 Hello, I'm Dr. Nagai Shichi, consultant cardiologist at Manipal Hospital, Malaysia and Old Airport Road. Today is the World Heart Day. Cardiovascular diseases, they remain the world's number one killer, resulting in nearly 19 million deaths worldwide every year. 29th of September every year celebrated as the World Heart Day. The aim is to create awareness in the society about prevention and also the management of cardiovascular diseases. As far as the prevention is concerned, it takes a back seat. We have enough gadgets in the armamentarium for investigations and treatment. Maybe it is medications, an angioplasty or a cobalt therapy or CT scan. Any world number are available. But when it comes to prevention, it boils down to the individual. If a person suffers a heart attack, tens and hundreds of relatives, they meet me or call me inquiring about the appropriate medications, about an angiogram or angioplasty. Irony is hardly anyone of them have come across who is inquiring about a periodic check-ups or a regular follow-up of the same patient. You invite 10 people for a drink party, which is a hotel or a club. Chances are that actually 12 or 13 people may turn up. The same people you call for them by morning, early morning cycling or swimming hardly one or two may turn up. Here also the prevention takes a back seat. The theme for this year's World Heart Day is use your heart to connect. Probably this has a lot of meaningful implications including connecting with the patients digitally. In my opinion, it implies connect your patients with empathy. COVID pandemic has made a major impact on the healthcare sector over the last two years. Apart from draining the healthcare resources, it has created a panic among non-COVID patients for seeking timely medical health. Telehealth, digital health, the applied key role and entered the main arena during this period connecting a patient and doctor at the click of a button. Video consultations, tele-consultations, tele-reporting, remote monitoring of cardiac devices. The future of healthcare sector is going to be digital and more digital. So on this occasion of a World Heart Day, I would like to demystify certain myths about cardiovascular diseases. Number one myth, heart disease means heart attack only. Apart from heart attack, there are congenital heart disease. Heart attack is to be in a simple terms, it's a mismatch between the oxygen demand and supply to the heart muscle due to blockages in the coronary heart arteries which supply the heart muscle. Apart from this, we have congenital heart diseases which are known as blood defects and dramatic heart disease which predominantly involves the valves and there are cardiomyopathies. There is a disease of heart muscles which can be genetic or following the viral infections. Which causes the heart muscle dysfunction and there are azmias also which are the electrical disturbances of the heart where in the heart it may go down, go below the critical level or it may go up critical level causing heart muscle dysfunction. So each of them requires a different approach and different management strategies. Then the second myth is heart attack present only with a chest pain. Please note that all chest pains are not heart attacks and every heart attack need not present as a chest pain. It can present as a gastritis, belching, a bloating of the abdomen, recurrent vomiting. You can have a shoulder pain or both arm pains or hand pains. Rarely as a jaw pain or a toothache and back pain, upper back pain on a gradient walking, shortness of breath, unusual tiredness or sweating and a giddyness. So these atypical symptoms like which are not present as a chest pain are more commonly seen in diabetics, women and elderly patients. Third myth is a normal ACG rules out heart attack or a heart disease. One can have a near normal ACG despite having a critical blockage in a coronary artery or one can have a significant valour disease or one can have a low agitin fraction where in a pumping efficiency becomes slow. In such scenarios additional investigations may be required like a blood test, cardiac enzymes like troponinide, echocardiography, exercise ACGs like a treadmill, CT angiography, invasive angiography and a cardiac MRI. All this may be required to diagnose and treat heart condition appropriately. I will see medical help next day morning or when time permits. This is the fourth myth. Please note that time is muscle. Each minute heart muscle dies after a heart attack. Report to the hospital as early as possible once the symptoms begin because first of all is a golden hour. First reverse is a very crucial period. Six hours is also a reasonable time to reach a hospital. 12 hours is a questionable. In 24 hours it causes irreversible damage to the heart muscle. Nothing much can be done. And one more myth is medications can be discontinued after angioplasty or a bypass or a control of blood pressure. Whether post procedure or surgery medications need a readjustment and these medications need to be taken for a long term or maybe lifelong. One may land up in a hospital with a stroke, heart attack, heart or kidney failure after a discontinuation of BP medication. High pretension, high BP is a silent killer. So coming to the risk factors of ischemic heart disease. The common SR high BP which is the most silent disease are the most silent killer, uncontrolled diabetes, smoking or tobacco consumption, sedentary lifestyle. Sitting is a new smoking and high cholesterol. Apart from this we have a family history of cardiovascular diseases wherein if both the parents are affected the chances of having cardiovascular disease is high in the children. Lack of sleep. 6 to 7 hours of quality sleep is a must. Obstructive sleep apnea. Snoring is not a sign of a sound sleep. Snoring suggests sleep apnea. So seek a medical help with a pulmonologist. Indoor outdoor pollution. They are very important cardiovascular risk factors. And we also noticed that most of the heart attacks follow viral infections of respiratory disease or a bacterial infection in a retract. So what are the preventive measures? Diet. So when it comes to diet, quality and quantity of food matters. Keep an eye on your calorie intake and expenditure. A cup of ice cream has 10 times of calories of a one chapati. So please limit 3s and 3r. They are saturated fat, salt, sugar, refined food, re-boiled food and re-cooked food. Also avoid canned and routine foods because they are high in the salt content. Coming to the physical activity, 45 minutes of daily walking at least 6 days a week is a must. Take a stairs wherever it is possible. Avoid sitting constantly at a place for more than 2 hours. As I mentioned, sitting is the new smoking. Add meditation or mental relaxation techniques to your regime. Sleep. A sound sleep rejuvenates mind and body. Humans sleep about one third of their lives asleep. Yet most individuals, they know very little about the sleep. Something is there called circadian rhythm which refers collectively to daily rhythm in the physiology of the body, behavior of the body, which controls the sleep cycle, modulates the physical activity and food consumption. Over a course of a day, they also regulate the body temperature, heart rate, muscle tone and hormone secretion which are all very important for the harmonious functioning of the body. Apart from this, proper control of diabetics, proper control of high blood pressure, even most importantly, go for a periodic health checkup. Prevention is always better than cure. Thank you all. Wish you all a very happy, healthy living on this occasion of World Heart Day. Thank you once again.