A 33 years young marketing executive, who has been smoking more than 10 cigarettes a day for last 10 years and eating non vegetarian food cooked in coconut oil and served with a lot of coconut gravy at least for 5 days in a week, whose father is on medication for diabetes and high blood pressure.
He had a very hectic day following which in the night at 11 P.M. had an heavy argument with his wife. In the early morning at 3 A. M. he woke up with unbearable squeezing sensation in the upper part of stomach associated with sweating. He also said that his stomach is full of gas. In fact for last 3 days he has been having some kind of gastric upset that he describes it as a "gas trouble."

[1] The desired action in such a setting is:
A] Drink some soda with limejuice.
B] Ask the family Doctor for some anti acid medication on telephone.
C] Request the family doctor for a visit.
D] Go to the nearest big hospital.
E] Call for a cardiac ambulance.

















































[2] Heart attack is:
A] Progressive partial blockage of the pipes that supply blood to the heart.
B] Progressive complete blockage of the pipes that supply blood to the heart.
C] Sudden partial blockage of the pipes that supply blood to the heart.
D] Sudden complete blockage of the pipes that supply blood to the heart












































The doctor on duty says that they may perform an angiography.

[3] Angiography is:
A] Opening of blocked pipes of the heart with a balloon.
B] Opening of blocked pipes of the heart with a laser beam.
C] Opening of blocked pipes of the heart with a rotating blade at a high speed.
D] Mapping of blood carrying pipes of the heart.
E] Mapping of blood carrying pipes any where in the body.







































The patient is stable after the initial medicines he received to dissolve the clot in the pipes of his heart. His all parameters are within normal limits and he does not have any discomfort anymore. The doctor on duty has asked the family to decide about their willingness to go ahead with angiography. He also told that angiography is the first step towards further interventions.

[4] The best time for any intervention in such a setting is:
[Best time means Maximum benefit with minimum risk]
A] Within first 6 hours from the onset of the problem.
B] Within first 6 hours from admission in the hospital.
C] After first 6 hours from onset of the problem but before end of 6 weeks.
D] After end of 6 weeks.
E] After end of 3 months.













































The subsequent angiography reveals a single 50% block in one of the major blood pipes.
[5] The patient should be treated with:
A] Dilatation of block.
B] Bypass surgery.
C] Vigorous life style modification.
D] Only medicines
E] No treatment.














































The subsequent angiography reveals multiple blocks in the major and minor blood pipes.
[6] Can the patient survive without any intervention:
A] Yes.
B] No.


















































Consider a scenario wherein on admission the condition of this young man is very much unstable and does not improve in spite of the medicine given to dissolve the clot. In fact it starts worsening and we take him to the operating room for emergency bypass surgery. On opening the chest we find that the pumping of the heart is very poor.

[7] We should:
A] Abandon the operation and close the chest, as it is hopeless to proceed further.
B] Perform the bypass surgery on beating heart.
C] Perform the bypass surgery on immobile heart.
D] Perform the bypass surgery and connect the patient to partial artificial heart.
E] Remove the native heart and replace it with either with a dead man's heart
[ Heart transplantation.] or with a total artificial heart.







































[8] Can the patient lead same old lifestyle:
A] Yes.
B] No.




















































[9] Change of lifestyle means:
A] He should go to a village and lead a peaceful life in a clean environment.
B] Change his profession.
C] Change his present job.
D] Stop eating fats, use only "good for heart" oil if at all he wants to eat fats, stop eating salt, non vegetarian food, coconut products, ice-cream, Milk products. He should do only light work.
E] Eliminate only the factor that is responsible for the trouble.





































[10]The patient would not have faced this problem had he:
A] Restricted his salt and water intake.
B] Restricted his salt but not water intake.
C] Restricted his water but not salt intake.
D] Consumed a lot of salt and water.
E] Consumed the normal amount of salt but a lot of water.







































[11]Cholesterol in blood is:
A] Dangerous for human survival therefore keep it as low as possible.
B] Neutral as far as our life is concerned.
C] Essential for human life.
D] Only the good cholesterol [HDL] is essential, other fractions are dangerous.

















































[12]The patient would not have faced this problem had he:
A] Had his food cooked in an oil that is advertised as "good for heart".
B] Restricted his oil intake totally.
C] Had his food cooked in ghee.
D] Avoided coconut products.
E] Had only vegetarian diet.













































[13]The patient would not have faced this problem had he:
A] Smoked less than 10 cigarettes a day.
B] Smoked less than 7 cigarettes a day.
C] Smoked less than 4 cigarettes a day.
D] Smoked less than 2 cigarettes a day.
E] Avoided even the passive smoking.











































[14] In diabetes the sugar is:
A] More in both blood as well as the cells of the body.
B] Less in both blood as well as the cells of the body.
C] Less in blood and more in the cells of the body.
D] More in blood and less in the cells of the body.







































[15] This type of heart disease occurs only after the age of :
A] 50 years.
B] 40 years.
C] 30 years.
D] 20 years.
E] Any age.

















































[16] Anger doubles your chances of having heart attack within next two hours:
A] Yes.
B] No.


















































[17] Closer the blood relation having heart disease, more are your chances of having it:
A] Yes.
B] No.


















































[18] Women have less chances of having this type of heart disease:
A] Yes.
B] No.


















































[19] More than normal body weight is responsible for:
A] Heart disease.
B] High blood pressure.
C] Diabetes.
D] Joint pains.
E] Acidity.

















































[20] Does lack of exercise increase risk of coronary heart disease?
A] Yes.
B] No.


















































[21] What does the exercise do?
A] Gives you pleasure.
B] Reverses the coronary artery disease.
C] Reduces the blood sugar level.
D] Reduces the levels of bad cholesterol.
E] Helps in the body weight reduction.










































[22] Is "high" blood pressure a cause of heart disease?
A] Yes.
B] No.


















































[23] How much "high" is risky?
A] Diastolic more than 120
B] Diastolic more than 110
C] Diastolic more than 100
D] Diastolic more than 090
E] Diastolic more than 080













































[24] Health means :
A] Physical well-being.
B] Mental well-being.
C] Both Physical and Mental well-being.
D] Both Physical and Mental well-being and a lot more.
E] Absence of disease.














































[25] In this patient the most probable primary cause of the heart trouble is :
A] Cholesterol.
B] Heavy smoking.
C] Diabetic father.
D] Stress.
E] Non-vegetarian diet.













































1 A The patient does not get relief even after drinking soda with lime.
He should:
Ask the family Doctor for some anti acid medication on telephone.
Request the family doctor for a visit.
Rush to the nearest big hospital.
Call for a cardiac ambulance.



































1B In spite of the anti acid medication the young man continues to have discomfort.
He should:
Request the family doctor for a visit.
Rush to the nearest big hospital.
Call for a cardiac ambulance.



































1C Even after anti acid medicine he is not relieved therefore he requests his family doctor for a visit. The family doctor visits him by 9 A. M. and asks for immediate admission in a big hospital as he suspects heart attack.
You should:
Rush to the nearest big hospital.
Call for a cardiac ambulance.



































1D Congratulations this is the right decision. You are saving the patient's heart with this decision.

[If you wish you can go to the discussion on this question or to the next question.]

Proceed to question 2
Proceed to the discussion.













































1E The cardiac ambulance takes longer time to reach and whenever it reaches you find that the doctor with the ambulance is not adequately qualified or experienced to take care of such an emergency. However you have no way out so you shift the patient to the big hospital.
Proceed to question 2
Proceed to the discussion.













































2ABC] This condition will lead to limitation of activity but not to this picture of heart attack.
Proceed to the discussion.














































Therefore Heart Attcak is:
Sudden complete blockage of the pipes that supply blood to the heart













































2D] This is the right answer.
You can proceed to question 3
Or to the discussion.













































3A,B,C] These are different types of angioplasty that is treatment. Whereas angiography is an investigation.
Back to question 3
To The explanation about angiography.
To the next question.














































3D] The mapping of arteries of the heart is called coronary angiography where as angiography is mapping of any pipe that caries blood or it's components.
Back to question 3
To The explanation about angiography.
To the next question.













































3E] Congratulations! This is the right answer
To The explanation about angiography.
To the next question.













































12 A] There is nothing like "good for heart" oil. This is marketing gimmick. It is good only for the pockets of the manufacturer!
Back to the same question
To the discussion
To the next question













































12B] Our body can make cholesterol out of any stuff oil or no oil. Body has this ability because cholesterol is the most important chemical in our body. Therefore it does not make any sense to restrict oils. The only thing to remember is you should not consume it in excess.
Back to the same question
To the discussion
To the next question













































12C] It does not matter whether you have ghee or any other fat. The idea is to have adequate amount of fat. But never in excess!
Back to the same question
To the discussion
To the next question













































12D] There is misconception about eating oils. You can consume any type of oil but in moderation.
Back to the same question
To the discussion
To the next question













































12E] The vegetarianism camp vigorously advocates vegetarian diet. But that is not right. You can have any diet in moderation and be healthy. If you love non-vegetarian food, you should enjoy it. Only thing is you should know the limits.
Back to the same question
To the discussion
To the next question