Heart disease in India is unusual in three ways: it starts younger (average MI patient is in their late 50s; Western average is mid-60s), it is harder to predict (we have low average cholesterol but high genetic risk), and it presents differently in women (often without classic chest pain). Coronary artery disease — CAD — is the most common form: cholesterol-laden plaque builds up in the arteries that feed the heart muscle, eventually blocking blood flow and causing chest pain (angina), heart attack, or sudden death.
Risk and prevention
Most heart attacks happen in patients with at least one of: diabetes, high BP, high cholesterol, smoking, family history of early heart disease (father / brother with MI before 55, mother / sister before 65), abdominal obesity, sedentary lifestyle. The combination matters more than any single number. We use validated risk calculators (QRISK3, ASCVD) tuned for the Indian population to estimate 10-year risk during routine cardiology OPDs.
For asymptomatic adults with risk factors, our prevention package includes:
- ECG + ECHO + TMT (treadmill test)
- Fasting lipid profile + HbA1c + creatinine + thyroid
- Lifestyle counselling — diet, exercise, smoking cessation
- Initiation of statin if 10-year risk is high
- Annual review
When to see a cardiologist urgently
The following deserve same-day evaluation:
- Chest pressure / heaviness lasting more than 5 minutes, particularly with sweating, breathlessness, jaw / arm radiation. Do NOT drive yourself; call 102 for ambulance.
- New breathlessness on minimal exertion — climbing one flight of stairs that you could do easily a month ago.
- Palpitations lasting more than a few minutes, particularly if accompanied by giddiness.
- Fainting — especially during exertion.
Diagnosis and treatment
When the picture suggests CAD, we use:
- ECG — first-line, takes 5 minutes.
- ECHO — looks at heart pumping function (ejection fraction). Critical after any suspected MI.
- TMT (treadmill stress test) — looks for blockages that show up under exertion.
- Coronary angiography — done in a cath lab, the gold-standard for visualising blockages. Asian Hospital coordinates angiography + angioplasty with our network cath lab for primary MI cases.
Treatment depends on what we find:
- Medical management — aspirin, statin, beta-blocker, ACE inhibitor. Suitable when blockages are not critically tight.
- Angioplasty + stent — opens a critically narrowed artery, restores blood flow. Done in the cath lab; the patient is awake.
- CABG (bypass surgery) — when multiple arteries are blocked and angioplasty isn't the right answer. Done at partner cardiac surgical centres; we manage all pre-op + post-op care.
After a heart attack — life doesn't stop
Most patients are back to office work in 4-6 weeks, back to brisk walking by week 2-3, and back to most activities of daily life. Cardiac rehabilitation — structured exercise + diet education + medication review — significantly reduces the risk of a second event. We strongly recommend it for every post-MI patient.
