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Dr K K Aggarwal

Predicting sudden cardiac death

By Dr K K Aggarwal
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  • Normally people can walk a distance of 400-700 meters in 6 minutes.
  • A 6-minute walking distance of less than 300 meter is a simple and useful predictor of sudden cardiac death in a patient with mild to moderate heart failure.
  • Patients with interstitial lung disease who can cover less than 200 meters during 6-minute walk test are 4 times more likely to die than those who can walk greater distance.
  • People who can cover a distance of 200-300 meters need further evaluation.
  • A fall of SpO2 of more than 4% ending below 93% suggests significant desaturation.
  • An improvement of more than 70 meters or 10% in distance walked can make all the difference.
  • An improvement of 30 meters in any distance walked is the minimally important difference in any treatment.
  • Sudden cardiac death is linked to 15% of total urban mortality.
  • Risk factors for sudden cardiac death include abnormal lipid level, high blood pressure, cigarette smoking, physical inactivity, diabetic, obesity and family history of premature heart disease or heart attack.
  • Binge alcoholism can cause sudden cardiac death (6 or more drinks per day or five drinks in one session)
  • Risk of sudden cardiac arrest is transiently increased for up to 30 minutes after strenuous exercise (1/1.5 million of episode of exercise)
  • If you are at low risk for having a heart problem, you do not need a regular treadmill test.

Tips on family history of high cholesterol

By Dr K K Aggarwal
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Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease, the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75-85%. Fifty-four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Hence, a screening test for lipids is recommended for first-degree relatives of patients with myocardial infarction, particularly if premature. Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A-I. About 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A-1 and HDL are likewise associated with reduced CHD risk. First-degree relatives are brothers, sisters, father, mother; second-degree relatives refer to aunts, uncles, grandparents, nieces, or nephews and third-degree relatives refer to first cousins, siblings, or siblings of grandparents. Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL “bad cholesterol”) levels and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant. To detect familial high cholesterol levels, a universal screening must be done at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.

Tips on family history of high cholesterol

By
Filed Under Wellness | Tagged With: , , , | | Comments Off on Tips on family history of high cholesterol

Premature heart disease is when heart disease occurs before 55 years in men and 65 years in women. In premature heart disease, the prevalence of dyslipidemia (high cholesterol levels without symptoms) is 75-85%.

Fifty-four percent of all patients with premature heart disease and 70% of those with a lipid abnormality have a familial disorder. Hence, a screening test for lipids is recommended for first-degree relatives of patients with myocardial infarction, particularly if premature. Screening should begin with a standard lipid profile and if normal, further testing should be done for Lp(a) and apolipoproteins B and A-I.

About 25% patients with premature heart disease and a normal standard lipid profile will have an abnormality in Lp(a) or apo B. Elevated apo A-1 and HDL are likewise associated with reduced CHD risk.

First-degree relatives are brothers, sisters, father, mother; second-degree relatives refer to aunts, uncles, grandparents, nieces, or nephews and third-degree relatives refer to first cousins, siblings, or siblings of grandparents.

Familial hypercholesterolemia (FH) is a genetic disorder, characterized by high cholesterol, specifically very high LDL “bad cholesterol”) levels and premature heart disease. Patients may develop premature cardiovascular disease at the age of 30 to 40. Heterozygous FH is a common genetic disorder, occurring in 1:500 people in most countries. Homozygous FH is much rarer, occurring in 1 in a million births. Heterozygous FH is normally treated with drugs. Homozygous FH often does not respond to medical therapy and may require apheresis or liver transplant.

To detect familial high cholesterol levels, a universal screening must be done at age 16. The cholesterol levels in heterozygous patients are between 350 to 500 mg/dL, and in homozygous, the levels are between 700 to 1,200 mg/dL.