Dr Devi Shetty in an exclusive interview with South First speaks about issues like trying to differentiate chest pain and acidity, the importance of regular checks, the role of technology in heart care, and what people can do to maintain a healthy heart.
Published Sep 29, 2024 | 8:56 AM ⚊ Updated Oct 10, 2024 | 9:16 PM
Dr Devi Shetty speaks to South First on common mistakes by people which can lead to problems with heart health (Supplied)
On World Heart Day renowned cardiac surgeon Dr Devi Shetty, founder and chairman of Narayana Health, discusses with South First the common mistakes that people make when it comes to heart health despite increased awareness post-COVID-19.
From issues like trying to differentiate chest pain and acidity, to the importance of regular checks, role of technology in heart care, and what people can do to maintain a healthy heart, Dr Shetty spoke about all in detail.
He also answers criticisms about Narayana Hrudayalaya’s health insurance scheme— India’s first ever started by a hospital.
Here are the edited excerpts:
Q. Post-COVID-19, there have been several cases of young people dying from heart attacks. Do you think people are more aware of heart health now?
A. Yes, people are more aware of heart health post-COVID. The pandemic has heightened awareness about health in general.
Sudden cardiac arrest and sudden cardiac deaths made headlines frequently, and social media has amplified this information. People feel that the incidence of heart attacks has increased, but I believe, we are feeling they are more due to increased reporting and social media exposure.
Q. What does your OPD say about this? Are there changes in the types of cases you are seeing?
A. There is no significant increase in the incidence of heart disease. However, with increased awareness, people are now consulting doctors even for minor discomforts, leading to more diagnoses.
But there are still thousands of undiagnosed heart patients—young men and women in their forties and fifties who appear very fit and athletic but have advanced heart disease. If they run a marathon or continuously run on a treadmill, they could collapse.
Any time you read in the newspaper about someone collapsing due to a sudden cardiac arrest, people often attribute such incidents to stress.
However, if the same person had undergone a cardiac evaluation 10 years earlier and had a CT scan, the issue could have been detected and the death potentially prevented.
Q. What are some signs of heart problems that people generally ignore?
A. Nearly 50 perent of people with heart disease have no idea they are at risk, especially people with diabetes, who suffer from silent ischemia.
Many patients come to us because they were advised to get a cardiac opinion for other surgeries or check-ups.
The key message is: How fit you feel does not reflect how fit you are. Everyone over 20 should know their vital numbers—blood pressure, blood sugar, cholesterol, kidney, liver, and heart functions.
Q. How can people differentiate between cardiac pain and acidity?
A. The problem is when a layman tries to differentiate between cardiac pain and acidity pain, that’s where the mistake is.
If you experience pain at any time which you have never experienced before, go to the nearest cardiac hospital and get the test done. Let the doctors do an ECG and blood tests and let them decide if the pain is a cardiac one or not.
The biggest problem we have in treating heart patients is, that at two o’clock at night, they get chest pain. They wake up and attribute the chest pain to the fish they ate for dinner and sleep over it.
The next morning, when the breathing difficulty gets worse, they go to the hospital. At that time, they have already missed the bus.
The four to six hours after the heart attack is the golden period. In that period, if you land in the hospital, most of the heart attack can be reversed and your heart muscle can be saved.
After six hours, you reach there, you can spend millions of dollars, your heart is damaged and once the heart is damaged, it is permanent, it will never recover.
Whatever treatment you take, a damaged muscle of the heart can never be revived. So the biggest problem we have is lay people trying to differentiate between cardiac pain and acidity pain or muscle pain. Don’t ever do that.
Q. Is there something called a mini heart attack? How do we identify it?
A. The term “mini heart attack” is not medically accurate. However, there is something called anginal pain, which indicates blockages without leading to a heart attack.
This pain needs to be investigated immediately to prevent a full-blown heart attack. This kind of anginal pain is God’s way of giving you a signal that please go and get it sorted out. It is an advance notice, the heart is giving you.
Q. Can people die from heart attacks during sleep?
A. Yes, heart attacks can happen during sleep. However, it’s extremely rare for someone with a normal heart to die from sudden cardiac arrest. Most people who experience this have pre-existing conditions that could be detected with regular check-ups.
Q. What role does diet play in heart health? Should we avoid any foods completely?
A. The healthy diet for people with heart disease or those with a risk of developing blockages in the future has changed over time. Earlier, we always blamed oil. Now, the new villain is carbohydrates, such as rice, chapati, and sugar.
We have to moderate our intake of these three, especially sugar. I recommend everyone control their carbohydrate intake. Of course, they should also control their oil consumption. Following this type of diet and avoiding red meat will help.
Q. What are your top five recommendations for maintaining good heart health?
Q. Can smartwatches and other wearable technology help in detecting heart issues?
Absolutely. Wearables, especially smartwatches, are remarkable tools. My advice to everyone is to wear a smartwatch and count the number of steps. If you can walk 10,000 steps per day, believe me, it has a magical impact on your life.
Many scientific articles speak about the benefits of walking 10,000 steps. They have studied thousands of people who walk consistently and have shown a significant impact on their quality of life in terms of cardiac health, liver health, overall body health, and mental well-being—even reducing the risk of cancer.
Most people don’t walk more than 3,000 steps a day, so wearing a smartwatch makes a huge difference.
I also recommend using earphones, like AirPods, while talking to walk simultaneously. Doing this can help you walk an extra half an hour to an hour every day without even realizing it.
These wearables can significantly improve your lifestyle and health by increasing your physical activity. I am a strong advocate of smartwatches as they can even detect electrical abnormalities in the heart.
In the future, they will be able to diagnose blood sugar levels and many other health parameters. It’s just a matter of time.
Q. You mentioned a pilot project for preventive health checks in Bengaluru. How is that going?
A. We are working on a pilot project to bring preventive health check-ups closer to people’s homes or workplaces. People avoid hospitals because they don’t want to go there. We hope to increase participation in preventive check-ups by making them more accessible.
Q. Critics argue that by privatising health insurance, we could be creating a monopoly similar to the US healthcare system, which has been criticised for high costs, long wait times, and limited access to care for many. How do you address concerns that such a model might not be the best fit for India, particularly concerning Narayana Hrudayalaya’s Aditi Health Insurance scheme?
A. Ideally, the government should provide free healthcare to all citizens. However, we have studied governments that successfully offer universal healthcare funded by taxpayers are typically small countries with a high tax-to-GDP ratio, spending between 10 percent to 18 percent of their GDP on healthcare.
Our government spends only 1.5 percent to 2 percent, less than 3 percent of GDP on healthcare. So, expecting free healthcare is wishful thinking because we simply don’t have the financial resources.
Even the United States, the richest country in the world, cannot offer free healthcare to all its citizens with taxpayer money. If they can’t do it, we certainly can’t. But Indians can afford affordable health insurance. Our approach is to lower insurance costs and make it accessible to everyone.
India is already the lowest-cost healthcare provider in the world, but still, more than 60-70 percent of the population cannot access healthcare because they simply can’t afford it.
How long can we wait for the government to generate enough funds to provide healthcare for all? It’s not feasible.
We believe that hundreds and thousands of entities should come forward and launch affordable health insurance plans, collecting premiums from millions of people. As more people get insured, the premiums will decrease, making it more affordable.
I have no issue with anyone proposing any initiative, but it’s essential to take action instead of criticising from the sidelines. We may fail, or we may succeed, but we should keep trying. That is the whole idea.
Q. The scheme has been criticised for focusing mainly on surgical procedures. What do you say to that?
A. We cover both surgical and non-surgical treatments. For surgical treatments, with a premium of ₹10,000, we provide coverage up to ₹1 crore. Our dream is that the poorest man in the country should be able to afford the same treatment as the richest man, whether it’s a heart transplant or an artificial heart, which can cost ₹70 to ₹80 lakh.
We don’t want people to choose treatment options based on their financial situation. That is the greatest challenge we face as doctors—having to present patients with options based on their ability to pay.
It’s not like choosing between a ₹500 shirt and a ₹5,000 shirt. There is only one appropriate treatment, especially for surgical procedures, and both rich and poor should be able to afford it. That’s the whole idea.
For medical treatment, we provide coverage up to ₹five lakh because medical treatments involve many complexities, and costs can vary significantly depending on the method of treatment.
This is a pilot project to see how people respond. If we can’t save lives with ₹5 lakh, it’s not easy to do so with ₹10 lakh either.
Q. Narayana hospitals are mainly in urban areas. How will this scheme benefit rural families?
A. This is just the beginning. It is a pilot project. Once we understand the effectiveness of the scheme, we plan to roll it out nationwide, including in rural areas. Our goal is to make healthcare accessible to everyone, everywhere.
(Edited by Sumavarsha Kandula)
