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Words Of Wisdom by Prof B. M. Hegde
Your health
Articles about heart related diseases are necessary today because most people die everyday worrying about their heart problems. Heart diseases are found both in the rich and the poor; much more in the latter. While the rich get it labeled, the poor are unaware of its existence. Whereas lower animals like snakes get their blood supply to the muscles directly from the cavity , man pays a very heavy price of evolution with a very complicated blood supply system, the coronary tree ; taking origin from the large outlet vessel, the aorta. The three epicardial coronary vessels, on the surface of the heart, supply blood to the heart muscle through millions of tiny vessels, called perforating vessels; the latter really feed the muscle.
Under normal conditions, at rest, these small vessels supply enough blood: under stress they open up more supplying extra blood. This mechanism is called coronary reserve. Coronary artery disease results due, mainly, to a reduced coronary reserve and not so much to the blockages in the larger vessels seen in the x-ray picture. ( coronary angiogram). Doctors should diagnose coronary artery disease mainly from the patients symptoms and other ancillary tests like stress ECG, thallium Scan, etc. Coronary angiogram is not a diagnostic procedure. It is needed only after a doctor decides that the patient needs surgical bypass, as a pre-requisite for plumbing.
Atherosclerotic large vessel blocks, start in child-hood in those who inherit the Athras gene (only 30% of Caucasians have it). In those with the gene, blockages start even at the age of 10.
In a survey of about 60,000 patients who underwent bypass and angioplasty, only 14% got the benefit of an increase in their life span of 4 months to 4.5 years; whereas, 84% of them did not benefit by even a day’s extra life. In fact, those who benefited had been either bed-ridden or had unbearable chest pain before surgery.
On the other hand, Nature has its own bypass mechanisms in those with large arterial blocks :
- Muscles adapt to live with reduced blood supply.
- Collateral circulation starts whenever the main coronary vessel develops blocks.
- Whenever there is a blockage, the perforating vessels dilate more and supply enough blood to the muscle. Then, do we need doctors’ advice ? Yes, when natural systems fail or become incapable or weak, we can make them work through proper medication.
If a person has a heart attack gene, then he is sure to get a heart attack. However, if one lives without hatred and jealousy, then one can postpone the evil. In those without the gene, the heart does not suffer. Smoking and drinking aggravate this disease. Fried foods and meat are not good. Daily exercise helps to fight the disease.
- abstract of an article in the Kannada magazine "Taranga" dated DEC 1, 1996 by Dr. B.M. Hegde, a Cardiologist, and Dean, Kasturba Medical College, Mangalore.
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