India has become a hub for cardiac diseases. The number of deaths caused by cardiovascular diseases rose by nearly 34% between 1990-2016. We can conveniently call this a state of a medical emergency. And it is valid now if you, like us, have questions about your heart-health.
The core of Credihealth’s endeavor revolves around the health of individuals. So to address our and your concerns, we set out to seek answers from the best in the field.
We spoke with Dr. Yugal Kishore Mishra from Manipal Hospitals Dwarka to throw some light on the issue of the heart-health of Indians.
Dr. Yugal Kishore Mishra is among the greatest doctors in not only in India but, across the world. He heads the Department of Cardiac Sciences and is the Chief Cardiovascular Surgeon. He was awarded a lifetime achievement award by Dr. APJ Abdul Kalam. He is also a recipient of the Rashtriya Rattan Award.
Ques: Congenital Heart Diseases leads to the death of nearly 80,000 children in India every year. What can expecting parents do at their end to ensure that their newborn is healthy concerning heart diseases?
Ans: Cardiologists or other doctors do not have control over the development of congenital heart diseases. Several factors including medications taken by the mother, viral infections, genetic disorders and more lead to this disease.
The only way to decrease the number of deaths is by diagnosing the disease as early as possible. It is important to detect this problem while the baby is inside the womb of the mother. We should have a model to find out if there is a congenital heart problem.
For example, In France, every pregnant mother is subjected to an echocardiography examination. This is to check the abnormality in the heart of the fetus during the antenatal period. But sadly, right now our country cannot afford this system.
So whenever possible, fetal cardiography should be conducted. This would help us in knowing the degree of congenital abnormality. With the use of highly-trained manpower, we can help the mother. Only early detection and thus early treatment is the way to minimize the deaths caused by congenital heart diseases.
Ques: According to a study, Indians die 10 years earlier due to heart diseases compared to people from other countries. What do you think is the cause of this? What can we Indians do to maintain our heart health?
Ans: So, there are three kinds of heart diseases- congenital, acquired and coronary. In congenital heart diseases, a baby is born with a heart defect. Some children die early in their young years because of improper or lack of treatment.
Secondly, The Indian subcontinent is the pivot of acquired heart diseases. Rheumatic heart disease is a sub-type of this category. A peculiar group of patients with this type of disease is not seen in developed countries like western Europe and North America. This heart condition is very common in areas that are densely populated and where there is a lack of sanitation.
This condition is very much prevalent in Madhya Pradesh, Uttar Pradesh, Chattisgarh, Bihar, and some southern states. Developed countries have already taken care of this problem because of expensive models of treatment. Many governments in India are doing relief work in this area. There are many welfare schemes also.
Lastly, there is coronary artery disease which affects most of our working population. I have worked with western worlds and I have received patients from abroad. Our coronary artery disease is more peculiar as compared to western. Our disease is more defused and it is very difficult to carry out the surgery, while in western countries people have very segmental diseases.
This is because we have a very high incidence of diabetes, our food habits are different. And most importantly our population has a genetic predisposition for coronary artery disease.
Besides that, the detection of the disease is very late. This is because in diabetes the individual doesn’t get chest pain, so they visit the hospital when they are nearing a heart attack. By that time, the disease has already advanced.
So, the treatment is given at a very late stage. These are the main reasons why Indians die early from heart diseases than others.
Ques: So Columbia University in the US found that leisure-time sitting (while watching TV) was associated with a greater risk of heart disease and death. Does that mean we have another reason for not watching television?
Ans: The fact of the matter is that if you watch too much TV, don’t go outside or play, which is exactly what the kids are doing today, then it will become a problem. Our kids are sitting and watching TV more than going outdoors and playing in the park or the streets. Some emotional issues also come along with this lifestyle. Our younger and even older generation is utilizing more time sitting and watching TV instead of doing physical exertion.
Ques: You have successfully performed more than 20k surgeries, what is the biggest challenge you feel being a surgeon?
Ans: Each patient on whom I have performed heart surgery is a challenge for me. Like a batsman has to play each ball with equal concentration. For me, none of the cardiac operations are easy. Every operation is a challenge and we have to see it with that perspective only.
There are certain operations which are performed very frequently, on day to day basis and that becomes a routine for us. Like CABG is performed very commonly. But there are also demanding surgeries like when we operate with a robot.
Obviously, that is much more challenging. 50-60% of my surgeries are keyhole surgeries. For me, every case is a challenge because either the approach is different or the disease is different.
Ques: You have dealt with over 500 successfully operated Robotic Cardiac cases in India, yet the awareness about these latest advancements is lacking. People still feel worried while pursuing minimally invasive treatments, how do you think we can improve this awareness? What would be your message to those who are fearful of MICS?
Ans: We started robotic surgeries way back in the year 2002. That was when the first generation DaVinci robot was introduced, maybe for the first time in Asia. When the robot came, it was specifically designed for heart surgeries.
There were tricky situations associated with this approach. To deal with these situations, cardiac surgeries were done with a robot.
I started working at Manipal Hospitals Dwarka with a third-generation robot which is more operator friendly. Because of these advances, Minimal invasive has always been growing.
In Manipal, 60% of my work is minimally invasive. A lot of overseas patients demand this method. Because we, at Manipal, are utilizing a different technology.
The cost is a little more but the net gain to the patient including the total financial aspect is much cheaper than conventional surgery. Because, the individual can go back to his/her normal life, less blood loss and less pain are there. There is a tremendous technological improvement in the area of minimally invasive because the industry is bringing out the latest technology. And we have better instruments today.
Ques: Are Ayurvedic treatments of any help in treating heart diseases?
Ans: Ayurvedic treatment cannot treat heart diseases but at least they can prevent some. I cannot say what are these but yes ayurvedic medicines have been in use for a long time. They can be utilized for prevention.
“As APJ Abdul Kalam had said that India is going to be a hub of heart diseases and diabetes, so we have to start working on this issue now.”
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This write-up was contributed to Credihealth by Dr. Yugal K Mishra
Dr. Yugal K Mishra is the head of Cardiac Science and chief of cardio Vascular Surgery at Manipal Hospital, Dwarka. He has 30 years of experience in cardiology. He was one of the core team members that built the Escorts Heart Institute. Dr. Mishra has conducted more than 500 successful robotic surgeries and 1000 redo cardiac surgeries.
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