FAQ Heart Failure

Sep 27th, 2019

Archive for September, 2019

FAQ Heart Failure

Friday, September 27th, 2019
What is heart failure?

When your heart is working less efficiently can’t pump enough blood that you need.

Your heart chambers respond to stretching to hold more blood to pump. This helps to keep blood moving but gradually the heart pumping deteriorates.

Your kidneys react to this by retaining more salt and water.

What are symptoms:-

Depending on severity of disease, one cane have mild, moderate or severe symptoms.

Fluid overload – As a result of fluid retention you develop swelling in ankles and legs (called edema). This leads to bloating of stomach and loss of appetite.

Fatigue and weakness – less blood and flow to your muscle can cause fatigue and weakness. Less blood to brain may lead to dizziness.


Heart attack, high blood pressure, diabetes, atrial fibrillation (fast heart beat) disease of valves of heart, disease of heart muscle – (cardiomyopathy), congenital heart defects.

Smoking by causing heart attack leads to heart failure.


Diagnosis of heart failure is based on clinical examination and few tests.

Blood test: For sugar, cholesterol, kidney and thyroid. Also NT-proBNP is blood test which help in diagnosis. Higher levels are seen in heart failure.

ECG: Shows heart rate and rhythm, chamber enlargement and electric conduction delay in heart.

Echocardiogram: This is sonography of heart and is most important test. It gives complete interaction of heart pumping, heart valves and is most important tool for diagnosis as well as to seen response to treatment.

X-ray chest: Gives information of water build up in lungs and size of heart.


Three important medications to improve heart pumping are betablocker, ACE inhibiter / ARB / ARNI and third is Aldosterone Antagonist.

Unfortunately majority of patients do not get target dose of these drugs.

Diuretics are used to reduce fluid retention.

Newer Antidiabetic drugs like SGLT2 inhibitor also gives lot of benefits to patient with heart failure even if they don’t have diabetes.

Correction of iron deficiency also improve outcome of heart failure patients.


Salt restriction of less than 1500 mg previous day is important way to manage heart failure.

When to report to Doctor / A & E:-
  • If weight gain more than 2 kg in week,
  • Increasing swelling of ankle, feet,
  • Worsening of breathlessness,
  • Feeling tired or harder time to do daily activity,
  • Fast heart beat or palpitations,
  • Decrease urine frequency and quantity,
  • Dizziness, loss of appetite.
Advanced treatment:

Some candidates with heart failure are candidates of special procedures and surgery.

  • CRT (Cardiac resynchronisation) It is type of pacemaker which helps to improve heart pumping.
  • ICD (Intracardiac defibrillation) Some heart failure patient may require ICD, to prevent and treat cardiac arrest. It is also a type of pacemaker.
  • Heart valve surgery for affected valves.
  • Heart transplant for advanced heart failure, not responding to all treatment options.

World Alzheimer’s Day

Friday, September 20th, 2019

Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry simple everyday tasks. Alzheimer’s disease is the most common cause of dementia among older adults. The disease is named after Dr. Alois Alzheimer.

People suffering from Alzheimer’s might forget their loved ones. They might forget how to dress themselves, feed themselves, and use the toilet. The disease makes your brain tissue break down over time. It usually happens to people over age 65. A person can live with Alzheimer’s disease for just a few years or for a few decades.

Prevent Alzheimer’s

Here are a few things you can do to enhance your brain health and work to prevent Alzheimer’s:

1. Learn a second (or third, or fourth) language.

2. Eat raw fruits and vegetables.

3. Add a vitamin K supplement to your diet.

4. Reduce stress.

5. Commit to regular exercise.

6. Laugh more.

7. Limit sugar intake.

8. Make time for meditation.

9. Quit smoking.

10. Adopt a Mediterranean diet.

How to care for an Alzheimer’s patient:

Communication difficulties can be one of the most upsetting aspects of caring for someone with Alzheimer’s. It’s frustrating for those with the disease and for the caretaker. Familiarize yourself with some of the common situations that arise when someone has dementia, so that you can respond calmly and effectively. Here are few to tips to make note of:

  • Scheduling. In order to keep your parents or loved ones safe, you have to establish a routine that will make your ordinary day more predictable, stable and less stressful.
  • “Cues.” Explain regular, everyday things in detail. For example, if you name a drawer for what is inside, the patient will most likely put things in the correct place you suggested. This will ease things for both the caregiver and the patient.
  • Remove danger. Remove things that could endanger patients like knives, car keys and matches.
  • Use technology. Use technology at its best to monitor patient health, location as well as to keep a check on them while you are away from home.
  • Create limitations. Limit your instructions to one step at a time. If you are having a conversation, limit surrounding distractions like the TV and radio. It will help your loved ones stay focused on the conversation.
  • Professional help. If the patient’s health deteriorates ask for help. If required hire a professional caretaker or a nurse for full time or on a part time basis.
Facts About Alzheimer’s Disease
  • More than 4 million Indians suffer from Alzheimer’s and other forms of dementia.
  • Half of adults aged 85 and over have Alzheimer’s.
  • More than half of the cases of Alzheimer’s remain undiagnosed.
  • More women have Alzheimer’s than men.
  • Globally India has the third highest number of cases of Alzheimer’s.
  • India’s dementia and Alzheimer’s burden is forecast to reach almost 7.5 million by the end of 2030.
Alzheimer’s Symptoms

To receive a diagnosis of Alzheimer’s, the person must have experienced a decline in cognitive or behavioural function and performance compared with how they were previously. This decline interferes with their ability to function at work or in usual activities. The cognitive decline must be observed in at least two of the five symptom areas listed below:

1. Reduced ability to take in and remember new information, which includes:

  • Getting lost on a familiar route.
  • Repetitive questions or conversations.
  • Misplacing personal belongings.
  • Forgetting events or appointments.

2. Impairments related to reasoning, complex tasking, taking decisions, for example:

  • Poor decision-making ability.
  • Poor understanding of safety risks.
  • Inability to manage finances.
  • Inability to plan complex or sequential activities

3. Impaired visuospatial abilities like:

  • Inability to recognize faces or common objects.
  • Inability to use simple tools.

4. Impaired speaking, reading and writing, for example:

  • Difficulty thinking of common words while speaking.
  • Speech, spelling, and writing errors.

5. Changes in personality and behaviour, for example:

  • Mood changes, including agitation, social withdrawal.
  • Loss of empathy.
  • Compulsive, obsessive, or socially unacceptable behaviour.

The number one symptom of Alzheimer’s still remains as memory loss especially in the area of learning and recalling new information. If you know someone showing these symptoms guide them to our Alzheimer’s Clinic. Please find below link of our website for further details:


Spine Care

Friday, September 13th, 2019

Spine care is an essential part of your health. The three main functions of the spine are to: 1. Protect the spinal cord, nerve roots and several of the body’s internal organs. 2. Provide structural support and balance to maintain an upright posture. 3. Enable flexible motion. Your spine allows your body to be in a stable and upright position. A strong spine and good posture are essential to healthy mobility, a painful spine can eliminate it.

Your spine is a part of the central nervous system, along with the brain, and relies on the peripheral nervous system: the millions of nerves that send messages to the brain that control the body’s functions. An unhealthy spine interferes with this entire system, causing a host of unwelcome health issues such as pain, numbness, and weakness in the arms and legs, digestion and impaired control of the bowel and bladder.

Spine disorders:

Here are a few common spine disorders that affect people:

  • Degenerative disc disease is a normal part of aging that often occurs along with spinal stenosis. Over time, stressors and minor injuries cause the spinal discs to gradually degenerate, shrinking the space between discs and causing instability and nerve compression.
  • Slip disc can occur as a result of injury, fall or repetitive motion or as a part of normal ageing process.
  • Spondylolisthesis occurs when one vertebra slips forward on the vertebra below it. It causes immense back pain.
  • Kyphosis is an abnormal forward curve in the upper part of the spine. It is typically found in older women but it may occur in any age. Severe Kyphosis may also cause fractures of the vertebrae.
  • Osteoporosis typically occurs in post menopausal women and may contribute to vertebral fractures.
  • Sciatica is caused by irritation of the root(s) of the lower lumbar and lumbosacral spine.
  • Spinal Stenosis is the narrowing of the spinal canal that often accompanies degenerative disc disease and is typically seen in people over 60. It progresses slowly over time and causes back and leg pain during activity.
  • Scoliosis is a sideways curvature of the spine that occurs during growth spurts before puberty or as a result of arthritis, spinal injury or other spinal disorders. Most cases are mild, but severe cases can be disabling too.

Strengthen your spine

Do you slouch?

Slouching is the reason why 80% people suffer from spinal problems.

Here are a few tips to help you take better care of your spine and back:

1. Good posture is essential

Maintaining an erect good posture is the key to a healthy spine and helps prevent many spine problems.

2. Deep belly breathing 

This can help improve your posture. Place your hands on your abdominal area and feel your belly move as you inhale and exhale. Do this as many times a day as possible to improve your posture and overall spinal health.

3. Exercise for good spine health

Just 10 minutes per day is all you need to perform some simple spine-strengthening exercises. Neck stretches, shoulder exercises, including bending and extension range-of-motion exercises can dramatically improve the health of the cervical spine.

4. Eat healthy for your spine

You may not think that your diet affects your spine, but it actually plays a key role. A healthy diet consisting mostly of lean proteins, healthy fats and lots of fresh fruits and vegetables is ideal for building a lean body and muscles that support the spine.

5. Get some sunlight

Sunlight contains vitamin D, which is required for strong bones, including the spinal column, and is manufactured in the body through sun exposure. Try to spend 10 to 20 minutes in sunlight daily.

6. Check your sleep pattern

Studies suggest that insufficient sleep is associated with increased neck and back problems. Sleep in a position that enables the spine to relax, the idal being on your side. Choose a suitable mattress as well as pillow for proper neck support.

7. Don’t hesitate to meditate

People who meditate tend to focus on their core, automatically straightening their spines in the process.

Stop these mistakes!

Here are a few mistakes that may ruin or worsen your spine problems:

  • Ignoring your pain for too long – If back pain continues for a few days do not ignore. Do not just reply on self medication. Consult a spine expert for correct diagnosis and treatment.
  • Choosing surgery too quickly – Do not take hasty decisions. It is recommended to try non-surgical treatments for at least several weeks or months before considering surgery.
  • Poor sitting posture – Do you work for long hours at your desk in a poor posture? It is time to correct it with ergonomics.
  • Excess mobile usage – Excessive texting or seeing your cell phone for long hours can cause repeated stress injury and pain in the neck. This is called text neck.
  • Remaining inactive – If you are in pain, one or two days of doctor-recommended rest is fine. However, over time lack of activity will in fact lead to more pain. Consult a physiotherapist for a daily exercise routine that suits your spine.

Are you or a family member suffering from a spine injury or a chronic back ache? Get yourself checked, consult experts at our Centre for Bone and Joint for further help. Please find below link for more details: