Understanding Heart Disease: How It Starts

Heart disease is the world's leading cause of death, responsible for 17.9 million deaths per year globally. The most common form is coronary artery disease (CAD) — a condition where the arteries supplying blood to the heart muscle become narrowed or blocked by a buildup of cholesterol-rich plaque (atherosclerosis).

Over time, this plaque hardens and narrows the arteries, reducing blood flow to the heart. When blood flow is severely restricted, the heart muscle is starved of oxygen — causing chest pain (angina). If a plaque ruptures and a blood clot forms, it can completely block an artery, causing a heart attack (myocardial infarction).

• High blood pressure (hypertension) — damages artery walls, accelerating plaque buildup
• High cholesterol (LDL) — the primary building block of arterial plaque
• Diabetes — damages blood vessels and accelerates atherosclerosis
• Smoking — damages the inner lining of arteries and raises clotting risk
• Obesity and sedentary lifestyle — raise blood pressure, cholesterol, and diabetes risk
• Family history — genetic predisposition to early heart disease
• Stress — raises cortisol and adrenaline, increasing blood pressure and clotting

Symptoms That Mean You Need Heart Surgery

Not all heart conditions require surgery. Many are managed with medications and lifestyle changes. However, when blockages are severe, multiple, or when the heart valves are damaged, surgery becomes necessary.

• Chest pain (angina) that occurs at rest or with minimal exertion — not relieved by medication
• Shortness of breath during normal activities or while lying flat
• Heart attack — emergency surgery may be needed if angioplasty fails
• Heart failure — when the heart cannot pump enough blood to meet the body's needs
• Valve disease — damaged heart valves causing breathlessness, fatigue, and fainting
• Blocked arteries in 3 or more vessels (triple vessel disease) — surgery preferred over stents
• Left main coronary artery disease — the most dangerous blockage, requiring urgent surgery

Types of Heart Surgery Performed in India

India's cardiac surgery centres perform over 100,000 open-heart surgeries per year — among the highest volumes in the world. High volume means more experienced surgeons and better outcomes. The most common procedures are CABG (bypass surgery) and valve replacement.

• CABG (Coronary Artery Bypass Grafting) — a healthy blood vessel (from the leg, chest, or arm) is used to bypass blocked coronary arteries, restoring blood flow to the heart muscle
• Valve replacement — damaged aortic or mitral valves are replaced with mechanical or biological valves
• Valve repair — the damaged valve is repaired rather than replaced (preferred when possible)
• Angioplasty + stenting — a balloon is used to open a blocked artery and a stent is placed to keep it open (less invasive, no open-heart surgery)
• TAVR (Transcatheter Aortic Valve Replacement) — valve replacement without open-heart surgery, for high-risk patients
• Heart failure surgery — ventricular assist devices (VAD) or heart transplant for end-stage heart failure

Recovery and Life After Heart Surgery

Most patients are discharged from hospital 7–10 days after open-heart surgery. Full recovery takes 6–12 weeks. The vast majority of patients experience dramatic improvement in symptoms — chest pain disappears, breathlessness reduces, and energy levels improve significantly.

Cardiac rehabilitation — a supervised programme of exercise, diet, and lifestyle counselling — is strongly recommended after surgery and significantly improves long-term outcomes.

• ICU stay: 1–2 days after surgery for monitoring
• Hospital stay: 7–10 days total
• Return to light activity: 4–6 weeks
• Return to work (desk job): 6–8 weeks
• Driving: 4–6 weeks after surgery
• Diet: heart-healthy diet — low saturated fat, low sodium, high fibre
• Medications: aspirin, statins, beta-blockers, and ACE inhibitors for life
• Follow-up: echocardiogram and stress test at 3 months, 1 year, then annually