Good to see some gyms doing a clinical assessment and asking for #cardiacfitness before enrolling people. 28y guy with a family history of premature Coronary artery disease. Detected to have high BP. Overweight by 12-15kg. A basic clinical check can reveal so much information! Image
In such a patient assessing overall cardiac risk and controlling blood pressure before allowing him to exercise is crucial. In the absence of a pre-enrollment check if any cardiac event like heart attack happens, people will be quick to blame #exercise as the culprit!
Most people who develop a heart attack or cardiac arrest while exercising have a pre existing cardiac condition which has not been diagnosed. So it is critical to screen people before letting them join the gym. Also depends on how intense the training will be. Image
here's a good video on pre exercise screening
acrobat.adobe.com/link/review?ur… a nice screening tool

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More from @DrDeepakKrishn1

Aug 26
48y guy presented with breathing difficulty. BP 240/140. Acute pulmonary edema (fluid in lungs). Echo - Severe left ventricular dysfunction, EF 20%. S.creat 3.5. Stopped BP medicine 4y ago after listening to a BMHegde YouTube video saying BP medicine is not necessary #MedTwitter Image
It's high time the health ministry and NMC take strict action on people propagating wrong health advice on social media. Videos need to be pulled down from websites. Some of these people like BMHegde and few others have spoilt health of more people than someone can imagine.
I've personally seen hundreds of patients like this who have landed in severe complications after listening to BMH videos. Being a medical doctor who occupied such high positions of reputed institutions, he's a disgrace to our profession. Shameful.
Read 5 tweets
Aug 24
The atherosclerotic plaque is formed by deposits of cholesterol and calcium and inflammatory cells into the endothelial lining inside the artery. It can slowly narrow down the artery causing Stable angina or suddenly rupture leading to clot formation and #heartattack ImageImageImage
This explains why some people experience chest pain going on for months or stable angina and some people suddenly present with heart attack as the first symptom. Stable angina is due to gradual narrowing of lumen while heart attack is due to sudden occlusion.
A 50% narrowing plaque can rupture leading to a heart attack. But unless the narrowing is more than 70% it won't cause any chest pain. Hence many patients with heart attack haven't had any symptoms before that. A vulnerable plaque is at risk of rupture irrespective of narrowing Image
Read 7 tweets

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