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Photo of Dr. Prithwish Banerjee

A Heart-Loving-Heart

by Dr. Prithwish Banerjee



I deal with heart disease and encounter smoking related heart disease almost everyday. Smoking is a principal, preventable cause of premature death in the developed world. It is a major cause of coronary artery disease (CAD), a condition where the blood vessels supplying the heart muscles become narrowed leading to chest pains (angina) or heart attacks. The image below shows a coronary artery (blood vessel supplying the heart) with a tight narrowing affecting the mid segment. This is often a finding in smokers.

coronary artery with tight narrowing affecting the mid segment - RCA lesion

For comparison, this next image of the same heart artery shows a normal artery with no narrowings.

normal coronary artery with no narrowing - RCA Normal

Heart attacks lead to damage of the heart muscle, which can lead to the failure of the heart to pump adequately. This can cause fluid build-up in the lungs as well as in the limbs. This condition, called heart failure, is very common and associated with a very high rate of disability and death.

The first link below is to a short movie clip (AVI file - 459K) of an ultrasound scan of a heart damaged by a heart attack. The main chamber of the heart called the left ventricle (LV) is enlarged, with damaged, thin walls, and does not contract well. Stasis of blood in this chamber has also led to a 'smoky' appearance inside the chamber. The second link, for comparison, is a clip (AVI file - 348K) showing a normal heart with good contraction of the left ventricle (upper right hand chamber).

Damaged Left Ventricle      Normal Left Ventricle

Smoking multiplies the effect of other risk factors for CAD like high blood pressure, high cholesterol and diabetes. Men who smoke have a 60%-70% greater death rate than those who don't. Sudden death may be the first manifestation of CAD in young male smokers. Women smokers have a 10 times increased risk of developing CAD than non-smokers.

Low tar cigarettes and smokeless tobacco are not effective substitutes for discontinuing the use of tobacco products. Passive smoking in those who have never smoked increases the risk of CAD.

Smoking cessation produces immediate and long-term benefits. There is a substantial decrease in the risk of a heart attack within 1 year of stopping smoking. Those who quit smoking prior to the age of 50 have half the risk of dying in the next 15 years compared to continuing smokers.

Below you'll find a few poems I've written which my wife thinks are a waste of my time but I hope will help open your mind to where smoking is leading you and how much you stand to lose.


Dr. Prithwish Banerjee, Dip Card, MD, MRCP
Department of Academic Cardiology
The University of Hull, England



Special thanks to Dr. Justin Ghosh for his help in acquiring the above images.




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"Smoking and Circulation" by Joel Spitzer

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Three Poems by Dr. Prithwish Banerjee





CANCER

There is pain
In her eyes
And a deep
Sadness
A silent tear,
An anguished whisper
"Are you sure doctor?"
I nod in silence.


Then
There is panic
Her voice breaks
"Oh why did I smoke?
What shall I do?"


I speak softly
Of treatment options,
The strength of the mind
And prayer.


As she leaves
There is a light
In those eyes.
A weak smile
Then
With firm strides
She steps into
The night.






HEART ATTACK

I hear drumbeats
In the distance.
Cholesterol and platelets are preparing for war
Nicotine missiles
Are firing still.
Damn. We are
Running out of insulin
There's too much pressure guys
Hurry please hurry
I can hear drumbeats in the distance ...


Blinding pain
My eyes are glazed sheets
My chest is an inferno.
"It is an attack, sir."
"Has anyone in your family ..."
"Smoke ... exercise ... diet ..."
Injection.


I swim about
In space
Don't want an attack
No war please
Please.





Life as a junior doctor in a busy job can be tough. If both husband and wife are junior doctors in busy jobs it gets tougher. When, on top of this, they have a baby to look after with no other family around, the situation can be near extreme. My wife and I were in that situation 3 years ago. I only have confused memories of those days but do remember feeling quite emotional at times. While rummaging through the drawers recently I discovered a poem I had written at the time that expresses feelings that we medics often have at some stage of our career. It is called 'I Love My Baby.' I offer it here as no loving relationship should be destroyed by chemical dependency. I wish you a healthy heart-loving-heart!

I Love My Baby

The rude screeching alarm
Interrupts a pleasant dream,
Damn it, I'm late.
I quickly brush and shave,
Grab some breakfast
And jump into the car.
No time to kiss my little one
Deep in sweet slumber.
I love my baby.


In the middle of the ward-round
The cardiac arrest bleep goes off.
Adrenaline please, continue CPR;
It's VF now! C'mon, shock at 360.
We have been going 30 minutes,
No pulse. Check again.
Okay stop resus. All agreed.
I love my baby.


It is a busy clinic
Interrupted by several bleeps.
You are fine ma'am
See you again in a year.
Monica, could you ring for this
Blood result please.
Doctor Banerjee, the clinic
Is running behind by an hour.
I love my baby.


Stuck in the traffic
On the radio the latest
On the Cossovo war
Three American soldiers abducted
More than 600,000 Albanians flee
Memories of previous wars
Sit heavy on the heart.
I love my baby.


8.30
He sinks into slumber
His head on my shoulder
As I sway softly
To his favourite music.
I feel his soft heart
Thumping on my chest.
I love my baby.

by Dr. Prithwish Banerjee


2003 © Dr. Prithwish Banerjee, MD



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