How not to have a heart attack

foreign [Music] hi guys um my name is Sanjay Gupta I'm a consultant cardiologist in York and today I thought I'd um talk about um heart attacks okay and um let me start off by asking you a question do you know anyone who's had a heart attack and I'm sure that the answer is yes because heart attacks are incredibly common and there are two types of patient really there are those patients who say they've been getting chest pains and they say oh I was getting chest pains and the pains were getting worse and worse and I went to the hospital and they said I was going to have a heart attack and luckily I had I had some stents put in and thank God that saved my life and then there are other patients who who you know are completely Fit and Well and you you just hear oh my God he's had a heart attack and he's dropped down dead or suddenly out of the blue there's been a heart attack and so today I wanted to talk to you um about heart attacks okay because this is by uh by and large one of the largest killers in the western world and um there is a lot you can do to try and avoid having a heart attack and I thought I'd talk you through heart attacks and um and why heart attacks happen Okay so the first thing to talk about is that any muscle in your body needs blood okay to function so if um if I have my bicep my bicep needs blood you know it needs to be supplied by Blood so that it can get oxygen sustains my muscle the heart is also a muscle and it's working all the time and therefore it needs blood and it needs blood all the time okay and the blood is delivered to the heart muscle by three heart arteries okay they're called the coronary arteries and we're all equipped with three small arteries which are very small and embedded within the heart but they Supply different parts of the heart so the whole of the heart is getting the blood but different parts of the heart are getting blood from one of the three arteries and essentially what a heart attack is is that if you block the supply of blood from one any one of these arteries then that part of the heart will not get the blood it needs and therefore it will start suffocating and as it starts suffocating it cries out and that is manifested as discomfort in the chest like a tightness in the chest um and uh if nothing is done then that leads to a heart attack and the problem with a heart attack is that during that time when the heart is devoid of blood uh the heart becomes very weak it is not able to pump blood round and it can it can then fail or it can become very irritable because it's not getting the blood and it can go into a funny Rhythm which can be very fast and eventually cause someone to die I.E cardiac arrest and die okay so heart attacks are bad news now the way to try and work this out is this car and think of the car requiring fuel that's like your heart requiring blood okay and the fuel is delivered to the engine of the car through a fuel pipe those are your coronary arteries now what can happen is that over a number of years you start developing wear and tear in the pipe that takes the fuel to the engine all right and the things that can cause this wear and tear are age um high blood pressure diabetes smoking genetics cholesterol and that can these can all cause wear and tear and as you get more and more wear and tear the um you can develop a narrowing of the um of the pipe that is taking the fuel to the engine so you can do you can start getting more and more buildup of crud in that vessel and eventually what tends to happen is the the build up gets to the extent that it starts actually uh being obstructive to the flow of few blood to the hearts okay however this happens very slowly and it can take a number of years for this to happen and generally what tends to happen is that the patient or the person will be fine and then they will start noticing that at extreme exertion or on heavy exertion when the heart is asking for a lot more blood I you're driving the engine very fast it needs a lot more fuel but because there is a narrowing in the pipe that takes the fuel to the engine the fuel can't get through quick enough and therefore the engine starts asking for more or crying out and that then manifests as chest pain so a lot of people will say to me oh I can walk a certain distance um and after that if particularly if I'm going up a hill or it's very cold and my heart is beating fast I get this tightness or this discomfort like someone sitting on my chest and I have to stop and as I stop the discomfort goes away IE when the car is going very fast the fuel can't get through quick enough and as the car slows down the fuel is able to go and Supply the engine and so the car is okay and that is what a lot of people want to me and um you know they'll say I can walk I could walk a mile now I can only walk half a mile um because I get the discomfort and I have to stop after half a month and if you don't do anything this continues to build up and they'll come back and say I can now only walk a quarter of a mile and um eventually if you don't do anything at all this then leads to your heart attack now this kind of patient is very different to the kind of patient that has a sudden heart attack with no warning we all know people who are completely well who go to the gym and suddenly out of the blue have a heart attack no warning just there and then and often some of these unfortunately die now these patients have a very different mechanism of having a heart attack okay because by very virtue if you are getting a narrowing that is building up over a period of time then that narrowing gives you a warning you know you get the warning it would be a very um foolhardy person who would ignore these symptoms you know if they've been going on for several months and they're beginning to limit their activity be a very foolhardy person to say well I'm not going to seek help most people who get these symptoms find that their Exercise capacity is so limited that they actually go and seek help so in some ways having this warning is protective for you you know it's so a lot of people then go and have have these um have their tests and they find that there is a significant narrowing and they go and have a stent or a bypass and they come back and they tell the tale where they said if it hadn't been picked up I would have died yes it's possibly true but generally the very fact that they've been getting enough symptoms tells us that they would have sought help anyway they're not as worrying as those people who suddenly out of the blue have a heart attack so you have to ask yourself what is the um for in those people who have no warning and in those people there is a very different and very Sinister mechanism and I just wanted to explain this to you because a lot of people don't realize it um now what you can get sometimes is this you get a little bit of crud in the heart artery in the fuel pipe but that crud is not actually obstructing flow of blood or flow of fuel from the fuel tank to the engine it's not obstructing it so the fuel so the engine is running fine but there is a little bit of crud okay now what can happen sometimes is that a little bit of that crud can break off and if it breaks off what happens is the body thinks that you've sustained a wound in that area which has been left as a result of that crud falling off it's like a bit of crust you know that falls off and that bit that is Left Behind looks like a wound and the body therefore forms a blood clot to try and control that room and on inadvertently that blood clot actually blocks off the fuel pipe altogether and that can happen within a matter of a few minutes and so suddenly from nothing something breaks off and suddenly the body decides to form a blood clot and that then obstructs the blood getting to the heart and that causes a sudden heart attack and those are the people that is how people can get have heart attacks without warning and those are the most Sinister type of heart attacks you can have because there is no warning it can happen at any time so it's really important then to say well okay how do I go about minimizing my chances of having this how do I go about minimizing my chances the truth is very few there is no technology at the moment which will tell you if you look at the heart artery as to which bit of crud could break off and cause this you know all you can do is look at the bits of crud which are causing the most narrowing okay but the narrowings would cause a warning so you can fix a narrowing but it's not necessarily the narrowing that will cause the sudden heart attack it's the bits of crud which are probably not even causing a narrowing but for some reason are very unstable I I very unstable so when we look at this we try and work out well what are the things that make bits of crud unstable and the secret is that the thing that makes bits of crud unstable is inflammation okay the more inflamed you are the more likely you are to have crud breaking off and causing heart attacks uh okay and so whereas a lot of people concentrate very much on blood pressure and that's okay and diabetes and that's fine and cholesterol it's very important to bear in mind that the things that really inflame you are things like a stress okay B lack of sleep see lack of exercise D um smoking because every time you smoke you're taking a hit you're inflaming yourself you're putting stuff in your body which is meant to be there that's a hit and if you have an unstable area even one cigarette you know the just the hitch from that could cause a plaque to break off and form a clot and um Nutrition a lot of people nutrition is really um you know neglected because we're always taking in good um bad food you know even supermarket food is bad food because we don't know how it's been grown we don't know what fertilizers and chemicals have been put in it we don't know how it's been preserved and we um you know we go we go to our Supermarket we look at something we think oh wow that looks healthy let's take that but actually we don't know what's gone beyond what's gone on behind that food uh before it is placed uh on our tables and therefore it's really important just to be conscious of that it's very very important to try and reduce your stress levels it's very important try to try and eat healthy ideally local grown fresh food it's very important to get regular exercise because we know regular gentle exercise is anti-inflammatory we know sudden unaccustomed exercise is pro-inflammatory so it's not uncommon when someone you know suddenly does something which is very very exertional and they're not accustomed to it that can cause heart attacks however we know that people who are doing gradual exercise you know who are not doing anything too heavy uh in those people the exercise is protective having sleep is really important as well if you don't go if you go without sleep you know how inflamed you get you know you can fall you fall ill and therefore having good amounts of sleep cutting down in your stress levels getting regular good exercise having the right mindset is incredibly important avoiding smoking is really important avoiding recreational drugs like cocaine Etc is really important um you know being in the rat race um being uh being well how do I say this being happy is important being happy is incredibly anti-inflammatory you know being relaxed is really important and so we also know that certain tablets are anti-inflammatory and in particular statins the reason they work is not because they lower the cholesterol a lot of people think oh my cholesterol isn't High why are they giving me statins the reason statins work is because they have been found to be anti-inflammatory and they stabilize Glock and that is why what we know is that things like bypasses and stents don't really prolonged life you know those people who come and say oh well look you know I had this stent put in otherwise I would have died no what would have happened is if you didn't have the stent you would still have your symptoms of chest discomfort when you walked and now that you have the stem the discomfort is gone but actually the stent isn't tackling that area of the heart vessel that would have likely caused the sudden heart attack that area is somewhere else you can't see you can't pick out which of the slight narrowings is going to suddenly misbehave and that's why the only thing you can do is to try and modify your lifestyle try and pay attention to what you're eating pay attention to exercise pay attention to avoiding cigarettes pay attention to getting enough sleep and pay attention to your mindset okay so um I hope this was helpful um don't hesitate to get in touch should you need to I'll try and do some more videos it's just been quite busy recently but I'm really really grateful for all the amazing feedback you've given me about the videos you can get in touch with me through Facebook if you wanted to or Twitter or if you wanted to speak to me you can do so through my secretary Jeanette and she's on this number my website is www.yourcardiology.co.uk uh feel free to give me a send me a message and I promise to respond um uh and that's it thank you so much for listening all the best take care bye foreign

Channel: York Cardiology

Views: 554,636

Keywords: #hangoutsonair, Hangouts On Air, #hoa, heart attacks, cardiac arrest, sudden death, inflammation, sanjay gupta, yorkcardiology, Heart (Anatomical Structure), Myocardial Infarction (Disease Or Medical Condition)

Id: jcnx4ScHk_k

Length: 15min 35sec (935 seconds)

Published: Thu Oct 15 2015