Dr. Sevdalin Topalov: Many diabetics get a painless heart attack

Dr. Sevdalin Topalov: Many diabetics get a painless heart attack
Dr. Sevdalin Topalov: Many diabetics get a painless heart attack

In recent years in medical practice, the role of the so-called invasive cardiology. In addition to large clinics and medical centers, such departments were also opened in some regional and municipal hospitals. One of them is the invasive laboratory at the cardiology department in Haskovo hospital. This department became operational at the beginning of 2013, but in practice it reduced the number of heart attacks in the Haskovo region by as much as three times. The characteristic feature of invasive cardiology in Haskovo is that it is one of the few in the country where even an expensive stent does not require a leva surcharge.

Today in MyClinic we offer you an interview on the subject with Dr. Sevdalin Topalov - one of the best specialists in this department, who saved more than one human life.

Dr. Topalov, what conditions are managed and treated by invasive cardiology?

- Invasive cardiology deals with both emergency and non-emergency conditions. An emergency is the so-called acute coronary syndrome, which can be both unstable angina and myocardial infarction. A non-emergency condition is considered the so-called stable angina. She also has symptoms, but it is not urgent. It occurs with higher physical loads. In addition, in invasive cardiology, we also perform imaging of patients who are about to undergo valve replacement, placement of aortic coronary bypasses and other such procedures.

Stenting is part of invasive cardiology practice, right?

- Yes, we place stents when necessary.

Is it necessary for non-emergency situations?

- Both non-urgent and urgent, as long as there are indications for it. The point is to follow the rules.

What are the indications for stent placement?

- Symptomatic angina is an indication for stent placement. In stable angina, the condition is that the person is at rest or that no symptoms appear when walking normally. But with greater physical exertion, symptoms appear with corresponding changes in the cardiogram. Symptomatic anginal pain is described. Basically, angina is a big part of cardiology, but it is essentially a symptom.

Dr. Topalov, if a stent is placed in time, will this prevent the heart attack?

- Yes, it prevents heart attacks and improves quality of life. The man lives quite normally. Can work normally and do physical work.

Is this consumable covered by the He alth Insurance Fund?

- Yes, it is accepted. Here I want to clarify that, in addition to ordinary stents, there are also modern ones - the so-called medicinal-emitting.

In many places they charge extra

but here, in invasive cardiology in Haskovo, not a single lev is paid by the patient, regardless of what kind of stent is placed.

What are the advantages of invasive cardiology, generally speaking?

- The biggest advantage in the first place - this is the control of myocardial infarction. As long as the patient comes on time. That is, to organize things so that he is brought to the ward on time. And, I assure you, he will leave here without any adverse consequences.

Are there conditions that cannot be treated by invasive cardiology, patients to whom the procedures cannot be applied?

- There is, yes. These are patients on whom we only diagnose and send them for surgery.

Dr. Topalov, are there such acute conditions that manifest themselves with atypical symptoms?

- Yes, there is atypical angina pectoris, the so-called silent ischemia, when a person does not feel any pronounced signs. A large percentage of diabetic patients, for example, get a painless heart attack. In them, the symptoms are not pain, but only shortness of breath. I.e. poor pump function. Of course, there are complaints, but they are more discreet. For example, I have had a patient in whom the only initial manifestation of the heart attack was only a toothache. There are cases, for example, with the so-called

lower heart attack when the pain is only in the stomach

That is why it is important for the sufferer to see an experienced specialist. He can point him in the right direction, think and analyze the situation. I have had a case where a heart attack patient vomited. Only vomiting, nothing more, which is why the diagnosis was delayed. In the end, it turned out that the man had a heart attack.

Why, despite everything, are these acute diseases not decreasing in frequency?

- This is as a result of our poor he alth culture. Our he alth care in general is such that we have practically no prevention. In this case, prevention means proper treatment of hypertension, dyslipidemia, and diabetes. If this is achieved, acute cardiac conditions would also decrease. I think all of society needs to get involved, of course, and so should you, the media. It is no secret that some actions of the state, society, politicians, turned society against doctors. Of course, control is also largely lacking. In general, the organization is lame. The system is such that pre-hospital and hospital care do not work in sync.

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