Max Institute of Heart and Vascular Sciences

It occurs when the heart does not get enough blood supply. This is due to the accumulation of plaque in the blood vessel which interrupts the blood flow. To restore the blood supply, heart starts beating faster and harder, and this condition is known as angina. Its signs and symptoms vary from person to person. However, some of them are common which are as follows: Discomfort, tightness or heaviness in the chest Ache in other parts of the body such as the back, shoulders, neck or jaw Shortness of breath Sweating and dizziness Nausea People who experience these symptoms must visit cardiology hospital and seek medical assistance to avoid further complications. It must be noted that the severity of angina can be different in different people. Hence, getting it diagnosed is the best step one can take to identify the underlying issue.

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Aorta is the main artery that carries oxygen and nutrient-rich blood from the heart to the remaining parts of the body. Aorta dissection is a tear in the innermost layer of the aorta, which causes the inner and middle layers to separate or dissect. This is a life-threatening condition requiring immediate attention if blood bursts through the outer wall of the aorta. At times, blood haemorrhage from a rupture in the microvessels supplying the outside and middle walls of the aorta weakens the inner layer of the aorta, where a tear could occur, leading to an aortic dissection. Over time, the tear can affect the brain, lungs, arms, legs, and heart. This depends on where along the aorta the tear occurs.

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Atrial fibrillation, also known as Afib, is a type of arrhythmia that can disturb the blood flow in the body. The heart pumps blood to the whole body with each heartbeat. The blood is pumped through two upper chambers followed by the two lower chambers. In atrial fibrillation, the upper chambers of the heartbeat irregular, and the blood does not flow properly to the lower chambers. A-fib can increase the risk of stroke, heart-related complications, and heart failure. The atrial fibrillation episodes may come and go, or they may be persistent in nature. The condition can be treated with medications, though there may be a need for some surgical procedures in some cases.

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Bradycardia is characterized by a slower-than-normal heart rate. The heart of an adult, while at rest usually beat between 60 to 85 times a minute, whereas, in the case of individuals with bradycardia, the heart beats fewer than 60 times a minute. Bradycardia can be a complex issue if the heart rate is very slow and the heart cannot pump sufficient oxygen-rich blood to the body. If this occurs, individuals may feel dizzy, weak or very tired, and at times short of breath. Sometimes bradycardia does not present with any symptoms or complications. A slow heartbeat is not always a sign of concern. A heart rate of around 40 and 60 beats a minute is very commonly noticed during sleep and in some people, mainly healthy young adults and trained athletes. If bradycardia is severe, an artificial pacemaker may be required to help the heart maintain an appropriate rate. Electrical signals travel via the heart's four chambers, starting from the right upper chamber and then going through the upper to lower chambers of the heart. These signals regulate it to beat in a normal and steady rhythm. However, at times, electric pulses do not always fire off, as they should. This gives rise to abnormal heartbeats or arrhythmias. Some conditions make the heartbeat too quickly or flutter. With bradycardia, it's just the reverse. The electrical impulses slow down the time between heartbeats.

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Cardiac arrest is a severe heart condition that requires immediate medical response and treatment. In cardiac arrest, there is a sudden loss of heart function. The heart stops beating or beats too fast, stopping blood circulation to the brain and entire body. As a result, people suffering from cardiac arrest collapse and turn unresponsive. The heart sends an electrical impulse that triggers each heartbeat. When this electrical impulse pattern changes abruptly, the heartbeat becomes irregular, which stops the heart from beating. With this, the heart cannot deliver oxygen-rich blood to the brain and the rest of the body. Cardiac arrest can be fatal if not treated immediately.

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Cardiac arrhythmia refers to a large group of conditions resulting from abnormalities in the electrical activity of the heart. It is the abnormality of the heart rhythm wherein the heart beats too slowly, rapidly, irregularly or with extra beats (premature atrial or ventricular beat). There are several ways of classifying cardiac arrhythmias. A common way is to divide them into arrhythmias originating in the upper two cardiac chambers (an atrial arrhythmia) and those arising in the ventricles. Arrhythmias that arise in the atria are: Paroxysmal Supraventricular Tachycardia Atrial Flutter Atrial Fibrillation Ectopic Atrial Tachycardia Arrhythmias that arise in the ventricle include: Ventricular Tachycardia Ventricular Fibrillation 

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Cardiogenic shock is a serious condition in which the heart is unable to pump enough blood to meet the requirement of the body. As a result, the heart is unable to provide sufficient blood to various vital organs of the body. It is because of the inability of the heart to supply adequate nutrients to the body the blood pressure level falls, and organs may begin to fail. This condition is most often caused post a severe heart attack. It's not necessary that everyone who gets a heart attack has a cardiogenic shock. Cardiogenic shock is rare. It is often deadly if not treated immediately.

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Cardiomegaly, also known as heart enlargement, is a medical condition characterised by an increase in the size of the heart and, subsequently, poor pumping function of the heart. It can be a result of various underlying conditions, ranging from congenital abnormalities to chronic diseases. The heart can enlarge in two ways, namely: Dilatation: The heart walls become thin, widen, and weaken. It can lead to heart failure, a condition where the heart loses the ability to pump properly. Hypertrophy: Refers to the thickening of heart walls; it causes the heart to become less efficient. This generally occurs in athletes and pregnant women whose hearts undergo a high workload for long periods.

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Also known as a congenital heart defect, this refers to the structural defect in the heart which is present at birth. The defects can be related to the heart walls, heart valves, arteries and veins near the heart. The defect affects the normal blood flow that can lead to various complications. These complications may vary, with few infants not needing treatment for heart disease while others requires like surgery and even heart transplants.

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Heart failure, also known as congestive heart failure, refers to an inability of the heart to pump sufficient blood needed by the body tissues, due to weakening or hardening of the heart muscles. Although heart failure often begins at the left side, it may involve pumping chambers on either side of the heart or both. It may occur progressively as a complication of other heart diseases or unexpectedly due to sudden injury to the heart muscles.

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The most common misconception is that sugar causes diabetes. Watching out sugar intake becomes important only if you've been diagnosed with diabetes. However, if you do not have diabetes, sugar intake will not cause diabetes. Diabetes is an illness which occurs as a result of problems with the production and supply of insulin in the body. Most of the food we eat is turned into glucose, a form of sugar. We use glucose as a source of energy to provide power to the muscles and other tissues. If left untreated, diabetes can lead to serious heart problems such as cardiovascular disease (CVD), or heart disease, including peripheral artery disease (PAD) and stroke.

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Endocarditis is a rare condition that appears in the heart lining, heart valves, and heart muscles. The condition is also known as Infective Endocarditis. It is usually caused by an infection like bacterial, fungal or other germs. Endocarditis occurs when these germs spread through the bloodstream from another part of the body and attach to the heart's inner lining, the endocardium. The condition can become severe if not treated on time and may destroy or damage heart valves, causing some severe complications.  Heart condition is more common in men than women. People aged 60 years or above are more likely to get affected by endocarditis. Infective endocarditis is also common in people with abnormal heart valves, prosthetic heart valves or people with pacemaker lead. The symptoms can appear suddenly, or they may develop over time. However, the condition is treatable with medications, and in some cases, surgery may also be required. 

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Heart murmurs are the swishing or whooshing sound made by turbulent blood flowing across the heart valve. It passes through an abnormal heart valve, or in certain other cases, it may be possible that because of some other condition, the heart beats faster and forces the heart to handle more blood at a faster rate. Heart murmurs can exist either at birth (congenital) or develop later in life. Murmurs can be present without any medical or heart conditions. Two common examples include: Childhood murmurs Pregnancy The heart has got four chambers which are separated by valves that determine the amount of blood that enters each chamber at any given period of time. Normal valves help in the prevention of blood from flowing in the wrong direction in the heart. A healthy and normal heart makes a "lub-dub" sound during its beats. The "lub" sound, also called systolic sound, occurs during the contraction of the heart and the mitral and tricuspid valves close, whereas the "dub"  sound, also called diastolic sound, occurs during the relaxation of the heart and the aortic and pulmonic valves close during that event.  Therefore A heart murmur is an additional sound in a heartbeat-like a ''whooshing''  type of sound being caused by turbulent blood flow between the valves of the heart.

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Heart palpitations feel as if the heart is racing, pounding, or like the patient has missed heartbeats. Palpitations can take place at any time, even while at rest or performing normal day-to-day activities. Although they may be a cause of concern, palpitations are not usually consequential or dangerous. However, at times they can be related to an abnormal heart rhythm that needs medical attention. In very rare cases, they can be interpreted as a symptom of a more dangerous heart condition, for instance, irregular heartbeat (arrhythmia), that might require treatment. They often resolve on their own and subside slowly. Most of the time, they take place due to stress and anxiety or because you've had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant. Learn about stress management guides at Max Hospital.  

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At Max Hospital, we understand that a heart transplant is not just a medical procedure; it's a life-changing event that requires exceptional expertise, unwavering dedication, and compassionate care. We have a team of widely experienced cardiac specialists, surgeons, and healthcare professionals committed to providing the highest standard of care throughout the heart transplant journey. Leveraging deep expertise and cutting-edge technology, we offer personalised treatment plans, aiming to restore not only the heart of patients but also their overall quality of life after the procedure, making us one of the leading hospitals for heart transplants in Delhi, India.

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High cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack, and stroke. The medical term for high blood cholesterol is lipid disorder which is also known as hyperlipidemia. The higher your blood cholesterol is, the greater your chance of developing coronary heart disease. Cholesterol is a type of fat, one which is a major building block of various substances including the cell membrane of every cell in our body, digestive juices released by the gall bladder and the sex hormones. Not all cholesterol is bad. We need some cholesterol for our bodily functions and the liver can make that easily in our body. But the problem starts when the level goes beyond necessary. Bad Cholesterol is scientifically referred to as LDL or Low Density Lipoprotein. The Bad cholesterol tends to block the arteries. Good Cholesterol also known as the HDL or the High Density Lipoprotein acts as a cleansing agent cleaning up the bad cholesterol from the arteries.

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Hypertension refers to high blood pressure which may lead to many other symptoms. Blood pressure is the measurement of the force against the walls of your arteries as your heart pumps blood through your body. Hypertension is known to be a cause of chronic kidney disease. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your artery, the higher is your blood pressure. Higher than normal blood pressure is called hypertension and is a key risk factor for both heart disease and stroke. Normal blood pressure is when your blood pressure is lower than 120/80 mmHg. High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above.  If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension.

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Hypotension is the medical term used for low blood pressure among certain individuals. The normal blood pressure recorded is 120/80mm Hg (systolic/diastolic). In healthy individuals, low blood pressure without any symptoms is not usually a concern and does not need to be treated. However, low blood pressure can be a sign of some underlying problem, especially in the elderly, because of inadequate blood flow to the heart, brain, and other vital organs. It can occur either as a condition on its own or as a symptom resulting from plenty of conditions. It generally doesn't cause symptoms, but when it produces, it requires immediate medical attention.  Hypotension has two definitions: Absolute hypotension: When the resting blood pressure level is below 90/60 mmHg (millimetres of mercury). Orthostatic hypotension: The blood pressure level drops within three minutes of standing up from a sitting position. The drop level must be 20 mmHg or more for the systolic pressure and ten mmHg or more for the diastolic pressure. Another term used for this is postural hypotension because it occurs with posture changes. A blood pressure level lower than 90 millimetres of mercury (mm Hg) for the systolic or 60 mm Hg for the diastolic is generally considered low blood pressure. Under normal circumstances, the body manages to control blood pressure and keep it from dropping too much. If it starts to drop, the body tries to compensate for that by accelerating the heart rate or compressing blood vessels to narrow them. Symptoms of hypotension appear when the body can't compensate enough to accommodate the drop in blood pressure. Slight decreases in blood pressure normally occur, so hypotension becomes more common as people get older. A rapid decrease in blood pressure indicates that certain body parts aren't getting the sufficient amount of blood flow required. That can result in unpleasant, disruptive, or even dangerous effects.

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Mitral valve prolapse is the disease of the valve between the left heart chambers, called the mitral valve. The mitral valve's flaps bulge backward (prolapse) into the left chamber of the heart and when the heart contracts, it causes blood to leak backwards across the valve; the condition known as mitral valve regurgitation. Mitral valve prolapse can be treated with medications or surgery in case of severe regurgitation. However, it is not a life-threatening disease and cannot be treated by making lifestyle changes.

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Peripheral artery disease, also known as PAD, is blockage or narrowing of vessels (arteries) that supply blood to the legs from the heart. It occurs due to the build-up of fatty tissue or plaque within the blood vessels or at the periphery of the vessel referred to as atherosclerosis or arteriosclerosis. It commonly affects the lower limbs but can affect any blood vessel such as arms, stomach, head, kidneys. It usually affects the older population but can occur at any age. A warning sign of PAD is having cramps when moving that subsides on taking adequate rest. It can lead to stroke or heart attack if left untreated.Peripheral artery disease has a high prevalence rate among the population. However, it is one of the most underdiagnosed and undertreated diseases.

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It refers to the damage in one or more heart valves that can develop after rheumatic fever. The fever usually occurs as a result of strep throat or scarlet fever which is not treated properly. Rheumatic fever can damage the heart valves, leading to rheumatic heart disease. If left untreated, rheumatic heart disease can cause complications such as heart failure, atrial fibrillation and infection of the valves. Common signs and symptoms of this heart condition are: Heart palpitations or missing heartbeats Pain in the chest area Thumping sensations in the chest Shortness of breath Excessive fatigue Swelling in stomach, ankles, and wrists

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Sinus bradycardia is a condition characterised by an abnormally slow heart rate. It occurs when the sinoatrial (SA) node, the natural pacemaker of the heart, generates electrical impulses at a rate slower than the normal range. In adults, sinus bradycardia is defined as a heart rate below 60 beats per minute (bpm) at rest. While it can be a normal physiological response in certain situations, persistent or symptomatic sinus bradycardia may require medical attention. Types of Sinus Bradycardia Sinus bradycardia can be classified into two types: Physiological Sinus Bradycardia: This type of bradycardia is considered normal and is often seen in individuals with a high level of physical fitness, especially athletes. It is a result of increased vagal tone, which leads to a decreased heart rate. Pathological Sinus Bradycardia: This type of bradycardia is associated with underlying medical conditions or medications. It requires evaluation and treatment. Sinus Bradycardia Causes Several factors can contribute to the development of sinus bradycardia, including: Vagal Stimulation: Increased activity of the vagus nerve, which is responsible for regulating the heart rate, can lead to bradycardia. This can occur during sleep, relaxation, or due to certain medications. Medications: Some medications, such as beta-blockers, calcium channel blockers, and certain anti-arrhythmic drugs, can slow down the heart rate and cause sinus bradycardia. Athletes: Well-trained athletes often have lower resting heart rates due to increased cardiovascular efficiency. Hypothyroidism: An underactive thyroid gland can affect the heart rate and lead to bradycardia. Ageing: As individuals age, the electrical conduction system of the heart may naturally slow down, resulting in sinus bradycardia. Obstructive Sleep Apnea: Interruptions in breathing during sleep can trigger bradycardia. Sinus Bradycardia Symptoms In many cases, sinus bradycardia does not cause noticeable symptoms. However, when symptoms do occur, they may include: Fatigue and weakness Dizziness or lightheadedness Shortness of breath on exertion Fainting or near-fainting episodes (syncope or near-syncope) in an extreme degree of bradycardia. It is important to note that the presence of symptoms alone does not necessarily indicate a need for treatment. The severity of symptoms and underlying causes should be considered when determining the appropriate course of action. Sinus Bradycardia Diagnosis Diagnosing sinus bradycardia involves a comprehensive evaluation that may include the following: Medical History: The specialist will ask about symptoms, medications, exercise habits, and any other relevant medical conditions. Physical Examination: The healthcare provider will listen to the heart and check for any signs of underlying conditions. Electrocardiogram (ECG): This non-invasive test records the electrical activity of the heart and can confirm the presence of sinus bradycardia. Holter Monitor: It is a portable device that records the heart's electrical activity over a 24-hour period, providing a more extended assessment of heart rhythm. Sinus Bradycardia Treatment Treatment for sinus bradycardia depends on the underlying cause, severity of symptoms, and associated complications. Some common approaches include: Observation: Asymptomatic sinus bradycardia may not require any specific treatment but regular monitoring. Avoid medications causing bradycardia under the supervision of a physician. In extreme cases when a slow heart rate causes fainting episodes may need Pacemaker Implantation (A small device give electrical impulse to the heart and prevent Slow Heart Rate). Sinus Bradycardia Complication While sinus bradycardia is generally not life-threatening, complications can arise if the heart rate becomes excessively slow or fails to increase appropriately during physical activity. These complications may include fainting episodes, decreased exercise tolerance, and an increased risk of developing other cardiac arrhythmias. Prognosis for Sinus Bradycardia The prognosis for sinus bradycardia depends on its underlying causes and associated conditions. With appropriate management, most cases can be effectively controlled, allowing individuals to lead a normal life. Sinus Bradycardia Prevention Prevention and management of sinus bradycardia involve addressing the underlying causes and minimising associated risk factors. Some key considerations include: Medication Review: Regularly reviewing medications and adjusting dosages can help manage bradycardia caused by medication side effects. Lifestyle Modifications: Maintaining a healthy lifestyle and stress management can promote overall cardiovascular health. Regular Check-ups: Individuals with a history of sinus bradycardia or related conditions should have regular check-ups to monitor their heart rate and overall cardiac function. Frequently Asked Questions 1. Is sinus bradycardia a serious condition?Sinus bradycardia can be normal in certain individuals and may not require treatment. However, if it is associated with symptoms or underlying medical conditions, it may require medical attention. 2. Can sinus bradycardia be reversed?In some cases, addressing the underlying cause of sinus bradycardia can restore a normal heart rate. For instance, discontinuing medications that slow the heart rate or treating an underactive thyroid can reverse bradycardia. 3. Can sinus bradycardia lead to other heart rhythm abnormalities?While sinus bradycardia itself is a slow heart rate, it does not directly lead to other heart rhythm abnormalities. However, underlying conditions causing bradycardia may predispose individuals to other arrhythmias. 4. Is a pacemaker the only treatment option for sinus bradycardia?However, the choice of treatment depends on the underlying cause, severity of symptoms, and individual patient factors. Medications or other interventions may be considered as well. A pacemaker is reserved for extreme degrees of bradycardia causing fainting episodes and when other medical interventions fail to improve heart rate. Reviewed & Updated On Reviewed by Dr. Amit Malik, Director and Coordinator, Interventional Cardiology - Electrophysiology, Cardiac Sciences, Cardiology on 27-July-2023.

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Stable angina or angina pectoris is a common type of angina that occurs during exertion and subsides with rest. It is predictable on exertion and pain in the chest lasts for less than five minutes at rest It occurs due to reduced blood flow to the heart. This can be triggered by physical activity and emotional stress. It is less serious than its counterpart, unstable angina and is a sign of an underlying medical condition.

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Steatorrhea, also known as fatty stool, occurs due to excessive fat in the stool. Stools or faeces include a variety of nutrients that have not been digested properly. In the case of steatorrhea, stool appears bulky due to the presence of excess fat and also smells foul. The food we fail to absorb or digest is known to be the reason for this syndrome. Sudden changes in food habits can stimulate the chances of temporary steatorrhea that go away with time. In the other scenarios, the intestine, biliary tract, and pancreatic diseases can also trigger the chances of steatorrhea. In most cases, a patient might not need any medical help. On the contrary, if the condition doesn't improve within a couple of weeks, one should seek medical attention.

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Supraventricular tachycardia (SVT), also called paroxysmal supraventricular tachycardia, is a condition where a person's heart beats faster than normal. It is an irregularly fast heartbeat that affects the upper chambers of the heart. Normally the heart beats 60 to 100 times per minute. A heart that beats more than 100 times a minute (approx 150 to 200 times) is referred to as tachycardia. The condition may not need any treatments; lifestyle changes and medications can help to reduce the rapid heartbeats. It is not a serious condition, but some people may need treatment.

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Valvular heart disease refers to and is characterised by damage to or a defect in one of the four heart valves –mitral, aortic, pulmonary and tricuspid. Valves are placed between chambers and vessels to maintain unidirectional flows of blood. The disease may be from birth (congenital) or develops in later part of life (acquired).  One of the most common valvular heart diseases to effect individuals in our country is an aftermath of rheumatic fever. Rheumatic valvular heart disease is the commonest valvular involvements.  Mitral valve is between left atrium and left ventricle. Aortic valve is between left ventricle and aorta. Whereas tricuspid valve is between right atrium and right ventricle and pulmonary valve is between right ventricle and pulmonary artery. Commonest acquired valve affliction is to the mitral and aortic valves. The valve may become narrowed (stenosis) or it may start leaking back (regurgitation).

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Vascular disease is a group of diseases of the blood vessels (arteries and veins of the circulatory system) where there is a disorder and disruption in the blood flow that can lead to disability and even death. Vascular surgery is a surgical subspecialty which involves usage of minimal-invasive catheter procedures to treat diseases of the vascular system, arteries, veins, and lymphatic circulation. However, intracranial and coronary arteries are not included in vascular surgery.

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Ventricular Septal defect is a congenital (present at birth) heart condition characterised by a hole in the heart wall separating the lower chambers. The hole can form in the ventricles during pregnancy if the wall of the septum is not fully developed. A common congenital heart defect, VSD, can occur in isolation or be associated with other congenital heart defects. Recent data shows that 42 of every 10,000 babies have a ventricular septal defect. The cause of the condition is still unknown at the moment. However, certain conditions during pregnancy can predispose to an increased risk of the child being born with VSD. Treatment of this heart condition depends on the size of the hole and the consequences of the extra blood flow to the lungs and the heart.

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Ventricular tachycardia is a condition in which a fast heart rhythm begins in the lower chambers of the heart (ventricles). The condition is also known as V-tach or VT. In order to understand ventricular tachycardia, it is essential to note the functioning of the heart. The heart rhythm is controlled by the sinus node in the upper chamber (atrium). The sinus node sends electrical signals to start each heartbeat. When the process is disrupted in the lower chambers, it increases the heart rate to 100 beats, causing ventricular tachycardia.

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