urinary Tract Infection and Bleeding.

    What is an angina attack?

    Angina is a lack of blood and therefore oxygen to the heart muscle that does not cause damage. It may be a warning of a future heart attack.

    What exactly is the difference between an angina attack and a heart attack?

    In angina there is no death of the heart muscle tissue. It is reversible. There is enough blockage to cause pain, but not enough blockage to cause death of the muscle. Often angina, ie chest pain, is a warning signal for a possible heart attack.

    What is the difference between a heart attack and congestive heart failure?

    Congestive heart failure is an inadequate pumping of the heart. It may be caused by the damage that occurs in a heart attack, but it may also have other causes such as infection of the heart muscle.

    Can congestive heart failure develop simply from age?

    Yes, as muscles weaken with age.

    What are heart arteries?

    The coronary arteries are direct branches of the ascending aorta (the major blood vessel arising from the heart. There are 2 major arteries, the right and the left coronary artery. The left one branches into the left anterior descending artery (also known as LAD which is the most frequently occluded vessel in a heart attack) and the circumflex. The circumflex forms a connection with the right coronary artery. The right coronary artery gives rise to 3 branches, the anterior right atrial branch which goes to the sinoatrial node (the natural pacer of the heart), the marginal artery and the posterior descending branch.

    Does blood get to the areas of the heart in any other way besides arteries?

    Thesbian veins are small and fairly insignificant vessels that empty directly into the left chamber of the heart.

    Are there other ways arteries get blocked besides clogging from plaque?


    How can that happen to an artery?

    This happens if there is a tear in the artery.

    Who would be at risk for this?

    This may especially occur in young women post partum, after the birth of the baby.

    What can be done to prevent this from happening?


    How is stress related to heart attacks?

    Stress may increase the heart rate and blood pressure which increase the demand on the heart muscles.

    What does genetics or family history have to do with heart attacks?

    The risk factors such as high cholesterol and high blood pressure may be inherited, but there may be other factors which have not yet been identified.

    What are collaterals?

    Collaterals are arteries that develop spontaneously in response to an existing blockage as natural bypasses in the heart to help improve blood flow to the heart muscles. Exercising can help improve the development of collaterals.

    What causes a stroke?

    Stroke is caused by an interruption of the blood flow to the brain, by either a blood clot (thrombosis) or burst blood vessel (haemorrhage). As a result, brain cells are deprived of the oxygen and other nutrients, which they need. Some brain cells become damaged and others die. No two strokes are the same, and the symptoms depend on the area of the brain affected and the extent of the damage incurred.

    Are there any warning signs before a stroke happens?

    For most people stroke happens suddenly, without warning. However, sometimes people do experience symptoms before the stroke occurs, such as dizziness, headache and/or loss of balance. A transient ischaemic attack (TIA) or mini stroke is a clear warning of an increased risk of a stroke and requires medical attention.

    Does age have any bearing on stroke?

    Yes, stroke becomes more common as we get older. As we age our blood vessels become less elastic, which may increase the chance of high blood pressure developing, so increasing the risk of stroke. You can minimise your chance of stroke by paying attention to risk factors such as high blood pressure, smoking, exercise, diet and alcohol intake.

    Are strokes caused by high blood pressure?

    Persistent high blood pressure is a common risk factor for stroke. Over a period of time high blood pressure can cause damage to the blood vessels and encourages the blood to become stickier and so more likely to clot. Blood pressure should be checked in a healthy person every five years, if ever found to be abnormal it should be checked once a year.

    Does exercise help prevent a stroke?

    Yes, exercise can help prevent a stroke. Regular activity is a good way of lowering blood pressure. It will also help control your weight and it leads to favourable changes to the balance of fats in your blood. People should aim to take aerobic exercise for about 30 minutes five times a week, as this is the level of activity which brings significant health benefits. You should seek your doctor’s advice before exercising if you are on medication or have a health problem.

    Why do you feel so exhausted after stroke?

    Exhaustion is a common feeling after stroke. This is because your body is recovering from the effects of the stroke. You cannot resume your normal level of activity following a stroke. Everyday tasks can take more concentration and effort. You can help by pacing yourself, breaking tasks down and increasing your level of activity gently to build up strength and stamina. It is also important to take rest when your body tells you that you need it. Fatigue will lessen over time.

    How long does recovery take?

    Recovery is a very individual thing, depending on the severity of the stroke and other factors. Most recovery occurs within the first few weeks after stroke, however, people can go on gradually recovering for a long time after that.

    Does stroke run in families?

    If you have a close relative who has had a stroke, you are at an increased risk, however, stroke is not hereditary. Families with a history of stroke, cardiovascular problems or other risk factors are at an increased risk of problems. If you are concerned about stroke in your family, discuss your worries with your doctor.

    Why do I need to be concerned about heart healthy eating?

    What you eat affects your risk for having heart disease and poor blood circulation, which can lead to a heart attack or stroke. Heart disease is the number 1 killer and stroke is the number 3 killer of American women and men.
    In the main type of heart disease, a fatty substance called plaque builds up in the arteries that bring oxygen-rich blood to the heart. Over time, this buildup causes the arteries to narrow and harden. When this happens, the heart does not get all the blood it needs to work properly. The result can be chest pain or a heart attack.
    Most cases of stroke occur when a blood vessel bringing blood to the brain becomes blocked. The underlying condition for this type of blockage is having fatty deposits lining the vessel walls.

    What foods should I eat to help prevent heart disease and stroke?

    You should eat mainly:

    1. fruits and vegetables
    2. grains (at least half of your grains should be whole grains, such as whole wheat, whole oats, oatmeal, whole-grain corn, brown rice, wild rice, whole rye, whole-grain barley, buckwheat, bulgur, millet, quinoa, and sorghum)
    3. fat-free or low-fat versions of milk, cheese, yogurt, and other milk products
    4. fish, skinless poultry, lean meats, dry beans, eggs, and nuts
    5. polyunsaturated (pol-ee-uhn-SACH-uh-ray-tid) and monounsaturated (mon-oh-uhn-SACH-uh-ray-tid) fats (found in fish, nuts, and vegetable oils)

    Also, you should limit the amount of foods you eat that contain:

    1. saturated fat (found in foods such as fatty cuts of meat, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt, butter, lard, cakes, cookies, doughnuts, sausage, regular mayonnaise, coconut, palm oil)
    2. trans fat (found mainly in processed foods such as cakes, cookies, crackers, pies, stick or hard margarine, potato chips, corn chips)
    3. cholesterol (koh-LESS-tur-ol) (found in foods such as liver, chicken and turkey giblets, pork, sausage, whole milk, cheese made from whole milk, ice cream, sherbet, frozen yogurt)
    4. sodium (found in salt and baking soda)
    5. added sugars (such as corn syrup, corn sweetener, fructose, glucose, sucrose, dextrose, lactose, maltose, honey, molasses, raw sugar, invert sugar, malt syrup, syrup, caramel, and fruit juice concentrates)

    Eating lots of saturated fat, trans fat, and cholesterol may cause plaque buildup in your arteries. Eating lots of sodium may cause you to develop high blood pressure, also called hypertension. Eating lots of added sugars may cause you to develop type 2 diabetes. Both hypertension and diabetes increase your risk of heart disease and stroke.

    How can I tell how much saturated fat, trans fat, and other substances are in the foods I eat?

    Prepared foods that come in packages — such as breads, cereals, canned and frozen foods, snacks, desserts, and drinks — have a Nutrition Facts label on the package. The label states how many calories and how much saturated fat, trans fat, and other substances are in each serving. For information on how to read a Nutrition Facts label, see the Fitness and Nutrition section of
    For food that does not have a Nutrition Facts label, such as fresh salmon or a raw apple, you can use the U.S. Department of Agriculture (USDA) National Nutrient Database . This is a bit harder than using the Nutrition Facts label. But by comparing different foods you can get an idea if a food is high or low in saturated fat, sodium, and other substances. To compare lots of different foods at one time, check out the Nutrient Lists.

    What is a calorie?

    When talking about a calorie in food, it is a measure of the energy that the food supplies to your body. When talking about burning calories during physical activity, a calorie is a measure of the energy used by your body. To maintain the same body weight, the number of food calories you eat during the day should be about the same as the number of calories your body uses.
    The number of calories you should eat each day depends on your age, sex, body size, how physically active you are, and other conditions. For instance, a woman between the ages of 31 and 50 who is of normal weight and moderately active should eat about 2,000 calories each day.

    Are there eating plans that can help me choose foods that are good for my heart?

    There are four eating plans that can help you choose heart healthy foods:

    1. MyPyramid eating plan
    2. Dietary Approaches to Stop Hypertension (DASH) eating plan
    3. Heart Healthy Diet
    4. Therapeutic Lifestyle Changes (TLC) Diet

    The MyPyramid eating plan is based on the Dietary Guidelines for Americans. It was developed by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services to help people lower their risk of serious diseases linked to diet, including heart disease. DASH was developed by the National Heart, Lung, and Blood Institute (NHLBI) to help people with hypertension lower their blood pressure. But it can also be used to help prevent heart disease. The Heart Healthy Diet was developed by NHLBI to help people keep their blood levels of total cholesterol and LDL cholesterol (or "bad" cholesterol) low. The TLC diet was developed by NHLBI to help people with unhealthy blood cholesterol levels.
    These eating plans have interactive web sites to help you choose foods that meet their guidelines You key in your age, sex, height, weight, and activity level. Based on this information the web sites give you tips on what types of foods to eat and how much of each type.

    How do these eating plans work?

    The four eating plans are similar. They are all designed to help you eat foods that are good for your heart and avoid foods that are bad for your heart. Below is a table comparing the main guidelines of the four eating plans:

    Heart-Healthy Eating Plans: How They Compare


    % of the day's total calories from saturated fat

    % of the day's total calories from fat

    amount of trans fat

    milligrams (mg) of dietary cholesterol per day

    milligrams (mg) of dietary sodium per  day


    less than 10%


    as low as possible

    less than 300 mg

    less than 2300 mg*




    as low as possible

    136 mg

    less than 2300 mg*

    Heart Healthy Diet


    30% or less

    as low as possible

    less than 300 mg

    less than 2400 mg

    TLC Diet

    less than 7%

    25-35% or less

    as low as possible

    less than 200 mg

    less than 2400 mg

    *2300 milligrams of sodium in table salt is about 1 tsp of salt. People with hypertension should eat no more than 1500 mg of sodium a day (about 2/3 teaspoon of salt). African Americans and middle-aged and older adults should also eat no more than 1500 mg of sodium per day. The reason is that these groups have a high risk of developing hypertension.
    **These DASH guidelines are for someone eating 2000 calories each day.
    Notice that all four eating plans limit the amount of sodium you should eat each day to about 1 tsp of salt (2/3 tsp for people with hypertension or at risk for hypertension). Most of the salt we eat each day actually comes from processed foods rather than salt that we add to foods that we cook. Make sure to check the sodium content on the Nutrition Facts label when buying food. The sodium content in similar foods can vary a lot. For instance, the sodium content in regular tomato soup may be 700 mg per cup in one brand and 1100 mg per cup in another brand. Choosing the brands with lower sodium content can be one way to lower the amount of sodium you eat.
    Another way to limit sodium is to use spices other than salt. There are plenty of salt-free spice combinations that you can find in your grocery store. It may take awhile for you to get used to the taste. But give it time. After awhile, you may like them better than salt.
    Besides limiting the amount of sodium you eat, it is also a good idea to eat foods rich in potassium (puh-TASS-e-uhm). A potassium-rich diet blunts the harmful effects of sodium on blood pressure. Aim to eat 4700 mg of potassium a day. Foods rich in potassium include fruits and vegetables, especially:

    1. tomatoes and tomato products
    2. orange juice and grapefruit juice
    3. raisins, dates, prunes
    4. white potatoes and sweet potatoes
    5. lettuce
    6. papayas

    Check out the potassium list in the Nutrient List section of the USDA National Nutrient Database for more foods rich in potassium.

    I've heard that eating fish is good for my heart. Why is that?

    Fish and shellfish contain a type of fat called omega-3 (oh-MAY-guh) fatty acids. Research suggests that eating omega-3 fatty acids lowers your chances of dying from heart disease. Fish that naturally contain more oil (such as salmon, trout, herring, mackerel, anchovies, and sardines) have more omega-3 fatty acids than lean fish (such as cod, haddock, and catfish). Be careful, though, about eating too much shellfish. Shrimp is a type of shellfish that has a lot of cholesterol.
    You can also get omega-3 fatty acids from plant sources, such as:

    1. canola oil
    2. soybean oil
    3. walnuts
    4. ground flaxseed (linseed) and flaxseed oil

    Is drinking alcohol bad for my heart?

    Drinking too much alcohol can, over time, damage your heart and raise your blood pressure. If you drink alcohol, you should do so moderately. For women, moderate drinking means one drink per day. For men, it means two drinks per day. One drink counts as:

    • 5 ounces of wine
    • 12 ounces of beer
    • 1½ ounces of 80-proof hard liquor

    Research suggests that moderate drinkers are less likely to develop heart disease than people who don't drink any alcohol or who drink too much. Red wine drinkers in particular seem to be protected to some degree against heart disease. Red wine contains flavonoids (FLAY-vuh-noidz), which are thought to prevent plaque buildup. Flavonoids also are found in:

    1. red grapes
    2. berries
    3. apples
    4. broccoli

    On the other hand, drinking more than one drink per day increases the risks of certain cancers, including breast cancer. And if you are pregnant, could become pregnant, or have another health condition that could make alcohol use harmful, you should not drink.
    With the help of your doctor, decide whether moderate drinking to lower heart attack risk outweighs the possible increased risk of breast cancer or other medical problems.

    I need help working out an eating plan that's right for me. Who can I ask for help?

    You may want to talk with a registered dietitian. A dietitian is a nutrition expert who can give you advice about what foods to eat and how much of each type. Ask your doctor to recommend a dietitian. You also can contact the American Dietetic Association (see the resources section for more information).

    Besides eating healthy foods, what else can I do to keep my heart healthy?

    To reduce your risk of heart disease:

    1. Quit smoking — talk with your doctor or nurse if you need help quitting.
    2. Get at least 2 hours and 30 minutes of moderate aerobic physical activity each week. For more information on physical activity.
    3. Lose weight if you are overweight, and keep a healthy weight.
    4. Get your blood pressure, cholesterol, and blood sugar levels checked regularly.

Is a registered society (NGO) which works to promote wellness, and has a mission to `STOP HEART ATTACK`. WARIS does awareness programs for public and for Doctors in this connection.

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