A d v a n c e d H e a r t C a r e C l i n i c k

PREVENTION . WELLNESS . REHABILITATION. ADVANCED THERAPEUTICS PREVENTION . WELLNESS . REHABILITATION. ADVANCED THERAPEUTICS
UNIQUENESS
All non invasive cardiac facilities from simple
ECG to the most advanced therapeutic
treatment options under one roof.
First time in Navi Mumbai
Facilities available Facilities available
ECG
ECHO
STRESS ECHO
TMT TMT
Holter monitoring
Event recorder
Ambulatory Blood pressure monitoring
Blood tests
Unique Facilities
Periscope (CVA) Age of the artery test
HMCG
ECP
ESMR ESMR
Genetic testing to predict future risk
Why need of such facilities? Why need of such facilities?
Productive Life-Years lost due to
early CV deaths
PPYLL- potentially productive years of life lost
J ACC Vol. 50, No. 14, 2007. October 2, 2007:13702
UK Indian Study
Age-specific death rates form CAD in UK Indians and general
population per 100,000/yr
7
Balrajanet al, I Heart J 1999
CAD strikes the young in India
8
Enas A Enas et al, I Heart J 2001
The BIG FOUR
H
Y
P
E
R
T
E
N
S
I
O
N
D
I
A
B
E
T
E
S
SMOKING
HEART
Only 35%- 50% of the angiographicallyproved CADI is accounted for by
www.drsarma.in
9
H
Y
P
E
R
T
E
N
S
I
O
N
D
I
A
B
E
T
E
S
CHOLESTEROL
HEART
ATTACK
Only 35%- 50% of the angiographicallyproved CADI is accounted for by
these BIG FOUR
Missing Links for Indians Missing Links for Indians
35% to 50% of CADI only have the BIG FOUR
Many CADI have no traditional risk factors
Low HDL by itself is Dyslipidemia in Indians
Many have normal LDL but low HDL
30% to 50% may not have BIG four and HDL
High Lp(a), MS, TG, account for most
sLDL, Fibrinogen, Inflammation, Infection
10
Co Prevalence of risk factors
Percent chance of also having
Primary
Diagnosis
Hypertension
(HT)
Dyslipidemia
Diabetes
(DM)
Hypertension/
dyslipidemia
Hypertension/
diabetes
Dyslipidemia/
diabetes
HT
62 16 13
Dyslipidemia
44 15 10
11
DM
64 85 54
HT/Dyslipide
mia
22
HT/DM
84
Dyslipdemia/
DM
64
http://www.qualityprofiles.org/leadership_series/cardiovascular_disease/cardiovascular_managingrisk.asp. accessed on 4.5.2014
GuesstheAge?
Calendar Age 80yrs 35yrs
Vascular Age 50yrs 50yrs
What isEVA??
Vascular Aging
Real age
Vascular age
Endothelial Dysfunction is root cause of CVD
Oxidative
stress & CHF
Oxidative
stress & CHF
Endothelial dysfunction Endothelial dysfunction
Dyslipedemia Dyslipedemia
Insulin
resistance
Insulin
resistance
Diabetes Diabetes Hypertension Hypertension
15
Journal of Hypertension 2005, 23 (suppl 1):S9S17
ISCHEMIC
Vasoconstriction Vasoconstriction Atherosclerosis
Coronary
events
Inflammation
Plaque rupture
Thrombosis
ACS
Howdo newtechnologies help Howdo newtechnologies help
CVA CVA
Will detect internal age/vascular age/age of the
arteries
Genetic testing Genetic testing Genetic testing Genetic testing
To predict future risk of developing heart disease
or diabetes
HowCardiumwill deal
Non Pharmacological approach
Exercise Training
Stress management
Diet counselling Diet counselling
ECP
Pharmacological approach
Cardium Cardiumoffers state of the art non offers state of the art non
invasive treatment for patients with invasive treatment for patients with
advanced blocks who cant undergo advanced blocks who cant undergo
bypass or angioplasty treatment for bypass or angioplasty treatment for bypass or angioplasty treatment for bypass or angioplasty treatment for
any reason any reason
ECP
ESMR
ESMR VIDEO
ECP
Speciality Speciality clinics will be launched in clinics will be launched in
staged manner staged manner
Heart failure prevention and recovery clinic
Hypertension clinic
Cholesterol clinic
Diabetes clinic Diabetes clinic
PVD clinic
ED clinic
PH clinic
Our Approach
Friendly
Evidence based practice
Internationalized protocol driven practice