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Dr Deepak Krishnamurthy Profile picture
@DrDeepakKrishn1
Oct 16, 2020 • 7 tweets • 2 min read • Read on X
High LDL or bad cholesterol and a strong family history of heart attacks and bypass surgeries and angioplasties - I recommended statins. The patient said the cholesterol theory is a hoax and statins are dangerous. Argued and left my Opd and gave this feedback. #statins #LDL Image
A few months later he was rushed to emergency with a heart attack and blockages which needed angioplasty and two stents. One 100% and one 80% in major arteries. Survived and gave this feedback. #heartattack #Blockage #angioplasty #stentssavelives Image
High cholesterol is a risk factor for heart attacks and coronary artery disease. Especially LDL or bad cholesterol. There is a huge volume of data and studies which confirm this. Obesity, Diabetes, high blood pressure and smoking are other risk factors. Of course genetics too. Image
Everyone having high cholesterol doesn't need medicine (Statin). The ACC/AHA recommend calculating the ASCVD risk score and advice Statin based on risk score. #ASCVD (atherosclerotic cardio vascular disease)
tools.acc.org/ASCVD-Risk-Est…
@serioustaurean @Selkrish98 @cardio_gotya @reader_wanderer @anupamarmkrshn0 @ramachandrabng @FoolzWizdom @MansiKhanderia @imacuriosguy @bijlanirajesh @RajaniSurendarB @baxirahul @DoctorLFC @drtejallathia
@RekhaBasavaraju And we don't want anyone to consider us as God or believe us blindly! But it is important to have a scientific temper/thought process and try to understand the evidence at hand and take informed decisions.

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More from @DrDeepakKrishn1

Dr Deepak Krishnamurthy Profile picture
Feb 1
Up to 50% of women report sleep problems in midlife, and cardiovascular disease (CVD) is the leading cause of death in women
Insomnia - defined as trouble falling asleep, waking up several times a night, or waking earlier than planned more than 3 times/week.
SWAN (Study of Women's Health Across the Nation) looked at association of insomnia with cardiovascular risk. #MedTwitterImage
At baseline, SWAN participants (n=2964) were 42 to 52 years of age, premenopausal or early perimenopausal, not using hormone therapy, and free of CVD. They completed up to 16 visits, including questionnaires assessing insomnia symptoms (trouble falling asleep, waking up several times a night, or waking earlier than planned ≥3 times/week classified as insomnia), typical daily sleep duration, vasomotor symptoms, and depressive symptoms; anthropometric measurements; blood tests; and CVD event ascertainment (ie, fatal or nonfatal myocardial infarction, stroke, heart failure, revascularization). #SleepImage
Four trajectories of #insomnia symptoms emerged: low insomnia symptoms (n=1142 [39% of women]), moderate insomnia symptoms decreasing over time (n=564 [19%]), low insomnia symptoms increasing over time (n=590 [20%]), and high insomnia symptoms that persisted (n=668 [23%]).
Read 8 tweets
Dr Deepak Krishnamurthy Profile picture
Jan 10
42-year-old lady had acute chest pain. ECG showed significant changes. Told her it looks like a heart attack. She was very nervous and worried. Despite telling her not to go, she went back to meet her physician, who convinced her and sent her back. I did an angiogram, which showed 99% narrowing in one artery. Stented successfully. Today, she went home happy after 2 days in hospital. Came to my room and hugged me, and tried to fall at my feet 🥹. #MedTwitter
She was detected to have very high cholesterol and blood pressure, which were undetected before.
Most such heart attack patients have risk factors that haven't even been detected before. A very small percentage would really have no obvious risk factors. Even they would have genetic risks that are difficult to detect. #MedTwitterImage
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Cardiovascular illness is the leading cause of death in women too! Especially if women smoke or develop diabetes, their risk is same as men. Image
Common Cardiovascular risk factors
1. High cholesterol
2. High blood pressure
3. Diabetes
4. Genetic factors (family history)
5. Smoking
Plus stress, sedentary lifestyle, obesity, over eating. Image
Read 7 tweets
Dr Deepak Krishnamurthy Profile picture
Dec 22, 2023
Being treated for palpitations, breathlessness, and anxiety for 4 months, this 49 year old lady turned out to have Thyrotoxicosis or Graves' disease when I asked for a thyroid test. Subsequently, she was seen by an endocrinologist, and an isotope scan confirmed the diagnosis.
We need to be physicians first and then "super specialists!" #MedTwitter #CardioTwitterImage
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Many patients with a hyper functioning thyroid can present with cardiac symptoms like palpitations, exertional breathlessness and even chest pain. In some cases it may lead to cardiac arrhythmia especially atrial fibrillation and high output heart failure. A simple blood test will reveal the diagnosis.Image
Cardiac complications include
1. Premature atrial and ventricular contractions (APCs and VPCs)
2. Atrial fibrillation (irregular rapid heart beat)
3. Tachycardia induced cardiomyopathy (reduced heart pumping due to high heart rate)
4. Systolic and diastolic hypertension
5. Heart failure
6. Worsening angina
Read 6 tweets
Dr Deepak Krishnamurthy Profile picture
Dec 15, 2023
We all know that Diabetes is a risk factor for heart attacks, stroke and peripheral vascular disease. #Insulinresistance leads to these macrovascular complications even before a diagnosis of Diabetes is made!
Some simple indicators of insulin resistance include
1. Abdominal obesity (high waist hip ratio and waist height ratio)
2. Skin tags
3. Acanthosis nigricans or dark velvety patches of skin on neck and arm pits and back and hands
4. High triglyceride to HDL ratio in lipid profile
5. Large appetite
6. Hungry/sleepy/tired after eating
7. Fatigue
8. Craving for sweets
9. High blood pressure
10. Impaired fasting glucose level
#MedTwitter #heartattack #CardioTwitter
A low carbohydrate diet and regular exercise helps to combat this and delay onset of #Diabetes and reduce cardiovascular risk.Image
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@serioustaurean @Geeky_Foodie @FastingCoach_MS @reader_wanderer @cardio73 @mmamas1973 @abledoc
Fatty liver or NAFLD (Non alcoholic fatty liver disease) is another important indicator of insulin resistance and so is PCOD or polycystic ovarian disease.
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Read 9 tweets
Dr Deepak Krishnamurthy Profile picture
Nov 5, 2023
Air pollution is an important and under recognised risk factor for cardiovascular events. #HeartAttack
Higher levels of fine particulate matter (PM2.5) lead to endothelial dysfunction and slow flow in coronaries and systemic inflammation, leading to accelerated atherosclerosis and thrombus (clot formation).



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Before some smart Alec asks if it is just an anecdotal thing or I have any data....sciencedirect.com/science/articl…
Biological pathways through which PM2.5 leads to Cardiovascular disease Image
Read 9 tweets
Dr Deepak Krishnamurthy Profile picture
Oct 20, 2023
Mysore is steeped in culture and tradition and the Gombe Habba or the doll festival celebrated during Dasara stands testimony to this.
The most important dolls are the “pattada gombe”. This is a pair depicting husband and wife/ King and Queen. This pair of wooden dolls is decorated and handed over to the daughter of the family during her wedding as a symbolic gesture for her to continue this tradition of the festival #Dasara
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We know the story of how Goddess Chamundeswari killed Mahishasura and restored peace and harmony to the universe. Legend has it that in order for her to do so all the other Gods and Goddesses gave their powers to Goddess Chamundeshwari and being devoid of their powers they became statues. It is in their honour that the Gombe habba is celebrated.
The way the dolls are arranged is noteworthy. Tiered structures are built in odd numbers like 7, 9, 11. This is then covered with a white cloth and then dolls are arranged in a hierarchy. The dolls of Gods and Goddesses are placed on the top most tiers. Usually Goddess Chamundeshwari is the centre of attraction
Read 6 tweets

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