Hypertensive heart disease
Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped or is about to stop working. It means that your heart is not able to pump blood the way it should. It can affect one or both sides of the heart.The weakening of the heart's pumping ability causesBlood and fluid to back up into the lungsThe buildup of fluid in the feet, ankles and legs - called edemaTiredness and shortness of breathCommon causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are overweight, and people who have had a heart attack. Men have a higher rate of heart failure than women.Your doctor will diagnose heart failure by doing a physical exam and heart tests. Treatment includes treating the underlying cause of your heart failure, medicines, and heart transplantation if other treatments fail.NIH: National Heart, Lung, and Blood Institute
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Top Cases of Hypertensive heart disease
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Top doctors who continously share their opinions on Hypertensive heart diseaseWest Bengl Health Service Transferable Serviceì In Different Hospitals
Physician
PGI,Chandigarh
M D MEDICINE)

PHC Bichpuri and ESI Dispensary Chippitola Agra & SN Medical College Agra & Fatehgarh
Medical Officer Incharge
SN Medical College, Agra
DA



Consultant Medicine(Physician2001-2012)Medical Officer(1984-2001)ART Physician Working As SMO(2012-til Date)
Consultant Medicine-J&K H&M Deptt Hospitals;Currently SMO-(ART Physician )GMC Jammu
Govt. Medical College, Jammu
MBBS(1975-1981);M.D (Medicine)1993-1996

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Last week was back-to-back five bilobed bipaddled PMMC flaps for full-thickness buccal mucosa defects. It made me reflect— In India, where many patients present late with advanced head and neck cancers, and where microvascular expertise or resources may be limited, this flap becomes more than a salvage,It becomes a purposeful craft, especially when where risk, and resources are in short supply. Success in reconstruction lies less in patient factors, and more in the surgeon’s design and execution. Every wound dehiscence, infection, or flap failure often reflects a planning flaw rather than patient factors. The Bilobed PMMC Flap Is More Than a Procedure.It’s a mastery of balance between form and function & between art and science As surgical oncologists, we must reconstruct with the same precision we resect. Both are part of the same journey,and in that journey, mindful reconstruction is where true surgical wisdom lies. Here are my 2 cents for how to plan for Bilobed PMMC Flap ✅ Flap Design • Center on the Nipple-Areola Complex (NAC) • Inner paddle → inferolateral, for mucosal lining • Outer paddle → medial, for skin cover • Lateral “C” design allows a large harvest with primary closure ✅ Paddle Orientation • Taper both ends to prevent dog-ears • Leave 1 cm between paddles for de-epithelialization & tension-free folding ✅ Safe Flap Limits • Do not extend >2 cm beyond the pectoralis major borders to preserve viability ✅ Pedicle Handling • Avoid spiraling of the pedicle • If NAC is included, anticipate nipple positioning in inner paddle or mark inner paddle ✅ Commissure Reconstruction • Prioritize primary closure • Use flap bulk to maintain commissure symmetry and prevent deviation ✅ Nerve Division • Always divide the lateral pectoral nerve to prevent post-op compression Suggestions are welcome for insightful discussion regarding same .
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