FAQs - Multispecialty

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  • When should we go or not go in for a bypass surgery?
    When should we go or not go in for a bypass surgery?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about when should we go or not go in for a bypass surgery


    Bypass surgery is based on multiple factors such as patient’s symptoms, the coronary anatomy, the type and degree of the blockage, the financial status whether the patient could afford the surgery and also his psychological state.


    He also talks about how to manage mild to moderate blockages with the help of medical therapy. And patients who have disease which can be corrected by angioplasty then it is a preferable option over bypass surgery.

  • What is minimal invasive bypass surgery?
    What is minimal invasive bypass surgery?
    OP  Yadava
    In Earlier Times, Bypass Surgery Was Done As An Open Heart Procedure Which Had Lot Of Disadvantages. Owing To The Disadvantages And Whole Body Inflammatory Response, Minimal Invasive Surgery Was Introduced To Avoid The Use Of Heart Lung Machine. Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks About Minimal Invasive Bypass Surgeries In This Video.

    He Describes About Different Forms Of Minimal Invasive Surgeries Used Currently And Which Helps To Avoid Pulmonary Complications, Deep Wound Infections And Also Disadvantages Which Were Caused Due To Open Heart Bypass Surgery.
  • What is the complication rate in bypass surgeries?
    What is the complication rate in bypass surgeries?
    OP  Yadava
    Bypass Is A Major Surgery And It Has Both Serious As Well Minor Complications. In This Video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, will Talk About The Major And Minor Complication Rates In Bypass Surgery.

    The Complication Rates Depend Upon The Retrospective Or Prospective Clinical Studies. Serious Complications Include Stroke, Deep Sternal Wound Infection Or Life Threatening Tachyarrhythmias. Temporary Complications Such As Superficial Infections, Lung Infections, And Pleural Effusion Can Be Managed With Conservative Treatment.
  • Can we drive after a bypass surgery?
    Can we drive after a bypass surgery?
    OP  Yadava
    In This Video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks About Whether Driving Is Safe After A Bypass Surgery. Dr. Yadava also Tells Us About The Adverse Effects If Proper Care Is Not Taken While Driving.

    Normally, A Person Can Drive From The Very Next Day Of The Bypass Surgery As There Won’t Be Any Problem With The Functioning Of His Heart But The Problem Is Of Safety. The Patient Has To Swirl While Driving And This Can Pull His Pectoral Muscle Leading To Severe Sternum Pain.

    Driving Is Not Recommended For At Least 4 – 6 Weeks After The Bypass Surgery.
  • How many times can we undergo a bypass surgery?
    How many times can we undergo a bypass surgery?
    OP  Yadava
    Bypass Surgery Can Be Performed Multiple Number Of Times. In This Video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will Talk About How Many Times We Can Undergo Bypass Surgery.

    Second Time Bypass Has Become A Very Standard Procedure Nowadays. As Many Of The Patients Are Operated In Late 60’S And 70’S So The Need For A Second Bypass Surgery Arises. There Is No Specific Limit Of Times That A Person Can Undergo Bypass Surgery. But With Each Number Of Surgery, The Risk Also Goes On Increasing.
  • What is total arterial bypass surgery?
    What is total arterial bypass surgery?
    OP  Yadava
    In This Video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks About Total Arterial Bypass Surgery. Whenever A Bypass Surgery Is Done, Only Arterial Conduits Are Used Which Is Then Known As Total Arterial Myocardial Revascularization.

    It Can Be Performed Using Various Configurations. Free Grafts, In Situ Grafts, Single Grafts Or Sequential Grafts Are Used In Bypass Surgery. In Sequential Grafts, One Conduit Can Be Used To Bypass Two Arteries. Dr. Yadava Will Also Describe That A Free Graft Can Be Attached To A Pedicle Graft And Can Do T Or Y Configuration Of Total Arterialrevascularization Known As T Or Y Grafts.
  • What is robotic bypass surgery?
    What is robotic bypass surgery?
    OP  Yadava
    Robotic Bypass Heart Surgeries A Type Of Minimally Invasive Heart Surgery. Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, In This Video Talks About Why Robotic Bypass Surgery Was Introduced.

    Robots Were Introduced To Perform Robotic Bypass Surgery With Equal Human Dexterity. Robotic Surgery Has Advantages Over Open Heart Bypass Surgery. Dr. Yadava Talks About Fourth Generation Robots And How Robotic Surgery Is Gaining Attraction. Also, The New Arms Of The Robots Have Received Good Feedbacks And Has Become Feasible In Cardiac Robotic Surgery.
  • When should we go in for a total arterial bypass surgery?
    When should we go in for a total arterial bypass surgery?
    OP  Yadava
    In This Video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will Tell Us The Criteria Of Total Arterial Bypass Surgery And When It Is Done.

    The Results Of Total Arterial Bypass Surgery Are Mostly Superior To The Venous Revascularization. Almost 10 – 15 % Of The Venous Grafts Are Blocked By The End Of One Year. Whereas, The Patency Rates Of Arterial Grafts Is High Even At 10 – 20 Years.

    Total Arterial Bypass Surgery Revascularization Is Done When A Patient Is Young But It Also Depends Upon Various Factors.
  • What is the life of a pacemaker?
    What is the life of a pacemaker?
    Aparna  Jaswal
    This video talks about the life of a pacemaker by Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute. She discusses that pacemakers longevity depends on the type of pacemaker and also on the usage of an individual patient.

    The Types Of Pacemakers Are:

    1. Single-Chamber Pacemaker
    2. Dual-Chamber Pacemaker
    3. Biventricular Pacemaker

    Biventricular Pacemakers Lasts Little Less Than Single And Dual Chamber Pacemakers Because Their Current Utilization Is More And Their Battery Usage Is Also More Than The Other Pacemakers.

    Pacemakers Have A Longevity Of Approximately 7 – 12 Years.
  • What are the different types of pacemakers and when are they necessary?
    What are the different types of pacemakers and when are they necessary?
    Aparna  Jaswal
    In this video, Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute describes the different types of pacemakers and when is the necessity for a pacemaker.  Pacemakers are given whenever a patient cannot maintain his heart rate corresponding to his age. They are life saving devices. Pacemakers are given to patients with either sick sinus syndrome or complete heart block. 


    Dr. Aparna also talks when and how the pacemakers are situated depending upon the age of the patient. Also depending upon the disease process, the patient needs a pacemaker.
  • What are the reasons for pacemaker failure?
    What are the reasons for pacemaker failure?
    Aparna  Jaswal
    Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute talks about various reasons of pacemaker failure in this video. The pacemaker failure can be due to several reasons but most commonly due to end of service.

    In India, Patients Generally Don’t Come For Follow Up Every Six Months Which Is Necessary. They Come Back When The Pacemaker Stops Functioning Due To Its Battery Is Completely Drained. Pacemaker Failure Can Also Occur Due To Lead Failure.
  • How can a physician check a pacemaker?
    How can a physician check a pacemaker?
    Aparna  Jaswal

    In this video, Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute will discuss about how a physician can check a pacemaker. A physician can check the working of a pacemaker by taking a 12 lead ECG. In a patient with pacemaker, the ECG will show spikes preceding the QRS or preceding the P wave. This is the simplest form of test to check the pacemaker. The physician can also check the battery life of the pacemaker by placing a magnet on the top of the device. She will also explain about the magnet rate and how to check using it.

  • Are all cardiac devices battery operated?
    Are all cardiac devices battery operated?
    Aparna  Jaswal
    In this video, Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute tells us that the cardiac devices used are all battery operated.

    Types of cardiac devices:

    • Pacemakers
    • Biventricular Pacemaker
    • Implantable Cardioverter Defibrillator (ICD)

    Currently, new technologies are still ongoing with respect to heart contractions can recharge the pacemakers.
  • What is the difference between one lead, two lead and three lead pacemakers?
    What is the difference between one lead, two lead and three lead pacemakers?
    Aparna  Jaswal
    The video talks about the difference between one lead, two leads and three leads pacemakers by Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute. Pacemakers are generally are implanted in the right atrium and right ventricle. A bi-ventricular pacemaker has one lead in the right atrium and tow leads in both the ventricles. She will also talk about lead-less pacemakers which are a recent technology and are US FDA approved and have a battery life of 9 – 12 years.
  • What are life threatening arrhythmias?
    What are life threatening arrhythmias?
    Aparna  Jaswal
    Life threatening arrhythmias are those arrhythmias which arise from the lower chambers of the heart.

    Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute will talk about these life threatening arrhythmias. She talks about ventricular tachychardia when associated with structural heart disease or ventricular fibrillation can be life threatening.

    Ventricular arrhythmias are potentially life threatening and needs immediate treatment in ICU with the electrolyte correction and external defibrillator.
  • What does a pacemaker look like?
    What does a pacemaker look like?
    Aparna  Jaswal
    Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute, will discuss the features of a pacemaker in this video. She will talk about the CRT-P and CRT-D. CRT-P is little smaller in size and has an ability to pace whereas the CRT-D has an ability to pace and defibrillate. The CRT-D pacemaker has a capacitor and a battery hence, it is larger in size.
  • Can you show us all types of pacemakers?
    Can you show us all types of pacemakers?
    Aparna  Jaswal
    In this video, Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute, will talk on different types of pacemakers. She will show two-wired and three wired pacemaker device. She will further explain how the wires goes into right atrium, right ventricle and left ventricle. The whole unit of pacemaker is implanted under the collar bone and the wires goes to the heart. She will also explain the implantable cardioverter defibrillator (ICD) device.
  • What are the Non- pharmacological methods for supraventricular arrhythmias?
    What are the Non- pharmacological methods for supraventricular arrhythmias?
    Aparna  Jaswal
    In this video, Dr. Aparna Jaswal, Cardiologist, Fortis Escorts Heart Institute talks about the non- pharmacological methods for supraventricular arrhythmias. She describes the vagal maneuvers methods for the treatment of supraventricular arrhythmias.
  • When is bypass done along with angiography?
    When is bypass done along with angiography?
    OP  Yadava
    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, tells when the bypass surgery is done along with angiography. This type of surgery is known as hybrid cardiac surgery.
  • How difficult is it to redo bypass surgery?
    How difficult is it to redo bypass surgery?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about the advantages and complications of redo bypass surgery. Currently redo bypass surgery is technically demanding.

  • Is there any age limit for bypass surgery?
    Is there any age limit for bypass surgery?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, tells us that there is no age limit for bypass surgery. With new techniques introduced, bypass surgery can be done in elderly patients.

  • Should bypass surgery be done in low ejection fraction?
    Should bypass surgery be done in low ejection fraction?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about the bypass surgery in low ejection fraction. The results of the bypass surgery are not very good if the heart is damaged.

  • What about bypass surgery with LV volume reduction?
    What about bypass surgery with LV volume reduction?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, tells us about the bypass surgery with LV volume reduction. After the bypass surgery, the viable myocardium recovers but non-viable myocardium does not recover leading to ventricular dilatation and remodeling. Surgical remodeling is superior to medical therapy and improves the patient.

  • How difficult is cardiac transplant?
    How difficult is cardiac transplant?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi tells us that technically the cardiac transplant is not a difficult operation. The main issues are the logistic problems in organ donation, preservation and ongoing follow-ups post-transplant.

  • What are the long term results of cardiac transplant?
    What are the long term results of cardiac transplant?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about the long-term results of cardiac transplant. The results of this transplant surgery are improving.

  • After bypass, when can a person enjoy his married life?
    After bypass, when can a person enjoy his married life?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about the person who has undergone bypass surgery, as when can he enjoy his married life.

  • After bypass, when can a person drive?
    After bypass, when can a person drive?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about whether driving is safe after a bypass surgery. Dr. Yadava also tells us about the adverse effects if proper care is not taken while driving.


    Normally, a person can drive from the very next day of the bypass surgery as there won’t be any problem with the functioning of his heart but the problem is of safety. The patient has to swirl while driving and this can pull his pectoral muscle leading to severe sternum pain.


    Driving is not recommended for at least 4 – 6 weeks after the bypass surgery.

  • After bypass when, can a person return to work?
    After bypass when, can a person return to work?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, tells us about when can a person return to work after a bypass surgery. The patient can start with simple chores at home and get back to their normal desk job within four weeks.

  •  How long does bypass surgery last?
    How long does bypass surgery last?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks about the longevity of bypass surgery. It depends upon the control of risk factors with lifestyle modifications, following the medical treatment properly. It also depends upon how good the surgeon has done his job. 


    Dr. Yadava discusses that if arterial revascularization has given then the results are for long term and if veins are used then chances of failure are higher. Hence, he tells that control of blood pressure, lipids, control of diabetes status, weight control is very essential. Also the patients should be involved in some physical activities for a long term benefit after bypass surgery.

  • How long does arterial graft last?
    How long does arterial graft last?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks about the arterial graft. He will discuss that with arterial graft, the results are for 20 years. He will explain the positive results with different types of arteries. 


    The percentage and results of these grafts also depends on the control of risk factors. Quitting smoking, regular physical activities and control of diet will prolong the efficacy of these grafts. 

  •  Are the results of bypass surgery different for diabetics?
    Are the results of bypass surgery different for diabetics?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks about the results of Bypass Surgery in diabetics. The results are seen in both short term as well long term. 


    In short term, it is seen that diabetes is a systemic disease and even atherosclerosis. Cholesterol gets deposited in the arteries of the heart, also in the arteries of the brain, kidneys or the other vasculature. Thus, in these patients, there is multisystem involvement with increased chances of renal failure, CVA or wound infections in diabetes. These patients spend longer time in the hospital with high mortality and morbidity. 


    Dr. Yadava will also talk about long term results in terms of survival and drug patency rates are lower in diabetics as compared to non-diabetics. In such patients, an aggressive treatment is required for glycemic control.

  • What are the chances of a heart attack after bypass surgery in the first year?
    What are the chances of a heart attack after bypass surgery in the first year?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talks about the chances of heart attack after bypass surgery during the first year. He will explain that in various studies, it is shown that bypass surgery does not reduce the total incidence of heart attack. It only reduces the incidences of fatal heart attacks but overall heart attacks are not reduced. 


    The reason behind it is that the side branches, the microcirculation, each coronary arteries branches 10 – 14 times before it becomes a capillary, all these are not bypassed. The cholesterol can also saturates in major arteries as well as microcirculation. Even after bypass surgery, there are certain areas which continues to be ischemic. If the graft has failed, then 3% of patients might get a heart attack within a year. 

  • Can bypass be done along with renal artery stenosis?
    Can bypass be done along with renal artery stenosis?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will discuss whether the bypass surgery can be done along with renal artery stenosis. Bypass can be done with renal artery stenosis, if the coronary anatomy is not critical. Renal artery stenting can be done before the bypass surgery and then restore the blood supply.


    Dr. Yadava will also explain the condition if the coronary artery is critical or the patient gets unstable angina. In such cases, first CABG should be done with certain precautions. He will discuss these precautions to be taken in critical patients. Also avoid using nephrotoxic drugs in such patients.

  • Can bypass be done along with carotid artery intervention?
    Can bypass be done along with carotid artery intervention?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will discuss whether bypass can be done along with carotid artery intervention. Bypass surgery can be done with coronary artery intervention which is also called as simultaneous procedure. Dr. Yadava will explain the procedure with different models which are used.


    He will also talk about advantages and disadvantages of the methods used. The simultaneous method is the best option for this type of surgery but the patient has to be selected carefully. The patient should be symptomatic and carotid stenosis should be significant.

  • Can bypass be done along with peripheral artery intervention?
    Can bypass be done along with peripheral artery intervention?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will discuss whether bypass surgery can be done with peripheral artery intervention. 


    He tells us that bypass surgery can be done with peripheral artery intervention. It reduces the hospitalization and is cost effective. It can also be done under the same anaesthesia. Dr. Yadava will also explain the pros and cons of the intervention. Normally coronary bypass is done and the patient is allowed to recover. 4 – 6 weeks is generally recommended for recovery and then peripheral artery intervention is done. If the limb is threatened then both interbventions is done under same anaesthesia.

  • How long to continue aspirin?
    How long to continue aspirin?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Will talk about how long to continue aspirin. Dr. Yadava tells us that aspirin has to be continued lifelong.

  • After how much time can a non-cardiac surgery be done after bypass surgery?
    After how much time can a non-cardiac surgery be done after bypass surgery?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, will talk about when to do a non-cardiac surgery after a bypass surgery. If the non-cardiac surgery is of emergent nature, it can be done at any time without any problem. There are no such contraindications for doing non-cardiac surgery immediately after a bypass surgery.


    Dr. Yadava tells us that the problem arises when the patient has an elective cardiac surgery. In such patients, it is recommended that the patient should recover which is generally 4 – 6 weeks and then the non-cardiac surgery is scheduled. 


    He will also talk about the consequences if we stop the anti-platelets treatment for non-cardiac surgery and what can be done.

  • How long should I continue dual antiplatelet therapy?
    How long should I continue dual antiplatelet therapy?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, Talk about how long to continue dual antiplatelet treatment. The current recommendations for dual antiplatelet therapy is from 6 – 12 months. There are no adequate data available which suggests to continue the dual antiplatelet treatment beyond 12 months. Ideally, after a year one antiplatelet therapy should be stopped and continue with the other antiplatelet for lifelong.

  • Are miss beats always a cause of concern?
    Are miss beats always a cause of concern?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain why miss beats are a cause of concern. These are premature contractions or extra beats. One of the beat might be of lower strength and the next beat will be of higher strength and it feels as if a miss beat.


    He further tells that if any miss beat comes with exertion then it might be a sign of underlying heart disease. Miss beats which comes on rest and disappears on exercise are to be ignored.

  • Which is more serious: LBB or RBB?
    Which is more serious: LBB or RBB?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss which is more serious LBB or RBB. He explains that right bundle block (RBB) is not an emergency and can get investigated over a period of time. But left bundle block (LBB) is abnormal and needs investigation immediately. He further adds that not to ignore LBB in ECG as it could be an acute myocardial infarct. In some patients, LBB could be the only sign of myocardial infarction if the patient is symptomatic.

  • How long should we give dual antiplatelet therapy (DAT) in acute MI?
    How long should we give dual antiplatelet therapy (DAT) in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the dual antiplatelet therapy in acute myocardial infarct (MI). He explains that any acute MI with any form of treatment such as medical management, stent or bypass surgery has to have a dual antiplatelet therapy for at least 12 months to avoid the recurrence of the events. Any person who has stent has to be put on mandatory 12 months on dual antiplatelet therapy.

  • When should we do primary PCI after tenecteplase in acute MI?
    When should we do primary PCI after tenecteplase in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket will talk on primary PCI after tenecteplase in acute MI, in this video. He explains that after 2-3 hours of thrombolysis, these patients should undergo angiography and if there is a need then angioplasty should also be done. 


    He will further talk that the golden period is after two hours any time with 12 or 24 hours’ time. It is different from facilitated PCI. Any patient who gets thrombolysis should be shifted to PCI capable centre with 2 to 12 hours.

  • What is the role of absorbable stents in acute MI?
    What is the role of absorbable stents in acute MI?
    Viveka Kumar

    This video will talk on the role of absorbable stents in acute MI by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. These absorbale stents are mostly used in young patients and are absorbed. These patients do not have to take dual antiplatelet therapy after 3 years.


    Dr. Viveka will highlight that the data from ABSORB 2 & 3 has shown that the risk of stent thrombosis in absorbable stents have increased significantly. Therefore it is advisable not to use absorbable stents in such conditions.

  • When should we use bare metal stents in acute MI?
    When should we use bare metal stents in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about when to use bare metal stents in acute MI. He explains that the first generation stents use to have risk of stent thrombosis and when the arteries size was bigger, bare metal stents were used. But now in third generation stents, there are no such indications for using bare metal stents except for economical reason. He will also discuss the conditions when the bare metal stents are used.

  • What are drug coated balloons and when should we use them in acute MI?
    What are drug coated balloons and when should we use them in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will explain about drug coated balloons and when to use them in acute MI. Drug coated balloons are used in patients with restenosis such as patient had a stent and recurrence in the stent occurred. These drug coated balloons decreases the risk of the recurrence without increasing the metallic burden of the artery.


    Dr. Viveka will also talk on if the patient has an acute MI and it is in the branch artery then drug coated balloon should be used or else the stents are superior to them. He will also talk on the other conditions where these drug coated balloons are used with their advantages.

  • What are the third generation stents?
    What are the third generation stents?
    Viveka Kumar

    The video talks about the third generation stents by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. The current generation stents are known as the third generation stent. They are very thin and are available with a bio-friendly or bio-degradable polymer. He will also discuss about third generation stents which has a very small amount of polymer and gets absorbed within a month.

  • What are the second generation stents?
    What are the second generation stents?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about the second generation stents. The second generation stents are the ones in which polymer coating is less and stent thickness is also less and is also made up of cobalt chromium in which risk of restenosis is less.

  • What are the first generation stents?
    What are the first generation stents?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk about the first generation stents in this video. The bare metal stents and the stainless steel stents are the first generation stents. Drug-eluting stents are also first generation stents. But nowadays no one uses them as third generation stents are more advanced.

  • Should we do primary PCI of culprit vessel only in acute MI?
    Should we do primary PCI of culprit vessel only in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss whether primary PCI of culprit vessel should be done in acute MI. current data and guidelines suggest that only the culprit artery should be done and the other arteries should be tackled later. If the other arteries are severely diseased approximately by 95% and are responsible for significant problems and the patient is in cardiogenic shock, then the indications are that along with culprit artery these arteries are also tackled.

  • When should we go for primary PCI of culprit vessel only in acute MI?
    When should we go for primary PCI of culprit vessel only in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about when is the primary PCI of culprit vessel done in acute MI. The existing data suggests that the best possible treatment for the acute myocardial infarct is primary PTCA. All patients cannot get benefited by PTCA as they are unable to reach the hospital in time. He will also talk about that the trained staff should do the primary PTCA for better outcomes. If the MI patient is within the window period of 90 minutes then primary PTCA is the first option.

  • When should we give tenecteplase in acute MI?
    When should we give tenecteplase in acute MI?
    Viveka Kumar

    This video will discuss about the tenecteplase in acute MI, by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. The moment when the diagnosis of acute MI is made and the patient has pain more than 15 – 20 minutes and ECG has elevation of ST leads, then thrombolyse the patient within first 12 hours and after 2 – 3 hours, angiography can be done. He will also explain what to do if the revascularization is not satisfactory by thrombolysis and which fibrin specific therapy is needed in acute MI patients.

  • What is a therapeutic window in acute MI?
    What is a therapeutic window in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk about the therapeutic window in acute MI, in this video. The first three hours are the golden hours. Up to six hours, the patient should be treated with thrombolysis and primary PTCA. Beyond six hours to twelve hours, primary PTCA should be done in patients who did not had any treatment options or a pharmaco-invasive strategy is done. 


    He will explain that beyond 12 hours, the window period is lost and patient should be treated medically unless the patient has a chest pain or has gone into cardiogenic shock. The first three hours are the best period for the treatment.

  • How important is early diagnosis in acute MI?
    How important is early diagnosis in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the importance of early diagnosis in acute MI. If the treatment is done early, within one hour, the myocardium will be as good as the normal person. This time is known as the golden hour. As the time is delayed the benefits becomes lesser. The acute MI patients should be treated within first 6 hours with thrombolysis and primary PTCA for maximum benefits. Beyond 12 – 24 hours there is no benefit. Primary PTCA can save the life and decrease the mortality.

  • What is first aid in acute MI?
    What is first aid in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on the first aid in acute MI in this video. Acute MI is a devastating condition which can happen anywhere. The affected person has to relax and sit if he is standing or walking and avoid exertion. He should try to cough and take deep breath so that coronary perfusion improves. If the patient has an access to aspirin, he should take one tablet completely chewable and if the person is a known case of heart disease, he should take one sorbitrate and if his condition improves should visit the doctor immediately.

  • Can primary PCI be done along with renal angioplasty?
    Can primary PCI be done along with renal angioplasty?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Specialty Hospital, Saket, will discuss whether primary PCI can be done along with renal angioplasty. Renal angioplasty is always an elective procedure and primary PCI is an emergency procedure. If the patient’s hospital stay and cost has to be reduced, then it can be combined. But the primary procedure is PCI followed by the renal angioplasty.

  • Can primary PCI be done along with carotid angioplasty?
    Can primary PCI be done along with carotid angioplasty?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk about whether primary PCI be done along with carotid angioplasty, in this video. He explains that the primary PTCA should not be combined with any other procedure unless there is a compelling indication and the thrombus migration in the carotid has happened. The primary PTCA is generally not combined as the carotid has bleeding issues and needs strong anti-platelets therapy, hence is avoided as a combined procedure.

  • What is a learning curve in primary PCI?
    What is a learning curve in primary PCI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about learning curve in primary PCI. According to the international guidelines, one should do at least 75 primary PTCA as a primary operator and should have assisted another 75 primary PTCA as a secondary operator, then only he is qualified to do a primary PTCA on his own.

  • Radial angiography & angioplasty vs. Femoral angiography & angioplasty?
    Radial angiography & angioplasty vs. Femoral angiography & angioplasty?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about radial angiography and angioplasty with femoral angiography and angioplasty. In a patient with acute MI, lot of blood thinners are given and the risk of groin complications, GI bleed and hematoma is high. He will also talk about the current guidelines which suggests that if feasible the primary PCI in acute MI settings should be done with the radial route only. The radial route has lesser risk of complications and the patient can move and is discharged early.

  • When can the patient resume to his routine after acute MI?
    When can the patient resume to his routine after acute MI?
    Viveka Kumar

    The video talks about the when can the patient resume his routine after acute MI by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. It depends on the condition and presentation of the patient. If the patient had treatment within three hours then after two weeks he can resume work and his normal activities. If the patient is thrombolyzed, then he can resume after 4 weeks while the myocardium heals. Vigorous exercises can be done after 4-6 weeks only.

  • When should we discharge the patient after primary PCI?
    When should we discharge the patient after primary PCI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss when to discharge the patient after primary PCI in this video. Patients who are on medical management should be discharged after one week. Those patients who are thrombolyzed are discharged after four days and after primary PTCA, the patient can be discharged after 48 hours. Patients with acute MI without any complications and are treated within three hours are discharged after 48 hours.

  • MI with normal coronaries?
    MI with normal coronaries?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on MI with normal coronaries. Body itself has a tPA secreting protein which can lead to autothrombolysis. So a regular angiogram is done in patients with MI but normal coronaries. He will also talk how to manage the young patients who have been thrombolyzed or re-canalised arteries.

  • Role of CABG in acute MI?
    Role of CABG in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of CABG in acute MI, in this video. Bypass surgery has a high mortality whereas thrombolysis and primary PCI have shown to decrease the mortality. If the patient has a bad anatomy and the lesions are calcified then these are certain situations when the patients can undergo bypass surgery. He will explain that if the patient is taken for bypass surgery within 6 hours of MI, then the mortality is low. If the patient is taken for the surgery after 6 hours to 48 hours then the mortality is as high as 50%. Bypass surgery is only recommended when primary PCI is not feasible.

  • What should be the ideal level of potassium in acute MI?
    What should be the ideal level of potassium in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on the ideal level of potassium in acute MI. Serum potassium should be 4.5 – 5, if it is lower than this, there is a risk of acute arrhythmic complication. If the patient goes into ventricular tachycardia and ventricular fibrillation with potassium level less than 3.5, then they are difficult to bring them back and can have VTVF, hence potassium level should be kept beyond 3.5 level.

  • Is there any role of IV magnesium in acute MI?
    Is there any role of IV magnesium in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of IV magnesium in acute MI. IV magnesium is given only for patients who have refractive arrhythmias. They get ventricular tachycardia and ventricular fibrillation even if the magnesium levels are normal. He will further talk on the data which suggests IV magnesium of 2 grams in 24 hours can save the patient. Only in arrhythmic complications, the role of magnesium is present otherwise there is no advantage in the regular use for these patients.

  • When should we give low molecular weight heparin in acute MI?
    When should we give low molecular weight heparin in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will explain when to give low Molecular Weight heparin in acute MI, in this video. The acute MI is a pro-thrombotic condition who are on medical management. He will explain the conditions where the low molecular weight heparin can be given. Those who have high blood sugar, high risk patients, etc. are given low molecular weight heparin dose for 2-3 days. Also for those patients who have come out of the window period, have acute coronary syndrome and acute MI and cannot undergo primary PCI, shows good outcome with low molecular weight heparin dose.

  • Is there any role of conventional heparin in acute MI?
    Is there any role of conventional heparin in acute MI?
    Viveka Kumar

    The video talks about role of conventional heparin in acute MI by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. He explains that till the patient gets into cath lab or gets thrombolysis done, conventional heparin is good. If the patient has no access to thrombolysis or primary PTCA, then in those situations with the dual anti-platelets heparin is also given and the patient who gets post MI angina, heparin is considered to be good. He will explain that injectable heparin is given to patients who have acute MI, who are on medical management and who are thrombolyzed.

  • When should we not go for primary PCI in acute MI?
    When should we not go for primary PCI in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss when to not undergo primary PCI in acute MI. There are certain situations such as if the patient is pain free after 12 hours of the index MI, delayed presentation after 24 hours then the role of primary PTCA is not there. Also in patients with high risks of bleeding complications and in any patients where a major surgery has done, primary PCI is avoided as the risk of bleeding will be life threatening.

  • How long should we continue with 80 mg atorvastatin after acute MI?
    How long should we continue with 80 mg atorvastatin after acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss how long to continue with 80 mg atorvastatin after acute MI, in this video. There is enough data which has shown that if 80 mg of atorvastatin is given immediately after the diagnosis of acute coronary syndrome or acute MI, then it should be continued minimum for one year. The longer the continual, the more is the benefit and if the lipid profile is not satisfactory, then it should be continued for long.

  • When should we use tirofiban in acute MI?
    When should we use tirofiban in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket will talk on tirofiban usage in acute MI. Tirofiban is an anti-platelet which is injectable and is given in situations where the risk of clot formation is high such as huge thrombus burden in large arteries or in primary PCI situation. He will also explain that it is given in patients who has a high platelet count. He will also discuss the situations where the tirofiban is not indicated.

  • When should we use eptifibatide in acute MI?
    When should we use eptifibatide in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on the usage of eptifibatide in acute MI, in this video. Eptifibatide is an antiplatelet which is an injectable one and used in conditions like acute coronary syndrome and acute MI or has slow flow or no flow and thrombus burden is very high. He will explain that it is given as a protection but the regular use of eptifibatide is very low.

  • When should we use abciximab in acute MI?
    When should we use abciximab in acute MI?
    Viveka Kumar

    The video talks about the usage of abciximab in acute MI, by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. Abciximab is a potent antiplatelet but its usage has gone down because nowadays there is an access to strong potent antiplatelets. The usage of injectable abciximab is in situations where there is no flow or huge thrombus burden. He will also discuss how and when the abciximab is given and when the patient has to be rechecked.

  • When should we use IV antiplatelet in acute MI?
    When should we use IV antiplatelet in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the usage of IV antiplatelet in acute MI. Those patients who cannot chew or swallow or cannot be given oral antiplatelet through Ryle’s tube, injectable antiplatelets are given. With injectable antiplatelets, aspirin is always given. Earlier the injectable antiplatelets were used in acute MI conditions but nowadays only in special conditions it is used.

  • What is the role of dipyridamole in acute MI?
    What is the role of dipyridamole in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of dipyridamole in acute MI. Dipyridamole is not a very potent antiplatelet and can be used if the patient if allergic to aspirin and can be used as a triple drug combination to reduce the risk of deep vein thrombosis. In such conditions, dipyridamole is used.

  • What is the role of ticlopidine in acute MI?
    What is the role of ticlopidine in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of ticlopidine in acute MI. Ticlopidine is a drug which was used in late 90’s and nowadays it is not been used. It is also not available too. There is no role of ticlopidine in current generation unless the patient is allergic to other all antiplatelets.

  • What is the role of prasugrel in acute MI?
    What is the role of prasugrel in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of prasugrel in acute MI. Prasugrel is a very potent drug in acute MI. Any patient after his angiography is done and has to undergo primary PCI, then prasugrel is given to such patients and the stent patency and thrombosis rate is controlled. He will also explain the conditions when the prasugrel is not recommended and which other alternative treatment is given.

  • What is the role of aspirin in acute MI?
    What is the role of aspirin in acute MI?
    Viveka Kumar

    The video talks about the role of aspirin in acute MI by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. Aspirin is a proven and golden drug for acute MI patients and it has been shown to reduce the mortality by 22%. He will also explain that it is the most essential drug in patients who have stent. It is contraindicated in patients who have bleeding complications. In patients with stent, it has to be given at least for a year. Patients who are allergic to aspirin should be given different alternatives.

  • Which antiplatelet should we use in acute MI and why?
    Which antiplatelet should we use in acute MI and why?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss which antiplatelet to use in acute MI. In acute MI, there are three antiplatelets apart from aspirin has to be combined. Clopidogrel and aspirin is the oldest drug but many patients are resistant to this combination. He will further explain that in acute MI if the patient has undergone angiography, then prasugrel and aspirin or ticagrelor and aspirin or aspirin and clopidogrel is used. He will also highlight that more preferably prasugrel or ticagrelor is used.

  • Late restenosis after primary PCI?
    Late restenosis after primary PCI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on late restenosis after primary PCI. Late restenosis is a possibility and annual attrition rate of 0.1 % patients can get restenosis even after 10 years. This problem can be tackled by drug eluting balloons or stents can be managed. These patients are followed annually by stress test or stress-echo or stress thallium to check for restenosis. If it shows positive, then repeat angiogram is done.

  • Early restenosis after primary PCI?
    Early restenosis after primary PCI?
    Viveka Kumar

    The video talks about the early restenosis after primary PCI by Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket. The patient may not have restenosis but can have early stent thrombosis. Many a times, patients stop their dual antiplatelets which can be a reason for early restenosis. He will explain that the dual antiplatelets are mandatory given to these patients for a year. He will further explain that preferably the newer antiplatelets are given to avoid the risk of stent thrombosis.

  • Complication after PCI?
    Complication after PCI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on the complication after PCI. The risk of bleeding and hematoma at the access site, internal bleeding are the complications. Stroke is a major threat in acute MI patients. He will further discuss the complications in acute setting.

  • How safe is primary PCI?
    How safe is primary PCI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on how safe is primary PCI, in this video. Primary PTCA is one of the safest and life-saving procedure and has the mortality below 5 %. He will also explain that the patients are selected properly and there shouldn’t be a delayed presentation beyond six to twelve hours, then the mortality can be in double digits.

  • Acute MI in pregnancy?
    Acute MI in pregnancy?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on acute MI during pregnancy. Acute MI in pregnancy is very uncommon. The commonest cause of acute MI in pregnancy is generally seen in younger patients with spontaneous dissection of the coronary arteries. Other risk factors are smoking, drug abuses or strong family history of heart problems or stress of pregnancy. He will explain that it is very uncommon. The acute MI is treated with medical treatment till the patient is stabilised.

  • Acute MI in women?
    Acute MI in women?
    Viveka Kumar

    Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss about acute MI in women, in this video. It’s a myth that MI doesn’t happen in women and that’s the reason they come very late for treatment. The hormones in females protect them from myocardial infarction and coronary artery diseases but after menopause they are at equal high risk as men. Also, lifestyle risk factors are also responsible for MI such as smoking, lack of sleep, stress, etc.

  • Acute MI in young?
    Acute MI in young?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk on acute MI in young people. Maximum acute MI is seen in younger patients less than 40 years nowadays. These patients have associated risk factors such as strong family history, hypercholesterolemia, high intake of junk food, smoking etc. Any young patient with an acute MI is always with a lifestyle risk factors.

  •  Which is the earliest age to present for a patient age with acute MI?
    Which is the earliest age to present for a patient age with acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the earliest age to present for a patient age with acute MI, in this video. Patients with secondary causes such as drug abuse can have earliest to present with acute MI. Patients with familial hypercholesterolemia and embolization can have earliest signs. Data suggests that Indians get acute MI from the age group of 35 – 50 years of age as compared to the Western countries.

  • Role of primary PCI in Cardiogenic shock in acute MI?
    Role of primary PCI in Cardiogenic shock in acute MI?
    Viveka Kumar

    In this video, Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will discuss the role of primary PCI in cardiogenic shock in acute MI. Cardiogenic shock in acute myocardial infarct is a dangerous event. In such situations, rescue angioplasty can help the patient. Primary PTCA in cardiogenic shock can reduce the mortality and can save the patient.

  •  When should we use aspirin in acute MI?
    When should we use aspirin in acute MI?
    Viveka Kumar

    Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will explain the use of aspirin in acute MI, in this video. Aspirin reduces the mortality and event rates by 22% in acute MI settings. If even there is a clinical diagnosis which is not proven by ECG, the patient is given aspirin. If the patient has pain which lasts for 15-20 minutes, then it is typical angina pain which is crushing chest pain. The patient should immediately take aspirin and when the diagnosis is confirmed, clopidogrel or ticagrelor is added and the patient is shifted for primary PCI.

  • How should we Diagnose Dissection of Aorta?
    How should we Diagnose Dissection of Aorta?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will talk about how to diagnose dissection of aorta? Dissection of aorta is a very confusing disorder unless a key suspicion is present.


    In such patients, history is important. Dr. Sameer will also explain the symptoms which are help to diagnose the disorder. He will tell us many a times ECG are normal. In such patients, hypertension exist and the pulses are uneven, for example, absence of pulse in one limb or carotids, etc. Whenever you have a strong suspicion of dissecting aorta, then the first test to be done is 2d-echo and Transesophageal echocardiography (TTE). TTE is done as when 2d-echo is unable to detect dissecting aorta due to certain limitation.

  • How should we Diagnose Coarctation of Aorta?
    How should we Diagnose Coarctation of Aorta?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will talk on diagnosis of coarctation of aorta. Coarctation of aorta is the most misdiagnosed disorder when a person comes in adulthood. The reason behind this is that physician’s do not look at the femoral arteries or the peripheral lower limb arteries.


    Dr. Sameer discusses that if a person is suffering from hypertension at a young age, then signs and symptoms of the coarctation of aorta should be investigated. He will also talk on differential blood pressure between the upper and lower limbs which can help to diagnose coarctation of aorta. For the detection of it, echocardiography is advised. Hence, this is one of the few conditions of blood pressure which need to be detected aggressively.

  • What is Diastolic Dysfunction?
    What is Diastolic Dysfunction?
    Sameer Shrivastava

    Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, in this video will talk on diastolic dysfunction. He will explain that in diastolic dysfunction, due to failing of heart which cannot contract or push out blood adequately when it is contracting. The heart expands with stiffness or reservations in this abnormality. The stiffness of heart causes the problem of filling of blood. 


    Dr. Sameer tells and explains the parameters of diastolic dysfunction. He will talk that when a person complains of shortness of breath, then how to rule out lungs problems or coronary artery disease. Diastolic dysfunction can be only be detected through echocardiography. Also, invasive techniques are available to calculate diastolic dysfunction.

  • How Can we Differentiate Diastolic Dysfunction & Diastolic Failure?
    How Can we Differentiate Diastolic Dysfunction & Diastolic Failure?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will differentiate between diastolic dysfunction and diastolic failure. Diastolic dysfunction is detected objectively on echocardiography which may or may not manifest into symptoms. It may have restricted filling of blood.

  • What are the guidelines for interventing Mitral Stenosis?
    What are the guidelines for interventing Mitral Stenosis?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will discuss the guidelines for mitral stenosis. Earlier the severity of mitral stenosis was considered as less than 1 cm square but with recent guidelines, lesser than 1.5 cm square is considered as severe mitral stenosis.


    Regardless of the severity of mitral stenosis, the first and foremost intervening is the symptoms. If the person is symptomatic then even it is moderate valvular disease, then it needs to be corrected. Dr. Sameer will also talk on how mitral stenosis is mostly related to young rheumatic children. He will discuss the treatment modes in such children and long it can be managed with out surgery. He will also talk the problems when patients with mitral stenosis are asymptomatic.

  • What are the indications for not intervening pure mitral stenosis?
    What are the indications for not intervening pure mitral stenosis?
    Sameer Shrivastava

    In this video, Talks about indications for not intervening pure mitral stenosis by Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi. If it is mild mitral stenosis, then it is a class three indication. It shouldn’t be interfered or might turn complicated. These patients are well managed with bacterial endocarditis prophylaxis and some diuretics. 

  • What are the indications for surgery in mitral Regurgitation?
    What are the indications for surgery in mitral Regurgitation?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will talk about the indications for surgery in mitral regurgitation. If patients are symptomatic, then it indicates surgical intervention. If the patient has a significant mitral regurgitation with symptoms then he requires surgery. 


    Dr. Sameer tells us that the correct guidelines to intervene in mitral regurgitation are not yet present. The existing guidelines indicate that the patient is subjected to surgery only. When the mitral regurgitation is of rheumatic origin, then mitral valve replacement is needed versus prolapse where the surgery should be repair of the valve. He will explain the repair as well as replacement of valve methods.

  • What are the indications for surgery in a case of aortic?
    What are the indications for surgery in a case of aortic?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will talk on the case of aortic stenosis. In case of severe aortic stenosis and the patient is asymptomatic, then they do not need surgery. Severe aortic stenosis with symptomatic patients are the candidates for surgery or valve replacement. 


    Dr. Sameer will also discuss that even in moderate aortic stenosis and symptomatic patients, surgery or valve replacement is suggested. He will also explain a new method known as TAVI (Transcatheter aortic valve implantation), recently introduced for the intervention of aortic stenosis. It is a procedure like angioplasty or angiography. He will tell the advantages and disadvantages of the procedure TAVI.

  • What are the guidelines for intervention in a case with aortic Regurgitation?
    What are the guidelines for intervention in a case with aortic Regurgitation?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will discuss the guidelines for intervention in a case with aortic regurgitation. Aortic regurgitation is a lesion of valves which is tolerated for a very long time. Many people are asymptomatic. Dr. Sameer will highlight the guidelines when there is a need for surgery. 


    If the patient has a pulmonary arterial hypertension or if the heat functioning of the left ventricular ejection fraction is reducing then he is a candidate for surgery. If arrhythmias in the form of atrial fibrillation is seen and even if patient is asymptomatic, then he needs to be operated. He will also explain why only valve replacement is recommended in aortic regurgitation.

  • Whats the significance of interatrial septal aneurysm?
    Whats the significance of interatrial septal aneurysm?
    Sameer Shrivastava

    In this video, Dr. Sameer Shrivastava, Heads the department of Non-Invasive Cardiology at Fortis Escorts Heart Institute, New Delhi, will talk on significance of interatrial septal aneurysm. In interatrial septal aneurysm, the echocardiography will show a septal bulge either towards the right atrium or left atrium or it might be seen in both the sides. The interatrial septal aneurysm is significant only in young stroke. In these patients of interatrial septal aneurysm, put them on anti-platelet therapy and keep them in observation.

  • Why is trans-fat bad for the heart?
    Why is trans-fat bad for the heart?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, Padma Shri Awardee, Editor-in-chief IJCP Publications, will explain why trans-fat is bad for the heart in this video. Transfat is any oil which is hydrogenated, liquid oil is solidified. Hydrogenated transfat increases LDL cholesterol which is bad for health and will decrease the HDL cholesterol. He will also discuss that pure ghee will not decrease HDL even if it increases LDL cholesterol. Transfat is bad and the meal should not have more half gram of transfat or it should be transfat free.

  • How should we Differentiate PFO from ASD?
    How should we Differentiate PFO from ASD?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will explain how to differentiate patent foramen ovale (PFO) from atrial septal defect (ASD). This differentiation is generally by echocardiography. When a flap is seen overlapping each other then it is known as a PFO. When the flap separates crating a clear defect, it is called an ASD. 


    Dr. Radha Krishnan will talk on stretch PFO which can become an atrial septal defect. And it becomes difficult to differentiate between them and needs to be detected by echocardiography. He will also discuss the differentiating features between a PFO and ASD.

  • How Early should a Baby With PFO Should Go for Intervention?
    How Early should a Baby With PFO Should Go for Intervention?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will discuss about a baby with PFO and when should he/she go for an intervention. He said that generally PFO’s are not closed. Nearly 26% of normal population has PFO. 


    He further explained that the closure of PFO is done only when the doctors feel that it is give extra benefits and in certain conditions such as cryptogenic stroke which is a hidden stroke. There is no known cause for this type of stroke. Echocardiogram with bubble study is done to diagnose it and if confirmed then closure of PFO is done to avoid recurrent cryptogenic stroke. He will further talk on other conditions when is it done as a prophylactic measure.

  • When Should ASD closure be done?
    When Should ASD closure be done?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will talk on the ASD closure and when it is done. ASD is a true defect in atrial septum. The atrial defect is closed when it causes an enlargement of the right atrium and right ventricle. 


    He will also explain that the period for closing ASD is after 2 years of age. Sometimes ASD can cause pulmonary hypertension or the baby is symptomatic, then the closure of atrial septum defect can be done before 2 years of age.

  • How is ASD repaired?
    How is ASD repaired?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will explain the repair of atrial septum defect in this video. He will explain that there are only two ways of closing an ASD.


    One way of closure is the surgery and the other way is with a device. He will further talk on the criteria which are need to be fulfilled for a device to be suitable for the closure of the hole. Echocardiography is done to analyze the margins around the defect. Also, there are lot of other factors which are taken into consideration for closure of ASD.

  • Surgical intervention in a case with VSD?
    Surgical intervention in a case with VSD?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will talk on surgical intervention of ventricular septal defect (VSD). He will discuss that VVSD is little different from ASD. If the VSD is large, which is defined by clinical symptoms and echocardiography, then all VSDs should be closed before six months of age. 


    Dr. Radha Krishnan will also discuss as to why the closure in done immediately. The closure is done to repair the irreversible pulmonary hypertension. If it is a moderate size ventricular defect then one can wait up to 1-2 years of age and the baby is growing well. If the defect doesn’t close by itself then closure of the VSD is advised. He will further talk on the follow-ups regarding VSD.

  • How frequent should the child come for follow up studies after surgical intervention?
    How frequent should the child come for follow up studies after surgical intervention?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will talk on the follow-up of the child especially after intervention. 


    Dr. Radha Krishnan suggests that the child should be followed up 6 month or yearly basis at least for 2-3 years of age. He will also talk on if the ventricular septal defect is seen at a later age of 10, 15 or 20 years, then 3 – 5 years follow up is recommended.

  • Intervention in a case with PDA (Patent Ductus Arteriosus)?
    Intervention in a case with PDA (Patent Ductus Arteriosus)?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, discuss the intervention in a case with PDA (Patent Ductus Arteriosus). PDA is treated similarly as ventricular septal defect. 


    He explains that if it is a large PDA which is defined by echocardiography, then is it closed soon before six months of age. Many a times it is closed within 3-4 months of age. If it is of moderate size then till one year of age the closure is done. If it is a small defect, till 2-3 years of age the closure is done. Dr. Radha Krishnan will talk about the difference between PDA and VSD.

  • What is the criteria for differentiating mild, moderate and sever defects?
    What is the criteria for differentiating mild, moderate and sever defects?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will explain the criteria for differentiating mild, moderate and severe defects. It is generally a echocardiography findings and the measurements of the defects.

     

    Pulmonary artery pressure is predicted after the findings. If it is a large PDA or VSD, it will always cause pulmonary hypertension which damages the heart and lungs. After a certain period, pulmonary hypertension is irreversible. So it is always an emergency to close large PDA or VSD before six months of age.

  • When should we correct TOF?
    When should we correct TOF?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will talk on Tetralogy of Fallot (TOF) and when to correct it. He informs that all TOFs have to be corrected. It generally depends on the oxygen levels at the time of presentation of the patient. 


    If the oxygen levels are very low at the time of birth, then a palliative form of surgery known as Blalock–Taussig shunt or the BT shunt. He also tells us that it is generally corrected beyond six months of age.

  • Which congenital heart diseases are inoperable?
    Which congenital heart diseases are inoperable?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will talk about congenital heart disease which are can’t be operated. There are certain congenital heart disease which are inoperable. These include pulmonary vein stenosis which can’t be corrected.  If a small sub-sect is stenosed then possibly can be corrected. Diffused pulmonary stenosis is also considered inoperable.

     

    Dr. Radha Krishnan will also explain the heterotaxy syndrome which is also inoperable. The anamolies of this syndrome is very complex and has lot of challenges in correcting the defects and due to bad prognosis, parents opt out of treatment.

  • What are the precautions Taken After Device Closure BT Shunt Operation?
    What are the precautions Taken After Device Closure BT Shunt Operation?
    Sitaraman Radhakrishnan

    In this video, Dr. Radha Krishnan, Director, Pediatric Cardiologist at Fortis Escorts Heart Institute, New Delhi, will discuss the necessary precautions taken after device closure BT shunt operation. A certain protocol is followed as each surgery or device has a certain protocol to be followed. These instructions are explained to the parents or patients if they are grown up.


    These protocols include clinical checkups and echocardiography at a fixed intervals which can be 6 months or yearly or maybe three yearly. Dr. Radha Krishnan also talks when the patient is been told that there is no need of follow-up.

  • How should we check for endothelial functions?
    How should we check for endothelial functions?
    RR Kasliwal

    In this video, Dr. RR Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will discuss how about endothelial functions. Endothelium is the first lining of all the arteries of the body and it is thinner than the thinnest muslin cloth. 


    Dr. Kasliwal will also talk that the first marker if any disease is the endothelial dysfunction. If by any means the endothelial dysfunction is diagnosed than cardiovascular diseases, stroke, peripheral vascular diseases could be prevented. He will also explain the importance of studying endothelium.

  • How should we check for arterial elasticity and stiffness?
    How should we check for arterial elasticity and stiffness?
    RR Kasliwal

    In this video, Dr. RR Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta - the Medicity, will talk on arterial elasticity and stiffness in this video. He tells us that by echocardiography the arterial elasticity and stiffness is checked.

     

    Also, he will talk on pulse wave velocity as it is the marker of arterial stiffness. It should be less than 12 meters/sec and if it is more than that it is termed as arterial stiffness. The importance of this test is to detect the arteries are growing thicker and blocked by fatty substances.

  • What is the cut out limit for intima media thickness?
    What is the cut out limit for intima media thickness?
    RR Kasliwal

    This video talks about the cut out limit for intima media thickness by Dr. RR Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta - the Medicity. Intima media thickness is the anatomical part whereas endothelial dysfunction is a physiological process. If intima media thickness is above 8 mm then it is related to hardening of the arteries and requires treatment.


    Dr. Kasliwal will talk about the data of intima media thickness related to the different age groups and about the normal and abnormal measurements. Approximately above 7 -8 mm thickness is considered to be pathological.

  • What is the cut off limit for ankle brachial index?
    What is the cut off limit for ankle brachial index?
    RR Kasliwal

    In this video, Dr. RR Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will talk on the limit for ankle brachial index. If the ankle brachial index is above 0.9 then it is normal. Below 0.9 is considered as abnormal.

     

    He will further talk that the values of ankle brachial index will demonstrate the peripheral vascular diseases. Ankle brachial index is a parameter for people who has extremities problems. Many people have to stop if they walk a certain distance, they could have blockages in the legs arteries and ankle brachial index is a diagnostic marker. Dr. Kasliwal advises in diabetic, smoker, and hypertensive patients, if they get pain in legs then they should test for ankle brachial index.

  • What is the importance of LVH on echocardiography?
    What is the importance of LVH on echocardiography?
    RR Kasliwal

    In this video, Dr. R. R Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will discuss the importance of LVH on echocardiography. When LVH is seen in patients with hypertension, then it signifies that the blood pressure is not completely under control.

     

    If the blood pressure is not controlled then he might suffer from disease of arteries of the heart also. LVH and LV mass are two the parameters which are important. In an LVH patients, medicines also differ. If he has LVH then different set of medicines are given. If he doesn’t have LVH, then different medications are given in hypertensive patients.

  • Why do we check for renal artery atherosclerosis?
    Why do we check for renal artery atherosclerosis?
    RR Kasliwal

    In this video, Dr. R. R Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will talk on renal artery atherosclerosis and how to investigate it. Renal artery atherosclerosis might be present in those young patients who have high blood pressure. Renal arteries supply blood to the kidneys. Kidney is affected by the blood pressure and if these arteries are blocked, high blood pressure is the cause.

  • How reliable are echo-guided hemodynamic parameters?
    How reliable are echo-guided hemodynamic parameters?
    RR Kasliwal

    In this video, Dr. R. R Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will talk on echo-guided hemodynamic parameters and how reliable are in diagnosing. Dr. Kasliwal explains that they are very reliable. As it is non-invasive and can be done at bed-side. Through its results, what kind of therapy should be given is decided and for how long the treatment should be given. Echo-guided hemodynamic parameters are very important in staring the treatment of the patient. Also all parameters of the heart are detected without pain.

  • What are reversible cardiac risk factors?
    What are reversible cardiac risk factors?
    RR Kasliwal

    In this video, Dr. R. R Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will discuss the reversible cardiac risk factors. He will tell that age, gender, family history are irreversible factors. Reversible factors are cigarette smoking, control of diabetes, high blood pressure, high cholesterol, sedentary lifestyle, excess sugar and salt. 


    Lifestyle modification, regular exercise, quitting smoking and decrease in salt intake etc. can reverse the cardiac risk factors and can control sugar levels and blood pressure and cholesterol.

  • How should we diagnose CAD in women?
    How should we diagnose CAD in women?
    RR Kasliwal

    In this video, Dr. R. R Kasliwal, Chairman - Clinical & Preventive Cardiology, Medanta – The Medicity, will explain how to diagnose coronary artery disease (CAD) in women. 


    He informs that after doing physical examination and ECG, the best investigation is to do stress-echocardiogram. Stress echocardiogram is thread-mill-test along with echocardiography. If the doctor is still in doubt, then non-invasive CT coronary angiography can be done. Stress echocardiogram is done after investigating all the blood tests related to heart and cholesterol.

  • What is the incidence of heart defect in babies?
    What is the incidence of heart defect in babies?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the prevalence of heart defects in babies. Around 7-8 babies born out of 1000 children, might have some kind of heart defect for which certain intervention is necessary such as surgery or a cath procedure.

  • When should surgery be done in single ventricle?
    When should surgery be done in single ventricle?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk on the topic when should surgery be done in single ventricle, in this video. If single ventricular heart is presenting with symptoms of hypoxia, cyanosis, then these babies should be put on beta blockers and iron. If these babies are having frequent attacks of cyanotic and hypoxic spells then a BT shunt surgery is advised.

  • How is aortic stenosis treated?
    How is aortic stenosis treated?
    Smita Mishra

    The video talks about the treatment of aortic stenosis in children by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. The aortic stenosis might respond well to valvotomy procedures which is ballooning of the aortic valve. Later in life, these infants might need a repeat intervention such as valve replacement surgery in adolescent age group.

  • What is pulmonary stenosis?
    What is pulmonary stenosis?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about pulmonary stenosis. Pulmonary stenosis is the valvular obstruction at the level of pulmonary valve. It can present immediately after birth or later in age. If pulmonary stenosis is severe at birth, then baby will be blue. These patients are treated with the ballooning procedure but if valve is not involved or the obstruction is below or above the valve then in such cases surgery is advised. Once it is corrected, the baby doesn’t need any other intervention.

  • What is aortic stenosis?
    What is aortic stenosis?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about aortic stenosis in this video. Aortic stenosis can happen in a newly born baby presenting with sudden circulatory failure. These babies are palliated with prostaglandins. In future, these children should be sent to tertiary health care center and can be treated with ballooning procedure. She further tells that rarely these children needs surgery.

  • What is the follow-up patient treated for coarctation of aorta?
    What is the follow-up patient treated for coarctation of aorta?
    Smita Mishra

    The video talks about the follow up patient who were treated for coarctation of aorta by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Coarctation of aorta might be an etiological factor for hypertension. These babies should be assessed for blood pressure rise and should be diagnosed early and treated with proper medication. Also, echocardiography is done along with other investigations such as CT angiogram etc., if hypertension persists in these babies.

  • What is the management of children with coarctation of aorta?
    What is the management of children with coarctation of aorta?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the management of children with coarctation of aorta. If the baby is very sick and has femoral pulses, should be started on prostaglandin and transferred to tertiary care center. Ballooning procedure or surgery is done below six months and after that the baby should be treated with ballooning procedure which can be required more often. She will further explain that after the age of 10 years, a stent is placed in the narrow portion of the aorta so that recurrence of coarctation is avoided.

  • What is coarctation of aorta?
    What is coarctation of aorta?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, with explain about coarctation of aorta in this video. In coarctation of aorta, the aorta has some kind of stenosis. These babies present themselves when ductus arteriosus is closed which is generally very late. The lower limb pulses of these babies are very weak or absent. Hence, it is recommended that any new born baby suddenly becoming symptomatic should check the femoral artery.

  • What are other precautions for patients with prosthesis?
    What are other precautions for patients with prosthesis?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the precautions for patients with prosthesis. Infection is prevalent in patients with prosthesis. They are prone of cardiac infections so need to be very careful. Infective endocarditis prophylaxis along with dental hygiene is very important.  Six month dental checkup should be done to avoid any caries of tooth. Any infection in the body should be promptly treated. Patient with artificial valve should be careful with antibiotics and avoid self prescription.

  • What is the postoperative monitoring following a surgery?
    What is the postoperative monitoring following a surgery?
    Smita Mishra

    The video talks about the postoperative monitoring following a surgery by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. After surgery, postoperative monitoring is similar after 7 days, 3 months or six months and after that a six monthly follow up is necessary for these patients. In few patients, things are stable for a year or two, then yearly monitoring is advised.

  • When is mechanical prosthesis required?
    When is mechanical prosthesis required?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about mechanical prosthesis and when it is required in this video. Mechanical prosthesis is preferred as the life of tissue valves is very less. In mechanical prosthesis, it is expected to be 20 years of longevity and re-intervention is not frequently needed. Life-long blood thinner is given and certain blood tests are advised such as INR which has to be between 2-3. INR should be monitored every 3 weeks. When the INR value stabilizes then can be repeated every three months and the drugs needed to be adjusted. She will further explain what to do if an INR value is less or more than normal value.

  • What is postoperative management after valve replacement?
    What is postoperative management after valve replacement?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain postoperative management after valve replacement. If the valve is leaking, then ballooning is not a good option. In such cases, mostly valve replacement is advised. The valve replaced can be mechanical or tissue made. In case of tissue made valve, blood thinners are required for three months and in mechanical prosthesis, lifelong blood thinners are required.

  • What is rheumatic heart disease?
    What is rheumatic heart disease?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about rheumatic heart disease. It is the throat infection by streptococcal bacteria which might lead to heart disease known as valvular heart disease. The valves become regurgitant or stenotic or both. A close follow-up is maintained for these patients. She will further talk on balloon mitral valvotomy. Penicillin prophylaxis is also checked in these patients.

  • What is valvular heart disease?
    What is valvular heart disease?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about valvular heart disease in this video. Rheumatic heart disease is the major cause of valvular heart disease. In this the valves don not function properly. The valves are present in between the chambers of heart and they open in one direction to avoid backflow of the blood. She will further explain the importance of the valves.

  • What is congestive heart failure?
    What is congestive heart failure?
    Smita Mishra

    The video talks about congestive heart failure by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Congestive heart failure is seen in babies born with large hole in heart due to which there is large amount of blood flow to the heart. These babies have large liver and can have cardiomegaly. They can’t breastfeed properly and take more time to feed. Echocardiography is done and early intervention is advised.

  • What is cyanotic spell?
    What is cyanotic spell?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about the cyanotic spell. Cyanotic spell is intermittent increase in cyanosis in children who are born with blue lips and fingers known as blue baby. These babies cry excessively and have deep breathing and sometimes can become unconscious too. Dr. Mishra will further discuss the negative effects of cyanotic spells in these babies. The brain can become hypoxic and have convulsions too. Medical management or early surgical intervention should be considered in these babies with cyanotic spell.

  • What is fenestration in Fontan surgery?
    What is fenestration in Fontan surgery?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about fenestration in Fontan surgery in this video. Many a times when the lung pressure is not appropriate, then there is a hole between right and left side of heart which is known as fenestration. The saturation of the baby can fall around 90% and the hole in these kids is closed by a device through CAT procedure.

  • What is the postoperative medical management plan following Fontan surgery?
    What is the postoperative medical management plan following Fontan surgery?
    Smita Mishra

    The video talks about the postoperative medical management plan following Fontan surgery by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. These patients need warfarin which is a blood thinner for the rest of life. Rhythm disturbances has to be taken care in these patients. They need a regular checkup at least yearly after the first year of life. They might need a conduit replacement when they are of 14-15 years of age.

  • What is the outcome of a Fontan surgery?
    What is the outcome of a Fontan surgery?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the outcome of a Fontan surgery. Children who are undergoing Fontan repair, most of the time they have 20% complication rate and 80% they might have a better life. They can’t be an athlete but can perform day to day activities and lead a normal routine life and can also do exercises in a symptom restricted manner.

  • What is Fontan surgery?
    What is Fontan surgery?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about Fontan surgery in this video. When a single ventricle patient reaches 5 years of age, both his veins which comes from the upper part of the body and the lower part of body are connected to the pulmonary artery and in the lower part of body, blood comes from IVC, hence a channed is been put between IVC and pulmonary artery and a conduit is been placed. This is known as a Fontan completion of a single ventricular heart.

  • What is Glenn surgery?
    What is Glenn surgery?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about Glenn surgery. When right ventricle is not formed properly, the superior vena cava, the venous channel brings blood from upper part of body is directly connected to the right pulmonary artery. Hence, the ventricle is bypassed in this case so one ventricle is present and it needs to support the system and systemic artery.

  • What should be done in an asymptomatic baby with left ventricle?
    What should be done in an asymptomatic baby with left ventricle?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the management of an asymptomatic baby with left ventricle in this video. If a baby with a single ventricle remains asymptomatic up to age of 5-6 months then they do not need PA banding known as palliative surgery. After six months of age, can undergo Glenn surgery which is a step towards the single ventricular repair known as Fontan surgery.

  • What is the management plan for single ventricle?
    What is the management plan for single ventricle?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the management for single ventricle. Many a times when babies with single ventricle have congestive heart failure at birth and have little cyanosis, feeding difficulty and high lung pressure then these babies should go for first stage of surgery known as pulmonary arterial banding. PA banding is a procedure which reduces blood supply to lungs protecting it.

  • What is a single ventricle?
    What is a single ventricle?
    Smita Mishra

    The video talks about single ventricle by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. A serious heart defect where the chamber of the heart is not formed in babies is known as single ventricle. She will give example of the abnormal heart valve and explain in details about this condition.

  • What is the postoperative outcome of a baby with TAPVC?
    What is the postoperative outcome of a baby with TAPVC?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk on the postoperative outcome of a baby with TAPVC. An obstructed TAPVC is a disease where post-operative outcome maybe negative and baby can be very sick. In non-obstructive TAPVC, the risk is low and the baby can have a normal life. Dr. Mishra will further explain the complications regarding this condition.

  • What is obstructed TAPVC?
    What is obstructed TAPVC?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the obstructed TAPVC in this video. Babies born with obstructed TAPVC are very sick from birth and many times they are taken as case of lung infection rather than a cardiac problem. In these babies, an early surgery is advised. A bluish baby with tachypnea and not having fever should be considered of obstructed TAPVC. She will further discuss the management if the baby is born with non-obstructive TAPVC.

  • What is a TAPVC?
    What is a TAPVC?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about TAPVC. TAPVC is the total anomalous pulmonary venous return. It is a disease where pulmonary veins don’t give their pure blood to left side of heart rather are connected to right side of heart. If the baby presents with a high lung pressure, then baby becomes very sick within 72 hours of life and needs a very early surgery.

  • What is the follow-up of TGA babies?
    What is the follow-up of TGA babies?
    Smita Mishra

    The video talks about the follow-up of TGA babies by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. After surgery, the follow-up period remains the same such as one month, three months, six months and one year. They should also undergo echocardiography to check the growth of the pulmonary artery and the aorta which can be seen properly. There might be a rare possibility of narrowing of the pulmonary artery. These children generally do well and no intervention is needed later in life.

  • When can the surgery for a TGA baby be delayed?
    When can the surgery for a TGA baby be delayed?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the surgery for a TGA baby can be delayed in this video. A baby who is born with the ventricular septal defect and has patent ductus arteriosus, these kids can wait till four weeks and a surgery can be performed between four to eight weeks successfully.

  • When should we operate a TGA baby?
    When should we operate a TGA baby?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about when to operate a TGA baby. TGA baby should be operated at the first opportunity available. Ideally they should be operated within 15 days so that the normal arterial switch operation is done. She will also explain when the baby can undergo operation if presented after 15 days or one month.

  • What should be done if a TGA baby is born in a remote area?
    What should be done if a TGA baby is born in a remote area?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk on what can be done if a TGA baby is born in a remote area in this video. In such situations, prostaglandins are the best treatment option. A new born center should be provided with prostaglandin injection. They should be given in an infusion form and should be transferred to tertiary care center after the injection has been started. These injections are life saving for these babies.

  • What is balloon arterial septostomy?
    What is balloon arterial septostomy?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about balloon arterial septostomy. The balloon arterial septostomy done for TGA babies to create an ASD and systemic and pulmonary blood can be mixed and a saturation in the body can be achieved up to 60 – 70 %.

  • What is the transposition of great arteries (TGA)?
    What is the transposition of great arteries (TGA)?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the transposition of great arteries (TGA) in this video. The pulmonary artery which comes from left ventricle where pure blood is present and the aorta is connected to right ventricle. She will explain about the series of sequences of the blood circulation and the saturation level in the babies. She will also discuss the management of this condition.

  • What is the medical management of TOF?
    What is the medical management of TOF?
    Smita Mishra

    The video talks about the medical management of TOF by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. After the diagnosis of TOF, the hemoglobin level should be 13-14 mg/dl. Hemoglobin below 12mg/dl is anemia for a cyanotic baby. Beta blockers are given regularly to control the heart rate and cyanotic spell. After the surgery, beta blockers are given and the child might need some additional medical management. These babies should have regular follow-up with pediatric cardiologist.

  • When should the complete repair be done in TOF baby?
    When should the complete repair be done in TOF baby?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk on the complete repair be done in TOF baby. If the patient has undergone some kind of palliation in first 2-3 months of life then surgery is usually delayed for one or two years depending upon the saturation of the baby. If the saturation is low around one year, then complete repair should be done around one year.

  • What is the outcome of TOF repair?
    What is the outcome of TOF repair?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the outcome of TOF repair in this video. These babies can become completely cyanotic. They might have dilatation of heart after 10-12 years. In case the heart dilatation is present, they undergo certain tests and if required a valve replacement surgery is done.

  • What is the complete repair of TOF baby?
    What is the complete repair of TOF baby?
    Smita Mishra

    The video talks about the complete repair of TOF baby by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Complete repair of TOF is usually done after five months of age and the ventricular septal defect should be closed. The right ventricular outflow should be reconstructed. She will further explain how the reconstruction is general done in these babies.

  • What is early surgery of TOF baby be done?
    What is early surgery of TOF baby be done?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk on the early surgery of TOF baby be done. A baby who is having saturation level less than 70% have 2-3 options below six months of age. A total correction should be done at a younger age or a BT shunt surgery is conducted. Sometimes a cath procedure is also done known as RVOT stenting.

  • What is the treatment of tetralogy of Fallot?
    What is the treatment of tetralogy of Fallot?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about the treatment of tetralogy of Fallot in this video. If these kids are not very symptomatic in first 5-6 months of age then they are allowed to grow and keep monitoring their saturation level. If saturation is above 70% then they are allowed to grow up to 6-7 kg of weight. If the baby is blue and gets cyanotic spells, an early surgery can be planned.

  • What is the tetralogy of Fallot?
    What is the tetralogy of Fallot?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain tetralogy of Fallot. It means that there is a large hole in the heart and blood flow to lungs is restricted either due to absence of pulmonale valve. It this case the right side of blood directly enters the left side of the heart.

  • What is a blue baby?
    What is a blue baby?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about blue baby in this video. In babies born blue, the right sided blood flows in the left sided heart and this connection is because of abnormal pulmonary valve where blood is not flowing into lungs. Pulmonary arteries should be connected to the right side of heart. She will further explain the cause of the blue baby.

  • What are precautions required in those children with a hole in the heart?
    What are precautions required in those children with a hole in the heart?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, talks about the precautions required in those children with hole in heart. A child who presents very late and has high lung pressure has to undergo cath procedure. She will further explain how which surgery is done along with medical management. These children should be followed up regularly. She will also explain the precautions to be taken in these kids.

  • What are the precautions needed in patients who come late for treatment?
    What are the precautions needed in patients who come late for treatment?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the precautions needed in patients who come late for treatment in this video. When children comes late, they might be having very high lung pressure and can go for surgery and closure of the hole in the heart. In these children, echocardiography is done more frequently and are started with pulmonary vasodilators. She will further explain how long the medications are to be continued.

  • What is the postoperative management of a child with hole in heart?
    What is the postoperative management of a child with hole in heart?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the postoperative management of a child with hole in heart. For these kids, medical management is given for 3 – 6 months. As per the institute guidelines, aspirin might be required post-surgery. Aspirin is given for ASD closure. She will further explain the other medical management given in ASD closure device. Warfarin is prescribed for old patients and the device is large.

  • What is the medical management for babies with hole in heart?
    What is the medical management for babies with hole in heart?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss the medical management for babies with hole in heart in this video. Mostly a decongestive therapy is given such as digoxin, diuretics and enalopril are prescribed for medical management.

  • How frequently should the children with hole in heart be followed up?
    How frequently should the children with hole in heart be followed up?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about the follow-up of the children with hole in heart. In general, children having hole in heart needs follow-up at one month, three months, six months and after that yearly follow-up and after 2-3 years can be followed up at 5 years. She will also talk about the medical management in these patients.

  • What are the other kind of holes?
    What are the other kind of holes?
    Smita Mishra

    The video talks about the other kinds of hole in the heart by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Aortopulmonary window or AP window and atrial septal defect (ASD) are other kind of holes which should be addressed as early as possible. These are operated after six weeks of life and can be complicated than simple ASD or VSD. She will further explain the details of different kinds of heart defects.

  • What is patent ductus arteriosus (PAD)?
    What is patent ductus arteriosus (PAD)?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about patent ductus arteriosus (PAD) in this video. It is common in foetal life. Once the baby is born, PAD closes within 72 hours or within three months. If the baby is born before 40 weeks, the ductus remains open and is troublesome and requires medical management. Sometimes even surgical ligation is required as early as 2 weeks of life. If the baby is responding to medical management, then can undergo device closure.

  • How is the heart defects in babies managed?
    How is the heart defects in babies managed?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about the heart defects in babies managed. A hole in the heart is a simpler defect and all the holes can be managed very effectively with normal functional capacity. A hole in heart generally represents within 3 to 6 months of life with a feeding difficulty with irritable babies and not gaining weight. These babies should undergo echocardiography and be operated within 3 to 6 months. They might need medical management for some time after surgery.

  • What is ventricular septal defect (VSD)?
    What is ventricular septal defect (VSD)?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain about ventricular septal defect (VSD) in this video. VSD is little more complicated than ASD. Dr. Mishra will explain the physiology of ventricular septal defect. The lung pressure should not increase or they will become stiff and thick and in these children lung changes might develop.

  • What is the frequency of follow-up in these babies?
    What is the frequency of follow-up in these babies?
    Smita Mishra

    The video talks about the frequency of follow-up in these babies by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Any intervention done in these babies have to be followed up at one month, three months, six months and one year. After one year, a yearly follow-up is recommended.

  • What are the different types of ASD?
    What are the different types of ASD?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss different types of ASD. ASD can be of many types and can be associated with other defects such as leak in valve. Many a times it is related to acute ventricular septal defect (AVSD). It should be operated early in the first year only.

  • What is atrial septal defect (ASD)?
    What is atrial septal defect (ASD)?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain atrial septal defect (ASD) in this video. In this defect, the baby usually remains asymptomatic in first year of life. If the ASD is more than 8mm in size, then it needs to be operated. She will further explain which type of surgery is done.

  • What is hole in heart?
    What is hole in heart?
    Smita Mishra

    The video will explain about the hole in heart by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. Blood comes to right side of heart and then goes to lungs and then left side of heart. There is no connection between right and left side of heart. If there is any defect in the heart valve, blood directly passes between them. It can affect lungs and baby can have lot of respiratory problems.

  • What is the normal blood circulation?
    What is the normal blood circulation?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will explain the normal blood circulation. There are two systems in the body: pulmonary related to lungs and body. Body utilizes oxygen and lung gives oxygen. Once the body accepts oxygen, blood reaches to right side of heart and then lungs and comes to left side of heart and again circulated to the whole body.

  • What is the normal oxygen saturation of a baby?
    What is the normal oxygen saturation of a baby?
    Smita Mishra

    Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will discuss about the normal oxygen saturation of a baby in this video. All adults and children have oxygen saturation of about 98-100 %. It should not be below 95%.

  • Do all the babies with heart defect need surgery?
    Do all the babies with heart defect need surgery?
    Smita Mishra

    The video talks about the babies with heart defect need surgery by Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital. All babies who are born with the birth defect might need surgery. 40 – 60% of the babies might need some kind of cardiac intervention and the others might heal on its own.

  • How many babies in India are born with heart defects?
    How many babies in India are born with heart defects?
    Smita Mishra

    In this video, Dr. Smita Mishra, Pediatric Cardiology, Associate Director - Jaypee Hospital, will talk about babies in India are born with heart defects. Around 80,000 babies per year in India are born with the heart defect.

  • What about AED in Mountains?
    What about AED in Mountains?
    KK Aggarwal

    Dr. K K Aggarwal, Padma Shri Awardee, Editor-in- chief, IJCP Publications, will talk about automatic external defibrillator (AED). He will explain that at the top of the mountains, people are likely to get angina or cardiac arrest. Hence it is important to know CPR and the AED machine is placed at the mountain place to avoid any emergencies.

  • Are cardiac patients at risk of nephropathy?
    Are cardiac patients at risk of nephropathy?
    Suman Kirti

    In this video, Dr. Suman Kirti, Endocrinologist, Holy Family Hospital, New Delhi, will discuss that if patients at risk of cardiovascular disease or nephropathy, then what is the other substitute for ACE inhibitors or ARBs.


    In such patients, treatment with calcium channel blockers (CCB) are given. Nowadays, calcium channel blockers are more advanced and the drugs act centrally thus reducing the central blood pressure.


    Dr. Suman will describe the advantage of reducing the central blood pressure. Hence CCB are preferred when ACE inhibitors and ARBs cannot be used as it improves the renal blood flow as well cardiac blood flow.  Dr. Suman will also talk about different CCBs which are used in renal failure.

  • What is the role of ticagrelor in acute MI?
    What is the role of ticagrelor in acute MI?
    Viveka Kumar

    Dr. Viveka Kumar, Senior Director - Cath Lab, Max Super Speciality Hospital, Saket, will talk about the role of ticagrelor in acute MI, in this video. Ticagrelor has revolutionized the treatment of acute MI. it has also shown to reduce mortality in all situations. He will also explain that the only condition where the ticagrelor treatment is not used is when the patient is undergoing thrombolytic therapy.

  • How long does venous graft last?
    How long does venous graft last?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, talks about venous graft. The standard natural phases of venous grafts are three phases of occlusion: immediate which might be due to technical fault, fibro-endothelial hyperplasia might occur in 1 % of patients after a month. And last phase, is the atherosclerosis which happens over one year which can block the coronary artery as well the graft. Overall, approximately 50 % of the venous grafts might get blocked over 10 years.

  • What is bypass surgery without cutting the sternum?
    What is bypass surgery without cutting the sternum?
    OP  Yadava

    In this video, Dr. OP. Yadava, Chief Executive Officer & Chief Cardiac Surgeon, National Heart Institute, New Delhi, will talk about bypass surgery without cutting the sternum. Any surgery in which the sternum is not slit in the center and is approached towards the heart using a small lateral thoracotomy or the anterior thoracotomy is also called as the mid cap operation. These types of surgeries are called sternal sparing minimally invasive surgeries and can be done for single vessel coronary artery disease.

  • I am on regular antihypertensive and PPI therapy Does that increase my...?
    I am on regular antihypertensive and PPI therapy Does that increase my...?
    Umapati Narasinha Hegde

    In this video, Dr. Umapati Narasinha Hegde, Consultant Nephrologist, Gujarat will discuss about antihypertensive and PPI therapy. Recent evidences have shown that in long run PPI’s have increased the incidence of kidney disease. He will further talk about the side effects of this combination and when not indicated shouldn’t take it.

  • I have CKD and hypertension Can pain killers worsen my condition?
    I have CKD and hypertension Can pain killers worsen my condition?
    Om Kumar

    Dr. Om Kumar, HOD, Department of Nephrology, Patna will discuss about painkillers in CKD and hypertension in this video. The painkillers can worsen the condition if the person is suffering from CKD and hypertension. He highlights the point to avoid taking painkillers if creatinine or urea is high. Also do not take any NSAIDs without the advice of doctor.

  • I have diabetes How often should I get renal function test done?
    I have diabetes How often should I get renal function test done?
    Om Kumar

    In this video, Dr. Om Kumar, HOD, Department of Nephrology, Patna, will talk about renal function tests. Any patient who has been diagnosed diabetes at the onset should get all their target organ evaluation done. He will also talk about renoprotective drugs and keep their blood pressure and sugar levels controlled.

  • What are the clinical presentation of syncopy?
    What are the clinical presentation of syncopy?
    Vanita Arora
    In this video, Dr. Vanita Arora, Associate Director & Head - Cardiac Electrophysiology Lab & Arrhythmia Services, Max Super Speciality Hospital, answer "What are the clinical presentation of syncopy"
  • Do you know what is the ejection fraction of heart?
    Do you know what is the ejection fraction of heart?
    Vanita Arora

    In this video, Dr. Vanita Arora, Associate Director & Head - Cardiac Electrophysiology Lab & Arrhythmia Services, Max Super Speciality Hospital, answer "Do you know what is the ejection fraction of heart"

  • What is syncopy?
    What is syncopy?
    Vanita Arora
    In this video, Dr. Vanita Arora, Associate Director & Head - Cardiac Electrophysiology Lab & Arrhythmia Services, Max Super Speciality Hospital, answer "What is syncopy"
  • Should heart patients take folic acid supplementation?
    Should heart patients take folic acid supplementation?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss whether heart patients take folic acid supplementation. In India, generally folic acid deficiency is very common as there is no mechanism for food fortification. If the patient is at risk of stroke then folic acid supplementation should be given everyday. He will further explain which vitamins are essential.

  • Explain the checklist in emergency for a patient with stroke?
    Explain the checklist in emergency for a patient with stroke?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the checklist of emergency management in a patient with stroke in this video. Aspirin should be started within 48 hours, DVT prophylaxis, and start statins as early as possible. Within 1 hour TPA is given. Dr. Aggarwal will further talk about the time limit and what should be done within 24 hours. He will also talk about the parameters which are needed to be stabilized.

  • Explain overnight pulse oximetry?
    Explain overnight pulse oximetry?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain overnight pulse oximetry in details in this video. Many a times, the patient’s overnight oxygen desaturation needs to be checked. It is generally done in patients with asthma, sleep apnea, COPD, heart failure, etc. and check for more than 4% desaturation. If the patient has more than 10 levels of desaturation levels in an hour then it is a positive desaturation index.

  • In a patient with paralysis, is the acute rise in blood pressure treated?
    In a patient with paralysis, is the acute rise in blood pressure treated?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about whether in a patient with paralysis, they should treat the acute rise in blood pressure. If the doctor is contemplating in giving TPA, then keep the systolic blood pressure below 165 mmHg and diastolic blood pressure below 110 mmHg. He will further state that the blood pressure should be kept below 180/105 mmHg. He will also discuss the treatment or management if no TPA is given and the patient is on conservative treatment.

  • Do women get heart attack?
    Do women get heart attack?
    KK Aggarwal

    The video will discuss whether women get heart attack by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. He says that in India, women are getting heart attack before menopause. Deaths due to heart disease is more than breast cancer in women. Heart attack symptoms in women maybe atypical and not classical chest pain symptoms. Angioplasty is delayed as there women do not go for check up in the hospital. Heart awareness should be done in women.

  • What is FAST?
    What is FAST?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about FAST acronym in this video. FAST is an acronym for early diagnosis of stroke or paralysis. F means facial dropping, A means weakness of the upper or lower arm, S means speech difficulty and T means time denoting how long these symptoms were present. If these symptoms are present for an hour and a clot dissolving medicine is given immediately then stroke can be reversed. This period is known as the golden hour. He will further talk about the second window period which is of 4.5 hours in which the TPA or clot dissolving medicine should be given.

  • What is the golden period in stroke?
    What is the golden period in stroke?
    KK Aggarwal

    The video talks about the golden period in stroke by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. The golden period of stroke is the 90 days in which there is maximum recovery of the patient. The patients should do everything possible to have fastest recovery in this 90 days period whether from medicines or rehabilitation.

  • When a chest pain is not because of heart disease?
    When a chest pain is not because of heart disease?
    KK Aggarwal

    The video describes about the chest pain which are not related to heart pain by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. Any chest pain which can be localized by a finger cannot be a heart pain. Heart pain is diffuse and the patient will show with a whole palm the area which is having discomfort. Also, he will further explain that any pain lasting less than 30 sec is not a heart pain.

  • When should we give aspirin in acute MI?
    When should we give aspirin in acute MI?
    KK Aggarwal
    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss when to give aspirin to a patient in acute MI in this video. When a heart attack is suspected, then chewable 300mg of aspirin is given or is dissolved in water and given. The scientific literature states that after the diagnosis is confirmed, aspirin has to be given or in high suspicion of MI it is given. High dose is avoided as it can cause acidity.
  • Do you take aspirin for a heart attack?
    Do you take aspirin for a heart attack?
    KK Aggarwal
    The video will discuss about aspirin during heart attack by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. In a heart attack, 300mg of aspirin is given to chew or dissolved completely in water. Along with that 80mg of atorvastatin is given. Dr. Aggarwal will further explain the various drugs given for different management for heart attack patients.
  • Can aspirin be given in an ambulance or at home in patient suspected to have had a heart attack?
    Can aspirin be given in an ambulance or at home in patient suspected to have had a heart attack?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss whether an aspirin can prevent a heart attack if given in ambulance or at home if suspected to have heart attack in a patient.  At the diagnosis of a heart attack, the patient should be given water soluble 300mg of aspirin wherever the patient gets it. All heart patients should keep the strip of aspirin in their pocket or at home or in car or office. All doctors should also keep a strip in their clinic or car.
  • Define hypotension?
    Define hypotension?
    KK Aggarwal
    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about hypotension in this video. Hypotension means low blood pressure. It is an important aspect of shock causing low blood pressure. By definition, it means less than 90mmHg of systolic blood pressure. He will also explain about relative hypotension where there is a drop of 40 mmHg of systolic pressure. Relative hypotension is the commonest cause of ischemia of kidneys. He will further explain about orthostatic hypotension too.
  • LBB vs RBB: What will you ingore in an ECG?
    LBB vs RBB: What will you ingore in an ECG?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about LBB vs RBB in an ECG. He says that never to ignore LBB occurrence in an ECG. LBB should be investigated. If it is an acute LBB, it is a sign of myocardial infarction. If it is a chronic LBB, then it might be some cardiomyopathy or low ejection fraction.
  • How should we measure abdominal obesity?
    How should we measure abdominal obesity?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on abdominal obesity.  The abdominal circumference is measured by a measuring tape at the level of iliac crest. If it is more than 102 cm in men and 88 cm in women internationally and more than 90 cm in men and 80 cm in women in India then it is abdominal obesity or central adiposity. He will further discuss about the lifestyle disorders caused by abdominal obesity.
  • What is affordable health care?
    What is affordable health care?
    KK Aggarwal

    The video talks about affordable health care by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. It is the safe and quality assessable health care which is accountable and available to everyone with value for money. Affordable health care is both for masses and classes. Dr. Aggarwal will further explain these with examples.

  • What is takayasu disease?
    What is takayasu disease?
    KK Aggarwal

    The video will discuss about the takayasu disease by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. It is a rare autoimmune disorder which is dominant in women in between 10-40 years of age. This is a chronic autoimmune disease which can be managed well with steroids. Investigations including ESR and CRP are done regularly and treatment is initiated. He will further explain the symptoms and diagnostic evaluation of this disease.

  • Should all patients with a cyanotic or cyanotic heart disease needs infective....?
    Should all patients with a cyanotic or cyanotic heart disease needs infective....?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss whether all patients with a cyanotic or cyanotic heart disease needs infective endocarditis prophylaxis. All patients with cyanotic congenital heart disease which are unrepaired needs infective endocarditis prophylaxis. He will also discuss the conditions of repaired congenital heart disease which needs prophylaxis.

  • Should patients with complex cyanotic congenital heart disease be put on prophylaxis....?
    Should patients with complex cyanotic congenital heart disease be put on prophylaxis....?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on whether patients with complex cyanotic congenital heart disease should be started with prophylaxis for infective endocarditis in this video. All unrepaired cyanotic congenital heart disease as well as repaired congenital heart disease with residual shunts or valvular regurgitation at the site or adjacent to the site of prosthetic device, etc. needs prophylaxis for infective endocarditis.

  • What is stable coronary artery disease?
    What is stable coronary artery disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about stable coronary artery disease. In stable coronary artery disease, the symptoms are predictable and producible. Predictable symptoms means walking a particular distance might precipitate angina symptoms and on rest the symptoms disappear. If the patient is asymptomatic, the next step is thread mill test or stress test. He further says that if patient is stable and has no symptoms then medical management can be continued.

  • Should persistent tachycardia be noticed or taken care of?
    Should persistent tachycardia be noticed or taken care of?
    KK Aggarwal

    The video will discuss about persistent tachycardia by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. Persistent tachycardia means a heart rate of more than 100 per minute at the time of presentation or more than 90 per minute in the last 24 hours. Anemia can cause tachycardia which is reversible. Also, check for thyroid disorders, angina and diabetes. Dr. Aggarwal will also talk about inappropriate sinus tachycardia which is more than 100 per minute.

  • What is prognosis of TAPVC (Total anomalous pulmonary venous connection) type of cases?
    What is prognosis of TAPVC (Total anomalous pulmonary venous connection) type of cases?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the prognosis of Total anomalous pulmonary venous connection in this video. He will discuss a case of a six month old baby who was diagnosed with mix TAPVC with enlargement of right atrium and right ventricle. He further says that early surgery is needed for such babies so that they can live a normal life.

  • A patient is suffering with rheumatic heart disease, mitral stenosis and tricuspid regurgitation...?
    A patient is suffering with rheumatic heart disease, mitral stenosis and tricuspid regurgitation...?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about a patient who is suffering from rheumatic heart disease, mitral stenosis and tricuspid regurgitation in this video. He further says that rheumatic heart disease is not progressive after the age of 35 years. E will explain the symptoms of rheumatic heart disease and mitral stenosis along with other underlying possible causes. In such patients, pulmonary artery pressure should be controlled.

  • What is critical congenital heart disease?
    What is critical congenital heart disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about critical congenital heart disease. He says that 1% of the new born children born suffer from congenital heart disease and 25% of them may have critical congenital heart disease. Critical congenital heart disease generally requires catherter based intervention or surgery within one year of life. He will further tell that 70% of such babies can be diagnosed on day one but remaining 30% cannot be diagnosed.

  • Which types of ASD require surgical intervention?
    Which types of ASD require surgical intervention?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about the types of ASD which requires surgical intervention in this video. He says that all types of primary ASDs need surgical intervention. He will further explain the types too. If the ASD is secondary, consider the option of device closure or surgical closure. But in primary ASDs, surgery is only the option.

  • How often we follow up a patient with mitral stenosis?
    How often we follow up a patient with mitral stenosis?
    KK Aggarwal

    The video will talk about the follow up of a patient with mitral stenosis by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. In the mitral valve stenosis, if the area is more than 1.5 cm2 and the patient is asymptomatic then a follow-up is needed every 3-5 years. If the valve area is between 1-1.5 cm2 then follow up every 1 -2 years. If the mitral valve is less than 1 cm2 then follow up annually.

  • Is it true whether missed beat are always dangerous?
    Is it true whether missed beat are always dangerous?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the missed beat in this video. Occasional missed beat can be normal. Those miss beats which disappear on walking and exercising are normal and those which appear on exercise are abnormal. Such abnormal beats need evaluation.

  • How work stress is associated in heart disease and diabetes patients?
    How work stress is associated in heart disease and diabetes patients?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the association between work stress in heart disease and diabetes patients. Stress is directly linked as a risk factor in heart disease and diabetes patients. Work stress is basically a high demand of work with little or no responsibility. Work stress leads to depression, increase in sugars, hypertension, atherosclerosis, etc. Whenever there is stress, act and don’t react to avoid further complications.

  • How does a family history affect my risk for heart disease?
    How does a family history affect my risk for heart disease?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on the topic of whether family history has a risk of developing heart disease in their offspring’s in this video.  If there is a strong family history of heart problems in any person then he is prone to develop it. But if the risk factors are known, then it can be reduced by taking proper care. Risk factors such as obesity, high cholesterol should be managed with lifestyle modifications. Also, quitting smoking and reducing alcohol can also benefit.

  • How do you prevent rheumatic fever?
    How do you prevent rheumatic fever?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the prevention of rheumatic fever. With each episode of rheumatic fever, rheumatic heart disease becomes more serious. Prevention of streptococcal sore throat is necessary. Hence, prophylaxis is very necessary for such infection with penicillin or azithromycin or the protocol which is mentioned regarding the streptococcal sore throat infection.

  • How long can we give penicillin prophylaxis to treat rheumatic fever?
    How long can we give penicillin prophylaxis to treat rheumatic fever?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the penicillin prophylaxis for treatment of rheumatic fever. The prophylaxis of penicillin depends on the risk of severity and recurrence of rheumatic fever. Simple rheumatic fever with no carditis can be given prophylaxis for 5 years or till the age of 21 years whichever is longer. Rheumatic fever with carditis can be given for 10 years. He will further explain the treatment if there is residual lesion with rheumatic fever.

  • Can you cure congenital heart disease?
    Can you cure congenital heart disease?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on the topic of congenital heart disease in this video. He will discuss about a patient’s case who is of 9 years and has a ASD of 4.1 mm, ejection fraction is normal, aortic regurgitation is significant. Outlet muscular VSD should be given a chance to close on its own or spontaneously or else surgery is advised

  • Is double valve replacement is superior to aortic valve replacement with mitral valve repair?
    Is double valve replacement is superior to aortic valve replacement with mitral valve repair?
    KK Aggarwal

    The video will discuss the double valve replacement and aortic valve replacement with mitral valve repair by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. According to literature, single valve replacement is always better than double valve replacement. In severe cases, double valve replacement can be done but always try to salvage one valve.

  • Can dabigatran prescribed in patient with valvular atrial fibrillation?
    Can dabigatran prescribed in patient with valvular atrial fibrillation?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks will discuss whether dabigatran can be prescribed in patients with atrial fibrillation in this video. Dabigatran should not be used in mechanical prosthetic heart valve. Warfarin is given in such patients and INR has to be maintained above 3. He will further explain the complications also.

  • What is considered a large ASD?
    What is considered a large ASD?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about large ASD. A small ASD of less than 6mm can wait for 5 years for its spontaneous closure. Moderate ASD is 6-8 mm in diameter and large ASD is more than 8 mm in diameter. Large ASD usually requires correction as it will not close spontaneously.

  • What is best treatment for LAD Blockage 80-90%?
    What is best treatment for LAD Blockage 80-90%?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the best treatment for LAD Blockage 80-90% in this video. LAD Blockage patients can undergo stenting. If the patient is stable, then can undergo a medical management trial. After medical treatment, then can be evaluated further according to the patient’s condition.

  • What is the management of tachycardia?
    What is the management of tachycardia?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about tachycardia. Inappropriate tachycardia is more than 90 beats per minute. Investigate for anaemia and thyroid disorders. If anaemic, then correct the patient’s haemoglobin levels. After correction of anaemia still the patient has tachycardia, then start with short term betablockers to avoid increase in blood pressure.

  • What should be the duration of dual antiplatelet therapy?
    What should be the duration of dual antiplatelet therapy?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the duration of dual antiplatelet therapy given after LAD stenting. Most of such patients are put on the combination of clopidogrel and aspirin during stenting. The dual antiplatelet drug should be re-evaluated every six months. After six months, if the patient is at low risk of bleeding and has tolerated the medicine then should be continued for more 18 months. After this, only aspirin can be continued.

  • What happens when an artery gets blocked?
    What happens when an artery gets blocked?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on the topic of a blocked artery in this video. If the patient is asymptomatic, then can be put on medical management and lifestyle modifications such as reducing weight, exercise, control of blood pressure and sugar levels. If the patient is symptomatic, then a bypass surgery is indicated.

  • What is meant by collateral circulation?
    What is meant by collateral circulation?
    KK Aggarwal

    This video will explain collateral circulation by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. Anastomotic channels, also known as collateral vessels can develop in the heart as an adaptation to ischemia. When there is insufficiency of blood flow, the body might try to develop collaterals in the coronary circulation. They serve as conduits which bridges severe stenosis. There are two classes of collaterals: capillary and coronary. Dr. Aggarwal will describe in details both these collaterals.

  • What is interatrial septal aneurysm?
    What is interatrial septal aneurysm?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain about interatrial septal aneurysm in this video. It is the mobile interatrial septal tissue in the region of fossa ovalis with excursion of 10-15mm during cardio-respiratory cycle. If the atrial septal is mobile and excursion is more than 10-15mm then it is called as an aneurysm of the interatrial septum. He will further discuss about the types also.

  • Who is eligible for the treatment?
    Who is eligible for the treatment?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk on the treatment eligibility. He will discuss about a case with chronic total occlusion in one of the coronary artery. All patients who undergo coronary angiography, 33% of the report will show that one of the artery is 100% blocked. Also, a person who is treated with clot dissolving therapy after a heart attack will show total occlusion in one of the artery after 6 months in 30% of the cases.
  • Definition of stable angina?
    Definition of stable angina?
    KK Aggarwal
    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about ASD surgery in this video. He will discuss the case about atrial septal defect. He will further discuss whether such patients require angiography before the surgery. There are two conditions whether the patient has coronary artery disease or undergoing device surgery in presence of pulmonary arterial hypertension. Angiography is required in such cases if there is a device surgery with pulmonary arterial hypertension.
  • Relationship between carditis and Barretts esophagus?
    Relationship between carditis and Barretts esophagus?
    KK Aggarwal
    The video will discuss about stable angina by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. Stable angina refers to chest discomfort which occurs predictably and irreproducible on certain amount of exertion and relieved by rest or sublingual nitroglycerin. He will further explain it with example.
  • How is the need for heart bypass surgery determined?
    How is the need for heart bypass surgery determined?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss whether carditis recur. He says that it can recur. The presence of cardiac involvement in rheumatic fever can cause carditis to recur. If in the first episode of rheumatic fever, carditis is not present then, in second episode it will not occur. And if there is cardiac involvement in first episode of rheumatic fever then every time carditis will recur worsening the existing carditis.
  • How rare is dextrocardia?
    How rare is dextrocardia?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "How rare is dextrocardia"
  • Some common worries about angina?
    Some common worries about angina?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "Some common worries about angina"
  • What is the most common cause of aortic regurgitation?
    What is the most common cause of aortic regurgitation?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "What is the most common cause of aortic regurgitation"
  • Characteristics of angina?
    Characteristics of angina?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "Characteristics of angina"
  • Common origin of all three coronary arteries?
    Common origin of all three coronary arteries?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "Common origin of all three coronary arteries"
  • Coarctation of the aorta in children?
    Coarctation of the aorta in children?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "Coarctation of the aorta in children"
  • When do we intervene in a patient with coarctation of aorta in children?
    When do we intervene in a patient with coarctation of aorta in children?
    Smita Mishra
    In this video, Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will discuss about the intervention in coarctation of aorta in children. Coarctation of aorta generally presents early in life. If the baby is sick and lower limb pulses are absent the early surgery is recommended. If the baby is presented late then clinical symptoms are evaluated and balloon angioplasty is recommended.
  • When do we intervene in VSD (Ventricular septic defect)?
    When do we intervene in VSD (Ventricular septic defect)?
    Smita Mishra
    Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will discuss about the intervention done in ventricular septic defect in this video. If the VSD is large, baby is not growing well and is of six months of age then one should intervene. If the VSD is moderate then can wait for 3-4 months more. If the VSD is very small and heart size is normal and lung pressures are also normal, then can wait for long and monitor the patient.
  • How do we classify small medium and large VSD?
    How do we classify small medium and large VSD?
    Smita Mishra
    The video will talk on the classification of small, medium and large VSD by Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida. These can be well defined with echocardiography. Clinically, the heart is large or can be classified according to lung pressures. Large VSD should be closed early in life.
  • When do we intervene in ASD (Atrial septic defect)?
    When do we intervene in ASD (Atrial septic defect)?
    Smita Mishra
    Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will discuss about the intervention done in atrial septic defect in this video. Atrial septic defect can be intervened within two years. Atrial defects can be of four types and atrial secundum is the commonest defect. She will also explain the conditions where the atrial defects are intervened within one year of life. Classical symptoms should be evaluated and if the baby is not growing well then early intervention is necessary.
  • How we manage a VSD with some degree of aortic regurgitation?
    How we manage a VSD with some degree of aortic regurgitation?
    Smita Mishra
    In this video, Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will discuss the management of VSD in aortic regurgitation. She will explain that VSD with aortic regurgitation should be checked at which location it is and proper follow-up and treatment is needed depending upon the location. Generally early surgery is recommended and it would depend upon the status of aortic valve.
  • What is BT shunt, left BT shunt, right BT shunt and modified BT shunt?
    What is BT shunt, left BT shunt, right BT shunt and modified BT shunt?
    Smita Mishra
    Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will explain about the different types of shunt in this video. She will explain the circulation of the body and when there is any defect in the heart such as hole in the heart or pulmonary stenosis, the circulation is impaired. BT shunt is done, when the condition is hypoxic. Dr. Smita will further explain the different shunts in details.
  • When do we give aspirin after surgery to a child with congenital heart disease?
    When do we give aspirin after surgery to a child with congenital heart disease?
    Smita Mishra
    In this video, Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will discuss about aspirin therapy in congenital heart disease. After BT shunt surgery, aspirin is given. Also, when any prosthetic material is used for surgery, aspirin treatment is given.
  • After a congenital heart surgery, when do we give blood thinners or anticoagulants?
    After a congenital heart surgery, when do we give blood thinners or anticoagulants?
    Smita Mishra
    Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida, will talk about blood thinners about a congenital heart surgery in this video. When prosthetic materials are used in the surgery, anti-coagulation medicines are prescribed. She will further discuss the different kinds of surgery in which blood thinners are given.
  • When do we a second stage surgery, for example after BT shunt when do we do a characteristic....?
    When do we a second stage surgery, for example after BT shunt when do we do a characteristic....?
    Smita Mishra
    In this video, Dr. Smita Mishra, Associate Director, Paediatric Cardiologist, Jaypee Hospital, Noida will talk about the second stage surgery after BT shunt surgery. After the BT shunt surgery, if the children is stable and has saturation above 75 then one can wait for the surgery. Corrective surgery is possible without using conduit and can be done in a year or two. She will further talk about when to wait for corrective surgery.
  • Is it okay to pop a blister that formed after a burn?
    Is it okay to pop a blister that formed after a burn?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Is it okay to pop a blister that formed after a burn"
  • When should a burn send you to the hospital?
    When should a burn send you to the hospital?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "When should a burn send you to the hospital"
  • How does soap clean you?
    How does soap clean you?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "How does soap clean you"
  • How do you care for stitches?
    How do you care for stitches?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "How do you care for stitches"
  • What are dissolving stitches made of? What do they dissolve in?
    What are dissolving stitches made of? What do they dissolve in?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "What are dissolving stitches made of? What do they dissolve in"
  • What is the best treatment for scars after surgery?
    What is the best treatment for scars after surgery?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "What is the best treatment for scars after surgery"
  • How should we Reduce the intensity of Surgical Scars?
    How should we Reduce the intensity of Surgical Scars?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "How to Reduce the intensity of Surgical Scars"
  • Surgical Scars: How should we Minimize and Treat their Appearance?
    Surgical Scars: How should we Minimize and Treat their Appearance?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Surgical Scars: How to Minimize and Treat their Appearance"
  • Bites: Preventing Infections and Treating Injuries?
    Bites: Preventing Infections and Treating Injuries?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Bites: Preventing Infections and Treating Injuries"
  • What might have caused an infection at the site of surgery?
    What might have caused an infection at the site of surgery?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "What might have caused an infection at the site of surgery"
  • Wrong site surgery and surgical marking practices among clinicians?
    Wrong site surgery and surgical marking practices among clinicians?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Wrong site surgery and surgical marking practices among clinicians"
  • Use of mobile phone in operating room?
    Use of mobile phone in operating room?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Use of mobile phone in operating room"
  • Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB)?
    Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB)?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Comparison between fine needle aspiration cytology (FNAC) and core needle biopsy (CNB)"
  • Can a biopsy cause a cancer to spread?
    Can a biopsy cause a cancer to spread?
    Shiv Chopra
    In this video, Dr. Shiv Chopra, General Surgery Senior Consultant, Mool Chand Hospital, New Delhi, answer, "Can a biopsy cause a cancer to spread"
  • Differentiate progressive and non-progressive coronary artery disease?
    Differentiate progressive and non-progressive coronary artery disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about progressive and non-progressive coronary artery disease and its differentiation. Progressive coronary artery disease is defined as new obstructive or non-obstructive coronary artery disease in a previously diseased free vessel. Such patients have more LDL cholesterol and uncontrolled blood pressure. He will further discuss the management of progressive coronary artery disease.

  • What are the considerations for heart transplant?
    What are the considerations for heart transplant?
    KK Aggarwal

    The video talks about heart transplant considerations by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. According to the literature, the considerations for heart transplant are: whether the patient is in cardiogenic shock, intractable arrhythmia, refractory congenital heart disease, refractory angina, or class IV heart failure. If the patient is stable then it is not necessary that heart transplant is needed and multiple options can be considered.

  • Can stress and anxiety cause heart palpitations?
    Can stress and anxiety cause heart palpitations?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss whether stress and anxiety can cause heart palpitations. If a person has heart palpitations and migraine like symptoms in absence of anemia, anxiety, thyrotoxicosis, then the drug of choice is the betablocker. He will further explain that propranolol is FDA approved and the drug of choice in such situation.

  • When should we operate a person who has large hole in the heart?
    When should we operate a person who has large hole in the heart?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the symptoms of hole in heart in this video. He will discuss about a patient with eisenmenger syndrome, sub-aortic VSD, a hole between the two ventricles of the heart and high pulmonary artery pressure. Such patients might have desaturation on exercise. Dr. Aggarwal will also discuss the symptoms present in this patient and how to manage it.

  • Is intervention necessary in rheumatic heart disease patient with mitral stenosis?
    Is intervention necessary in rheumatic heart disease patient with mitral stenosis?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about the rheumatic heart disease and its management. If the patient is symptomatic and valve area is less than 1.5 then balloon valvotomy or mitral valve repair. If the patient is asymptomatic then follow up is needed every one to two years. Also, rule out other possibilities of breathless such as anemia, thyroid problems, lung function test, etc.

  • What is the surgical mortality in patients with ASD?
    What is the surgical mortality in patients with ASD?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about the mortality rate in ASD patients. In absence of high pulmonary pressure the mortality rate in less than 1 % in such patients and life expectancy is normal.

  • What are the complications of rheumatic heart disease?
    What are the complications of rheumatic heart disease?
    KK Aggarwal

    This video will about the complications of rheumatic heart disease by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. In the first episode of rheumatic fever, there are 50% chances of involvement of heart and might develop rheumatic carditis. If the patient has more than one attack of rheumatic fever then 75% of chances of developing heart disease. The complications are fibrosis or mitral stenosis. Dr. Aggarwal will further explain the complications in details.

  • Should angioplasty be performed in coronary artery obstructive disease?
    Should angioplasty be performed in coronary artery obstructive disease?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about angioplasty in coronary artery obstructive disease in this video. He will explain that before any procedure, hemoglobin levels should be checked. Inappropriate tachycardia can be due to anemia. He will further explain the tests done in such patients and after correction of the parameters if the patient is stable then should put them on medical management.

  • What is the management of triple vessel disease?
    What is the management of triple vessel disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about the management of triple vessel disease. He will discuss about a patient who had undergone total and complete arterial revascularization. He will also talk about T and Y graft procedure.

  • Atrial Septal Defect Treatment & Management?
    Atrial Septal Defect Treatment & Management?
    KK Aggarwal
    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, answer "Atrial Septal Defect Treatment & Management"
  • When to intervene when one artery of a patient is 100% is blocked?
    When to intervene when one artery of a patient is 100% is blocked?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about intervention process in a patient whose artery is 100% blocked. He will discuss a case with stable angina and angiography shows single vessel right coronary artery 100% blocked. In chronic total occlusion, stenting is warranted when the following three conditions are met:


    • The occluded vessel is responsible for the symptoms.
    • The myocardial territory of the occluded artery is viable.
    • The likelihood of success is more than 60% with estimated rate of death and heart attack less than 1% and 5% respectively.
  • How common is atrial fibrillation in underlying rheumatic heart disease?
    How common is atrial fibrillation in underlying rheumatic heart disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about atrial fibrillation in underlying rheumatic heart disease. He says that atrial fibrillation is very common in rheumatic heart disease patients. He will further discuss the other conditions in which it can be present. Atrial fibrillation in present in 70% of mitral stenosis, mitral regurgitation and tricuspid regurgitation patients. In isolated mitral stenosis, it is present in 29% of cases and in mitral regurgitation, it is present in 16% of the cases.

  • In what circumstances does a patient require cardiac transplant?
    In what circumstances does a patient require cardiac transplant?
    KK Aggarwal

    The video will discuss the circumstances in which a patient requires cardiac transplant by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. He will discuss the circumstances in which cardiac transplant in suggested as per the literature:


    1. Cardiogenic shock
    2. Persistent class IV heart failure
    3. Severe angina
    4. Life threatening arrhythmias 
    5. Hypertrophic cardiomyopathy
    6. Refractory congenital heart disease
  • What is feasible, double valve replacement versus single valve replacement or other valve repair?
    What is feasible, double valve replacement versus single valve replacement or other valve repair?
    KK Aggarwal

    The video will discuss about double valve replacement versus single valve replacement or other valve repairs by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. In any patient if two valves are damaged, then feasibility is checked to repair one valve and replace the other. In every case of rheumatic heart disease or mitral stenosis, refer the patient to a surgeon to evaluate first because single valve replacement is always better than double valve replacement.

  • When to intervene in pulmonary stenosis?
    When to intervene in pulmonary stenosis?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the intervention in pulmonary stenosis in this video. Pulmonary stenosis can be mild, moderate or severe. Dr. Aggarwal will explain the gradients respectively. If the pulmonary valve velocity is less than 3 meters, it is mild. If it is more than 4 meters per second then it is severe. And in between 3-4 meters per second then it is moderate. The patient has to be reevaluated every three months. If it is mild, then do not intervene immediately.

  • What medical treatment should be given to a patient with stable and unstable angina?
    What medical treatment should be given to a patient with stable and unstable angina?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the medical treatment given to a patient with stable and unstable angina in this video. He will discuss a case of symptomatic angina. He further says that failure in adequate medical treatment in providing the required quality of life is indication for further intervention.

  • What precaution should we take when we are dealing with the patient of acute heart attack?
    What precaution should we take when we are dealing with the patient of acute heart attack?
    KK Aggarwal

    The video will discuss about the precautions to be taken while dealing with the patient of acute heart attack by Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks. Ask the history of Viagra like drugs such as sildenafil etc. Sometimes, patient might not give you the history of such drugs. In case of acute heart attack, if nitrates is given then it can react with the Viagra like drugs and pose danger and lead to complications.

  • Angina - causes, symptoms and treatment?
    Angina - causes, symptoms and treatment?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss the causes, symptoms and treatment of angina. He will further talk about when to intervene in angina. Failure of adequate medical treatment to provide wanted quality of life or better quality of life, such cases requires intervention. Dr. Aggarwal will discuss the case of the triple vessel disease with one artery completely block. Such patients require bypass surgery.

  • What is inappropriate sinus tachycardia (IST)?
    What is inappropriate sinus tachycardia (IST)?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about inappropriate sinus tachycardia (IST) in this video. In young females, without thyroid disorders or anemia, the heart rate is more than 100 beats per minute and mean heart rate of 24 hours is more than 90 beats per min or with slight exertion, the heart rate is inappropriate. This is known as the sinus inappropriate tachycardia. These people are generally symptomatic, have palpitations, etc. they are treated with meditation and breathing exercises as there is no active disease present.

  • What is the potassium level in cardiovascular patients?
    What is the potassium level in cardiovascular patients?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the potassium level in cardiovascular patients. In patients with low ejection fraction, eGFR has to be checked. To reduce the potassium levels, certain precautions has to be taken. Painkillers needs to be stopped as many of them might contain potassium. They should be given low potassium diet. He will further explain about the low potassium diet.

  • Medical management of chronic stable angina?
    Medical management of chronic stable angina?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about medical management of chronic stable angina in this video. He will discuss a case of triple vessel disease and premature heart disease. The drug of choice is beta blockers if not contradicted. It should be given in such a dose where after exercise, the heart rate shouldn’t exceed 90 beats per minute and the resting heart rate shouldn’t be less than 60 beats per minute. If the patient is taking any alternative medicine then modern medicines dosage should be adjusted.

  • What are the types of heart disease?
    What are the types of heart disease?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will explain the types of heart disease. He will explain about stable and unstable angina. Also, first medical treatment is given to the patient and if he is stable then continue and should be followed regularly. If the patient is not better and has angina symptoms on exercise then surgical management such as stenting is planned if the patient has blockages.

  • What Is Congenital Heart Disease?
    What Is Congenital Heart Disease?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the congenital heart disease in this video. It is present since birth. Almost 1% of the babies born have congenital heart disease and 0.25% of them have critical congenital heart disease. These babies require surgical management or intervention in first year of life. Such babies before the discharge should get check by pulse oximeter and if it is low, necessary steps should be taken.

  • Difference between an embolic stroke and a thrombotic stroke?
    Difference between an embolic stroke and a thrombotic stroke?
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will talk about the difference between an embolic stroke and a thrombotic stroke. He will discuss a case of rheumatic heart disease, mitral stenosis and brain stroke. Embolic stroke is usually with sudden onset causing paralysis. They have more hemorrhagic manifestations.

  • Constrictive pericarditis – prevalence, causes and clinical presentation?
    Constrictive pericarditis – prevalence, causes and clinical presentation?
    KK Aggarwal

    Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about constrictive pericarditis and its clinical presentation in this video. He will discuss about pleural and pericardial effusion case with T.B and hypothyroidism. Inflammation of pericardium and pericardial fluid is known as pericarditis. There is constriction of the heart. Medical management with aspirin or steroids are given to treat pericarditis. And if symptoms are not better than surgery has to be done.

  • Dr K K Aggarwal - Sameer Malik Heart Care Foundation Fund to Support Free Heart Care Interventions.
    Dr K K Aggarwal - Sameer Malik Heart Care Foundation Fund to Support Free Heart Care Interventions.
    KK Aggarwal

    In this video, Dr. K K Aggarwal, President Heart Care Foundation of India and Group Editor in Chief MEDtalks, will discuss about the free heart care interventions. Dr. Aggarwal will talk about Sameer Malik heart care Foundation fund. This organization helps patients who cannot afford heart surgery. It supports such patients and collects money through funds and help in treating economically poor heart patients.

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