Padma Sri awardee Dr Ashok Seth, Chairman & Chief Cardiologist, Escorts Heart Institute & Research Centre, New Delhi, globally known for introducing pioneering techniques in curing heart ailments and for his invaluable contribution and achievements in the field of medicine, in an exclusive chit chat with Smita Mishra of Zeenews.com talks about the causes behind growing heart ailments, preventive measures and the latest cures of the fatal disease.
Is it true that people who have diabetes are more likely to get heart disease?
That is true; people who have diabetes have a greater incidence of heart disease as diabetes leads to greater deposition of cholesterol in the arteries all across the body including coronary arteries, arteries to the brain, carotid arteries and arteries to the legs (peripheral vascular disease).
Serious cardiovascular diseases in many cases begin before the age of 30 in persons with diabetes?
That is correct. As diabetes pre disposes to heart disease, diabetics tend to get atherosclerosis and coronary artery disease at a much younger age than other people. If diabetics start smoking, it multiplies the risk factor by at least 15 times.
What preventive measures should be taken to ward off heart disease?
Control of risk factors is the most important preventive measure. Especially if you have a family history of heart disease, one has to be over cautious not to add on any of the avoidable risk factors. One should not acquire the habits of smoking, should do regular exercise, avoid obesity, if one gets hypertension or diabetes; these should be kept under check.
Lifestyle modification & regular exercise for at least 40 minutes a day with 5 minutes warm up and 5 minutes cool down, is important for prevention of heart disease.
What are the recent breakthroughs in the treatment of heart ailments?
The recent breakthroughs in the treatment of heart disease have been ‘drug eluting stents’ or ‘medicated stents’. These stents constantly release drugs which clear the blockages and prevent new blockages from developing in the coronary arteries.
Another breakthrough is the replacement of the aortic valve without the need of surgery in an angioplasty like procedure done in the cath lab. This is almost unbelievable but it is true that the valves can now be changed this way especially in high risk patients.
Is it true that bypass surgery is largely being replaced by stents today? Is it true that stents weaken arteries?
With the success of drug eluting or medicated stents and the fact that they are durable in most cases, it is true that 75% of patients with coronary artery disease are now treated with stent and bypass surgery is usually done on patient with triple vessel disease and diabetes especially in those who have diffuse disease and long lesions not easily treated by stent implantation.
Stents do not weaken the artery. In fact they have proven to be an efficient and durable option, of course with continued precautions, aggressive cholesterol lowering & life style modifications.
But how successful is stenting? How long do they last and what is the survival rate of patients?
Both bypass surgery and stenting are successful procedures. Bypass surgery has been an established treatment for coronary artery disease and is an efficient and durable procedure with advent of drug eluting stents and their improved safety and efficacy. ‘Stenting’ is an extremely safe option with greater than a 99% safety, rapid recovery & return to work in a few days and 95% durability in the long term.
But treatment in India is very expensive? Aren’t there cheaper options available?
Treatment in India is expensive because all the technology and devices have been developed outside and are imported. Therefore as the technology progresses the cost of the procedure also keeps on increasing.
The best way to go forward is for Government to develop national strategies whereby we encourage the manufacture of these devices locally at a much lower cost. Also a good collaboration between the Government and the private sector is needed to provide these facilities at a lower cost. There needs to be medical insurance schemes and third party payments to decrease the cost for the common man.
People from across the world come to you for treatment. How does it feel to be in a position to provide that healing touch?
I think it is a God given privilege and opportunity that I am in a position to treat sick people. The patients and colleagues put a lot of trust and hope. When I think of this, I feel that I am honored.
I would like to work to the best of my abilities, ethics, sincerity and to be able to treat & help as many patients as possible.
What is your message to the readers…
As a doctor my message to the readers is that “Prevention is the best form of Therapy”.