Dr Ricardo Petraco MD PhD Heart Specialist in London

Fresh data released on the impact of the pandemic in the UK.

COVID continued to directly kill people in 2022, but also led to a significant increase in excess deaths (not caused by COVID itself).

Why? Disrupted NHS, longer waiting in A&E, difficult to reach GPs, lower diagnosis of high blood pressure, lower rates of prescription of statins and BP pills.

Most affected were man 50-60yo, precisely those who suffer from CV disease.

And before anyone out there links this to vaccines, guess what? The rate of death was HIGHER amongst non-vaccinated people.

https://www.bbc.co.uk/news/health-64209221.amp

In this large study we have shown for the first time in humans, across a broad range of pathologies, the strong association between reduced blood flow to the heart muscle and increased chance of death.

Delighted to see it made the top 10 papers of the year of 2022 in the prestigious European Heart Journal.

Huge amount of work on this meta analysis by fellows Henry, Mihir and consultant colleagues James and Matt.

‼️Exercise, fever, dehydration, emotions (fear and stress), all can cause what we call tachycardia, the technical name for a racing heart. 

🔹These physiological causes for heart racing have a few things in common: they are normally gradual in onset and termination and they resolve once the stimulus has ended (for example, your heart rate starts going down immediately when you stop exercising or when you resolve your stress).

🔹Racing hearts are a little more concerning when (1) they start and terminate suddenly and (2) when the rate is fixed and not in keeping with any physiological response (say, for example, if you are relaxed, sitting down watching TV and you feel your heart racing at above 130 beats per minute).

🔹You should talk to your doctor about it if you are concerned. I will talk to you more about palpitations later this week, as this is a very common complaint from patients.
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‼️Exercício, febre, desidratação, emoções (medo e estresse), tudo isso pode causar o que chamamos de taquicardia, o nome técnico para um coração acelerado.

🔹Essas causas fisiológicas para a aceleração cardíaca têm algumas coisas em comum: normalmente são graduais no início e no término e desaparecem quando o estímulo termina (por exemplo, sua frequência cardíaca começa a diminuir imediatamente quando você para de se exercitar ou quando você resolve seu estresse).

🔹Corações acelerados são um pouco mais preocupantes quando (1) eles começam e terminam repentinamente e (2) quando a frequência cardíaca é fixa e não está de acordo com qualquer resposta fisiológica (digamos, por exemplo, se você está relaxado, sentado assistindo TV e você sentir seu coração acelerar acima de 130 batimentos por minuto).

🔹Você deve conversar com seu médico sobre isso se estiver preocupado. Falarei mais sobre palpitações ainda esta semana, pois essa é uma queixa muito comum dos pacientes.

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‼️Typical symptoms are pain, pressure, heaviness or tightness in the chest, at rest, which does not resolve within 20-30min. The pain can radiate to the arms, shoulder, back, neck and even jaw. 

🔹It is often associated with feeling unwell, sweaty and nauseous, but not always. Occasionally, particularly in the elderly and diabetics, the symptoms can be more vague, such as upper abdominal pain, sudden shortness of breath and even an unexplained collapse.

🔹The best thing you can do if you spot someone experiencing the above is to call an ambulance immediately. You might save their lives.

➡️Please share this with as many people as possible. Sharing this might also save lives.
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‼️Os sintomas típicos são dor, pressão, peso ou aperto no peito, em repouso, que não se resolve dentro de 20-30min. A dor pode irradiar para os braços, ombros, costas, pescoço e até mandíbula.

🔹É frequentemente associado a sentir-se mal, suado e enjoado, mas nem sempre. Ocasionalmente, principalmente em idosos e diabéticos, os sintomas podem ser mais vagos, como dor na parte superior do abdome, falta de ar repentina e até mesmo um colapso inexplicável.

🔹A melhor coisa que você pode fazer se identificar alguém passando pelos sintomas citados acima é chamar uma ambulância imediatamente. Você pode salvar a vida desta pessoa.

➡️Por favor, compartilhe isso com o maior número de pessoas possível. Compartilhar isso também pode salvar vidas.

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‼️Because this deposition occurs slowly over decades, and because the first presentation of a heart attack can be sudden death, we call high cholesterol a true silent killer, as it causes no symptoms at all, until cardiovascular events occur.

🔹I recommend that people should check their cholesterol in their 30s or at the latest 40s. However, those with a strong family history of early cardiovascular disease in first degree relatives should be tested sooner, whilst teenagers or in their 20s.

🔹Now that you know that, how about sharing this post so that more people know about it?
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‼️Como essa deposição ocorre lentamente ao longo de décadas, e porque a primeira apresentação de um ataque cardíaco pode ser a morte súbita, chamamos o colesterol alto de um verdadeiro assassino silencioso, pois não causa nenhum sintoma, até que ocorram eventos cardiovasculares.

🔹Eu recomendo que as pessoas verifiquem seu colesterol em seus 30 ou no máximo 40 anos. No entanto, aqueles com forte histórico familiar de doença cardiovascular precoce em parentes de primeiro grau devem ser testados mais cedo, enquanto adolescentes ou na faixa dos 20 anos.

🔹Agora que você já sabe disso, que tal compartilhar este post para que mais pessoas saibam sobre ele?

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‼️If it’s progressive and out of proportion for your usual fitness (say if you are breathless walking inside your house)

- If associated with chest pains or chest tightness (it could be angina)

- If you are also retaining fluid in your legs (it is a sign of heart failure or a weak heart)

- If you have a history of heart disease (heart operations, heart attacks, etc)

Breathlessness can also come from your lungs, so it is always a good idea to see your doctor if your symptoms are persisting and disturbing you!
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‼️Se for progressivo e desproporcional ao seu condicionamento físico habitual (digamos, se você estiver sem fôlego andando dentro de casa) 

- Se associado a dores no peito ou aperto no peito (pode ser angina) 

- Se você também estiver retendo líquido nas pernas (é um sinal de insuficiência cardíaca ou coração fraco) 

- Se você tem histórico de doença cardíaca (operações cardíacas, ataques cardíacos, etc) 

A falta de ar também pode vir dos pulmões, por isso é sempre uma boa ideia consultar o seu médico se os sintomas forem persistentes!

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Thank you The Jeremy Vine for helping us raise awareness about Beat SCAD UK

Dr Ricardo Petraco MD PhD 🫀 on Instagram: "‼️Have you heard of a SCAD Heart Attack? In this video, I speak to Holly, a young woman who suffered a rarer type of heart attack. I’m very grateful to her for openly speaking to everyone about it,. Dr Ricardo Petraco MD PhD 🫀 shared a post on Instagram: "‼️Have you heard of a SCAD Heart Attack? In this video, I speak to Holly, a young woman who suffered a rarer type of heart attack. I’m very grateful to her for openly speaking to everyone about it, raising awareness of this rare but p...

👉The main causes are (and often a combination of) smoking, diabetes, high cholesterol, high blood pressure and genetic predisposition.

‼️They are mostly related to poor life-style choices, such as high sugar and high calorie diets, being overweight and sedentarism.

‼️Atherosclerosis is much easier to prevent than to treat, so don’t leave it until it’s too late.

😉Please join me in educating others about it, sharing this information with friends and family!
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👉As principais causas são (e muitas vezes uma combinação de) tabagismo, diabetes, colesterol alto, pressão alta e predisposição genética.

‼️Eles estão principalmente relacionados a más escolhas de estilo de vida, como dietas ricas em açúcar e calorias, excesso de peso e sedentarismo.

‼️A aterosclerose é muito mais fácil de prevenir do que tratar, então não espere até que seja tarde demais.

😉Por favor, junte-se a mim para educar outras pessoas sobre isso, compartilhando essas informações com amigos e familiares!

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‼️How about sending this post to someone who you think might be suffering from angina?

They need to see a cardiologist to confirm the diagnosis and start appropriate treatment.
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‼️Que tal enviar esta informação para alguém com esses sintomas?

É importante procurar um cardiologista o quanto antes para confirmar o diagnóstico e iniciar o tratamento correto.

‼️Heart failure is the technical name we use to describe a heart which is not pumping blood very well through the body. It’s most commonly caused by a weak heart, but sometimes a stiff heart can cause it too, even when it remains strong.

The most common causes of heart failure are:

1. Previous heart attacks and blocked arteries, which lead to a weak heart muscle due to lack of blood supply.
2. Hypertension. If uncontrolled over the years, high blood pressure can make the heart enlarge and become weak.
3. Chronic and excessive alcohol intake can cause direct damage to the heart muscle, making it weak. This can be reversible if stopped early.
4. Unknown causes. Sometimes we just can’t find the specific cause of heart failure. We call it idiopathic.
5. Other rare conditions such as infection (myocarditis) and inflammation.

To diagnose heart failure your doctor will perform a test called an echocardiogram (ultrasound), some blood tests and a more advanced test called cardiac MRI.

Great to chat to and .walton.1441 at today. Wonderful to see Terry openly talking about his diagnosis of heart failure and how he is planning to go back to his allotment work soon.

👉You have been diagnosed with high cholesterol and your doctor told you to lose weight, eat healthy food and maybe start taking some pills, like statins.

‼️But is this forever? Can you normalize your cholesterol with life-style changes and perhaps even stop the pills? This is a very difficult question to answer to everyone, but here are some general rules:

🔹1. The higher your initial cholesterol the less likely it will normalize without medications. Diet and lifestyle changes can reduce your cholesterol by up to 20-30%, for most people.

🔹2. The healthier you are at the time of diagnosis, the less likely it is that you would be able to lower it without pills.

🔹3. If you are at high risk of vascular disease you will likely need statin pills even if your cholesterol is normal. This is also the case if you have diabetes.

🔹4. Cholesterol is a number and the lower the better to fight heart disease. Therefore, the higher your risk, the lower your cholesterol should be, so even if ‘normal’ we can make it even ‘more normal’.

‼️So the short answer is, yes, high cholesterol is a lifelong diagnosis for most people, and the earlier you detect it, the more effective the therapy is to prevent real cardiovascular damage, such as heart attacks and strokes.

➡️A Organização Mundial da Saúde (OMS) alertou a respeito das doenças cardíacas. Quase 500 milhões de pessoas desenvolverão doenças cardíacas, obesidade e outras comorbidades relacionadas à inatividade física entre 2020 e 2030.

Com isso, os gastos com a saúde pública serão ainda maiores, esse é um ponto de grande novidade no relatório.

Falamos de bilhões de dólares, quando esta cifra é apresentada aos governos, é mais provável que eles ajam de forma mais veemente nesta questão.

A OMS tenta esclarecer que temos que fazer alguma coisa, a prevenção é algo mais barato do que tratar diabetes, derrame e infarto.

O desafio torna-se ainda maior quando levamos em consideração o fato de que estamos vivendo um estilo de vida pós-pandemia que não favorece a atividade física. Sentamos na frente do computador, fazemos tudo virtualmente, até compras no supermercado.

A mudança de mentalidade não deve depender apenas do governo, deve primeiramente passar pela educação das crianças nas escolas e dentro de casa.

‼️Confira a matéria completa nas plataformas da CNN Brasil.

👉Have you seen a cardiac pacemaker before?

‼️That little device is implanted under a patient’s skin and two wires travel down to the right side of the heart to generate the electrical impulses needed to keep the heart beating and the patient alive.

‼️The cardiac pacemaker is one of the greatest medical inventions of all times and one of the most cost-effective therapies in cardiology!
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👉Você já viu um marcapasso cardíaco antes?

‼️Esse pequeno dispositivo é implantado sob a pele do paciente e dois fios percorrem o lado direito do coração para gerar os impulsos elétricos necessários para manter o coração batendo e o paciente vivo.

‼️O marcapasso cardíaco é uma das maiores invenções médicas de todos os tempos e uma das terapias mais econômicas na cardiologia!

➡️Today is World Heart Day, a special date dedicated to raising awareness about heart diseases. The aim is to reduce the burden of cardiovascular death by 25% by 2025, an ambitious goal set out by global health leaders. So, what can YOU do to help?

🔹Start by looking after yourself:

🔹Stop smoking
🔹Eat less sugar and processed food
🔹Exercise at least three times a week until you get sweaty
🔹Know your numbers: what is your blood pressure, sugar and cholesterol levels?

🔹Then look after your family and loved ones:

‼️Teach them the above
‼️Tell them to look after their hearts in the same way I do with you
👉Join the global leaders in raising awareness about heart disease

✨29th September, World Heart Day, you can do something about it too!!
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➡️Hoje é o Dia Mundial do Coração, uma data especial dedicada à conscientização sobre as doenças do coração. O objetivo é reduzir o numero de mortes cardiovascular em 25% até 2025, uma meta ambiciosa estabelecida por líderes globais de saúde. O que você pode fazer para ajudar?

🔹Comece cuidando de você:

🔹Pare de fumar
🔹Coma menos açúcar e alimentos processados
🔹Exercite-se pelo menos três vezes por semana até ficar suado
🔹Conheça os seus números: qual é a sua pressão arterial, níveis de açúcar e colesterol?

🔹Depois cuide de sua família e entes queridos:

‼️Ensine-os sobre o que foi citado acima
‼️Diga a eles para cuidarem de seus coracoes da mesma maneira que faco com você
👉Junte-se aos líderes globais na conscientização sobre doenças cardíacas

✨29 de setembro, Dia Mundial do Coração, você também pode fazer algo a respeito!!



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The circle of life continues. On the same day that a remarkable woman departs, another princess is born. Welcome Rafaella to this challenging yet wonderful world.

A Rafaella chegou!

Last week many new studies were presented at one of the largest cardiology scientific meetings, the European Society of Cardiology, held in Barcelona.

I selected 3 to show you here, as I think they have direct relevance for patients. The study cards on this post were taken directly from the account ​.

As always, go and see your doctor if you think they are relevant to you and you want to discuss things further.
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Na semana passada, muitos novos estudos foram apresentados em um dos maiores encontros científicos de cardiologia, a Sociedade Europeia de Cardiologia, realizado em Barcelona.

Selecionei 3 para mostrar aqui, pois acho que têm relevância direta para os pacientes. Os cartões de estudo deste post foram retirados diretamente da conta .

Como sempre, consulte seu médico se achar que eles são relevantes para você e quiser discutir mais as coisas.

We all know that our heart rate varies during the day, from beating slowly at times of rest, to racing when we exercise. But what is considered normal? 🤔👇

Our heart has evolved to save energy, so if your body is not consuming too much oxygen, your heart naturally slows down. That is why when you sleep your heart rate can go down to 40s, or even 30s, and this is normal, particularly if you are young and fit. And when you are resting - say watching TV or reading - your heart rate could vary between approximately 50 and 100.

Equally, when you need it, your heart works harder, so if you are stressed, working or exercising, you can reach heart rates well above 100. A simple way of estimating your “maximal” heart rate is by using the formula [220 - your age], but this can also vary a bit depending on whether you are sedentary or an athlete!

What is not normal is if you feel your heart racing suddenly and continuously when you don’t need it (for example a heart rate of 140 when sitting down), particularly if you don’t feel well with it.

Go and see a doctor if that’s the case.

Feliz dia dos pais a todos os pais do Brasil!

I’m lucky to celebrate this twice every year - today is Father’s Day in Brazil!

7:15am BR 😬 / 11:15am UK

Target audience: healthcare professionals interested in cardiology, particularly coronary physiology

We will discuss our recent study showing the importance of coronary flow as a prognostic marker of death and cardiac events.

Online and face to face.

Event mostly in English but I can still handle questions in Portuguese 😊

Thank you and congratulations to rs
cardiointerv

🔺If you have been diagnosed with high blood pressure (BP), here are 10 things you must know and do:

Take it seriously. High BP is a silent killer and treating it properly will dramatically reduce your chances of having a heart attack and stroke - 10% more protection for every 5mmHg reduction in BP!

Know the targets of your BP treatment (see table).

Invest in a good quality BP machine for home monitoring. It is more reliable than BP readings taken by doctors and nurses when you are in the hospital or clinic.

Lose weight. Even if you are not extremely overweight, a few kilos down will help control your BP.

Exercise more, as it helps opening up your arteries, lowering your BP with time.

Eat less salt - you will get used to it with time

Look after your other risk factors (diabetes, smoking, high cholesterol etc) as cardiovascular risk increases significantly when they are together.

See a healthcare professional regularly to ensure you are achieving your goals.

See a specialist if you are struggling to control BP.

Share this post with your friends who have high BP.

➡️There are many things which can increase your heart rate (number of heart beats per minute) without necessarily meaning you have a heart problem. Exercise, fever, dehydration, emotions (fear and stress), all can cause what we call tachycardia, the technical name for a racing heart. 

▫️These physiological causes for heart racing have a few things in common: they are normally gradual in onset and termination and they resolve once the stimulus has ended (for example, your heart rate starts going down immediately when you stop exercising or when you resolve your stress).

🚨Racing hearts are a little more concerning when (1) they start and terminate suddenly and (2) when the rate is fixed and not in keeping with any physiological response (say, for example, if you are relaxed, sitting down watching TV and you feel your heart racing at above 130 beats per minute).

▫️You should talk to your doctor about it if you are concerned. I will talk to you more about palpitations later this week, as this is a very common complaint from patients.

🚨Heart attack (myocardial infarction) is the biggest killer worldwide. So you must be able to know how to identify one. Caused by an acutely blocked coronary artery, the symptoms represent the heart complaining of lack of oxygen. 

Every minute without oxygen means more dead muscle and more damage to the heart function. If left untreated, some will die, some will survive but with severe heart failure. 

🔹Typical symptoms are pain, pressure, heaviness or tightness in the chest, at rest, which does not resolve within 20-30min. The pain can radiate to the arms, shoulder, back, neck and even jaw. 

🔹It is often associated with feeling unwell, sweaty and nauseous, but not always. Occasionally, particularly in the elderly and diabetics, the symptoms can be more vague, such as upper abdominal pain, sudden shortness of breath and even an unexplained collapse.

⚠️The best thing you can do if you spot someone experiencing the above is to call an ambulance immediately. You might save their lives.

➡️Please share this with as many people as possible. Sharing this might also save lives.

A useful reminder from a poster in my hospital,

Regardless of residential status EVERYONE is entitled to free life saving treatment in the emergency department under the NHS.

(And everyone has the right to register with a GP!)

However, elective, or even urgent hospital based treatments may be refused - or charged after they take place.

If you are not a UK resident (with document) and you don’t have private medical insurance, you might be putting your health (and/or your hard earned money) at risk if you end up needing hospital treatment!


clinic

🚨More than one in every three people will briefly lose consciousness at some point in their lives. Collapse, fainting, or the correct technical name, syncope, occurs when blood flow to the brain is too low to keep us awake and standing. It’s one of the most common reasons for people to see a cardiologist.

➡️The most most common causes of syncope are:

1. Sudden drop in blood pressure. People call it fainting, we call it vasovagal syncope. It is very common in young people and nearly always preceded by “warning symptoms” of feeling hot, lightheaded, sweaty or nauseous. It is in general benign, although people can get hurt.

2. Cardiac. When the heart suddenly starts pumping too slowly (bradycardia) or too fast (tachycardia) it can’t keep the blood flowing normally. It comes with no warning at all, a true sudden collapse. It can be a sign of significant heart disease.

3. Other causes such as stroke and epilepsy are also possible, but less common.

Only a careful medical history and examination - taken by someone with experience! - together with some investigations (ECG monitors and cardiac ultrasound) can really discriminate between the causes above.

🩺You should see a cardiologist if you experienced any syncope without warning (it could be your heart) or if you faint regularly (as you need to learn techniques to avoid it).

Most people will experience the sensation of being out of breath a few times in their lives, and most of the time it is not a sign of significant heart disease. Particularly if you are sedentary and overweight.

However, shortness of breath could also be a sign of a weak heart (we call it heart failure). Here are a few “red flags” - which could suggest the breathing problem is cardiac in origin:

👉 If it’s progressive and out of proportion for your usual fitness (say if you are breathless walking inside your house)

👉 If associated with chest pains or chest tightness (it could be angina)

👉 If you are also retaining fluid in your legs (it is a sign of heart failure or a weak heart)

👉 If you have a history of heart disease (heart operations, heart attacks, etc)

Breathlessness can also come from your lungs, so it is always a good idea to see your doctor if your symptoms are persisting and disturbing you!

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A maioria das pessoas experimentará a sensação de falta de ar algumas vezes em suas vidas e, na maioria das vezes, não é um sinal de doença cardíaca significativa. Particularmente  se você é sedentário e sofre com sobrepeso. 

No entanto, a falta de ar também pode ser um sinal de um coração fraco (chamamos isso de insuficiência cardíaca). Aqui estão alguns ”sinais de alerta" - que podem sugerir que o problema respiratório é de origem cardíaca: 

👉 Se for progressivo e desproporcional ao seu condicionamento físico habitual (digamos, se você estiver sem fôlego andando dentro de casa) 

👉 Se associado a dores no peito ou aperto no peito (pode ser angina) 

👉 Se você também estiver retendo líquido nas pernas (é um sinal de insuficiência cardíaca ou coração fraco) 

👉 Se você tem histórico de doença cardíaca (operações cardíacas, ataques cardíacos, etc) 

A falta de ar também pode vir dos pulmões, por isso é sempre uma boa ideia consultar o seu médico se os sintomas forem persistentes!

Did you know that for most of us cardiovascular diseases could be avoided with prevention and that a sedentary lifestyle is on the list of the main risk factors that harm your health?

✅The benefits of physical exercise go beyond your heart. Better sleep quality, better stress management, reduced risk of diabetes and cancer. The list is long!

✅However, It is not easy to start exercising, particularly if you are overweight and have an office based job. People make the same mistakes when starting and here I present a few tips to guide you.

Set achievable short term goals, choose activities you enjoy and don’t forget your diet! Now just go out there and get sweaty!

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Você sabia que para a maioria de nós as doenças cardiovasculares poderiam ser evitadas com prevenção e que o sedentarismo está na lista dos principais fatores de risco que prejudicam sua saúde?

✅Os benefícios do exercício físico vão além do seu coração. Melhor qualidade do sono, melhor gerenciamento do estresse, risco reduzido de diabetes e câncer. A lista é longa!

✅ No entanto, não é fácil começar a se exercitar, principalmente se você estiver acima do peso e tiver um emprego em escritório. As pessoas cometem os mesmos erros ao começar e aqui apresento algumas dicas para orientá-lo.

Defina metas alcançáveis ​​de curto prazo, escolha atividades que você goste e não esqueça sua dieta!
Agora basta ir lá e ficar suado!

☕️Drinking coffee daily is part of our lives. Caffeine keeps us more alert, increases our concentration, and gives us energy to fight our physical and mental battles.

✅But what are the long term effects of regular coffee consumption on our heart and brain health? I guarantee you have read conflicting information: coffee is good, coffee is bad. So is coffee a friend or an enemy of our cardiovascular health?

Like with many other things we eat and drink, it is difficult to be very precise when we talk about the potential benefits (or harms) of coffee consumption in isolation. But here is what we know:

👉Moderate coffee consumption (3-4 cups per day) is safe and probably beneficial, reducing the risk of heart attacks and strokes.
Excessive consumption (8-9 cups per day), particularly of unfiltered coffee, can be potentially harmful as it can raise bad cholesterol levels, so it should be avoided.

👨‍⚕️Once again the best approach to nutrition and lifestyle choices is: moderation! Daily coffee consumption can make you feel better and maybe even protect your heart, but don’t abuse it!

Now that you know that, how about sharing it with your coffee obsessive friends? If you want to read more, take a look at the references I provide above

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Mas quais são os efeitos a longo prazo do consumo regular de café na saúde do coração e do cérebro? Garanto que você leu informações conflitantes: café é bom, café é ruim. Então o café é amigo ou inimigo da nossa saúde cardiovascular?

Como acontece com muitas outras coisas que comemos e bebemos, é difícil ser muito preciso quando falamos sobre os potenciais benefícios (ou danos) do consumo de café isoladamente. Mas aqui está o que sabemos:

O consumo moderado de café (3-4 xícaras por dia) é seguro e provavelmente benéfico, reduzindo o risco de ataques cardíacos e derrames.
O consumo excessivo (8-9 xícaras por dia), principalmente de café não filtrado, pode ser potencialmente prejudicial, pois pode aumentar os níveis de colesterol ruim, por isso deve ser evitado.

Mais uma vez, a melhor abordagem para escolhas nutricionais e de estilo de vida é: moderação! O consumo diário de café pode fazer você se sentir melhor e talvez até proteger seu coração, mas não abuse!

Agora que você sabe disso, que tal compartilhar com seus amigos obcecados por café? Se você quiser ler mais, dê uma olhada nas referências que forneço acima.