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MERA
HRIDAYA patient information guide
CONTENT
1) HIGH BLOOD PRESSURE
2) HIGH CHOLESTEROL
3) HEART DISEASE: ANGINA
4) HEART DISEASE: ANGIOPLASTY
5) HEART DISEASE: BEING ACTIVE
6) HEART DISEASE: ANTIPLATELET TREATMENT
7) HEART DISEASE: LIFESTYLE CHANGES TO LOWER RISK
8) HEART DISEASE: HOW TO MANAGE YOUR LIFE AFTER A HEART ATTACK
9) HEART FAILURE
01
03
05
07
09
11
13
15
17
Page No.
MERA HRIDAY
MERA HRIDAY 01
Blood pressure is a measure of the force of
blood against the walls of your arteries. Blood
pressure readings include two numbers, such
as 130/80, or "130 over 80." The first number is
the systolic pressure. This is the force of blood
on the artery walls as your heart pumps. The
second number is the diastolic pressure. This is
the force of blood on the artery walls between
heartbeats, when your heart rests.
If your blood pressure is usually above 140/90,
yo u h ave h i g h b l o o d p re s s u re , o r
hypertension.
Despite what a lot of people think, high blood
pressure usually does not cause headaches or
make you feel dizzy or lightheaded. It usually
has no symptoms. However, it does increase
your risk for heart attack, stroke, heart
failure, and kidney or eye damage. The higher
your blood pressure, the more your risk
increases.
If you have high blood pressure, your doctor
will give you a blood pressure goal. Your goal
What is high blood pressure?
will be based on your health and your age. An
example of a goal is to keep your blood
pressure below 140/90.
Lifestyle changes, such as eating healthy and
being active, are always important to help
lower blood pressure. You might also take
medicine to reach your blood pressure goal.
Take your medicines as prescribed. Call your
doctor if you think you are having a problem
with your medicine. You may take one or more
types of medicine to lower your blood
pressure. If you stop taking your medicine,
your blood pressure will go back up.
See your doctor regularly.
Learn how to check your blood pressure at
home.
If you are taking blood pressure medicine talk
to your doctor before you take decongestants
or nonsteroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen. Some of these can
What can you do about high blood pressure?
Follow your treatment plan
HIGH BLOOD PRESSURE
MERA HRIDAY02
raise blood pressure or interact with blood
pressure medicines.
Ÿ Stay at a healthy weight. This is especially
important if you put on weight around your
waist. If you are overweight, losing even 10
pounds can help you lower your blood
pressure.
Ÿ Try to do moderate aerobic activity at least
2½ hours a week. Or try to do vigorous
activity at least 1¼ hours a week.
Ÿ If you drink alcohol, drink moderately. Limit
alcohol to 2 drinks a day for men and 1 drink
a day for women.
Ÿ Try to limit the amount of sodium you eat to
less than 1,500 milligrams (mg) a day.
Ÿ Follow the DASH (Dietary Approaches to
Stop Hypertension) eating plan. This plan
can help you lower blood pressure. Its
focus is on fruits, vegetables, healthy fats,
and low-fat dairy foods. This type of eating
plan can help you lose weight and also
lower your risk for heart disease.
Ÿ Do not smoke. Smoking increases your risk
for heart attack and stroke. If you need help
quitting, talk to your doctor about stop-
smoking programs and medicines. These
can increase your chances of quitting for
good health.
Call a doctor right away if you have high blood
pressure and:
Ÿ Your blood pressure is much higher than
normal (such as 180/110 or higher).
Ÿ You think high blood pressure is causing
Make lifestyle change
When should you call for help?
symptoms such as:
Ÿ Severe headaches.
Ÿ Blurry vision.
Ÿ Your blood pressure is 140/90 or higher on
two or more occasions.
Ÿ You think you may be having side effects
from your blood pressure medicine.
Ÿ Your blood pressure is usually normal and
well controlled, but it goes above the
normal range on more than one occasion.
Make an appointment to see your doctor if
you have never been diagnosed with high
blood pressure but you have a high blood
pressure reading.
Call a doctor if:
MERA HRIDAY 03
HIGH CHOLESTEROL
Cholesterol is a type of fat. Your body needs it
for many things, such as making new cells. You
get cholesterol from the foods you eat and
your body makes it.
Having too much cholesterol does not make
you feel sick. But it raises your risk of a heart
attack and stroke.
Your cholesterol levels can help your doctor
find out your risk for having a heart attack or
stroke.
LDL (low-density lipoprotein) is the "bad"
cholesterol. High LDL can raise your risk for
heart disease, heart attack, and stroke. HDL
(high-density lipoprotein) is the "good”
cholesterol. High HDL is linked with a lower risk
for heart disease, heart attack, and stroke.
But it's not just about your cholesterol. Your
doctor uses your cholesterol levels plus other
things to calculate your risk. These include:
Ÿ Your blood pressure
Ÿ Whether you have diabetes or not
Ÿ Your age, sex, and race
Ÿ Whether you smoke or not
Understanding your cholesterol levels
Treating high cholesterol
Lifestyle changes
The goal of treatment is to reduce your
chances of having a heart attack or stroke. The
goal is not to lower your cholesterol numbers
only. The two types of treatment are:
Ÿ Lifestyle changes
Ÿ Medicines called statins
The way you choose to lower your risk will
depend on how high your risk for heart attack
and stroke is. It will also depend on how you
feel about taking medicines. Your doctor can
help you know your risk. Your doctor can help
you balance the benefits and risks of your
treatment options.
Lifestyle changes are always important, even if
you take medicines to lower your risk.
Your doctor may suggest that you make one or
more of the following changes :
Ÿ Eat heart-healthy foods.
Ÿ Lose weight if you need to, and stay at a
healthy weight.
Ÿ Be active on most, if not all, days of the
week.
Ÿ Don't smoke.
Some people take medicines called statins, in
addition to making lifestyle changes. This
medicine can lower the risk of a heart attack or
stroke.
Statins reduce the body's natural production
of cholesterol. So they lower the amount of
cholesterol in your blood.
Statins don't cause side effects in most people.
When side effects happen, they tend to
include minor problems such as muscle aches
and tiredness. Serious side effects are rare. If
you can't take a statin, your doctor may
recommend another type of cholesterol
medicine.
Talk with your doctor about your risk of a heart
attack and stroke. Together you can decide if
medicine is right for you. Your doctor may
recommend that you take statins if the
benefits outweigh the risks.
For some people, the chance of having a heart
attack or stroke is high. These people may
decide to start taking a statin because statins
can reduce this risk.
For other people, it's not as clear if they need
to take a statin. You and your doctor will need
to look at your overall health and any other
risks you have for heart attack and stroke.
Take the sheet with you to your next doctor
visit. You may want to ask your doctor these
questions:
Ÿ What is my risk for heart attack and
stroke?
Medicines
Deciding about medicine
Talk to your doctor
Ÿ Should I do something to help lower my
risk?
Ÿ What lifestyle changes can help me stay
healthy? How can I make changes that
will last?
Ÿ Should I think about taking medicine?
Do you have any questions or concerns after
reading this information? It's a good idea to
write them down and take them to your next
doctor visit.
MERA HRIDAY04
MERA HRIDAY 05
HEART DISEASE: ANGINA
Angina is a symptom of heart disease.
Angina happens when your heart does not get
enough blood. This is caused by heart disease,
also called coronary artery disease. Heart
disease can narrow the arteries that bring
blood to the heart muscle. Heart disease
increases your risk for a heart attack.
Symptoms of angina include chest pain or
pressure, or a strange feeling in the chest.
Some people feel pain, pressure, or a strange
feeling in the back, neck, jaw, or upper belly, or
in one or both shoulders or arms. Other
symptoms of angina include shortness of
breath, nausea or vomiting, light headed
nessorsudden weakness, or a fast or irregular
heartbeat.The different types of angina include:
• Stable angina: This type has a typical
pattern. People who have it know when it
may happen, such as when they exercise or
do activities. It goes away when they rest or
stop the activity, or when they take a
medicine such as nitroglycerin.
• Unstable angina: This is a change in the
usual pattern of stable angina. The
symptoms happen at rest or with less
activity. They do not go away with rest or
nitroglycerin.
• Angina caused by coronary artery spasms:
This type of angina happens when a
coronary artery suddenly contracts (or
spasms). The spasm reduces blood flow to
the heart.
Variant angina (Prinzmetal's angina) is one
type caused by a spasm. It has a typical
pattern. It usually occurs when you are
atrest and lasts 2 to 5 minutes. It happens
more often at night, in the early morning,
or at the same time of the day.
With both a heart attack and angina, part of
your heart muscle is not getting enough
oxygen because of reduced or blocked blood
flow in your coronary arteries. With angina,
the lack of oxygen is temporary. Permanent
heart damage doesn't occur. But during a
What is the difference between angina and
a heart attack?
Unstable angina is an emergency
because you might be having
a heart attack.
MERA HRIDAY06
heart attack, the lack of oxygen lasts longer
and damages the heart.
With stable angina, you may notice the
problem only when your heart is working
harder and needs more oxygen, such as during
exercise. The pain goes away when you rest,
because your heart no longer needs as much
oxygen.
With unstable angina, a clot may be partially
blocking your coronary artery, or it completely
blocks it for a short time.
Most people who have stable angina can
manage their symptoms. This includes taking
medicines as prescribed.
If your doctor has given you nitroglycerin, keep
it with you at all times. If you have angina
symptoms, sit down and rest, and take a dose
of nitroglycerin as directed.
Staying active and knowing when to rest during
activity is also important. You can try these
tips:
Ÿ If an activity causes angina, stop and rest.
Be active at a level that does not cause
symptoms.
How can you manage angina?
Ÿ Ease into your day. Warm up slowly before
activity.
Ÿ Give yourself time to rest and digest right
after meals.
Ÿ Change the way you eat. Eat smaller meals
more often during the day instead of two
or three large meals.
If angina is more severe and you are having a
hard time managing it, you can:
Ÿ See if family members or hired help can
assist with heavy chores such as shoveling
snow or mowing lawns.
Ÿ Try taking nitroglycerin before you start a
stressful activity that can cause angina,
such as walking uphill or having sex.
Ÿ If you are not taking a medicine for angina,
ask your doctor if one could help you.
Call 108 if you have symptoms of a heart
attack. These may include:
Ÿ Chest pain or pressure, or a strange feeling
in the chest
Ÿ Sweating
Ÿ Shortness of breath
Ÿ Nausea or vomiting.
Ÿ Pain, pressure, or a strange feeling in the
back, neck, jaw, or upper belly or in one or
both shoulders or arms
Ÿ Lightheadedness or sudden weakness
Ÿ A fast or irregular heartbeat
If you use nitroglycerin and one dose has not
relieved your symptoms within 5 minutes, call
108. Do not wait to call for help.
After you call 108, the operator may tell you to
chew 1 adult - strength or 2 to 4 low-dose
aspirin. Wait for an ambulance. Do not try to
drive your self.
Ÿ There is a sudden change in your angina
symptoms.
Ÿ You begin to get angina at unexpected
times.
Ÿ You get angina when you are resting.
When should you call for help ?
Call your doctor now or seek immediate
medical care if:
If you have angina, pay attention
to your symptoms.
Know what is typical for you,
learn how to control it, and understand
when you need to get treatment.
MERA HRIDAY 07
Angioplasty is a way to get more blood flowing to the heart muscle. Your doctor may call it percutaneous coronary intervention (PCI).
It is a procedure that widens a coronary artery that was narrowed or blocked by plaque. Coronary arteries are blood vessels that provide blood and other nutrients to the heart muscle. Plaque is a fatty buildup that can block your arteries.
If you have a heart attack, an emergency angioplasty might be done to prevent more damage to your heart.
Or, you might choose to have this procedure if you have angina symptoms that do not go away with medicine and healthy life style changes. An angioplasty can improve blood flow to your heart. But it is not a cure for heart disease.
Before angioplasty, the doctor will do a test called a coronary angiogram. For this test, any tube called a catheter is threaded through an artery in your arm or groin and up to the coronary arteries. A dye is then sent through the catheter. The dye makes your coronary arteries show up on a screen so the doctor can see them. If one is narrowed or blocked, your doctor will do angioplasty.
How it is done ?
During angioplasty, the doctor threads a catheter into the narrowed or blocked artery. At the end of the catheter is a tiny balloon. The doctor inflates the balloon inside the artery to open the blocked or narrow area.
The doctor may put a stent in your artery
during angioplasty. A stent is a small tube that
expands against the walls of the artery. The
stent can keep the artery from closing again.The doctor may use a type of stent called a drug-eluting stent. These stents are coated with medicines that keep scar tissue from forming inside the stent. This helps keep the artery open.
Angioplasty doesn't require a large cut
(incision). You'll get medicine to help you relax,
but you'll be awake during the procedure.
What to expect after the procedure ?
Ÿ You will have a large bandage at the site
where the catheter was inserted.
Ÿ Nurses will check your heart rate and
blood pressure and check the insertion
site for bleeding.
Ÿ If the insertion site is at your groin, you will
need to keep your leg straight for a few
hours.
Ÿ If the insertion site is in your arm, you will
need to keep your arm still for at least one
HEART DISEASE: ANGIOPLASTY
MERA HRIDAY08
hour.
Ÿ You will probably go home in a day or two.
Once you are home:
Ÿ Gently wash around the insertion site with
clean water 2 times a day unless your
doctor gives you other instructions. Other
cleaning products, such as hydrogen
peroxide, can slow wound healing.
Ÿ Check the insertion site every day for signs
of infection: redness, swelling, pus, or
fever.
Ÿ You will probably be able to return to your
normal activities in a few days.
Ÿ Do not smoke. Smoking raises your risk of
having the artery close after angioplasty
or stent placement.
Ÿ Keep all your follow-up appointments.
Angioplasty is not a cure. You still need to
see your doctor and take your medicines.
Ÿ Take your medicines as directed. If you got
a stent, you'll take blood-thinning
medicines, including aspirin, to help
prevent a heart attack. Don't stop these
medicines unless you've checked with
your doctor first. If you got a drug-eluting
stent, you will probably take both of these
medicines for at least 1 year. If you got a
bare metal stent, you will take both
medicines for at least 1 month but maybe
up to 1 year. Then, you'll likely take daily
aspirin long-term. Your doctor might
recommend cardiac rehab for you. In
rehab, you'll get education and support to
help you recover and make lifestyle
changes to keep your heart healthy.
Risks
When to call your doctor Call your doctor if:
The rate of problems after angioplasty is very
low. But like all medical procedures, it does
have some risks. The most common are:
Ÿ Bleeding from the blood vessel where the
catheter was inserted.
Ÿ Damage to the blood vessel in your groin
or arm, which may need to be repaired.
Ÿ Damage to the coronary artery, which can
cause a heart attack.
Ÿ Infection.
Ÿ An allergic reaction to the dye used during
the procedure
Ÿ An allergic reaction to the dye used during the procedure
• You have any signs of infection.
These include:
¡ Increased pain, swelling,
warmth, or redness at the
insertion site
¡ Red streaks leading from the
insertion site
¡ Pus draining from the
insertion site
¡ Fever
Ÿ You have pain or bleeding at the insertion site
Ÿ You have any questions or concerns
MERA HRIDAY 09
When you have heart disease, it is very
important to get regular exercise. Exercise can
help your heart get stronger and work better.
Your doctor can suggest a safe level of
exercise based on your condition and the
stage of your disease. Even if you can only do a
small amount, exercise will help you have
more energy and manage your weight and
your stress
Your heart is a muscle. When you use a muscle
during exercise, it gets stronger and more
efficient. A more efficient heart can pump
more blood with each heartbeat and deliver
more oxygen and nutrients to the rest of the
body. Getting regular exercise is important
because even a short period of inactivity can
weaken your heart.
Ÿ Reduce angina symptoms, such as chest
pain or discomfort
Ÿ Improve cholesterol
Ÿ Lower your blood pressure
Ÿ Reduce or control your weight
Exercise: Why does it matter?
Regular exercise also helps :
Ÿ Reduce stress and lift your mood
Before you start an exercise program:
Ÿ See your doctor for a complete physical
exa m . Yo u r d o c t o r m ay d o a n
electrocardiogram (EKG or ECG) and a
stress test to see what level of activity
your
Ÿ heart can handle.
Ÿ Before your visit, make a list of questions
to discuss with your doctor.
Ÿ Learn how to check your heart rate. Your
doctor can tell you how fast your heart
rate should be when you exercise.
Your doctor can help you make an exercise plan. Or your doctor may suggest a cardiac rehab program at a local hospital or clinic. Cardiac rehab is a medically supervised program for people who have heart problems. It includes exercise, lifestyle changes, education, and emotional support. A team of doctors, nurses, dietitians, and physical therapists can design a program to help you improve your quality of life.
Getting ready to exercise
Making an exercise plan
HEART DISEASE: BEING ACTIVE
MERA HRIDAY10
Most exercise programs include:
Once you have started:
Ÿ Stretching for 10 to 15 minutes helps
warm up your muscles.
Ÿ Activities that raise your heart rate
(aerobic exercise). Walking, riding a
stationary bike, and swimming are all
aerobic exercises.
Ÿ Strength training. Exercises using light
weights can help tone and strengthen
your muscles.
Ÿ A cool-down period.
Once you start exercising, try to stick with it. Here are some tips that can help you succeed:
Ÿ Start slowly, and set realistic goals. If you
expect too much too soon, you may get
discouraged and give up.
Ÿ Find a partner. One of the best ways to stay
motivated to exercise is to include other
people. Ask a friend or coworker to join
you. Join a health club or walking group.
Ÿ Choose a type of exercise that you enjoy.
Walking is a great exercise that most
people like and can do. You may want to
set a goal of walking briskly for at least 30
minutes a day.
Ÿ Keep a daily record of your exercise. It is
okay to skip a day once in a while or to cut
back if you are too tired or not feeling well.
Ÿ Give yourself time. It can take months to
get into the habit of exercising. After a few
months, you may find that you look
forward to it.Ÿ Reward yourself. Build in rewards along
the way that help you continue your program.
Keep in mind It is important to:
For safety:
Ÿ Take your pulse often. Check your pulse
when you walk up hills or stairs. Make sure
it stays in a safe range.
Ÿ Watch for signs that your heart is working
too hard. You are pushing yourself too
hard if you cannot talk while you are
exercising.
Ÿ If you become short of breath or dizzy,
stop, sit down, and rest. If these
symptoms do not go away, call your
doctor.
Ÿ If you think you might be having a heart
attack, call 108 right away. Symptoms
include pain, pressure, or a strange
feeling in your chest, back, neck, jaw,
upper belly, arm, or shoulder.
Ÿ Ask your doctor about continuing your
exercise program if your medicines
change. New medicines can affect how
you feel when you exercise.
Ÿ Adjust your exercise program if it is
interrupted for more than a couple of
days. Gradually increase to your regular
activity level.
If you feel "wiped out" the day after you
exercise, walk slower or for a shorter distance
until you can work up to a better pace.
Ÿ Do not exercise outdoors when it is very
cold, very hot, or very humid. When the
weather is bad, exercise indoors or walk at
a mall.
Ÿ Avoid exercises that require or encourage
holding your breath, such as push-ups and
sit-ups. Also avoid heavy lifting.
Do not take hot or cold showers or sauna
baths right after you exercise. Very hot or
very cold temperatures can be dangerous
Ÿ
.
MERA HRIDAY 11
If you have heart disease, one of the things you
can do to help your heart is to take medicine
that helps prevent your blood from clotting.
This is called antiplatelet therapy.
Aspirin is the most common antiplatelet
medicine. Your doctor may suggest that you
take aspirin, another antiplatelet medicine, or
both.
Antiplatelet medicine helps prevent heart
attacks. Heart attacks occur when blood flow
to the heart is blocked. This usually happens
because fatty deposits called plaque have built
up inside the coronary arteries, which supply
blood to the heart. If a plaque breaks open, the
body tries to fix it by forming a clot around it.
The clot can block the artery, preventing the
flow of blood and oxygen to the heart and
causing a heart attack.
Blood clots also can form on stents, which are
small expandable tubes that are put in your
coronary artery during angioplasty. They keep
the artery open. Blood clots on a stent block
blood flow and can cause a heart attack.
Antiplatelet medicine helps prevent blood
clots in the arteries and on stents. This reduces
Why take antiplatelet medicine?
the chances that you will have a heart attack.
These medicines make bleeding more likely.
Talk to your doctor about your risk for
bleeding, especially if:
Ÿ You have stomach ulcers or have had
bleeding in your stomach or another part
of your digestive tract
Ÿ before.
Ÿ You had a stroke caused by bleeding in the
brain.
Ÿ Limit alcohol. Ask your doctor whether
you can drink alcohol and how much you
can drink. Drinking 3 or more alcoholic
drinks a day while taking antiplatelet
medicine increases your risk for liver
damage and stomach bleeding.
Ÿ Do not take prescription or over-the-
counter medicines, vitamins, herbal
products, or supplements without talking
Is the medicine safe?
Things to avoid when you take antiplatelet
medicine :
HEART DISEASE: ANTIPLATELET TREATMENT
MERA HRIDAY12
to your doctor first. Before you take any
over-the-counter medicine, read the
label. Many contain aspirin and could
cause you to take too much aspirin.
Ÿ Do not take prescription blood thinners
(anticoagulants) unless your doctor has
told you to.
Ÿ Do not stop taking aspirin or another
antiplatelet medicine without talking to
your doctor first. Call your doctor if you
think you are having a problem with your
medicine.
Ÿ Talk to your doctor before having a
medical procedure, surgery, or dental
work that may cause bleeding. Your
doctor can tell you if and when you should
stop taking your antiplatelet medicine
before the procedure. Make sure you
understand exactly what your doctor
wants you to do.
Ÿ Talk to your doctor before taking aspirin or
another antiplatelet medicine if you are
pregnant, are breast-
Other concerns :
When to call your doctor
feeding, or plan to
become pregnant.
Ÿ If you need to take a pain reliever, talk to
your doctor about which one you should
take.
Call 108 anytime you think you may need emergency care. For example, call if:
Ÿ You pass out (lost Consciousness).
Ÿ You have a sudden, severe headache that
is different from past headaches.
Ÿ You have symptoms of a heart attack.
These may include:
v Chest pain or pressure, or a strange
feeling in the chest
v Sweating
v Shortness of breath
v Nausea or vomiting
v Pain, pressure, or a strange feeling in
the back, neck, jaw, or upper belly, or in
one or both shoulders or arms
v Lightheadedness or sudden weakness
v A fast or irregular heartbeat
After you call 108, the operator may tell you to
chew 1 adult-strength or 2 to 4 low-dose
aspirin. Wait for an ambulance. Do not try to
drive yourself.
Call your doctor now or seek medical care
right away if:
Watch closely for changes in your health, and
be sure to contact your doctor if:
v You have any abnormal bleeding, such as:
¦ Nosebleeds
¦ Vaginal bleeding that is different (heavier,
more frequent, at a different time of the
month) than what you are used to
¦ Bloody or black stools, or rectal bleeding
¦ Bloody or pink urine
v You have:
¦ Ringing in your ears
¦ Problems with your vision
¦ Nausea
¦ Dizziness
¦ Rapid or deep breathing
v You have an upset stomach
v You have questions about aspirin or other
antiplatelet medicines
MERA HRIDAY 13
HEART DISEASE: LIFESTYLE CHANGES TO LOWER RISK
If you have heart disease, you can help lower
your risk of a heart attack and stroke with
healthy lifestyle changes. A healthy lifestyle
can also improve the quality and length of your
life.
You can lower your risk for heart attack and
stroke by making lifestyle changes and taking
medicine.
To be heart-healthy, eat healthy foods, be
active, stay at a healthy weight, and don't
smoke.
It's not easy to make changes. But taking the
time to really think about what will motivate or
inspire you will help you reach your goals. Also,
the more support you have for making a
lifestyle change, the easier it is to make that
change.
Ask your doctor if a cardiac rehabilitation
(rehab) program is right for you. In cardiac
rehab, you will get support to help you build
new, healthy habits.
Making lifestyle changes
Getting active
Before you start a new activity, talk to your
doctor about how much exercise is safe.
Start slowly, and go at a pace you can manage.
Try to do at least 2½ hours of moderate
exercise a week. One way to do this is to be
active 30 minutes a day, at least 5 days a week.
Walking is an easy, low-cost way to be active.
Walking with a partner helps you keep up a
routine. Try using a pedometer to count your
steps and set walking goals.
Here are some other ideas for getting active:
Ÿ Work in the yard or garden.
Ÿ Swim or go for a bike ride.
Ÿ Join a health club or walking group.
No matter what you do, the key is making
physical activity a regular, fun part of your life.
Healthy eating starts with learning new ways
to eat, such as adding more fresh fruits,
vegetables and whole grains and cutting back
on foods that have a lot of saturated fat,
sodium, and sugar.
Heart-healthy eating
Heart-healthy foods include:
Ÿ Lean meat, poultry, fish, and beans
Ÿ Fruits and vegetables
Ÿ Whole grains and cereals
You can work with a dietitian to make a healthy
eating plan.
Getting active and eating a healthy diet can
help you lose extra weight.
You'll have more success getting to a healthy
weight if you first change the way you think
about certain things:
Ÿ Don't compare yourself to others.
Healthy bodies come in all shapes and
sizes.
Ÿ Pay attention to how hungry or how full
you feel. When you eat, pay attention to
why you're eating and how much you're
eating.
Ÿ Decide that you're going to improve your
health and plan exactly what you'll do to
reach that goal.
Healthy weight
Quit smoking
Quitting smoking may be the best thing you
can do for your heart and your body. It is hard
to quit. But there are many things that can help
you. Ask your doctor about:
Ÿ Medicine.
Ÿ Support groups and quitting smoking
programs
Ÿ Internet programs and smartphone or
tablet apps
Tips for getting support
Partner with someone who is also making
lifestyle changes.
Ÿ Get friends and family involved.
Ÿ Join a class or workout group.
Ÿ Give yourself positive reinforcement.
You will also take medicine that lowers your
risk for heart attack and stroke. This includes
medicine to:
Ÿ Lower risk of blood clots.
Ÿ Lower blood pressure.
Ÿ Lower cholesterol.
Even though you are taking medicine, it is
always important to make lifestyle changes
that keep your heart and your body healthy.
Do you have any questions or concerns after
reading this information? It's a good idea to
write them down and take them to your next
doctor visit.
Taking medicine
MERA HRIDAY14
MERA HRIDAY 15
HEART DISEASE: HOW TO MANAGE YOUR LIFE AFTER A HEART ATTACK
After a heart attack, you probably have
concerns about your health. But you can start
doing things now to improve your health and
prevent another heart attack.
Medicines and healthy lifestyle changes can
help you prevent another heart attack. A
healthy lifestyle means being active, eating a
heart-healthy diet, and controlling your blood
pressure and cholesterol.
Your doctor may recommend a cardiac
rehabilitation program. This will help you
recover and improve your health. You will learn
how to exercise safely, change your diet, deal
with stress, and return to your daily activities.
Certain medicines can lower your risk of having
another heart attack. These include:
Ÿ Beta-blockers and ACE inhibitors to lower
your blood pressure and reduce the
workload on your heart
Ÿ Aspirin and other antiplatelet medicines
to help prevent blood clots
Ÿ Statins to lower your cholesterol
Take your medicines exactly as prescribed. And
Medicines
don't stop taking them unless your doctor tells
you to. If you stop taking your medicines, you
can increase your risk of having another heart
attack.
Call your doctor if you think you are having a
problem with your medicine.
You can help lower your chance of having
another heart attack by managing other health
problems you might have. Health problems
such as high blood pressure, high cholesterol,
and diabetes can increase your risk of a heart
attack.
If you have any of these health problems,
healthy lifestyle changes, such as quitting
smoking, eating better, and being active, can
help. You also may need to take medicines to
manage these conditions.
Healthy lifestyle changes can help prevent
another heart attack:
Ÿ Quit smoking, and avoid secondhand
smoke. This is one of the best things you
can do for your heart and your overall
Manage other health problems
Lifestyle changes
health.
Ÿ Be active. Get at least 30 minutes of activity
on most days of the week. Physical activity,
like walking, can help you lose weight,
lower your blood pressure, and improve
your cholesterol. Before starting activity,
talk to your doctor to find out how much is
safe for you. Increase your activity a little
bit at a time, as your doctor approves.
Ÿ Eat a heart-healthy diet. This includes
plenty of fruits and vegetables, fish, and
high-fiber grains and breads. Eat foods low
in sodium (salt), saturated fat, trans fat, and
cholesterol.
Ÿ Lose weight if you need to, and stay at a
healthy weight.
Ÿ Cut down on stress. Stress may damage
your heart, and it can trigger a heart attack.
Ÿ Avoid colds and flu. Get the flu vaccine
every year. Get a pneumococcal vaccine
shot. If you have had one
Ÿ before, ask your doctor whether you need
another dose.
Ÿ Ask for help if you think you are depressed.
A medical team can design a cardiac
rehabilitation (rehab) program to fit your
needs. This type of program helps you recover
from a heart attack. It also helps you take steps
to prevent another one.
In the program, your doctor and other
specialists will give you education and support
to help you build new, healthy habits. You will
learn how to manage your heart disease and
any other health problems you might have.
Working with your team, you'll decide what
lifestyle choices are best for you.
If your doctor hasn't already suggested it, ask
him or her if cardiac rehab is right for you.
Take part in cardiac rehab
When to call for help Call 108 if:
Ÿ You have symptoms of a heart attack.
Ÿ You have signs of a stroke, such as:
Ÿ Sudden numbness, paralysis, or
weakness in your face, arm, or leg,
especially on only one side of your body.Ÿ New problems with walking or balance.Ÿ Sudden vision changes.Ÿ Drooling or slurred speech.Ÿ N e w p r o b l e m s s p e a k i n g o r
understanding simple statements, or feeling confused. A sudden, severe headache that is different from past headaches.
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There are many steps you can take to feel
better and improve your health if you have
heart failure. Medicine and lifestyle changes
can slow heart failure in some people. Learning
all you can about your condition can help you
get the best results from your treatment.
Heart failure occurs when your heart does not
pump as much blood as your body needs.
Failure does not mean that the heart has
stopped pumping. It means it is not pumping
as well as it should. Anything that damages the
heart and its ability to pump can lead to heart
failure. This includes coronary artery disease,
heart attack, high blood pressure, and heart
valve problems. You may not know you have
heart failure until you have had it for years. This
is because your heart can make up for not
being able to pump well by getting bigger and
beating faster. But it can only do this to a
certain point. In time, your heart gets worn
out. You have symptoms, such as feeling weak,
lightheaded, and very tired. Fluid builds up in
your lungs and other parts of your body. This
causes you to be short of breath and have
swelling in your body.
What is heart failure and what causes it?
What are the types of heart failure?
What increases your risk for heart failure?
Ask your doctor what type of heart failure you
have.
Most people get heart failure because of a
problem with the heart's left lower chamber
(ventricle). During the resting phase of your
heartbeat, the left ventricle fills with oxygen-
rich blood. This phase is called diastole. Then
the ventricle squeezes and pumps the blood to
your body. This pumping phase is called
systole.
Ÿ When the left ventricle cannot pump
well, it is called systolic heart failure.
Ÿ When the left ventricle cannot fill
properly, it is called diastolic heart
failure.
Heart failure is generally caused by another
disease, such as CAD, heart attack, and high
blood pressure. Anything that increases your
risk for getting one of those diseases also adds
to your risk, or is a risk factor, for heart failure.
For example, diabetes increases your chance
of having CAD, so it is also a risk factor for heart
failure.
HEART FAILURE
Some risk factors exist because of who you are.
Some result from your lifestyle choices. Others
come from your environment. Some risks that
you cannot control include:
Ÿ Your age: The risk of developing heart
failure rises sharply as you age.
Ÿ Your sex: Overall, men are at a higher risk
for heart failure than women. But this
difference narrows as women get older.
Your family history: If any of your close
relatives have or had heart failure, you
may have
Ÿ
inherited a risk for heart failure.
You may be able to control many things
that increase your risk for heart failure.
Examples include:
Ÿ Using tobacco: Smoking increases your
risk of heart disease.
Ÿ Drinking large amounts of alcohol, which
can raise your blood pressure, trigger
uneven heartbeats, and damage your
heart muscle.
Ÿ Not getting enough physical activity: Lack
of exercise can increase your risk of high
blood pressure, high cholesterol, high
blood sugar levels, blood clots, obesity,
and stress.
Ÿ Poor eating habits, which can cause
obesity and lead to high blood pressure,
diabetes, and high cholesterol.
Having a risk factor does not mean that you will
develop heart disease. Even if you have no risk
factors, you still may develop heart failure.
Your doctor's goal is to relieve your symptoms
and prevent more heart damage. Your doctor
will also need to treat the problem that caused
your heart failure. You will probably take
several medicines to reduce blood pressure
and fluid buildup and decrease your heart's
How is heart failure treated?
workload.
It is very important to take your medicines
exactly as your doctor tells you to and to keep
taking them. If you have any problems with the
medicines, tell your doctor. You may be able to
take different ones to get the same benefit.
Your doctor will also recommend some
lifestyle changes. Taking these steps can help
you feel better and might help slow the
progression of heart failure:
Ÿ Eat less sodium. Sodium causes you to
retain water and makes it harder for your
heart to pump.
Ÿ Get regular exercise, which will help keep
your heart healthy.
Ÿ Lose weight if you are overweight. Even
small changes can make a difference.
Ÿ Stop smoking.
Ÿ Limit alcohol. Ask your doctor how much,
if any, is safe.
Ÿ Control your blood pressure. Exercise,
limit alcohol, and control stress to help
keep your blood pressure in a healthy
range. You may also need to take
medicine.
Ÿ Watch your fluid intake if your doctor
advises it.
Ask your doctor if a cardiac rehab program is
right for you. Rehab can give you education
and support that help you learn self-care and
build new healthy habits, such as exercise.
Heart failure often gets worse over time and
requires more treatment to manage
symptoms and control complications. Take
your medicines as prescribed, make some
lifestyle changes, and work closely with your
doctor. These give you the best chance to
co nt r o l h e a r t fa i l u r e a n d p r ev e nt
complications.
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Dr. Shaunak Shah (M) +91-98250 44502
Dr. Manan Desai (M) +91-96385 96669
Dr. Dhiren Shah (M) +91-98255 75933
Dr. Dhaval Naik (M) +91-90991 11133
Dr. Chintan Sheth (M) +91-91732 04454
Dr. Niren Bhavsar (M) +91-98795 71917
Dr. Hiren Dholakia (M) +91-95863 75818
CARDIOVASCULAR, THORACIC &
THORACOSCOPIC SURGEON
CARDIAC ANAESTHETISTS
PAEDIATRIC & STRUCTURAL
HEART SURGEONS
CARDIOTHORACIC &
VASCULAR SURGEONS
Dr. Pranav Modi +91-99240 84700(M)
Dr. Satya Gupta (M) +91-99250 45780
Dr. Vineet Sankhla (M) +91-99250 15056
Dr. Vipul Kapoor (M) +91-98240 99848
Dr. Tejas V. Patel (M) +91-89403 05130
Dr. Gunvant Patel (M) +91-98240 61266
Dr. Keyur Parikh (M) +91-98250 26999
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Dr. Urmil Shah (M) +91-98250 66939
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Dr. Anish Chandarana (M) +91-98250 96922
Dr. Ajay Naik (M) +91-98250 82666
Dr. Kashyap Sheth (M) +91-99246 12288
Dr. Divyesh Sadadiwala (M) +91-82383 39980
Dr. Milan Chag (M) +91-98240 22107
CARDIOLOGISTS
CONGENITAL & STRUCTURAL HEART DISEASE SPECIALIST
CARDIAC ELECTROPHYSIOLOGIST
Dr. Ajay Naik (M)
Dr. Vineet Sankhla (M) +91-99250 15056
+91-98250 82666
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