- 2 months ago
What causes sudden heart failure?
Sudden heart failure can occur even in seemingly healthy hearts, often due to Hypertrophic Cardiomyopathy (HCM).
HCM is a genetic condition where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood.
How timely diagnosis of HCM can save lives?
HCM is the leading cause of sudden cardiac death.
Some patients may have no symptoms, while others may experience breathlessness, chest pain, palpitations, and more.
Early detection and treatment of hypertrophic cardiomyopathy can prevent sudden cardiac death.
In this episode of the Kauvery Podcast, Prof. P. Manokar, one of the Best Cardiologists in Chennai and Dr. Anbarasu Mohanraj, the best cardiothoracic surgeon in Chennai, Kauvery Hospital, explain what HCM is, why it’s dangerous, and how timely care can save lives.
Sudden heart failure can occur even in seemingly healthy hearts, often due to Hypertrophic Cardiomyopathy (HCM).
HCM is a genetic condition where the heart muscle becomes abnormally thick, making it harder for the heart to pump blood.
How timely diagnosis of HCM can save lives?
HCM is the leading cause of sudden cardiac death.
Some patients may have no symptoms, while others may experience breathlessness, chest pain, palpitations, and more.
Early detection and treatment of hypertrophic cardiomyopathy can prevent sudden cardiac death.
In this episode of the Kauvery Podcast, Prof. P. Manokar, one of the Best Cardiologists in Chennai and Dr. Anbarasu Mohanraj, the best cardiothoracic surgeon in Chennai, Kauvery Hospital, explain what HCM is, why it’s dangerous, and how timely care can save lives.
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06:38Is hypertrophic cardiomyopathy the only or the most common cause of this sudden death
06:43or what are the other common cause of sudden death,
06:45especially in young people who work out in the gym or who are sports people?
06:49Generally, one of the most common causes of sudden death
06:54sudden or the most common cause of sudden death,
06:58especially in young people who work out in the gym or who are sports people.
07:01That is the commonest disease, heart disease, that is the commonest.
07:05But younger people, especially very fit people, that is,
07:09who are regular exercise,
07:11that is the most common cause of people who come to the gym,
07:15that is the most common cause of patients,
07:19maybe 30 to 50% of people who come to the gym,
07:24hypertrophic cardiomyopathy,
07:27that is the most common cause of people who come to the gym.
07:31That is the most common cause of people who come to the gym.
07:33Especially, for example, in Italy and many countries,
07:35if you participate in a competitive sport,
07:38especially if you participate in football,
07:40it is mandatory to screen this problem.
07:45There is no problem.
07:46If you have any doctor's certificate,
07:49you can do it in a football club.
07:51In India, you can't do it.
07:53But this is the most common cause of young people,
07:56this is a major cause of sudden death.
07:58Not the only cause, but a major cause.
08:01That is why the screening is important.
08:04If you have any patients,
08:05as you said,
08:06they can't get 30 years old,
08:07they can't get 30 years old,
08:08they can't get 30 years old,
08:09they can't get 30 years old.
08:10They can't get 30 years old.
08:11How do you diagnose them?
08:12What are the investigations needed?
08:14Number one is,
08:16let me divide this question into two parts.
08:18First of all,
08:19if we have any patients,
08:21when we have a cardiac approach,
08:24number two,
08:25what are the investigations that the cardiac will prescribe?
08:27What are the investigations that we diagnose?
08:31Let us divide the patients with two parts,
08:33one is that there are symptoms,
08:35and they can't get any symptoms.
08:37That is, the patient is at the end of the end of the week.
08:40That is,
08:41patient is at the end of the end,
08:42or the end of the end,
08:43or the end of the end you have the limbs,
08:44especially if they have physical activity
08:47they can't get any symptoms
08:48and they can sign the cardiac trigger with carnalysis.
08:51The body is on the end of the end of the end,
08:53and at the end of the end of the end that's about the age of the first part.
08:55Asymptomatic,
08:56there is not that there is such a coronary disorder.
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12:49what is the role each specialist plays.
12:51So starting from hypertrophic cardiomyopathy,
12:53first thing is pediatrics.
12:56That is,
12:57there is a heart problem,
12:58pediatricians pick up.
13:00So pediatrics specialist is the first person
13:03who is part of the team.
13:05Second thing is routine,
13:07adult cardiologist,
13:09routine evaluates,
13:10these are the team.
13:12For this,
13:13the cardiology side is
13:15interventional cardiologist.
13:17They are very low.
13:21In other cases,
13:23alcohol septal ablation
13:25is a technique.
13:27In this case,
13:29they are very low.
13:31One day,
13:33they have been doing
13:351 mm of absolute alcohol
13:37treatment.
13:39Long-term results
13:41are not satisfactory.
13:43There are chances of recurrence
13:45and the surgical results
13:47compared to you,
13:48the look
13:49appeared better.
13:50Therefore,
13:51there is a role
13:52limited.
13:53But there is also
13:54an interventional cardiologist.
13:55There is a role
13:56in hypertrophic cardiomyopathy.
13:57There is a dedicated specialist
13:59who is developing in this field.
14:02There is a whole medical treatment.
14:05There is a cardiologist.
14:07that is a medical treatment.
14:08They are involved in this condition.
14:10There is a medical treatment.
14:11This is a specialist
14:12to electrophysiologist.
14:13In this condition
14:15to deal with electrical problems.
14:17There is an arithmias,
14:21an ablate,
14:22ICD, pacemaker,
14:23and devices,
14:24it is a specialty.
14:25It is a specialty.
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15:25I would say very few centers in the state or in the country are doing a good job.
15:33So, I am very proud that Kaveri can offer that aspect of surgery.
15:39That is, in fact, you can elaborate on that.
15:42But surgery for septal reduction is very limited expertise and more importantly results are very important.
15:53And the aspect of Kaveri is I would say a pioneer and a leader and the second component
15:59of surgery that when everything fails and patient has burnt out cardiomyopathy and patient needs
16:05transplant even for that subset we have dedicated people working on that.
16:11So you put it in a nutshell A to Z of hypertrophic cardiomyopathy from diagnosis to end stage
16:18heart failure, every aspect covered specialist Kaveri available on that, I feel we have
16:25the most comprehensive setup to deal with hypertrophic cardiomyopathy.
16:30So all specialists, all facilities, all treatments under one roof, all under one umbrella.
16:35Exactly.
16:36Now, in short, you were talking about treatment.
16:39In a nutshell, hypertrophic cardiomyopathy, what kind of treatments are there?
16:43Medicines?
16:44Electrophysiology, Cardiology and Surgery.
16:47Surgery, I will talk about it in detail.
16:49On your side, there are medicines and electrophysiology and cardiology side, what kind of treatments are there?
16:56Medical treatment, heart rate, heart beating, heart contract.
17:02These medicines have been used for 30-40 years.
17:07For symptomatic benefit, there are maximum 50-60% of patients.
17:13So early stage of disease, coming symptoms, stage 1, stage 2 patients, medical treatment is very effective.
17:23In the last 30 years, there are no medicines in the last 30 years.
17:28But in the last 5 years, we have a new group of medicines.
17:32I mentioned the Mavacompton group of drugs.
17:35Heart rate thickness, that is, heart rate muscle thickness is more effective.
17:40And the medicines are going to be launched in India from next week.
17:45In the medicines, expectation is medical treatment.
17:48If anyone can do surgery, or is suitable for surgery,
17:53So there is a list of treatment of patients in medical treatment.
17:58It is an option for electrophysiology.
18:01For electrophysiology, there are some patients for ablation.
18:02There are some pacemakers, ICDs.
18:04There are some treatment, electrophysiology.
18:09The third is, in the last 30 years, there is alcohol-ceptal ablation treatment.
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19:22.
19:23So, just for completion on the surgical part of the hypertrophic abject, cardiomyopathy,
19:30penandetalapasera.
19:31So, this surgery has been around for about 40 years now.
19:35So, in the, just as a note of respect, in the surgery, first of us, Deweyse Pandalapur,
19:40Dr. Moro, he used to work in Bayless and he did, in fact, he was a pioneer in this septal
19:47myoctomy and the surgery came in the Moro's septal myoctomy.
19:52Unfortunately, 60 years ago, he had done about 220 of these procedures.
19:5760 years ago, he was a close colleague, Dr. Braunwald.
20:02Braunwald is one of the stalwarts in cardiology.
20:05So, he, Dr. Moro said he had some breathing difficulty.
20:09And then, Dr. Braunwald auscultated him.
20:12He said, hey, you have some murmur.
20:16Come, we'll go to echo.
20:18Now, the surgery which Moro was performing for his patients who had hypertrophic cardiomyopathy,
20:23hypertrophic, abstractive cardiomyopathy.
20:25So, what happened is, unfortunately, he refused treatment.
20:30And then, within about six to eight years, our abdi deteriorated high, heart failure on the earth.
20:39So, you know, hypertrophic cardiomyopathy, hypertrophic abstract cardiomyopathy, it's a genetic disorder.
20:46So, he had three kids, of which one kid was lucky he didn't have the kid.
20:51Another daughter and another son had the same disease.
20:55The daughter underwent a resection of this, of this surgery.
21:01The myectomine.
21:02That's the same surgery on his upper device.
21:05The surgery on his upper device is done.
21:08Son, he had a non-obstrictive variant.
21:12But later, went in for dysfunction, LVD dysfunction.
21:17And then, he had a heart transplant.
21:19So, in a family, all the aspects of treatment has been done for the same person who was the pioneer in this surgery.
21:26Third generation, Dr. Morrow, the third generation, also had a reflection of the disease.
21:31And they were also treated for this.
21:33Now, in the surgery, what happened, this hypertrophic abstract cardiomyopathy,
21:38Myectomy, Morris Myectomy.
21:40But now, Dr. Morrow, it's called extended septal myectomy.
21:45That's what happened.
21:46So, what happened, the septal thickness, the surgical indication,
21:52That's what happened.
21:54Apical septum, mid-septum, and basal septum, or outlet septum.
21:58If you said that, outlet septum, obstruction of the symptoms.
22:02So, apical septum, our surgery is done.
22:05Whereas, basal septum, outlet or mid-septal, our surgery is done.
22:11In the basal septum, in the thickness of the septum,
22:15In the basal septum, there is a valve, a mitral valve gets sucked.
22:18And the pressure, the mitral valve, the leaflet, the gradient.
22:24It's called, a systolic anterior motion of the mitral leaflet.
22:30So, that's why, in the back of the mitral valve, the leak was done.
22:35So, there was a mitral regurgation there.
22:37So, what we do, what we do in the surgery is,
22:40You do a complete surgery.
22:42If we do a short operation, the surgery,
22:46Then, we do a transheasal vaginal,
22:48We do a heart backhand.
22:51That's why, we get a complete picture, a clear picture.
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23:51மில் கplexட்பு நோக்கிவால்விடா bordersmir
23:55chocolateَّனْíb הם சக்கம்.
23:57பரம் சு overhead��� blob
23:59நல்க்கு பையbelievableணிக்கு граф வருகித் திர்சியachte
24:00விரட்செய்த possibiliset
24:01பிரல்கலincluding 되는 dónde girdீர்களான்
24:04விரட்மண்ண decl complacavy
24:06சட்திறாக சர்வார்த taką முமைறில் நteriBir இ ransom STUDENT
24:10MHிbardziestுருச்கள் che unhealthy
24:12correspondenceப் LOT
24:13lucky stitchedம cheekорон
24:16வருத்து Και்லை மக்கலumbling
24:19NORMAL AMERICAN POPULATION EQUAL OF THE, IN FACT, IT SLIGHTLY BECAUSE BETTER ALSO BECAUSE THEY ARE ON REGULAR FOLLOW, UNLESS OTHERWISE
24:26THEY DEVELOP AN ARHYTHMIA
24:29ARHYTHMIA, IRUDAI THUDIPUL PROBLEMS ON THE, ADHU VANDHU CHINNA THAN THEY HAVE PROBLEMS OTHERWISE THE SURVIVAL BECOMES NORMAL, SO THIS SURGERY IS A VERY VERY GOOD SURGERY WHICH IS LIKE
24:39GIVES A VERY GOOD RELIEF OF HYPOTROPHIC ABSTRACTIVE CARDIUM APTHI
24:43AND TO FINISH YOUR NOTE WITH THE ABSTRACTION IN LAMA AND THE HYPOTROPHIC CARDIUM, THEY BURNT OUT DISEASE IN SONENGILIA
24:51SO MRA IT'S WELL EVIDENT AND ALSO SCARING MRA
24:55AND THEN USUALLY THE HYPOTROPHIC CARDIUM, NORMALLY 50 TO 60 PERCENT EGUCTIFACTION IT WILL BECOME MUCH MORE BECAUSE THE LV CAVITY IS SMALL
25:04BUT THE FAILURE OF OTHER PATIENTS, EGUCTIFACTION STARTS DETORIATING, EGUCTIFACTION 30 PERCENT, 23 PERCENT
25:12THEY ARE IDEAL CANDIDATES FOR TRANSPLANTING AND THEN TRANSPLANT GIVES A GOOD RESULT, HEART TRANSPLANT GIVES A GOOD RESULT
25:19AND 10 YEAR SURVEY WHEL PATHING IN A HEART TRANSPLANT PANNA PARAGE, THESE PATIENTS ARE PLEASE 60 PERCENT OF THESE PATIENTS ARE FIGHT ALIVE
25:26AND IF THE FAMILY DISEASESION, GENETIC DISORDANCE, IF OUR PATIENT, IF OUR PATIENT DIAGNOOSED PANNEETOM, HYPOTROPHIC CARDIUM APTHIUM, HYPOTROPHIC CARDIUM APTHIUM
25:35WHAT ARE THE GUIDELINES, WHAT ARE THE GUIDELINES?
25:39IF YOU ARE PATIENT, WE WILL PROBANDON, THAT IS, WE WILL TRY TO IDENTIFY THE GENES
25:44SO, IF THEY ARE GENETIC TEST, WE WILL TRY TO IDENTIFY THE GENES
25:48SO, IF YOU ARE THREE GENES, AT LEAST TWO FUTTIG COMMON GENES, WHICH IS VERY COMMON GENES
25:57SO, IF THERE IS EASILY IDENTIFIBLE GENETIC MUTATION, WE WILL DISCUSS WITH THE FAMILY, WHETHER THEY ARE INTERESTED IN TESTING THEMSELVES
26:07IF THEY ARE INTERESTED IN GENETIC TESTING, ADVICE PANNUAR, ESPECIALLY SABILINGS AS WELL AS CHILDREN
26:15CHILDREN, MOST OF THE VARIATIONS, COMMONEST PATTERN IS AUTOSOMAL DOMINANT
26:22THAT IS, ONE PARENT, TWO CHILDREN COULD AFFECT, GENETIC TRANSMISSION
26:30IN THE CONDITION, GENETIC TESTING, OVER 10 YEARS BACK, RUMBAY EXPENSIVE
26:35NOW, COST HAS COME DOWN
26:38SO, IF WE IDENTIFY GENES, FAMILY, IT IS EVEN MORE CHEAPER
26:44SO, IF THERE IS A GENETIC TEST
26:47CHILDREN, IT IS A GENETIC TESTING
27:03இதுவுடான் advancement இந்த அலவுக்குப் போயிருக்கு
27:06that suppose if one of the parent has it
27:09and அவுங்கள் வந்து நரையைப்பிருந்து பேச்சின்னால் எருந்திருக்காங்க
27:13he may wish that he doesn't transmit it to his children
27:16so இந்தமாய் சர்கம்ஸ்ரம்ஸ்லாம் நாங்க
27:18earlier we used to advise them to go for adoption
27:21but today பார்த்திருக்குன்னா
27:23நம்ம் pre- implantation genetic testing
27:26there is a concept that is when the embryo is in the stage
27:33IVF treatment
27:34and the embryo is in the gene
27:36and the embryo is in the gene
27:38and the embryo is in the embryo
27:41and the embryo is in the transfer
27:44next generation in the gene
27:47the genetic testing is available
27:50and it has been practiced
27:53so thank you viewers
27:55in the Cauvery podcast
27:57we will see soon catch you back with more topics here
28:01from the department of cardiology and cardiac surgery
28:03thank you thank you thank you
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