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Dr. VK Chopra: Heart Failure: Drugs And Device Implants

India has good coronary care, but this has only increased survival rates of coronary patients leading to higher incidence of heart failure
Dr VK Chopra, Chairman Preventive Cardiology, Medanta - The Medicity on Coronary Artery Disease: Reasons for Occurrence
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Dr. VK Chopra

Chairman Preventive Cardiology

Medanta - The Medicity


“The incidence of coronary artery disease has risen 4 times in rural areas and 5 times in urban areas. India has good coronary care, but this has only increased survival rates of coronary patients leading to higher incidence of heart failure,” says Dr. VK Chopra. “Pollution and the lifestyle changes like obesity, smoking and junk food are gradually increasing. If the trend continues, WHO has predicted that by the year 2020, heart diseases will overtake infectious diseases as the primary cause of mortality in India.” “Beta blockers and renin angiotensin aldosterone antagonism are the two mainstays of heart failure therapy. When used judiciously, beta blockers result in a significant, not only symptomatic improvement, but also an improved LV function, decreasing mortality and morbidity effectively.” “The use of beta blockers depends upon the heart rate, blood pressure and the presence of any pulmonary disease, but the general rule is that you start small and gradually increase doses. Metoprolol succinate, carvedilol and bisoprolol are beta blockers which have been approved for treatment of heart failure.” Since heart failure is a permanent risk, use of beta blockers runs life-long. But if the patient begins to exhibit contradictions like hypotension, bradycardia, severe bronchospasm or a heart block, they can be temporarily discontinued and resumed after such a situation is resolved.” “When a patient gets a severe heart failure, beta blockers are either down titrated or stopped. Once acute heart failure is cured and euvolemic achieved, beta blockers must be resumed.” Talking about breakthroughs is heart failure management, Dr. Chopra says, “Neprilysin inhibitor, a new drug approved by FDA and the European Union, has shown nearly 22- 25% reduction in mortality and morbidity in a large study called paradigm trial.” “CRT or cardiac resynchronization therapy with implantable cardioverter-defibrillator is also a modality which is expensive and grossly underused in India. ICDs or implantable cardioverter defibrillators are a great method of preventing sudden cardiac death, the incidence of which is close to 10% per year.”


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Could handheld echocardiography replace a stethoscope?

Dr. Hardeep Kaur

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Dr. Hardeep Kaur

Consultant clinical and preventive cardiology

Medanta, The Medicity


Handheld echocardiography cannot really replace a stethoscope but it can definitely help in an emergency for ruling in and ruling out cardiac involvement. Therefore, helps in quick clinical decision making and also reduces the chances of doing unnecessary tests.


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Recent Advances in Echocardiography and their impact on clinical practice

Dr. Navin C Nanda

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Dr. Navin C Nanda

Director of Echocardiography

University of Alabama, USA



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Echo with telemedicine creates a multiple effect

CAD affects 10%of our population over 40 years

Dr. Sameer Srivastava

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Dr. Sameer Srivastava

Head of Non-invasive Cardiology

Fortis Escorts Heart Institute, New Delhi



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