Private Cardiology - Improving your heart health
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High intensity exercise programs
getting healthy
Weight loss Keep it simple
The pyschological impact of heart disease
weight loss after christmas

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Four rules for exercise

1. Gradually build up the intensity to avoid injury.
2. Vary what you do to avoid boredom-- walking, sitting up, bowls it does not matter.
3. Like a medicine take exercise regularly.
4. Start now and make it part of your daily routine.
 
 
Forming a habit of exercising is a lifelong gift. If I could prescribe it I would. Make exercise your medicine before you need to start taking medicine.

Diabetes and extra virgin olive oil

A recent trial in the Annals of Internal Medicine looked at the role of a Mediterranean diet in reducing the onset of type 2 diabetes. It seems to suggest that eating this type of diet which is especially high in extra virgin olive oil  (50ml/day) in some way prevents the onset of diabetes. The benefit was a 30% risk reduction in developing diabetes compared to controls who were on a low fat diet. The diet was relatively low in dairy products and low in carbohydrate content.
Although the mechanism of how the Mediterranean diet reduces the onset of diabetes is not completely understood it may be related to the relatively low carbohydrate content and the prevention of insulin resistance.

New Year's resolutions

Christmas is a great time to be with friends and family. Following on from this is new years and the inevitable drive to make a new year's resolution. Many of us will make a resolution to lose weight and get fitter.
A lot of us will keep the resolution for about a month and then slip back into our old habits. The secret is to make the resolution now and test yourself over Christmas. If your resolution survives the next few days then is may be strong enough to last well into the new year. Most diets work, but a year on we are back to our original weight.

Mitral valve disease

The mitral valve separates the left ventricle from the left atrium. It acts like all valves in the heart-- as a one way valve. This allows the blood to flow forward when the heart contracts and prevents leaking back into the left atrium as the heart relaxes between each contraction. The valve is composed of two leaflets which look, with the eye of faith, like the mitre the Pope wears-- hence the mitral valve.
The valve can become leaky (mitral regurgitation or MR) and this can cause the blood to leak into the left atrium.

Aortic valve disease

The heart normally has four valves in it. They all act as one way valves--opening fully allowing the heart to push blood forward when the heart contracts and -- closing completely stopping the blood from leaking backwards when the heart relaxes.
 
The Aortic valve
This valve separates the left ventricle (the main pump chamber of the heart) from the aorta (the main blood vessel-- supplying blood to the rest of the body).
 
The aortic valve can become narrowed (aortic stenosis). This restricts the blood flow out of the heart.

So, you are having an angiogram?

A coronary angiogram is the procedure that is the gold standard for assessing the degree of a possible narrowing of the arteries of the heart. The procedure takes about 30 minutes to do and is performed in a cardiac catheter lab. Usually you are awake for the procedure, but you can ask for sedation if you are very anxious.
The procedure is performed either from the top of the leg or from the wrist. Local anaesthetic is given to numb the skin, then a small tube called a catheter is passed up towards the arteries to the heart.

Atrial fibrillation (AF)

Atrial fibrillation or AF is a common condition that can affect upto 10% of the population above the age of 80. It is more common with age. Patients can present with a wide range of symptoms from --no symptoms to shortness of breath and chest pain with or without palpitations.
There are two important things to consider when someone is in AF.
 
1.Should you try to convert the rhythm back to a normal rhythm--or simply control the rate of the heart beat?
 
In patients who have recently gone into AF conversion back to a normal rhythm may be appropriate especially when they have symptoms associated with AF.

high blood pressure

High blood pressure is a major risk factor for heart disease and strokes. As we age blood pressure can become more likely. The major problem with blood pressure is that we can have it without feeling any ill effects andtherefore be undiagnosed for years. So it is really important to get is checked if you think you could be at risk-- a simple check by your family doctor or practice nurse or even at the local pharmacy is a start.
Blood pressure readings above 140/90 mmHg indicate some degree of high blood pressure.

Diabetes and heart disease

The number of people with diabetes is growing. The likelihood of developing in particular type II diabetes goes up if you have relatives with the condition. It is also associated with having a higher body mass index (BMI) (greater than 27). If you have a family history, it is better to keep your BMI low as you get older. The lower the better, some have argued that between 23 and 25 is better.
The reason that diabetes affects the heart is that it makes the blood vessels, the coronary arteries more likely to develop atheroma (fatty deposits blocking up the arteries).

Minimally invasive cardiac surgery

The field of cardiology is changing rapidly. The treatment of heart valve problems may involved open heart surgery in some patients, where the chest is opened via a wound at the front. 
There is pioneering work that has allowed the procedure to be performed via a much smaller incision, so called minimally invasive surgery. This reduces the recovery time after surgery and reduces the amount of discomfort for patients.
 
One the leading surgeons in this field is Mr Inderpaul Birdi.