Sunday, August 28, 2016

Ventricular Tachycardia - Patient Information

Ventricular tachycardia (VT) is a type of cardiac arrhythmia or heart rhythm disorder. VT causes abnormally fast beating of heart.

Symptoms: 

  • Feeling of palpitation inside chest
  • Lightheadedness
  • Dizziness
  • Loss of consciousness
  • even sudden death
Conditions increasing the risk of VT

  • Any previous history of Myocardial infarction (Heart attack), Coronary artery disease
  • Reduced pumping function of heart (reduced ejection fraction)
  • Many Congenital heart diseases (with or without surgery)
  • Cardiomyopathies (Diseases of heart muscles)
  • Some electrical diseases of heart like Long QT syndrome, Brugada syndrome. These diseases usually have family history of sudden cardiac death.
Diagnosis:
(By W.G. de Voogt, MD, PhD, SLAZ, The Netherlands - W.G. de Voogt, MD, PhD, SLAZ, The Netherlands, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=24366354)
  • ECG - ECG gives the diagnosis of VT. (shown above)
  • In some cases where ECG is not available, but cardiac arrhythmia is suspected, other modalities like - Holter monitoring, Event recorders, Electrophysiological study - are done.
Management:

  1. Acute management: When a patient presents to the emergency dept. with ongoing VT, electrical cardioversion (shock) is usually done. In some cases when the patient is hemodynamically stable treatment with medications can  be tried.
  2. Long term management: include
  • Medications
  • Catheter ablation of VT - It is a safe and effective method for management of VT. Catheter ablation is curative in some cases. In some cases recurrence of VT can occur, where repeat ablation can be done.
  • ICD (Implantable cardioverter defibrillator) : Is highly effective in preventing sudden death in patients with history of VT or reduced ejection capacity of heart (EF<35%).
(The materials on this blog are provided to educate the public about heart and heart diseases. The informations provided on the blog are not intended nor recommended as a substitute for professional medical advice, is for general information only, and is designed to support, not replace, the relationship that exists between you and your physician. This blog does not provide medical services or advice as part of this website and nothing contained on this blog is intended to be used for medical diagnosis or treatment. Always talk with your doctor if you have questions about your symptoms, diagnosis and treatment.)


Dr. Anupam Jena

Consultant Interventional Cardiologist and Electrophysiologist

Kalinga institute of Medical Sciences

Bhubaneswar, Odisha, India

Email: drjena@live.com


Monday, August 1, 2016

Heart Disease In Odisha : An Insight


Odisha the rich poor-state of India is caught in unique cross roads as related to heart diseases. According to Odisha economic survey 2014-15 (the latest I could get online) cardiac diseases are responsible for the majority of deaths excluding senility. Whereas senility was responsible for 36.4% of deaths, heart disease is the single most common treatable cause of death accounting for 10.8% of deaths: that is more than 25000 deaths per year. Considering the prevalence of Heart disease to be around 5% in the general population, Odisha has 25 lac patients with heart disease. Now I am not sure about the underlying diagnoses in the deaths due to senility but among available diagnoses heart diseases are the single most common cause of death in Odisha.  This is particularly of concern because majority of those deaths due to heart disease can be prevented by timely prevention and treatment. Another disturbing fact is that many of those dying of heart disease are young and middle aged in their 40s and 50s. So the loss of productive years and income also adds hugely to the economic burden as well as is disastrous to the families. While it is prudent to expect the state to implement public health measures and some kind of health insurance, it is of utmost importance that we as responsible individuals understand the seriousness of the situation and start taking care of our own health. We Indians are genetically predisposed to heart diseases. In India coronary artery diseases occur approximately 10 years earlier as compared to westerners, also the disease more extensively involves multiple coronary arteries. So Indians as a whole are hit early and hit harder by heart diseases. But as I have said earlier heart diseases can be prevented to a great extent by following healthy life styles. Heart diseases can also be effectively treated by timely diagnoses and management. 
This blog is an attempt to create awareness among the general population about diseases and management options for cardiac conditions especially in the Indian perspective. We will examine each and every issue related to heart disease in the coming days. 

Dr Anupam Jena
Consultant Interventional Cardiologist and Electrophysiologist 
Kalinga Institute of Medical Sciences
Bhubaneswar
Odisha, India