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Why Young People Collapse in Gyms | India's Top Cardiologist Explains Heart Attack Signs | Doctor vs Internet · Health Wealth

• 0:00
  Speaker 1: This is India Today Podcasts. Hello and welcome to Doctor
• 0:04
  vs Internet. I'm Sonal Mehrotra Kapoor. Today I have with
• 0:07
  me a doctor who I've waited a long, long time
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  to bring him on the podcast. If I say heart health,
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  there is one doctor who's a household name in the country.
• 0:18
  Speaker 2: Dr.
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  Speaker 1: Ashok Seth is not a doctor, he's an institution, what
• 0:22
  he's done for heart health, how he propagates about it,
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  and what he's really turning the entire health industry into
• 0:29
  is commendable. And today, when he sits down with us,
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  I wanted to do something which is different from what
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  he's already spoken. There are so many questions in our minds,
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  but one thing that has often like sort of got
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  into my head is why do Indians get heart attack
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  10 years earlier than the West? Are we genetically more
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  inclined towards a weaker heart? Are women's heart different than
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  the way a man's heart responds? And there's no romance
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  in that. I'm purely talking about biology here. What about
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  these high intensity programs like high rocks, like HIIT? What
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  are they doing to our heart? Why is it that
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  we still haven't figured out that young people are dropping dead?
• 1:18
  in their gyms? Or perhaps not very old people dying
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  in their sleep? These are all very fundamental questions, but
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  perhaps a time we bring you all the answers in
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  one podcast. Aisa kya hai jo hum samajh nahi paarein
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  ki fit rehne mein aur disease free rehne mein kitna
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  farak hai and how do we actually get there? So
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  with that, Dr. Seth, how are you doing?
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  Speaker 2: Very well, Sonal. In fact, I am drinking coffee because
• 1:48
  I want to keep up with your exuberance. And let
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  me just say, you know, your wonderful podcast, very informative.
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  I have been waiting for a long time for Sonal
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  to invite me for her podcast. So it's actually the
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  other way around.
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  Speaker 1: That is really, really sweet. Thank you so much. But
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  let me dive in straight with the question.
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  Speaker 2: Right.
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  Speaker 1: Indians are very kind-hearted people. But why are our hearts
• 2:12
  so weak? Are we genetically weaker? Our hearts are genetically
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  weaker than the West.
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  Speaker 2: That is absolutely correct. There are two aspects to it. Yes,
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  there is genetics in it. And along with that, our
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  risk factors are also the highest in the world. So
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  let's just consider genetics. What is it? There are two
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  or three things in genetics. One is our body habitus.
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  You must have heard that I will tell you about toffee.
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  Toffee is good and toffee is bad for heart. But
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  when we talk about toffee in heart disease, that is
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  related to thin outside and fat inside. So we in
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  India and Southeast Asia, we are actually thin from the top.
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  Our legs are thin, our muscles are less, everything is applied.
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  But the fat is more from the inside. The adipose
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  tissue that we call, like our stomach is more. Around
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  the liver, around the heart, around the intestines, fat is more.
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  And this visceral fat, which is our genetical, according to genetics,
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  it causes the most damage. So even if we look thin,
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  and according to body mass index, even if we are
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  between 23 and 25, But still, our heart is suffering.
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  And this is our genetics. That's why the same thing
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  raises triglycerides for us, lowers HDL cholesterol, resists insulin. That's
• 3:46
  the same damage it causes to our heart. In fact,
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  we have seen adipose tissue, which is the fat of
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  the stomach, adipose tissue around the intestines, harms the liver.
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  It harms the heart. And it produces some inflammatory process
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  which damages our arteries and produces atherosclerosis. Correct. So, people don't.
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  Speaker 1: Understand this visceral fat. So, I want you to spend
• 4:11
  some time on it.
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  Speaker 2: So, let's take the idea that this is our fatness
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  which we see all around us. Overall. We are completely fat.
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  And one is that we look thin from the top.
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  But inside, our... Intestines around, which is not visible, fat
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  is deposited there. Liver, which is not visible, fat is
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  deposited around it. Heart, which is not visible, fat is.
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  Speaker 1: Deposited around it. And you have not done anything to
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  do this, genetically or more inclined?
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  Speaker 2: Genetically inclined. Okay. So that's the first thing. That's why
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  in India, the obesity of the stomach is more visible.
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  So what do we say, what is obesity in India?
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  The figures of the West that BMI should be above
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  30 does not fit in India. And leave BMI. Simple fact.
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  If I say what is fat in India, then you
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  measure your waist circumference because that is your fat. Correct.
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  That is the visceral fat. Hip to waist ratio. I
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  will say only waist. If it is more than 90
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  centimeters in adults, in women it is more than 80 centimeters.
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  Speaker 1: So, there's a problem.
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  Speaker 2: So, think that he is measuring your visceral fat. And
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  we don't need to measure any BMIs.
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  Speaker 1: Yeah, BMI is not the gold standard anymore. That's been established.
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  But what is interesting is that you are saying, link
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  directly to your heart. That is so important.
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  Speaker 2: And the fatness of the stomach, which is the fatness
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  of the inside. The fatness of the inside. The fatness
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  of the inside. The fatness of the inside. The fatness
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  of the inside. The fatness of the inside. The fatness
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  of the inside. The fatness of the inside. The fatness
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  of the inside. The fatness of the inside. The fatness
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  of the inside. The fatness of the inside. Earlier, we
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  used to think that if it's going on in the family,
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  then maybe there's a marker that tells us that maybe
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  the heart disease is more. Now, this is a risk factor.
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  And in our India or Southeast Asia, it is found
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  more than the West. This is again genetics. LPA has
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  come a lot in our people. Unfortunately, these population-based studies
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  have not been done in India. But at least in groups,
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  it has been seen, and in other countries' population-based studies,
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  it has been seen that there is more LPA in India.
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  And if this LPA is high only in the West,
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  then we will say that the risk factor has increased
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  by one and a half times. But in India, it
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  has also been seen that if the LPA of the
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  same level is high, then there is three times more
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  heart disease in India. So we are suffering from two
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  sides of genetics. So then when it came to what
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  else is there in India, then it is clear. World
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  capital of diabetes, world capital of hypertension, 30% adults above
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  the age of 30, high blood pressure. So actually, this
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  is our genes and this is our fate. So one Indian,
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  one loaded gun, which we will say if triggered, then
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  heart attack happened. Unfortunately. Hmm.
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  Speaker 1: That's a lot to process.
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  Speaker 2: I didn't mean to frighten anybody. It's a good start.
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  Speaker 1: I'm very glad you brought it up because it's a
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  good start. Because if we don't even identify that as
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  a problem. See, what's the problem, Dr. Seth? In India,
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  people have taken it like this. If you're old, you'll
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  have BP. If you're old, your weight will increase. You'll
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  have diabetes. You'll keep taking medicines and you'll be fine.
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  That mindset, I don't know if you are seeing in
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  your clinic. I'm seeing in people around me that mindset
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  is shifting. Younger people are now saying that, listen, I
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  don't want to live with blood pressure. I want to
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  ensure I can delay it as long as possible because
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  genetically I know I'm going to get it. Diabetes runs
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  in the family. Blood pressure runs in the family. I'm
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  going to get it one day. But how do I
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  ensure that I delay it as long as possible?
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  Speaker 2: And I think it's a good mindset. And it's happened
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  in two ways. One, more education is happening through exactly
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  what you're doing today is happening. And the other factor is,
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  of course, those visuals of people suddenly dying, collapsing, etc.,
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  which is coming up more because of social media, etc.,
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  which used to happen earlier, but more. Because of that,
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  people say, in fact, patients come to me now, young ones,
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  between 30 and 40, they say, why? Have you done
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  this test? Because this has happened to a friend of mine.
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  Because I saw that visual on which it happened. I
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  also do exercise. I also do. I thought I will
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  do a test. Now that is very different to what
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  we have seen 10 years ago.
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  Speaker 1: Yeah, yeah. And I just want to say that a
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  lot of times television headlines become out the fact that
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  they used to exercise, take protein powder, that's why they
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  have a heart attack. Can you bust this myth? Absolutely.
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  What is the relationship between exercise and heart health? How
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  much exercise... is okay and where do you need to stop?
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  Speaker 2: So, there are two things. You asked the right question,
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  what is good exercise and what is good heart health.
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  But also, should that person be shooting a video? Should
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  not he be resuscitating that person who collapsed in front
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  of him? The two important questions come to my mind.
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  And I'm even more frustrated by the fact that that
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  person whose video was being pulled could have actually been
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  saved by the person who was pulling the video.
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  Speaker 1: That intervention could have saved his life.
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  Speaker 2: But anyway, let's come back to this. Heart health and bodybuilding,
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  physics are two different things altogether. One is muscle building.
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  And that is, of course, increasing with increased gyms up,
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  looking fit, etc. That's looking fit. But it doesn't mean
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  your heart is actually fit. It is not, you know,
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  taking all those, you know, steroids, etc. for building your
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  body is one aspect of that. But the other aspect is,
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  which is well known fact, if we do severe exercise,
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  If we suddenly do severe exercise, heavy weight lifting or
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  extreme sports, suddenly, then we don't know how our arteries are.
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  Are there blockages inside us or not? And even any
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  minor blockages which are not giving us symptoms, suddenly with
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  severe exercise can cause heart attack. If we are smokers,
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  then severe exercise can cause heart attack. Because severe exercise
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  increases blood pressure. Heart rate increases, arteries are strained, and
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  the same blockage that didn't have to do heart attack,
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  suddenly did heart attack. So we should differentiate that if
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  we are going on severe exercise, weightlifting, extreme sports, or
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  we are thinking that we have to run half marathon
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  in adult, then heart checkup is very important. And then
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  we start gradually. Yeah. That is a disaster. Don't try
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  to be macho about it. It is a disaster in making. Yes,
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  there are a few other conditions which are of the heart.
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  They run genetically, run in the family. And it is
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  known whether someone in the family has had a sudden
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  death or not. There are arrhythmias, there are conditions of
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  the heart muscle. They often precipitate in severe exercise. That
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  is why I will say after 30 years, these collapses
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  are definitely due to heart attack. In less than 30 years,
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  it could be any of those genetic disorders as well
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  as rare episodes of heart attack. Yeah. You know, you
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  may remember one of the celebrities who exercised for two
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  hours and suddenly collapsed and died. And everybody said, and
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  he was only 42, etc. And nobody knew that he
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  actually smoked 15 cigarettes a day. Yeah. And smokers, I
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  get this regularly, absolutely perfect life. 45-year-old says, I learn everything.
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  Look at my food. Mediterranean diet. I have left this,
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  I have left that. Looking absolutely fit. I jog for
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  15 kilometers. I say, I am scared about you. Because,
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  what's wrong with you? Do you smoke? Yes, I smoke.
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  I said, I am scared about you. You are exercising
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  for 15 kilometers. It will happen like this. One day,
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  a clot will come. And you will collapse and die.
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  Why are you smoking? This is the sadness of it
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  because smokers have that sudden cardiac death. They could have
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  actually been smokers because smoking itself precipitates clotting in the
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  even normal arteries. After 25 years of smoking, I have
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  seen heart attacks whose arteries are full of clot, there
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  is no blockage. And then we actually on the angioplasty
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  table are extracting those clots, trying to actually prevent the
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  heart damage. And that heart damage, I've got so many patients,
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  at least, at least I must have a thousand young
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  people between the age of 20 to 25 or even more,
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  who have heart attacks just because of smoking, whose heart
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  has been damaged so much that their normal heart functioning,
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  those heart attacks are very dangerous because they're happening on
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  normal arteries. Suddenly the artery is closed.
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  Speaker 1: Is vaping also equivalent to smoking?
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  Speaker 2: Yeah, vaping is bad. Vaping, all it's taking away is
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  nicotine part of it. Sorry, paper part of it. It's
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  just taking away the bad products of the paper it's
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  taking away. But it doesn't take away the other bad
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  effects on the arteries of the heart. So vaping is
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  just a consolation of trying to make it more socially
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  acceptable but still continuing to harm us and harm you
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  And if you keep doing this, you will get a
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  heart attack. And that heart attack, by the way, every
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  heart attack is shortening a life. So sometimes feel bad
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  for that 20-25 year old who had a heart attack.
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  Whose life of 80-90 years, maybe 100 years, gets cut
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  down to 50 years, 60 years only.
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  Speaker 1: Yeah.
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  Speaker 2: It's sad.
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  Speaker 1: Yeah, but every time people say this about smoking, my
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  mind triggers into this other problem, which is that if
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  I stay in Delhi, I am a smoker, sir.
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  Speaker 2: That's true.
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  Speaker 1: If I'm, you know, breathing in this polluted air, so
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  we are all at risk.
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  Speaker 2: I think everyone is scared.
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  Speaker 1: No, it's good to know.
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  Speaker 2: I really hope.
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  Speaker 1: I know, I know, I know what you're saying. But
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  I really hope the purpose of this conversation is.
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  Speaker 2: That we are able to Put a perspective. No.
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  Speaker 1: Get the right knowledge. And for us to push our
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  government also to say that, listen, my health, just by breathing,
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  I'm taking away like 8-10 years of my life here, right?
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  Speaker 2: Do you know what I say for smokers? What? You
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  left smoking. Now, don't even mix with the friends who smoke.
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  Because even if you keep smoking passively, you get a
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  30% increase in risk of heart attack. Your friend is smoking.
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  What is this? Now, stop smoking. Give it up. Nicotine
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  is one of the worst things that we've actually seen
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  in life. And let's not even passively smoke. But you're
• 15:29
  right about this pollution. You said, we're also smoking a
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  cigarette every day. Not just one, sir.
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  Speaker 1: In worse conditions, it's 20 to 23 cigarettes a day.
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  Speaker 2: So, pollution, of course, is something we need to take
• 15:44
  very seriously.
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  Speaker 1: You said about an LPA test. I think it's very
• 15:47
  important to clarify. It doesn't cost too much. You have
• 15:50
  to get it once in a lifetime. right, to just understand.
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  Would you suggest that young people, when you say should
• 15:57
  know more about themselves, get these tests done?
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  Speaker 2: Absolutely. Look, prevention of heart disease is no rocket science.
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  And I wouldn't say any government initiatives are needed. In fact,
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  it's the cheapest thing to do. And I'll explain that.
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  In my own life, it's the cheapest thing to do
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  in everybody's life. But let's consider this, that tests should
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  be done sometimes. which also includes the LPA. So we
• 16:24
  say once in a lifetime is correct. But clearly, in India,
• 16:28
  every person's cholesterol, which is lipid profile, should be at
• 16:33
  the age of 10. Because heart disease starts very early.
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  Deposits start very early.
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  Speaker 1: Ten years.
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  Speaker 2: It has been actually seen that those who have a
• 16:43
  tendency to cholesterol, those who have high cholesterol, those who
• 16:46
  have heart disease in their family, and those who have
• 16:49
  a history in the family, that father, mother at an
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  early age in life, less than 55, 60 years, Ya
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  to heart disease hoi hai, ya deaths hoi hai, ya
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  bypass surgeries hoi hai, ya siblings mein, ya unke siblings mein.
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  Speaker 1: Which is practically 90% of North India.
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  Speaker 2: Exactly. To ye to karna hi hai. Unke sab ke
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  liye karna hai. It's now a standardized care. The second
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  aspect is ki agar sab kuch theek nikla. Tabhi to
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  wo familial hypercholesterolemia, ye wo pick up ho jaata hai,
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  jo early in life, tabhi se treatment shuru ho jaa,
• 17:19
  to future mein hum bach sakte hai. But agar wo
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  sab theek nikla, to then by the age of 20,
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  again becomes a must. And then we know that heart
• 17:27
  disease starts very early. So if it comes out right,
• 17:30
  then you keep testing it for 5-6 years. And after
• 17:33
  30-35 years, you test it for cholesterol every year. Now,
• 17:38
  it's not just about cholesterol. And we know that we
• 17:40
  have to do LDL, we have to do HDL, we
• 17:42
  have to do triglycerides, we have to do LPA. But
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  LPA is done once in life because that test does
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  not change. The point is to find out the risk factors.
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  And cholesterol is the only risk factor. So along with that,
• 17:56
  we should also get a sugar test done. And at
• 17:58
  the same time, get a BP check done. If we
• 18:02
  know these three risk factors, then we have taken our responsibility.
• 18:07
  Because preventing heart disease is in our hands. We say
• 18:12
  we want this, we want that, we want a huge
• 18:15
  number of rules, regulations, etc., etc. But if we regularly
• 18:18
  know these three risk factors, then we can prevent heart
• 18:21
  disease ourselves. This is our responsibility. So, we have to
• 18:27
  take care of ourselves. The other thing I said about
• 18:30
  checking BP. So BP check, we know that in most countries,
• 18:35
  when BP is diagnosed, 50% of people have uncontrolled BP. Gradually,
• 18:39
  kidney damage keeps happening. They say, we are taking one pill,
• 18:42
  don't increase it more. Some doctor says, do you have
• 18:45
  uncontrolled BP? No, no, it was fine at home. Whenever
• 18:47
  we measure, it feels very good. We know that if
• 18:50
  we had a headache for a year, we would have
• 18:52
  taken BP. So there are so many myths that are
• 18:56
  going on. And some people don't even know, most people,
• 18:59
  how do they check their BP at home?
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  Speaker 1: How do I know that if I have uncontrolled BP?
• 19:07
  And I think you asked a very.
• 19:08
  Speaker 2: Right question and let me just close this. Yes, that's
• 19:11
  a fact, not a myth. But how much is it?
• 19:29
  If I am getting 180, which is really very high BP,
• 19:33
  then how can your house be 110? 10-20 mm variation
• 19:39
  will be there. So, really, the way it's checked is,
• 19:42
  sit at the table. Sit at the table comfortably, like
• 19:46
  I sit with you. But don't talk to Sonal at
• 19:49
  that time. In fact, before that, and you don't have
• 19:55
  to drink coffee. Before that, you don't have to eat
• 19:58
  any heavy food. You don't have to drink tea or coffee.
• 20:02
  It should be in a relaxed situation in which you
• 20:05
  are not talking to anyone. Yeh nahi ki ghar mein
• 20:08
  jhagda hua hai. Uske baad kaha ki BP ab check
• 20:11
  kar lijiye. So, ab aap usko rakhiye haath pe. Be
• 20:15
  comfortable in the chair. Comfortably. BP instrument bhi ussi level
• 20:21
  pe hona chahi. Jisra aapka haath hai. Aur haath aapke
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  heart ke level pe hona chahi. Joki yeh hai. Aapka nipple,
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  aapka haath hai.
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  Speaker 1: So, this level is fine.
• 20:30
  Speaker 2: This level is fine. Uske baad aapne cuff jo baadna
• 20:34
  hota hai. Wo yeh aapki jo elbow hai, usse approximately
• 20:39
  1 inch ya 2 cm upar aapka cuff hai. Aaj
• 20:42
  kal har cuff pe arrow bani hoti hai ki artery
• 20:46
  kahan pe hai. Artery hoti hai, agar yeh lele crease,
• 20:50
  to uska 2 third or 1 third agar join kar le,
• 20:53
  wahan pe artery hoti hai. Wahan pe arrow laga de.
• 20:57
  Phir aap apna button dabaye, aur aapka automated BP check
• 21:00
  ho raha hai. Jab automated BP check ho raha hai,
• 21:03
  to aap relax rahi hai, You will get one blood
• 21:06
  pressure reading. After that, take another reading after 3 minutes
• 21:09
  to 5 minutes. And take a third reading and average it.
• 21:14
  And if you really want to understand whether your BP
• 21:18
  is there or not. If you get a good reading,
• 21:20
  then it's good that you checked in between. Otherwise, if
• 21:23
  you really want to do it and if you want
• 21:25
  to see whether your control is right or not. Then
• 21:28
  twice a day. Before dinner and before breakfast. Check twice.
• 21:36
  And that's your real BP. Is there a preference on
• 21:39
  the hand? Nothing. There's a very minor difference in the
• 21:42
  two blood pressure readings. It's a myth that left should
• 21:43
  be given. Absolutely. It's absolutely a myth. When we do this,
• 21:47
  these are our right readings. And if this is followed,
• 21:50
  then we accept it. I spend half the time in this.
• 21:52
  How did you take it? Now I explain to you
• 21:54
  the same thing that I have explained to thousands of
• 21:57
  people through you. But these are all very important things.
• 22:03
  And that's why I'm happy that we are able to
• 22:04
  educate people through this.
• 22:06
  Speaker 1: Yeah. When it comes to issues like blood pressure, let's
• 22:10
  call it the birthday tests. Right.
• 22:12
  Speaker 2: Right.
• 22:12
  Speaker 1: So basic test which is know your risk factors.
• 22:14
  Speaker 2: Yeah. Now, if your family has a history, but you
• 22:35
  are still fine, then by the age of 30, beyond 30,
• 22:39
  or I would say beyond 35, get a calcium scoring done. Personalized,
• 22:45
  if we want to see personalized, if we want to
• 22:46
  see community-based, then we won't say because after all, expense
• 22:49
  goes into everything.
• 22:50
  Speaker 1: So this is for someone who has a family history.
• 22:53
  Speaker 2: Who has a family history, who's got a risk factor,
• 22:55
  diabetes has come at an early age, you know, high
• 22:58
  blood pressure is going on, obesity is there. They should
• 23:01
  always get a calcium scoring done by the age of 35.
• 23:04
  Calcium scoring is such a thing. CT doesn't die. It's
• 23:08
  a simple test. It's a five-minute test. I've done calcium
• 23:10
  scoring on personalization. I've done it on my family as well. So,
• 23:13
  how do you take it? No, not from the blood.
• 23:16
  Once CT scan is done.
• 23:17
  Speaker 1: Okay.
• 23:18
  Speaker 2: CT scan machine has to go for two minutes. It
• 23:21
  tells calcium of arteries that how much calcium is deposited. Now,
• 23:26
  this guideline is directed that if calcium is deposited a little,
• 23:30
  it means blockages have started. And if blockages start at
• 23:34
  the age of 35, then we have to control the
• 23:36
  risk factor more. We have to bring down the LDL,
• 23:39
  which we call bad cholesterol, from a target level. So
• 23:43
  then we become those targets. We are not just testing,
• 23:47
  but we don't know what the target is for us
• 23:50
  and at what level we should bring it so that
• 23:52
  we don't have heart disease in the future. So then
• 23:57
  the doctor calculates what our risk factors are and at
• 24:00
  what level we should reach. That makes us far more
• 24:03
  careful that our heart disease has started. Now, I have
• 24:06
  said this test, but in life, an echo should also happen.
• 24:11
  Echo is a simple test. Think, what is an ultrasound
• 24:13
  scan of the heart? Congenital heart disease, which is not
• 24:16
  known in childhood, when it presents in adults, when the
• 24:20
  heart is completely damaged, then breathing, heart enlargement, then symptoms
• 24:26
  come and it is a pity that this thing, someone
• 24:29
  has put a stethoscope, If someone had done an echo,
• 24:32
  then it would have been caught in childhood and it
• 24:35
  would have been treated. So heart disease, congenital heart disease,
• 24:38
  something serious happens. At that time, many heart diseases, holes
• 24:42
  in the heart, you don't know. You don't know. And
• 24:45
  that damages a lot. So basic test, I would say,
• 24:47
  should be done once in life during early part of life.
• 24:51
  I have done an echo of my 8-month-old granddaughter. Really?
• 24:57
  Because why not? I need to know she is fine.
• 25:00
  I don't want to know by the age of 22
• 25:02
  that she had some other disorder which we missed. Wow.
• 25:06
  And then, as we go on in life, yes, we
• 25:09
  should get somewhere between 20s and 40s echo. That is
• 25:14
  when we say, after 40 years, we should also echo
• 25:16
  in annual testing because we don't consider it as a test.
• 25:20
  We consider it as a part of examination. If we
• 25:23
  apply stethoscope, echo is available in every small city. And finally,
• 25:29
  when we go further and further, we talked about personalized
• 25:31
  testing of stress test. If there is any symptom or
• 25:35
  mild symptom, then stress test should be done. But I
• 25:38
  don't recommend routine. When the doctor says, then only. Because
• 25:42
  the TMT available routinely, it has 40% false positives. 40%
• 25:47
  false positives means that you are good. You are fine.
• 25:52
  You got a TMT done in regular testing. TMT positive,
• 25:56
  40% false positive came. After that, your advanced tests started,
• 26:01
  whereas you are a normal person. So, in a way,
• 26:05
  we are saying, those who have risk factors, they should
• 26:08
  definitely do advanced testing. But those who do not have
• 26:11
  risk factors, they should not go for advanced testing until
• 26:16
  a doctor says so.
• 26:18
  Speaker 1: This is a very important clarification. I did not know
• 26:20
  that TMTs are 40% false positives.
• 26:23
  Speaker 2: Absolutely. And then.
• 26:25
  Speaker 1: And this is also done by insurance companies. Absolutely. If
• 26:28
  you are going for a job, then there is also
• 26:30
  a test.
• 26:31
  Speaker 2: Absolutely. Because it's an external test. We do it because
• 26:36
  it's routinely and regularly available at every small place. It
• 26:41
  is a simple test. It's a cheap investigation. But it
• 26:45
  has to be coupled with risk factors. If a healthy
• 26:48
  person who has no symptoms, is exercising, has no risk factors,
• 26:52
  his TMT is positive, which is in fact even more common.
• 26:55
  So we'd say if 30% false positives come in men,
• 26:58
  then up to 50% false positives can come in women.
• 27:02
  And that is what differentiates us. So when we sit
• 27:04
  in OPD, actually... 10% of the patients come to me
• 27:08
  for check-up and say, we had done TMT, we had
• 27:10
  done routine check-up, TMT positive has come. They come petrified
• 27:14
  that we have heart disease, what to do now? Half
• 27:18
  the family is petrified by then and I am smiling.
• 27:21
  I am smiling because I say, you don't have risk factors,
• 27:25
  you don't have any symptoms. You say, I do breast
• 27:26
  walking for 5 kilometers, I even run in it. This
• 27:30
  will be false positive. After that, I still get it
• 27:33
  done non-invasive. Either CT angiogram is done or better exercise,
• 27:38
  nuclear scans are done. And then when I meet next time,
• 27:41
  I say, I told you, you have nothing. And that
• 27:44
  is what it is.
• 27:45
  Speaker 1: So, if TMT is not a good marker, then which
• 27:48
  other markers are there? You said that if you are
• 27:51
  in a high risk category, that is, you are genetically
• 27:54
  more inclined, you have a family history, you live a
• 27:57
  very stressful life. If these are the factors, then you
• 27:59
  said that you should also do a calcium scan.
• 28:02
  Speaker 2: If your calcium score is high and zero is the
• 28:05
  best number, then we say that your chances of heart
• 28:09
  attack are very low. Maybe like the normal population. But
• 28:15
  if the number is high, and it goes from 0
• 28:18
  to 100, above 400 means there are important blockages. Or
• 28:22
  there could be. Then what do we do? Then we
• 28:25
  say either we do CT angiography or we do nuclear scan.
• 28:31
  Nuclear scan is the best test. It's an advanced test.
• 28:35
  It's done in all the good cardiac centers. It's an
• 28:39
  expensive test. That's why we do it sequentially, that we
• 28:41
  pick up the cheap test first. After that, go for
• 28:45
  more advanced tests to exclude them. And the same thing
• 28:47
  should be done by the doctor. Angiography should not be
• 28:51
  done on this basis that TMT is positive. Unless symptoms
• 28:55
  are happening. And what are the symptoms of heart disease?
• 28:58
  That there is heaviness in walking. It is getting easier
• 29:01
  to stop. When I climb the stairs, I get breathless.
• 29:04
  I cannot do those things which I used to do earlier.
• 29:08
  Those are the symptoms of heart disease. So only then we...
• 29:12
  So we spoke about genetics, but there is a huge
• 29:14
  population right now because of the lifestyle that we lead.
• 29:18
  High stress, bad diet, no exercise. There are a lot
• 29:22
  of young people.
• 29:30
  Speaker 1: But there is a huge population right now because of
• 29:33
  the lifestyle that we lead. High stress, bad diet, no exercise.
• 29:39
  There are a lot of young people have early onset
• 29:43
  of diseases as well. For those people, what are some
• 29:48
  early signs that they should watch out for? You said
• 29:51
  if you're getting breathless... With a little bit of activity,
• 29:55
  that's one. Anything else to watch out for?
• 29:57
  Speaker 2: So there are a few signs. And the signs differ
• 29:59
  from men to women. And that's very important. Because we
• 30:04
  are a capital of heart attacks in the world. 50%
• 30:07
  of deaths from heart attack happen from our own country
• 30:10
  or this part of the world. We are three times
• 30:13
  more prone than the West to have coronary artery disease,
• 30:16
  six times more prone than Chinese, 20 times more prone
• 30:19
  than Japanese. And heart disease happens 10 years younger in
• 30:22
  our population. We die from heart disease far more commonly.
• 30:26
  And that's, we've just talked about that. So that's why
• 30:29
  it's very important for young people to understand heart disease.
• 30:32
  What are the symptoms? For women, the highest cause of
• 30:36
  heart attack is the highest cause of death in men,
• 30:38
  but also in women. In our own country, six times
• 30:40
  more than cancers, six times more than women cancers. So
• 30:43
  when we say that, symptoms sometimes are real. I mean,
• 30:46
  the commonest symptom is discomfort in the center of the
• 30:50
  chest on exercise and brisk walking.
• 30:54
  Speaker 1: Okay.
• 30:55
  Speaker 2: Climbing stairs.
• 31:02
  Speaker 1: But can you describe what discomfort is? Because people might
• 31:07
  confuse a bit of a wind getting trapped or a
• 31:10
  bit of a gastric thing to discomfort. Like how do
• 31:13
  I know this is a heart related issue or this
• 31:15
  is a gut related issue?
• 31:17
  Speaker 2: Very important. And in fact, both the symptoms can mimic
• 31:20
  each other. So actually, this is the very right point
• 31:24
  you asked. I don't want to differentiate. Because the commonest
• 31:29
  symptom is a pressure on the chest, which goes down
• 31:32
  the arm when you exercise. It can go up also
• 31:35
  the neck. And it goes away when you sit down
• 31:38
  or stop in the next five minutes. But some people
• 31:41
  will get actually a gastritis. It's burning. I feel gas
• 31:46
  in my walking. But if I stop and take two diagenes,
• 31:50
  I get better. Don't. Anything which is coming on exercise,
• 31:55
  including breathlessness, including pain even in the back on exercise,
• 31:59
  pain in the jaw on exercise and brisk walking, should
• 32:02
  not be ignored. Because exercise-related, any form of discomfort, including gas,
• 32:08
  is likely to be a heart problem. In fact, you know,
• 32:12
  you asked such an important point that these gas-related things...
• 32:16
  That heart attacks, we are missing out. 15% of heart
• 32:22
  attacks and people are damaging their heart thinking that it
• 32:25
  was gas and maybe they ate rajma at night or
• 32:28
  they went out to eat. And the whole night they
• 32:30
  keep eating gas, keep eating diogenes. By the time they
• 32:35
  land up in the hospital, their heart is badly damaged
• 32:38
  because 8 to 10 hours have passed by. So it will,
• 32:41
  it's okay. The heart attack symptom is very severe. At
• 32:45
  that time, it feels like sitting and sitting, suddenly, such
• 32:49
  severe chest pain, absolutely crushing, sweating, anxiety, nausea, vomiting, sense of,
• 32:57
  you know, doomsday has come. Pain in both hands. So
• 33:00
  that's okay. That's a typical one. That's clear. That's clear.
• 33:03
  That's clear. That's clear. That's clear. That's clear. That's clear.
• 33:09
  But this gas-like feeling, that also constitutes at least 20%
• 33:13
  to 15% to 20% heart attacks. Gas hit, didn't know. So,
• 33:18
  this is also a very important message. That if that
• 33:21
  gas is unusual to a person who never had acidity,
• 33:25
  or you didn't get relief in a diagenetic tablet in
• 33:29
  15-20 minutes or half an hour, Please go to the hospital.
• 33:34
  Make an ECG. Don't self-diagnose yourself. Because ECG is the
• 33:39
  only way to diagnose a heart attack. But saving the heart.
• 33:42
  Saving the heart from a heart attack is very important.
• 33:45
  If the heart is damaged, our longevity of life is affected.
• 33:49
  So don't take these decisions yourself.
• 33:51
  Speaker 1: You said something very important. You said if while exercising
• 33:54
  your back is hurting and your jaw is hurting, that's
• 33:57
  also a sign of a heart problem.
• 33:59
  Speaker 2: That's right. And it goes away when you relax, when
• 34:02
  you sit down. It could be a sign. It could
• 34:04
  be a sign of a heart problem. Get investigated. That's
• 34:08
  the way when we say, okay, let's get a TMT done.
• 34:13
  Let's get a TMT. Let's get a thallium scan done.
• 34:16
  Let's know that your symptoms, when we run you, are
• 34:19
  they reproduced in ECG or not? Are they reproduced in
• 34:22
  scans or not? Are you telling us that you have
• 34:25
  heart disease or not? That's the issue. Don't ignore any
• 34:29
  symptoms which is unusual related to exercise. In women, the
• 34:34
  symptoms of pain are less. The discomfort is less, which
• 34:37
  we typically call squeezing chest pain. And also in diabetics,
• 34:41
  silent heart attacks, just had a bit of fear, a
• 34:45
  bit of sweating, nothing much, a bit of acidity, a
• 34:50
  little pain here and there. You know, symptoms which are
• 34:54
  absolutely would be passed off as something else rather than
• 34:58
  that squeezing severe chest pain actually happen in women. The
• 35:01
  intensity is less. So often gets missed. And this is
• 35:06
  why we are very more careful in women. Diabetics will
• 35:10
  have a silent heart attack. These are the people who
• 35:21
  pass away in their sleep. They can pass away in
• 35:23
  their sleep. Or present a few days later saying, And
• 35:27
  when we find that the heart is badly damaged, but
• 35:30
  they could not relate that that episode till we tell them,
• 35:33
  And it just passed off the next day. So we
• 35:45
  got to be very careful in diabetics and in women
• 35:48
  by the atypical presentation, which could just be nausea, vomiting
• 35:52
  and the symptoms I've told you.
• 35:53
  Speaker 1: You are saying that in women, the signs are going
• 35:56
  to be much milder.
• 35:58
  Speaker 2: Could be milder and atypical.
• 35:59
  Speaker 1: And atypical.
• 36:01
  Speaker 2: Atypical. Atypical means there's a nausea, vomiting and ghabrahat. A
• 36:05
  bit of sweating. A bit of saans phoolna. So these
• 36:09
  are atypical. The typical means, you know, with severe chest
• 36:12
  pain going down the arms.
• 36:13
  Speaker 1: So go to your cardiologist, get an ECG done image
• 36:16
  at least.
• 36:17
  Speaker 2: At least. Especially chest. More so, if you have risk factors.
• 36:20
  If you are diabetic. More so, if your family is
• 36:24
  suffering from heart disease. More so, if you have hypertension. So,
• 36:28
  these are the things which happen, we should be careful about.
• 36:34
  Speaker 1: So many important things that you've mentioned over there, right
• 36:37
  from how to measure your blood pressure right, how to know.
• 36:40
  Speaker 2: All of it.
• 36:41
  Speaker 1: But in all these years of experience, Dr. Seth, what is.
• 36:47
  Speaker 2: Do you think.
• 36:50
  Speaker 1: The biggest mistake that Indians make when it comes to
• 36:54
  their heart?
• 36:55
  Speaker 2: Let's differentiate between heart attacks. Let's differentiate heart blockages. Heart attack.
• 37:04
  Heart attack. Heart attack. Heart attack. Heart attack. Heart attack.
• 37:09
  Heart attack. Heart attack. Heart attack. Actually, some of those
• 37:19
  heart attacks are not even heart attacks, for example. It
• 37:23
  could just be dehydration. Garmi bahut hai, khade hue the,
• 37:26
  paani nahi piya tha. This happens very commonly. Collapse kar gaye.
• 37:30
  Aur seetha ussi wakad sorbitrate de di gayi. I will
• 37:34
  tell you this. The other day, a young lad of 34, 35,
• 37:41
  who actually had a faint related to dehydration, etc., Because
• 37:45
  he hadn't eaten anything. It was claustrophobic atmospheres, etc. And
• 37:50
  he said, I'm sweating. And he had sat down. And
• 37:55
  his mother, being very intelligent and being a heart patient, said,
• 37:58
  give him sobriety. And can you believe what was just
• 38:03
  a common faint, which would be cured with two glasses
• 38:06
  of water. The guy came in with a 70 blood
• 38:10
  pressure systolic, which is really cold, clammy. And it took
• 38:14
  five hours for the BP to actually come up by
• 38:17
  giving fluids and drugs. Just because the sorbitrate has done
• 38:20
  more harm than good.
• 38:21
  Speaker 1: Gosh.
• 38:22
  Speaker 2: Because the sorbitrate drops the BP suddenly. So the thing
• 38:27
  that recovers like this with two glasses of water, it
• 38:30
  recovers after five hours. It became dangerous. So sorbitrate is
• 38:34
  an unnecessary drug unless the heart disease is known. And
• 38:37
  we know that we are taking it for our symptoms.
• 38:40
  And we know that this sorbitrate will give us relief
• 38:42
  by taking half a pill. then take sorbitrate.
• 38:45
  Speaker 1: If you are not taking sorbitrate, then suppose I am
• 38:50
  rushing somebody, my mom, my sibling or whatever to the hospital.
• 38:54
  Is there something I can do in the interim to help?
• 38:57
  Speaker 2: Absolutely. The most important drug and there is only one
• 39:01
  important medication which you can take yourself that is aspirin tablet. Dispirin. Really? Yes.
• 39:11
  Dispirin tablet should be available to everyone.
• 39:13
  Speaker 1: Hmm.
• 39:14
  Speaker 2: So you don't have to take it with water? Its
• 39:21
  effect comes in your body in practically 15 minutes. So
• 39:24
  you don't have to take it with water? No, not
• 39:27
  with water. Because it is absorbed in the stomach. If
• 39:29
  you crush it, if you chew it, it becomes powder immediately.
• 39:34
  And if it becomes powder, it is absorbed immediately. Right
• 39:39
  from the mouth to the stomach, it is absorbed. That's
• 39:42
  why the effect comes in 10 to 15 minutes. Okay.
• 39:46
  And if the effect comes in 10 to 15 minutes,
• 39:48
  in 5 minutes the effect starts, in 15 minutes the
• 39:50
  platelet activation actually starts to complete. And it acts fastest.
• 39:55
  Because what is the reason for heart attack? There were
• 39:58
  blockages in our arteries. The blockage suddenly ruptured. That started
• 40:02
  clotting on it. Our artery got blocked with clot. Think
• 40:07
  that there is a drain, there is a pipe in
• 40:08
  our house. It was getting narrowed from the beginning. Dirt
• 40:11
  got stuck and water got blocked. Now we put that
• 40:16
  in the drains. Drain X. Think that aspirin is a
• 40:20
  drain X. Which works immediately. So that's all. That's why.
• 40:26
  And are there side effects? No. There is no side
• 40:30
  effect of aspirin.
• 40:31
  Speaker 1: But when you reach the hospital.
• 40:37
  Speaker 2: Right. Wow.
• 41:03
  Speaker 1: We have told everyone that it doesn't mean that you
• 41:05
  will get an aspirin as soon as something happens. Please
• 41:07
  understand in detail. The reels of this podcast, you don't
• 41:10
  have to make a decision just by looking at the reels.
• 41:12
  You have to listen to the entire podcast. You have
• 41:15
  to get the information. You have to get the full information.
• 41:19
  Then you have to act on this.
• 41:21
  Speaker 2: You won't believe this, sir. Why it keeps on educating me?
• 41:26
  Because she sees reels. And she sees... Should I keep
• 41:29
  these four pills with me? Heart attack somewhere? Or do
• 41:34
  you keep these four pills? She has a heart attack kit.
• 41:38
  She has a heart attack kit for me even. You
• 41:41
  should keep these four pills. And I say, gosh. There's
• 41:45
  only one tablet that I want. Not four tablets. Because
• 41:51
  that is included. You can take Torvastatin. You can take
• 41:54
  another tablet. You can take Sorbitrate. I said, if someone
• 41:58
  takes these four tablets, then I won't want it. I
• 42:01
  have only one kit.
• 42:03
  Speaker 1: These deals are very dangerous. But you're saying, if you
• 42:05
  want to keep one thing handy, that's an aspirin. And importantly,
• 42:09
  you don't have to swallow it.
• 42:11
  Speaker 2: You have to chew it. You have to chew it.
• 42:14
  Speaker 1: That's important. Another aspect of these heart attacks and sudden
• 42:18
  deaths is also people dying in their sleep. Back in
• 42:21
  the day, it used to be said that the best
• 42:23
  way to go is to sleep.
• 42:25
  Speaker 2: That's the saddest.
• 42:27
  Speaker 1: Way for the family. It is the saddest way and
• 42:29
  I'm seeing that this is happening to younger people now. Yeah,
• 42:32
  it is.
• 42:33
  Speaker 2: It is and it's sometimes sad. Yes, there is a
• 42:35
  proportion who die in their sleep. There are many reasons
• 42:38
  for that.
• 42:39
  Speaker 1: And.
• 42:40
  Speaker 2: Some of the reasons relate, especially early in the mornings,
• 42:43
  and some of the reasons relate to, but this is
• 42:47
  a small proportion. It's not increasing. It's a small proportion.
• 42:51
  Numerous hormonal changes in the body happen during that time. Normally,
• 42:55
  the blood pressure falls during sleep, but there are instances
• 42:58
  where it actually rises. There are instances where tachycardia can occur.
• 43:02
  There are instances where certain hormonal balances change for the worse,
• 43:06
  including platelet stickiness, which is highest in the mornings. Related
• 43:10
  to steroids and the body changes of steroids. And that's
• 43:13
  why some of these can cause rhythm disturbances at night.
• 43:17
  Some of these cause increased clotting early in the morning.
• 43:20
  And that's what happens.
• 43:21
  Speaker 1: A lot of people take sleep medication.
• 43:24
  Speaker 2: Yeah, but I would say the sleep medications don't relate
• 43:27
  to these sort of situations. But there are others which
• 43:31
  actually can relate to. Such disorders. What is really important is,
• 43:36
  that's why the platelet secret is, that's why we say
• 43:38
  heart attacks happen the most early in the mornings.
• 43:41
  Speaker 1: Okay.
• 43:41
  Speaker 2: And that's when people arrive again because of platelet sickness,
• 43:44
  because of adrenaline surges, and essentially because of these issues,
• 43:50
  hormonal changes and steroids. So you see there, yes, you're right,
• 43:54
  arrhythmias and heart attacks happen at night or early in
• 43:58
  the morning, which is a well-recognized fact. Right.
• 44:01
  Speaker 1: People used to say that there are a lot of
• 44:03
  heart attacks even in winters.
• 44:04
  Speaker 2: That is very understandable. When you have cold, especially if
• 44:08
  you exercise in winters, and we tell our heart patients
• 44:10
  that in winters, if you have a car, don't push it,
• 44:13
  don't pick up heavy things in cold. Spasm of the arteries,
• 44:18
  increased clotting in the arteries, sudden rupture of any of
• 44:24
  the minor blockages. Hmm. Multiple reasons. Strain on the heart,
• 44:28
  sudden rise in BP, which happens in winters. These all
• 44:32
  things directly affect that blockage which is sitting comfortably. Who
• 44:37
  never wanted to have a heart attack. The environment has
• 44:40
  developed like this. They say, a trigger is stuck. We
• 44:45
  are a loaded gun. And if you just have bad
• 44:49
  triggers and good triggers. Good triggers are stuck with difficulty.
• 44:53
  And bad triggers are stuck quickly. These are the bad
• 44:55
  triggers of having a heart attack.
• 44:57
  Speaker 1: Yeah.
• 44:58
  Speaker 2: Even stress. You see. For years. What happens in Hindi pictures? Yeah.
• 45:04
  Speaker 1: Something dramatic has happened in life.
• 45:06
  Speaker 2: Either the boy or the girl said that I want
• 45:08
  to marry him. I have been running it for so
• 45:11
  many years. For 50 years. Yeah. And the father. He
• 45:13
  holds the umbrella and sits down at the same time. Yeah.
• 45:17
  And he has a heart attack. Yeah. And he gets
• 45:19
  admitted at the same time. I have been running it
• 45:21
  for 50 years. That's why. Stress is a bad milieu
• 45:27
  for causing heart attack. Yeah. And we have to avoid stress.
• 45:30
  And walking in the cold, pushing, these are all stresses.
• 45:37
  That's what it is.
• 45:38
  Speaker 1: I've heard of a lot of stories of happy heart
• 45:41
  attacks also. Have you heard of that? So people in
• 45:44
  the middle of a wedding, all happy, you know, scenes
• 45:48
  or happy scenarios in life. Their daughter is getting married
• 45:51
  one night before. They're singing and dancing at the sangeet
• 45:54
  and next morning they never woke up. So any kind
• 45:58
  of extreme reaction can trigger?
• 46:01
  Speaker 2: Extreme exercise and extreme reaction. What happens in that? Heart
• 46:06
  rate is increasing. Blood pressure is increasing. These are two
• 46:10
  normal reactions to anything that which is over joyous. So
• 46:15
  joy is also a stress if you're overjoyed. You're dancing
• 46:20
  in that. Surroundings are such that perhaps Ghotan wali surroundings hai.
• 46:26
  Bheed wali surroundings hai. Alcohol. Alcohol pih rahe hain. Bad food.
• 46:29
  Bad food. Uswakad pehri hota hai. Sleep again. I mean,
• 46:33
  you just put it all together. So actually, it's not
• 46:36
  a relaxed situation. It's actually a stressful situation.
• 46:40
  Speaker 1: Weddings are very stressful.
• 46:41
  Speaker 2: Very stressful situation. And ussi taraf aapne happy heart syndrome
• 46:45
  ki baat ki, to ussi taraf aapko pata ye broken
• 46:47
  heart syndrome bhi hai. Broken heart syndrome is a very
• 46:51
  it's an odd situation. It actually happens in young women,
• 46:55
  women more commonly than men, not because it's a broken
• 46:59
  heart for women, but any sad news, any severe, sudden
• 47:04
  sad news, any severe form of exercise can actually cause
• 47:10
  what looks like a heart attack. Suddenly, the heart, that
• 47:15
  area of the heart starts to get damaged because what
• 47:18
  happens is that the blood supply, the, the, Heart's demand
• 47:22
  of blood overpowers the amount of blood reaching the heart.
• 47:30
  And actually the symptoms are exactly the same as a
• 47:33
  heart attack. Patient goes there, arteries are normal. But suddenly
• 47:38
  heart attack. And it's called a broken heart syndrome. And
• 47:41
  you see that area of the heart not moving. You
• 47:44
  do an angiogram normal. And gradually these things recover over
• 47:48
  a period of two to three months. So damaged area recover.
• 47:52
  And we worry about this in sudden, sudden bad news.
• 47:57
  And sudden forms of severe exercise. Which does not block
• 48:01
  the arteries. But can still cause heart attack. Right.
• 48:05
  Speaker 1: You know there is a recurring theme in what you
• 48:08
  are saying. The recurring theme is that different forms of
• 48:12
  ailments or different forms of sudden deaths can happen. Only
• 48:16
  because you've not done your basic tests.
• 48:19
  Speaker 2: Absolutely.
• 48:21
  Speaker 1: If you do your basic tests right, and that does
• 48:23
  not just mean the package you get these days. That
• 48:27
  you did it, they just checked your lipid profile, etc. No.
• 48:30
  If you know that you have a family history, you
• 48:32
  have to go to your cardiologist and get some specific
• 48:36
  tests done to your age. Understand what the ailment is.
• 48:39
  And then take action accordingly.
• 48:41
  Speaker 2: Absolutely.
• 48:42
  Speaker 1: Okay, so we spoke about a lot of things in
• 48:44
  this last kind of segment. I want to speak about
• 48:48
  extreme exercises. Did you see what happened with the high rocks,
• 48:53
  that episode in China?
• 48:54
  Speaker 2: I didn't see it, but you told me. Which is horrifying,
• 48:59
  but it's also very disgraceful, but also very... You know,
• 49:05
  educational in some ways. It is.
• 49:07
  Speaker 1: It really put the spotlight on how much do we
• 49:10
  really need to push when it comes to exercising. Could
• 49:14
  you draw a sort of easy to understand paradox? for
• 49:20
  us that when should you know when to stop exercising?
• 49:24
  Speaker 2: Ek heart healthy exercise hoti hai. Ek weight reduction or
• 49:28
  stamina ke liye hoti hai. Or ek physical physique ke
• 49:32
  liye hoti hai. Let's differentiate the three. What is a
• 49:36
  heart healthy exercise? 200 what we say is 150 to
• 49:41
  200 minutes of brisk walking in a week. You can
• 49:46
  do it 300. It's been known that it probably helps
• 49:51
  slightly more. But it actually translates into 40 minutes of
• 49:55
  brisk walking a day, five times a week. So this
• 49:59
  is the thing. And we can decrease our risk of
• 50:01
  heart attack by 25%. 25% of our risk of heart
• 50:04
  attack is reduced, which is more than any of the tablets. Easily, why?
• 50:09
  Our weight reduction is done. Our diabetes is controlled. Our
• 50:12
  blood pressure is controlled. Our positivity is controlled. Our sense
• 50:15
  of fitness is controlled. We are doing a good, hopefully,
• 50:19
  less polluted atmosphere or whatever. But we are actually putting
• 50:25
  our body into those very causes that they are removing.
• 50:29
  Speaker 1: Correct.
• 50:29
  Speaker 2: In a single go.
• 50:30
  Speaker 1: So walking is a heart-healthy exercise.
• 50:31
  Speaker 2: Heart-healthy walking. And it's aerobic. And it's a brisk walking.
• 50:34
  And what is brisk walking? People say, we went with
• 50:38
  four friends, we go there every day, we talk, we
• 50:41
  don't even know the time. Actually, that's the worst form
• 50:45
  of exercise because if you are able to, what we
• 50:50
  say heart healthy exercise is that you can't even speak
• 50:52
  a single sentence. If you're talking sentences, that means you're
• 50:56
  not doing active exercise. It's not brisk enough. It's not
• 50:59
  brisk enough. It's not heart healthy. But, this is also... Now,
• 51:03
  let's say we're all office workers. We're sitting here and
• 51:06
  they're office workers. They work for hours. They say, I
• 51:08
  worked for 20-40 minutes in the morning. That's also bad.
• 51:13
  That's also being recognized to be bad. So, what we
• 51:14
  say is, if you worked for 30 minutes in the morning,
• 51:17
  it's not a quota. That I did my quota. Keep
• 51:21
  on actually being healthy. So that's the one part of
• 51:24
  being healthy. But the second I said.
• 51:46
  The thing I said about, yeah, stamina. So beyond this
• 51:50
  40 minutes, yes, you can improve your stamina. You want
• 51:52
  to lose weight. So you're burning calories. You're feeling good.
• 51:57
  And that's your average. No, I won't do it for
• 52:00
  40 minutes. I'll do it for an hour and a half.
• 52:02
  It's okay. You did it at that level, moderate level,
• 52:06
  which is okay because your body can take it. But
• 52:08
  then comes these extreme sports. And that comes when this
• 52:11
  heavy gymming and weights come. That's when you need to
• 52:14
  know that you are doing abnormal. Those are aerobic and
• 52:18
  aerobic exercises. They are extremely harmful for the heart. They
• 52:22
  could be harmful for the body. You're doing for the
• 52:25
  sake of what you call fitness, but you need to
• 52:27
  then get into extreme sports. And that's what you said
• 52:31
  was extreme sports is actually working your way gradually into it.
• 52:37
  Defining your body towards it. You have stamina in it.
• 52:41
  You have muscles into it. You have definitely active ingredients
• 52:45
  into it. It gives you satisfaction. I'm saying, nahi karo,
• 52:49
  yeh nahi hai. But apna check-up karao. Samjo ki jab
• 52:52
  body kitna kar sakti hai. And don't push yourself beyond
• 52:56
  a particular point because merko yeh karna hai. Because you
• 53:00
  will harm your body and you will harm yourself. And
• 53:03
  that extreme is not worth it.
• 53:06
  Speaker 1: Yeah, I've always battled with this question. Because sometimes people collapse. Yeah,
• 53:09
  I've always battled with this question because every doctor, every
• 53:14
  person who studies longevity, etc. will tell you that lifting
• 53:18
  weights is good for you. Muscle is the biggest currency
• 53:22
  that you have.
• 53:22
  Speaker 2: It is true.
• 53:23
  Speaker 1: So you have to work on it.
• 53:25
  Speaker 2: It is true.
• 53:25
  Speaker 1: But when do you stop?
• 53:27
  Speaker 2: And also.
• 53:28
  Speaker 1: When does exercise become too much?
• 53:31
  Speaker 2: When it is vanity. When you think that you're better
• 53:36
  Better lagna chahta ho. And that is vanity. When it
• 53:40
  becomes a vanity, when it becomes competitive, when it says
• 53:44
  ki dusra wala mere se zyada kyu weight lift kar
• 53:47
  raha hai. When it is that, you should be satisfied
• 53:51
  with what you are. We also say ki two days
• 53:53
  toh aapne muscle karni hi hai. Light weights karni hai.
• 53:57
  So in that exercises is definitely weight lifting, muscle toning,
• 54:03
  but wo muscle toning building nahi hai. Wo muscle toning hai.
• 54:08
  Compete with your own self. Don't look around.
• 54:12
  Speaker 1: Your father at 100 plus goes to the gym, if
• 54:15
  I'm not wrong.
• 54:16
  Speaker 2: Well, he used to.
• 54:17
  Speaker 1: Yes.
• 54:18
  Speaker 2: He's had a setback in the last six months. Yes,
• 54:20
  you're right.
• 54:21
  Speaker 1: Okay, yeah.
• 54:21
  Speaker 2: But till the setback, past age 102, exercise, weights, perfect. Walks, Yes,
• 54:34
  he did regularly weights with me.
• 54:36
  Speaker 1: You do weights?
• 54:40
  Speaker 2: Yes, I do.
• 54:40
  Speaker 1: How old are you, Dr. Seth? Let's reveal it.
• 54:43
  Speaker 2: Ah, okay. How old do I look? Okay, so let's
• 54:48
  reveal it. I passed 70. I'm 72. Wow.
• 54:52
  Speaker 1: I want to know Dr. Ashok Seth's fitness regime. You
• 54:57
  are way past 70.
• 54:58
  Speaker 2: Yes.
• 54:59
  Speaker 1: And you take good care of your heart. You possibly
• 55:02
  know more about heart health than anybody in the country.
• 55:05
  So I want to know what is it that you do?
• 55:08
  Speaker 2: So that's very clear. For me, exercise is important. It's
• 55:10
  actually grown into me. I have a gym at home
• 55:13
  and I really do good exercise. I actually make sure,
• 55:18
  you know, sometimes I go to Surrey Fort and do
• 55:24
  a 28 kilometer walk. when I'm not doing it at home,
• 55:28
  because I just want to go out in the open.
• 55:30
  So I've done that regularly. Just recently, over the last
• 55:35
  few months, that I sort of didn't do it. But then,
• 55:38
  for me, weights are also important. I mean, I hope
• 55:45
  I look fit.
• 55:46
  Speaker 1: You look very fit. Stop fetching now.
• 55:50
  Speaker 2: I said, I said, But yeah, and then I do weights.
• 55:56
  And a trainer comes home and he trains me for weights.
• 55:59
  It's under supervision. I do that four times a week.
• 56:02
  And then, of course, I have yoga two times a week.
• 56:04
  I think flexibility, etc. Those are also important exercises. But
• 56:09
  there are exercises which are, you know, far more. I
• 56:13
  don't do it for anything else. But they are related
• 56:16
  to body's constitution. Yogic exercises are very constitutional exercises. When
• 56:22
  we do weights here, we do it for muscles. We
• 56:24
  do it for constitution. If we want to improve the stomach,
• 56:28
  we do it. If we want to improve the mind,
• 56:30
  we do it. So I think I mix those two.
• 56:33
  And I'm very happy that that's how we should lead
• 56:35
  our lives. If we can read newspapers, if we can
• 56:38
  watch TV, and if we say that we have to
• 56:41
  bathe and shave every day, then I say, leave shaving.
• 56:46
  Exercise in its place, you'll be far better off. So
• 56:48
  this excuse doesn't stand with me that I didn't get
• 56:51
  time to exercise. I say, I got time to shave,
• 56:53
  leave shaving. Grow your beard, but do exercise.
• 56:57
  Speaker 1: So four days of weight training.
• 56:59
  Speaker 2: Yeah, weight training.
• 57:00
  Speaker 1: Two days of yoga.
• 57:01
  Speaker 2: Yeah.
• 57:02
  Speaker 1: And you ensure that you, during the day, the course
• 57:05
  of the day, you keep active. I'm sure you're doing
• 57:07
  rounds of the OPD, etc.
• 57:09
  Speaker 2: Not just that. When I function in the cath lab,
• 57:11
  that's a heavy lead coat, seven and a half kilograms.
• 57:14
  Speaker 1: Yeah.
• 57:14
  Speaker 2: And I function for 12 hours wearing that lead coat,
• 57:19
  doing procedures. Wow. Every alternate day. That's a seven and
• 57:23
  a half kilogram lead coat. It's continuous standing. Yes. And
• 57:27
  I do that.
• 57:28
  Speaker 1: Yeah.
• 57:29
  Speaker 2: And I think that probably loses me. You know, that
• 57:32
  gives me a lot of.
• 57:33
  Speaker 1: Yeah.
• 57:34
  Speaker 2: So I've got to keep my back fit. I've got
• 57:35
  to keep my everything fit to actually have that lead
• 57:38
  coat on. So, yeah, that keeps me fit. That's it.
• 57:42
  My profession keeps me fit.
• 57:43
  Speaker 1: It does. And I'm sure it keeps you happy as well,
• 57:46
  which is important. Tell me, what are you eating? Do
• 57:49
  you watch your calories? Are you also like all of
• 57:52
  us sending your food pictures to ChatGP to calculate how
• 57:55
  much calories you're eating? I don't.
• 57:57
  Speaker 2: I've actually been not a good representative of food. I'm
• 58:03
  a foodie. I love food. I say this many times.
• 58:06
  We were born in India because... I mean, look at
• 58:10
  the variety of food that exists in the country. But still,
• 58:14
  we should understand food. It's very important. Yes, occasionally, we
• 58:18
  eat anything. Occasionally, we eat kachori, samosas. There is no sin.
• 58:21
  But eating daily is not possible. Eating daily is not possible.
• 58:27
  Eating daily. So, nowadays, I am very clear. For the past,
• 58:32
  you know, let's say, years, more protein. And now, there
• 58:37
  are so many proteins. Vegetarians also have a lot of proteins.
• 58:40
  Speaker 1: Yeah.
• 58:41
  Speaker 2: There are all sorts of protein shakes, protein this, I
• 58:43
  keep giving lectures to every patient. He says, we are vegetarians,
• 58:47
  we have proteins. I say, dalwal do hai hi proteins. Beans, beans,
• 58:51
  sab proteins hai, nuts mein proteins hai, but aaj kal
• 58:53
  aap dekhiye, to har achche, say yogurt, high protein yogurts,
• 58:58
  high protein shakes with very low sugars, sab available hai.
• 59:02
  But if you go into all that, take away the
• 59:06
  refined stuff, etc. Wo jo pata hi hai hume ki
• 59:08
  chat GPT.
• 59:09
  Speaker 1: Se, You're making all our viewers very happy by saying that.
• 59:18
  Eat parathas.
• 59:20
  Speaker 2: But do exercise together. Take care of yourself. Right. If
• 59:26
  you keep eating parathas, you'll say, I'm sitting at the desk,
• 59:28
  not exercising. Then what will happen? Everything is a trade-off.
• 59:33
  Don't be an extremist. Yes.
• 59:35
  Speaker 1: All right. With that, I want to do the take
• 59:38
  it or trash it test with you. What I'm going
• 59:40
  to throw at you is a couple of heart health hacks. Hmm.
• 59:45
  or heart health myths that people have.
• 59:47
  Speaker 2: Right.
• 59:48
  Speaker 1: Very commonly in India. You have to tell me whether
• 59:50
  it's true so you should take it or whether you
• 59:53
  should just trash it away.
• 59:54
  Speaker 2: Okay.
• 59:55
  Speaker 1: Cold water right after a workout can trigger a heart attack.
• 1:00:01
  Speaker 2: Ah. It can. It can.
• 1:00:05
  Speaker 1: It can.
• 1:00:05
  Speaker 2: Wow. It can. That's why we say warm water peel. Again,
• 1:00:09
  for the same reasons. Stress. Stress. Stress.
• 1:00:14
  Speaker 1: Interesting. A normal ECG means your heart is fine.
• 1:00:17
  Speaker 2: Oh, no. Absolutely. Trash it. Okay.
• 1:00:20
  Speaker 1: Heart attacks always come with chest pain.
• 1:00:23
  Speaker 2: Trash it.
• 1:00:25
  Speaker 1: Coconut oil is bad for your heart.
• 1:00:27
  Speaker 2: Yes. True.
• 1:00:30
  Speaker 1: Young people don't need heart checkups.
• 1:00:33
  Speaker 2: Ah, trash it. Okay.
• 1:00:35
  Speaker 1: Silent heart attacks are painless, so less dangerous.
• 1:00:39
  Speaker 2: Trash it. More dangerous? It can be very dangerous.
• 1:00:42
  Speaker 1: Okay. If you can run a marathon, your heart is healthy.
• 1:00:46
  Speaker 2: Not necessarily. Trash it.
• 1:00:48
  Speaker 1: Okay. Stress alone can trigger a heart attack.
• 1:00:54
  Speaker 2: Yes, can.
• 1:00:56
  Speaker 1: Okay. This is very common. Cracking knuckles and eating eggs
• 1:01:00
  raises cholesterol.
• 1:01:02
  Speaker 2: Yellow effects absolutely can raise cholesterol. Okay.
• 1:01:05
  Speaker 1: But cracking knuckles?
• 1:01:06
  Speaker 2: You mean this one?
• 1:01:07
  Speaker 1: Yeah.
• 1:01:08
  Speaker 2: Oh, right. Yeah, of course, it'll crack your bones far
• 1:01:11
  more than your heart.
• 1:01:12
  Speaker 1: Okay. Once on BP medication, you don't really need to
• 1:01:17
  check it regularly.
• 1:01:19
  Speaker 2: Oh, no, no. Uncontrolled blood pressure, I said. 50% people
• 1:01:22
  have it. It's dangerous. Check it regularly.
• 1:01:24
  Speaker 1: Yeah, and check it the right way, like we discussed
• 1:01:26
  in the podcast, right? Okay, this is interesting. Ajwain and
• 1:01:30
  jeera water in the morning can clear your arteries.
• 1:01:33
  Speaker 2: Oh, no, no, no. Trash. Trash.
• 1:01:35
  Speaker 1: Garlic on an empty stomach can lower cholesterol.
• 1:01:38
  Speaker 2: Oh, trash.
• 1:01:40
  Speaker 1: Fasting, which is basically intermittent fasting or maybe regular interval
• 1:01:46
  fasting like Ekadushi etc. is good for the heart.
• 1:01:49
  Speaker 2: Well, this needs explanation. Okay. Intermittent fasting has been shown
• 1:01:53
  to actually decrease your weight etc. If it's for losing weight,
• 1:01:58
  it helps. But if it's just a fad, it doesn't help.
• 1:02:02
  So if you eat properly, say I'm doing intermittent and
• 1:02:06
  then keep eating anything, then it's a disaster. Hmm. So yes,
• 1:02:10
  there have been enough reviews on it. That's why I
• 1:02:13
  explained it. If you eat less calories, it's beneficial. But
• 1:02:16
  nothing more than that. Yeah.
• 1:02:18
  Speaker 1: Okay, next one. Ghee is actually better for the heart
• 1:02:20
  than refined oil.
• 1:02:23
  Speaker 2: Refined oil, let's say ghee is absolutely better than refined oils.
• 1:02:28
  But you should never take it in excess. One or
• 1:02:30
  two teaspoons full of ghee. It's definitely better than manaspati.
• 1:02:34
  It's better than a lot of other oils that we
• 1:02:36
  talk about. And it's actually not harmful in the small quantities.
• 1:02:40
  I tell my patients, they ask me this common question.
• 1:02:43
  I say, take one or two spoons of ghee. But
• 1:02:47
  follow the other things that we're talking about. Healthy diet. Right.
• 1:02:50
  Speaker 1: There are these Ayurvedic blood purifying karhas which claim to
• 1:02:55
  reverse blockages. Is there any such thing?
• 1:02:58
  Speaker 2: No, I would say trash when we talk about reversing blockages.
• 1:03:02
  I don't discount Ayurveda. There would be good things in it.
• 1:03:05
  After all, it's a very important heritage of ours. But
• 1:03:08
  we just need more evidence and understanding. There is nothing
• 1:03:15
  which reverses blockages. There is nothing apart from allopathic science
• 1:03:21
  which will prevent heart attacks. Okay.
• 1:03:24
  Speaker 1: Ice baths or cold plunges are good for cardiovascular health.
• 1:03:27
  Speaker 2: Oh, the worst thing that you can actually do. You
• 1:03:31
  plunge into a cold water, and that's why we talked
• 1:03:33
  about the cold water after. You can pressurize the heart
• 1:03:36
  and act straight away. Straight away. Wow. The body temperature
• 1:03:39
  drop is one of the most important ways of constrictors.
• 1:03:42
  If suddenly you give a surge of adrenaline, suddenly you
• 1:03:45
  put up your blood pressure and heart rate to so fast,
• 1:03:48
  and one would suddenly have platelet activation, it's the worst
• 1:03:52
  stress one can give to your own self. If you're
• 1:03:55
  not accustomed to it. Jump into a cold water is
• 1:04:03
  the biggest stress you can actually produce to your own
• 1:04:05
  body to precipitate a heart attack. So, kabhi bhi aisi
• 1:04:08
  galti na karen.
• 1:04:10
  Speaker 1: Okay, next one is interesting. Pranayama alone is enough. Heart
• 1:04:15
  doesn't really need cardio.
• 1:04:17
  Speaker 2: I wouldn't say that. Add on everything. There are good
• 1:04:20
  parts to everything. We definitely therefore need to combine. the
• 1:04:27
  exercises we talked about, with yoga. And yoga is, I
• 1:04:31
  would say yoga is not just exercises. Yoga is a
• 1:04:34
  way of mental relaxation, yogic way of life. A bit
• 1:04:38
  of spirituality comes in. So to be heart healthy, there
• 1:04:41
  are exercises, diet, but spiritually and mentally healthy is also there.
• 1:04:47
  That's why yoga comes in.
• 1:04:48
  Speaker 1: So you mean both, a combination of both.
• 1:04:50
  Speaker 2: A combination of both.
• 1:04:51
  Speaker 1: H-I-I-T, which is like very high intensity workouts, is better
• 1:04:55
  for the heart than steady state cardio?
• 1:04:57
  Speaker 2: No. Steady state cardio is much better for the heart.
• 1:05:00
  That's why we say, 35 minutes, 30 minutes, 30 minutes
• 1:05:10
  should be sustained. And it maintains the heart rate at
• 1:05:13
  a particular level and not suddenly going up and down.
• 1:05:16
  That's why we say squash, bad Anything which is not sustained,
• 1:05:24
  which has spurts of up and down, is bad. Is
• 1:05:27
  a risk. Yes. Because those are not anaerobic exercises. Those
• 1:05:31
  are anaerobic exercises.
• 1:05:33
  Speaker 1: So are there certain exercises which are great for the heart?
• 1:05:36
  Speaker 2: Brisk walking, cycling, swimming. Those are the best exercises. They
• 1:05:41
  get you to a sustained level and you continue. Pushing
• 1:05:44
  yourself suddenly up, down, up, down is a bad way
• 1:05:48
  to exercise.
• 1:05:50
  Speaker 1: What about golf?
• 1:05:51
  Speaker 2: Golf is hardly an exercise. People say, I'm glad you
• 1:05:56
  raised this. Patients say, I play golf every day. I exercise.
• 1:06:01
  It's such a big course. They talk a lot. They walk.
• 1:06:09
  They stroll around. And they say, that's exercise. That's not exercise,
• 1:06:12
  I keep telling them. I said, if you walk from
• 1:06:14
  one hole to the other so fast, if only one hole,
• 1:06:18
  Uske beech mein rukna nahi hota. So then you'd be exercising.
• 1:06:21
  But you're not exercising. That's not exercise. That's pleasure. And
• 1:06:24
  let's not count that. It's like, it's like, men talk
• 1:06:27
  about golf like that. And women talk about, ki ghar
• 1:06:31
  mein itna chalte rehti hai. Kabhi kitchen se bedroom. My
• 1:06:34
  mom used to say that. Mein toh betti nahi hoon.
• 1:06:37
  Ben toh betti nahi hoon. Ben toh 10,000 kya, 15,000
• 1:06:40
  steps ho jate hai. Yeh toh, you know, idhar se udhar,
• 1:06:43
  udhar se idhar, idhar se udhar, aapko kya pata. Haan.
• 1:06:46
  And I would never say gosh.
• 1:06:47
  Speaker 1: So golf is not an exercise and ghar ka kaam
• 1:06:49
  karna is also not exercise.
• 1:06:51
  Speaker 2: Wow.
• 1:06:52
  Speaker 1: Okay, that one has been trashed. So is there an
• 1:06:55
  optimum step count that people should do? Everybody's calculating steps.
• 1:06:58
  Speaker 2: Yeah.
• 1:06:59
  Speaker 1: Is there an age-wise step count that one should follow?
• 1:07:02
  Speaker 2: Can you believe where did the 10,000 steps come from?
• 1:07:06
  There is absolutely no scientific truth in 10,000 steps. 10,000
• 1:07:12
  steps came because a Japanese company made a pedometer. And
• 1:07:17
  they thought a good number that 10,000 becomes a good
• 1:07:21
  marketing gimmick. Because everyone will remember. And count on it.
• 1:07:25
  And we have a pedometer. And you count 10,000 steps.
• 1:07:27
  This is a very good thing. Do you know that actually,
• 1:07:31
  like I say, the 45 minutes of brisk walking, that
• 1:07:36
  translates into up to 4 kilometers. That's exactly 6,000 to 7,000 steps.
• 1:07:41
  Speaker 1: That's enough.
• 1:07:41
  Speaker 2: That's enough. So remember that we don't have to walk 10,000.
• 1:07:45
  But in 6,000-7,000 steps, it becomes that which is heart healthy.
• 1:07:50
  So let's not go for these gimmicks. But let's go
• 1:07:54
  for what I said.
• 1:07:55
  Speaker 1: But since you spoke about golf, I want to.
• 1:07:57
  Speaker 2: And by the way, 10,000 steps translated, 7 to 8
• 1:08:00
  kilometers of walking. Now who does 7 to 8 kilometers?
• 1:08:04
  Speaker 1: But since we spoke about golf, I have to talk
• 1:08:06
  about another very popular thing. Let's talk about alcohol. Okay,
• 1:08:11
  let's talk about alcohol. Is a little alcohol okay in life?
• 1:08:15
  Is no alcohol okay in life? I was interviewing, one
• 1:08:20
  of our early guests on Doctor vs. Internet was the
• 1:08:22
  Lancet chief, the editor-in-chief. And he came in and he said,
• 1:08:26
  I don't like doctors who say, don't do this, don't
• 1:08:29
  do that. At the end of the day, one has
• 1:08:32
  to live. So according to him, a little quantity of
• 1:08:36
  alcohol is okay. Now, you as a cardiologist, knowing the
• 1:08:41
  realities that you know of the Indian heart, what do
• 1:08:44
  you think is okay?
• 1:08:45
  Speaker 2: And as one who drinks occasional alcohol.
• 1:08:47
  Speaker 1: Okay.
• 1:08:48
  Speaker 2: Enjoys an occasional alcohol. Yeah. So, okay, now this is
• 1:08:51
  going to be fun. And I tell you, I could say,
• 1:08:54
  I don't drink, I was given. I don't know what
• 1:08:58
  to say. and health. WHO says, Okay, there is no
• 1:09:12
  benefit of alcohol. But we must firstly address that. People say,
• 1:09:16
  if you drink a little wine, it's healthy for the heart.
• 1:09:19
  HDL decreases.
• 1:09:21
  Speaker 1: That seems to be trashed.
• 1:09:22
  Speaker 2: Trashed. Okay. Now, the second thing is, how much is
• 1:09:25
  the loss? According to WHO, even a bit of alcohol
• 1:09:31
  is bad. And can you believe, WHO has put alcohol
• 1:09:34
  as a category one carcinogen. Yes. And that's mainly because
• 1:09:39
  there is a slight increase in esophageal cancers, mouth cancers,
• 1:09:43
  colorectal cancers, etc. There is a slight increase. That's also
• 1:09:46
  with telling the community that alcohol is not a good thing.
• 1:09:50
  That's a responsibility. So it's coupled with nicotine, it's coupled
• 1:09:54
  with asbestos as a carcinogenic thing. But let's be practical
• 1:09:58
  and that's true. If alcohol was so bad, then in
• 1:10:03
  every song, in every gazelle, for many years, in every picture,
• 1:10:09
  most glorified Is alcohol. Jam. My khana. Sake. You know,
• 1:10:17
  you name it. Sharabi. It's all been glorified.
• 1:10:23
  Speaker 1: But smoking was also glorified at one point.
• 1:10:26
  Speaker 2: At one point. So it is bad. A small quantity
• 1:10:28
  of alcohol is not bad for the heart. Okay.
• 1:10:38
  Speaker 1: Define small.
• 1:10:39
  Speaker 2: Okay. In India, I would define small as one small
• 1:10:42
  drink a week. In the West, by the way, where
• 1:10:46
  people drink less water and drink more alcohol, whether it's
• 1:10:49
  wine or not. Let's not put that alcohol where they
• 1:10:53
  drink alcohol regularly, whether it's wine, whether it's beer, whether
• 1:10:56
  it's alcohol. They say one drink every day. But we
• 1:10:59
  must remember their body habit is their coronary artery disease
• 1:11:02
  is low. Their other factors are low.
• 1:11:03
  Speaker 1: And they walk so much.
• 1:11:05
  Speaker 2: They walk so much.
• 1:11:06
  Speaker 1: They're eating healthier food, have better climate, better water, better air.
• 1:11:10
  Speaker 2: Absolutely. So alcohol being one of the risk factors, we've
• 1:11:13
  got to understand that we're filled with risk factors. And
• 1:11:16
  then we add on to that excess alcohol intake. What
• 1:11:19
  does excess alcohol intake do? Damages not just a heart.
• 1:11:24
  It damages a liver. It damages our kidneys. It damages
• 1:11:27
  our pancreas. It puts on weight, unnecessary calories. Damages our brain.
• 1:11:34
  Damages our thought process. Damages our society. Damages our social life.
• 1:11:38
  Damages our family life. Destruction, destruction, destruction at every point.
• 1:11:43
  Speaker 1: Yeah.
• 1:11:44
  Speaker 2: But you still drink. So that's that occasional one.
• 1:11:47
  Speaker 1: But you still drink.
• 1:11:47
  Speaker 2: That's the occasional one. But I say, one or two. Drinks,
• 1:11:56
  small drinks a week is not bad. You can actually
• 1:12:00
  spread it out. You can actually just have it at
• 1:12:01
  a time. But you go more than that. You're then
• 1:12:05
  damaging yourself as an Indian. And by the way, binge
• 1:12:09
  drinking is bad. That's so bad. That's actually worse than
• 1:12:12
  having a small drink occasionally. And as far as the
• 1:12:16
  question is in India, You know, one of the worst
• 1:12:25
  thing is to think of alcohol as jab khushi hai,
• 1:12:28
  toh let's have a drink. Jab gham hai, toh let's
• 1:12:31
  have a drink. Jab akele baithe hai, toh phir pi
• 1:12:35
  liya jaye. Aur jab dosto ke saath hai, aur maze
• 1:12:40
  mein hai, shaadi ho rahi hai celebration, toh aaj ki
• 1:12:43
  drink kahan hai. Toh it seems to be a tonic
• 1:12:48
  for every day and every part of our lives.
• 1:12:51
  Speaker 1: Yeah.
• 1:12:52
  Speaker 2: So I think we got to get it out of
• 1:12:55
  this thing. In fact, I would say restraint is when
• 1:12:58
  you are at home and you don't drink.
• 1:13:02
  Speaker 1: You don't feel like reaching out.
• 1:13:03
  Speaker 2: Reaching out for it. And if you are at that level,
• 1:13:07
  then occasionally you will take only that much when you
• 1:13:10
  sit with someone and drink less. So just keep it,
• 1:13:13
  make sure that it's not a good thing. But in
• 1:13:16
  small quantities, it's neither bad. But in large quantities, hard.
• 1:13:21
  Speaker 1: It's terrible.
• 1:13:23
  Speaker 2: And we know that. So one small drink occasionally is fine.
• 1:13:27
  It's okay.
• 1:13:28
  Speaker 1: But let me ask you a controversial question then.
• 1:13:30
  Speaker 2: Yeah.
• 1:13:31
  Speaker 1: Are there certain kinds of alcohol that are better or worse?
• 1:13:36
  Like people say... You've all seen that articles, which are
• 1:13:39
  funded by these alcohol companies, which say one glass of
• 1:13:42
  wine will keep your heart healthy.
• 1:13:43
  Speaker 2: That's why it crashed it early, right in the beginning.
• 1:13:46
  Absolutely no good effect of alcohol at all. People say
• 1:13:51
  that not just this wine lobby stuff, that HDL increases,
• 1:13:54
  does everything. Even people say, look, stress has reduced. Today
• 1:13:58
  there was a lot of stress, then yellow stress has reduced.
• 1:14:02
  Does it actually help my stress reduction? No, it's actually harming.
• 1:14:07
  It's a habit which is so bad that you think one,
• 1:14:12
  then two, then every day, then you say you can't
• 1:14:15
  live without it because it's not bad at all.
• 1:14:18
  Speaker 1: People don't understand that the percentage of alcohol in wine
• 1:14:20
  is much more.
• 1:14:21
  Speaker 2: Absolutely. Because you drink in a glass and that's its percentage.
• 1:14:25
  13 to 15 percent is there, but according to the
• 1:14:29
  quantity you are drinking, you drink three glasses like this.
• 1:14:33
  So no alcohol is good. I mean, ideal to yeh
• 1:14:37
  bahi kahunga, zero alcohol is the best. And you don't
• 1:14:42
  need to start what you don't drink. But what you
• 1:14:45
  are drinking, it should be so restrained that the bottle
• 1:14:48
  is there and it is there in the house. But
• 1:14:52
  once in two weeks, if you put one with a friend,
• 1:14:56
  then be happy. There is no harm in that. After all,
• 1:14:59
  exactly what you said. Life is to live, but it
• 1:15:01
  is not to live like this either.
• 1:15:06
  Speaker 1: That is true. Well, the good part here is that
• 1:15:08
  a lot of young people are actually moving towards sobriety.
• 1:15:12
  They're not drinking at all.
• 1:15:13
  Speaker 2: I hope so. Because one of the biggest things which
• 1:15:15
  has happened is increased alcohol intake amongst young in the
• 1:15:19
  recent times, including smoking, including vaping, which has led to
• 1:15:23
  this increase of heart disease. That's actually one of the
• 1:15:27
  reasons and we just need to. Be careful about it.
• 1:15:30
  But I hope people understood the way I told.
• 1:15:33
  Speaker 1: Them about it. I'm sure this will be very helpful.
• 1:15:35
  Speaker 2: Again, what's your poison?
• 1:15:41
  Speaker 1: We'll discuss after the podcast, after the cameras have stopped rolling.
• 1:15:45
  Last question before I let you go, Dr.
• 1:15:47
  Speaker 2: Seth.
• 1:15:47
  Speaker 1: And this has been so, so educational. So thank you
• 1:15:49
  so very much for your time. But, you know, you
• 1:15:52
  have perhaps treated more hearts, put in more stents than
• 1:15:57
  any other cardiologist in the country.
• 1:16:00
  Speaker 2: Is that a compliment? Is that a bad?
• 1:16:02
  Speaker 1: I'm assuming it's a compliment, but my question is slightly different.
• 1:16:06
  I want to know, is there a patient that you
• 1:16:12
  lost or perhaps almost lost that made you change the
• 1:16:17
  way you practice?
• 1:16:19
  Speaker 2: There could be many stories which have stayed with me.
• 1:16:22
  And I would, it'd be wrong to say one because
• 1:16:25
  patients have died. But I think the true crux of
• 1:16:30
  your integrity and credibility and that you care for your patients. And,
• 1:16:34
  you know, we're dealing with heart disease, which is very serious,
• 1:16:39
  which sometimes for us is a life-saving procedure. If we
• 1:16:42
  didn't do it, the patient would die. So we can't
• 1:16:44
  claim ourselves to be God and successful every time. But thankfully,
• 1:16:49
  people accept the fact that I do the best for them.
• 1:16:54
  And I tell you what's the criteria. is that if
• 1:16:58
  a patient dies, and he dies, then there are two
• 1:17:03
  things which happen. Firstly, the patient feels, because you don't
• 1:17:07
  leave him there. You're there to make sure that anything
• 1:17:12
  which has happened, you're there for that, for days and
• 1:17:14
  days and days, and try to save that. Whatever's happened.
• 1:17:19
  And the second aspect is that the patient, when he
• 1:17:22
  passes away, in your hands, the relatives, if they say
• 1:17:26
  that you did your best, I mean, this was bound
• 1:17:28
  to happen. It's God's will. Then you know you've done
• 1:17:30
  the best. Yeah. And finally, if they bring back another
• 1:17:34
  of their relatives exactly two weeks later and say, you
• 1:17:37
  have to treat them. You have to treat them.
• 1:17:39
  Speaker 1: But I'm sure there's one case that must have stayed
• 1:17:42
  with you. You treat so many VIPs. You don't have
• 1:17:45
  to name them.
• 1:17:45
  Speaker 2: I'll tell you the one case which stays with me. Yeah.
• 1:17:48
  That is my father's angioplasty. Hmm. At the age of 86,
• 1:17:53
  he had some bad heart disease. Hmm. It required extensive
• 1:17:58
  drilling into calcified arteries and putting stents in. And when
• 1:18:03
  I found that out, and he was complaining of chest pain,
• 1:18:07
  and I did that angiogram, suddenly it occurred to me,
• 1:18:10
  who's going to do this? It was a bad disease.
• 1:18:14
  And I said to myself, if I've done so much
• 1:18:18
  on everybody, and they have wanted me to do it,
• 1:18:21
  then why would I get anybody else to do my
• 1:18:23
  father's angioplasty? If I have to be credible, then I
• 1:18:29
  have to do his angioplasty if I believe I'm the
• 1:18:31
  best person to do it.
• 1:18:32
  Speaker 1: Pressure didn't get to you?
• 1:18:34
  Speaker 2: It did. And I therefore did that angioplasty. It took
• 1:18:37
  me three hours. And then I did make a mistake
• 1:18:41
  at the end because suddenly, towards the end, as the
• 1:18:45
  procedure became successful, which was very difficult, and it just kept.
• 1:18:50
  Speaker 1: off.
• 1:18:51
  Speaker 2: Me and thank god I've been successful and nothing's happened
• 1:18:55
  to him in a dangerous procedure suddenly something happened where
• 1:18:59
  I lost one of the steps and that led to
• 1:19:04
  severe bleeding where I had to press on his groin
• 1:19:09
  for literally stop that bleeding for the next three hours
• 1:19:12
  beyond the procedure. Because suddenly, that pressure drained off me.
• 1:19:16
  I think I work better under pressure than when it
• 1:19:20
  comes off. Because then I was being very careful with
• 1:19:23
  every step. It just... So when I do these things,
• 1:19:29
  I just get very focused. I get very blinkered. I
• 1:19:32
  try to make sure.
• 1:19:33
  Speaker 1: Would you do it again?
• 1:19:34
  Speaker 2: I would. I would. Hmm. You know, I've got to
• 1:19:37
  be clear. I do to my patients, treat my patients
• 1:19:42
  like my relatives. I'll do every technique on them because
• 1:19:48
  they trust me. The nation trusts me. And therefore, if
• 1:19:52
  I'm trusted by my nation, then I should be able
• 1:19:54
  to do it on my relative. That's the test that
• 1:19:59
  I have to stand.
• 1:20:00
  Speaker 1: The nation trusts you. Your father definitely trusts you. And
• 1:20:02
  we trust you. So which is why this is so,
• 1:20:04
  so lovely to have you here. This is an exceptional conversation.
• 1:20:08
  And I'm sure this is going to go out to
• 1:20:10
  help so many people out there. Much, much needed. Thank
• 1:20:13
  you so much, Doc.
• 1:20:14
  Speaker 2: Thank you, Sonal. Pleasure talking to you. One of my
• 1:20:17
  wishes has been given today, being invited by Sonal for
• 1:20:22
  a podcast.
• 1:20:22
  Speaker 1: Oh, come on, sir. Always a pleasure. We'll get you
• 1:20:24
  back soon. We'll talk about more.
• 1:20:25
  Speaker 2: Thank you.
• 1:20:26
  Speaker 1: Thank you so much.