Dr. Naresh Kumar Goyal

[drnareshkumar]

What exactly is coronary artery disease?

Coronary artery disease (CAD), also known as coronary heart disease, occurs when the coronary arteries become too narrow or when cholesterol deposits form in the walls. The coronary arteries are the blood vessels that supply the heart with oxygen and blood.

CAD develops when cholesterol deposits on the artery walls, forming plaques. These plaques narrow the arteries, reducing blood flow to the heart, or they can cause inflammation and hardening of the blood vessel walls. A clot can occasionally obstruct blood flow, causing serious health issues.

Coronary arteries are a network of blood vessels on the surface of the heart that supply oxygen to the organ. If these arteries narrow, the heart may not receive enough oxygen and nutrients.

Particularly during physical activity, oxygen-rich blood is required.

Symptoms Coronary artery disease

Angina can be caused by CAD. This is a type of chest pain that is associated with heart disease. Angina can cause the following sensations in the chest:

squeezing pressure

Heaviness

Tightening

Burning

Aching

Angina may also result in the following symptoms:

indigestion

Heartburn

Weakness

Sweating

Nausea

Cramping

Dizziness

Uneasiness

Shortness of breath can also be caused by CAD. Any form of exertion can become very tiring if the heart and other organs do not receive enough oxygen, which may cause a person to pant for air. At rest, a ruptured plaque can cause shortness of breath.

Complications Coronary artery disease

A heart attack occurs when the heart muscle is deprived of blood or oxygen, as when a blood clot forms in one of the coronary arteries.

Coronary thrombosis is the formation of a blood clot. If the clot is large enough, it can completely block the supply of blood to the heart through that blood vessel.

Heart attack symptoms include:

Discomfort in the chest

Coughing dizziness mild to severe chest pain

Breathing difficulties, a grey pallor in the face, and general discomfort

Panic

Vomiting and nausea

Restlessness

Clammy sweating skin

Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an incharge of heart failure programme at MAX BLKsuper speciality hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Speciality Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- Call on :- 9717173309 Mail id :- [email protected] Or you can visit our website :- https://drnareshkumargoyal.in/

[drnareshkumar]

High Cholesterol in Young age

May be Familial hypercholesterolemia – It is often known as FH — which is passed through the families to the young generations or even sometimes children. High cholesterol is a deposition of too much cholesterol or fats inside the arteries of the heart that can cause heart attacks.

It is usually of 2 Types -

●Heterozygous FH — In this child gets the FH gene from one Parent. ●Homozygous FH — In this, the FH gene is transferred from Both Parents. As this is a more serious disorder than Heterozygous FH. Because of this, the concentration of cholesterol in one is very high which may lead to a Heart Attack and results in death at a young age.

Symptoms of FH —

Heart Attack is the most serious symptom of the FH, along with this fatty and hard tissue deposits under the skin or other parts of the body like the heel of the foot, or knee, or elbow are the common sites.

Diagnosis of High Cholesterol or FH –

If some family adults Have a history of High Cholesterol, the young children must get it tested at an early stage between 9–11 years and then around 17–21 years. Or can be tested if any symptoms of fatty or hard tissue deposits are seen. Can be detected with the Routine Blood tests and if detected high can be treated with the Medical Guidance. Treatment for High Cholesterol in Young (FH) — Statins are the first choice of drugs for lowering high cholesterol. Maybe some young children may have some other medicine to add on due to a severe form of FH. It’s very important to take your medicine every day to control the Heart Attack and live a longer life.

Lifestyle and Diet Modifications play a vital role in controlling High cholesterol.

IF high cholesterol or FH is detected how is my Life –By Adopting — Right medicine, diet control, exercise, and lifestyle modification advised by your physician you can reduce the chances of heart attack to a very low. Even you must be well aware of the symptoms of Heart attack and Stroke as you are at risk. Can a young Adult get Pregnant having High Cholesterol or FH — When you plan to get pregnant seek a physician or a cardiologist’s advice to see the health of your heart to make sure your pregnancy is safe. The medicines you are taking for FH or high cholesterol need to be discontinued before 3 months to start a pregnancy. And need to discontinue till you breastfeed. As there is a high chance you will pass your disorder to your child, it is most important to get advice from your physician or cardiologist to learn the possible risks and how to minimize them. It’s better to avoid pregnancy if both partners have Familial Hypercholesterolemia(FH)

Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an incharge of heart failure programme at MAX BLKsuper speciality hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Speciality Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- Call on :- 9717173309 Mail id :- [email protected] Or you can visit our website :- https://drnareshkumargoyal.in/

[drnareshkumar]

Coronary Angiogram

A coronary angiogram is a special procedure that takes dynamic x-ray pictures of your heart. The purpose of this procedure is to see if your coronary arteries are narrowed or blocked and to look for abnormalities of your heart muscle or heart valves. Another term for coronary angiogram is cardiac catheterization. The test is done in a special laboratory called a cardiac catheterization laboratory (Cath lab), which is similar to an operating theater.

A slender catheter (a thin, hollow plastic tube) is threaded through the largest artery in your body (the aorta) via the wrist or the groin artery until it reaches the coronary arteries of the heart. A special x-ray sensitive dye (contrast) is injected and dynamic x-rays are taken of the blood vessels as the contrast moves through them.

Medical issues to consider before having an angiogram 1. Before the procedure, you need to discuss a range of issues with your doctor including: 2. your medical history, including whether or not you have asthma, allergies or kidney disease 3. if you have experienced allergic reactions to any drugs 4. any current medications you are taking. You may need to discontinue certain medications before the test, such as medications that thin the blood 5. fasting — you need to fast four to six hours prior to your test 6. other tests — you may undergo various tests before the angiogram, including blood tests, an electrocardiogram and chest x-ray and cardiac CT

Dr. Naresh Kumar Goyal MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist

Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an incharge of heart failure programme at MAX BLK super speciality hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Speciality Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- Call on :- 9717173309 Mail id :- [email protected] Or you can visit our website :- https://drnareshkumargoyal.in/

[drnareshkumar]

What is Cardiology?

Cardiology is an internal medicine branch. It’s mainly concerned with studying and treating a wide range of heart and blood vessel disorders. Cardiologists, on the other hand, are the medical experts who specialize in this particular field. Their major aim involves diagnosing, treating, preventing, and managing all types of diseases and malfunctions of the cardiovascular system. Basically, the cardiovascular system consists of the heart, blood vessels, as well as blood. The system function includes regulating how blood circulates through the body and carries oxygen and essential nutrients. Reasons to visit a cardiologist 1. Family history. :- Do some digging, chart your family tree, and ask questions of your family members about their health history.  If you notice a pattern of heart disease, including high cholesterol and high blood pressure, take action and get checked by a cardiologist. 2. High Blood Pressure. Regular blood pressure checks should occur from age 20 on. If your blood pressure is trending up, or maybe it’s always been high, it is crucial that you get it under control. 3. High Cholesterol. Increased cholesterol does not cause symptoms and can be difficult to manage. As one of the most significant risk factors for heart disease, getting cholesterol numbers under control is of utmost importance. 4. Your heart age is higher than your actual age. Do you know your overall risk for heart disease? If the answer is no, take a second and find out right now. 5. History of Smoking. Smoking at any time in your life raises the risk of developing heart disease. If you are or have been a smoker, making an appointment with a cardiologist may not be a bad idea. 6. You've been diagnosed with diabetes. Adults with diabetes are two to four times more likely to have heart disease than those adults without diabetes. The American Heart Association lists diabetes as one of seven major controllable risk factors of heart disease. Take action and work toward controlling it. Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an incharge of heart failure programme at MAX BLKsuper speciality hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care. Address :- BLK-Max Super Speciality Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005 For booking your appointment :- Call on :-  9717173309 Mail id :- [email protected] Or you can visit our website :-  https://drnareshkumargoyal.in/

[drnareshkumar]

What is Heart Failure?

Heart failure certainly doesn’t mean that your heart has stopped functioning; rather it means that your heart cannot pump enough blood and oxygen to your muscles and organs. Without sufficient oxygen and blood, many functions of the body may get affected.

Heart failure can affect the right or left side of your heart, or both at the same time.

Heart Failure is a condition when your heart becomes either too weak or too stiff to carry out its workload.

Some factor which can increase the risk of heart failure

Smoking

Age more than 55

Male gender

Family history

Unhealthy food

Sedentary lifestyle

Other diseases affecting heart

Symptoms of Heart failure

1. Feeling tired and finding exercise exhausting

2. Loss of appetite

3. Swollen ankles, legs or abdomen

4. Persistent cough or wheezing, a fast heart rate, confusion and dizziness

Diagnosis of Heart Failure

1. Physical Exam :- Like swelling of legs, irregular heart beat, weight gain.

2. Blood Test :- Chest X-Ray, 2-D echocardiography, Exercise stress Test.

Treatment of Heart Failure

Heart Failure can be managed well with the right combination of medication which help relieve symptoms and prevent worsening of the condition

1. Reduce the work on your Heart

2. Reduce the heart rate

3. Improve the ability of the heart to pump blood

4. Relax blood vessels

It is recommended that people with heart failure adhere to the prescribed medication for maximum benefits. Heart Failure medication helps prolong life and improve the function of the heart.

For More Information Contact -

Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS)

Sr. Cardiologist and heart failure specialist

Dr. Naresh Kumar goyal has an experience of more than 20+ years in treating cardiac patients and as an incharge of heart failure programme at MAX BLKsuper speciality hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Speciality Hospital

Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- 

Call on :-  9717173309

Mail id :- [email protected]

Or you can visit our website :-  https://drnareshkumargoyal.in/

[drnareshkumar]

CAD in Women

CAD in Women

Ischemic heart disease (IHD) represents the leading cause of death in women. It accounts for a third of all female deaths globally and affects nearly 48 million women in the United States. Women with IHD experience relatively worse outcomes compared with men.

 While men and women share many traditional risk factors for IHD, additional sex-based risk factors and mechanisms of disease have been shown to be important in women.  Menopause marks an important cardiovascular biological transition, with a significantly increased CVD risk in women aged ≥55 years,  Early menopause, whether natural or surgically induced, significantly increases a woman’s risk for IHD.

Hypertension, diabetes mellitus, and smoking are more potent risk factors for MI in women than in men, with an odds ratio (OR) of 1.5, 1.6, and 1.3, respectively.

Additionally, there are several nontraditional cardiac risks unique to or predominant in women, including early menopause or menarche, gestational diabetes mellitus, hypertension, preeclampsia and eclampsia during pregnancy, and systemic inflammatory disorders.

 Fewer women present with the classic symptoms of chest pain (31% compared with 42% men), particularly in young patients. Women often exhibit dyspnea, weakness, arm, back or jaw pain, palpitations, lightheadedness, or loss of appetite. This altered presentation of IHD contributes to misdiagnosis and delayed recognition of ischemia leads to delayed treatment.

 The distribution and burden of coronary plaque differs by sex, with nearly 60% of symptomatic women having no flow-limiting stenosis. The role of microvascular dysfunction, vascular inflammation, coronary reactivity, endothelial function, hormonal influences, oxidative stress, and coronary size on the development of IHD in women is being increasingly recognized. Similarly, there are pathophysiologic differences in MI, with women having a higher prevalence of plaque erosion compared with more plaque rupture in men.

Vascular dysfunction in absence of obstructive coronary disease is more prevalent in women and associated with increased use of healthcare resources, higher symptom burden, and importantly a 2-fold higher mortality, indicating that nonobstructive disease is not benign.

 Contemporary cardiac imaging techniques include detecting the extent and severity of myocardial ischemia resulting from obstructive coronary artery disease, visualizing the nonobstructive plaque burden on coronary computed tomography, and evaluating small vessel disease by use of myocardial perfusion coronary flow reserve (positron emission tomography and stress magnetic resonance imaging).

 Women were less likely to receive guideline-based primary and secondary treatment. Women experienced a 30-minute prehospital delay from symptom onset to hospital presentation compared with men.   Despite higher angina class, women were less likely to undergo coronary angiography (31% vs 49% men). or revascularization after heart attack. Paradoxically, women presenting with acute coronary syndrome have less obstructive disease but exhibit higher in-hospital (OR, 1.85) and 1-year (OR, 1.6) mortality compared with men.

 Despite dramatic improvements in mortality from IHD in women, it continues to be the leading cause of death. Sex- and gender-specific disparities in outcome persist, particularly, in subsets of women disadvantaged by race, ethnicity, income level, and educational attainment.

There is a need for improved recognition of the unique biological risk factors, differences in pathophysiology of IHD, and unique challenges of sex- and gender-specific delivery of care in women.

Take-Home Points for the Clinician

Sex-specific risk of traditional and novel risk factors for ischemic heart disease should be considered for improved risk stratification of at-risk women.

Diagnostic imaging should evaluate the full spectrum of ischemic heart disease and include assessment with stress testing and coronary computed tomography for epicardial stenosis and with positron emission tomography and magnetic resonance imaging for microvascular disease.

Psychosocial variables, including perceived social support, depressive symptoms, and caretaking responsibilities, play an important role in influencing health-seeking behaviors and clinical outcomes in women.

Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an in-charge of heart failure programme at MAX BLKsuper specialty hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Specialty Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- Call on :-  9717173309 Mail id :- [email protected]

Or you can visit our website :-  www.drnareshkumargoyal.in

[drnareshkumar]

Best TAVI surgical Doctor

What is TAVI?

A transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve implantation (TAVI) may be a minimally-invasive procedure for people with severe stenosis .

Aortic stenosis (AS) refers to a narrowing of the aortic valve opening which restricts the blood from the ventricle to the aorta and also affect the pressure within the left atrium of the heart . Aortic stenosis might not lead in much symptoms until blood flow is severely restricted which can cause symptoms like: 1. Chest pain 2. Rapid Heartbeat 3. Shortness of breath 4. Fainting spells 5. Swallow ankles or feet 6. Heart failure 7. Sudden cardiac death

If left untreated, the survival rate for patients affected by severe aortic stenosis is merely at 50% within 2 years after chest pain or fainting spells.

Usually a heart valve surgery requires an open heart procedure involving sternotomy, during which a vertical inline incision is formed within the middle of the chest at the breastbone (sternum) to supply access the heart. This kind of heart surgery may lead to complications in presence of multiple comorbidities, particularly in elderly persons.

A TAVR or TAVI allows a semilunar valve to be implanted employing a long thin and versatile tube (catheter) through a very small incision made within the groin that leaves all the chest bones in situ . A minimally invasive operation like TAVI may involve a shorter hospital stay, quicker recovery and fewer pain than traditional open operation.

Dr. Naresh Kumar Goyal

MBBS, MD, DM (AIIMS) Sr. Cardiologist and heart failure specialist Dr. Naresh Kumar Goyal has an experience of more than 20+ years in treating cardiac patients and as an in-charge of heart failure programme at MAX BLKsuper specialty hospital Delhi, is involved in many projects related to heart failure. He has got his DM expertise in Cardiology from the most prestigious institute of India AIIMS which makes him the best Physician in Cardiac Care.

Address :- BLK-Max Super Specialty Hospital Pusa Rd, Radha Soami Satsang, Rajendra Place, New Delhi, Delhi 110005

For booking your appointment :- Call on :-  9717173309 Mail id :- [email protected]

Or you can visit our website :-  drnareshkumargoyal.in