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It's all in the heart

To Dr. Saroja Bharati, the problems associated with congenital heart disease have always been intriguing. The Chicago-based cardiologist was in the city recently as a guest lecturer at the Sri Ramachandra Medical College.

WHEN DR. SAROJA Bharati speaks about cardiology, the medical fraternity the world over is all ears. One among a handful of experts on congenital heart disease and the conduction system across the globe, Dr. Bharati was recently in the city to deliver a guest lecture on "Aging changes in the heart with reference to the conduction system" at the Sri Ramachandra Medical College.

Though once a Chennai-ite, Dr. Saroja Bharati is now based in Chicago Illinois, and is director of the Maurice Lev Congenital Heart and Conduction System Centre Hope Children's Hospital, Advocate Christ Medical Center.

So what are the effects of ageing on the heart? "As you know, the heart is a muscle inside which there is a special muscle called the conduction system, responsible for the beating of the heart. Normally, the heart beats around 72 times a minute but, as one grows older, it may beat very slowly or even crazily. Aging is a reason for arrhythmias (irregular heart beats) in the elderly. Also, fat, in part, replaces the heart muscle and the conduction system. Sometimes, the muscle is replaced by scar tissue from a previous heart attack. Because the elderly also suffer from coronary artery disease, diabetes and high blood pressure, these affect the heart too. There may be deposits of calcium and loss of conduction fibres. If two-thirds of the vital part of the conduction system is affected the heart may not beat at all and may go into a state called heart block, necessitating a pace maker."

"Intrigued" and "excited" by the study of the heart even as a medical student, Dr. Bharati after graduation from the Kilpauk Medical College, Chennai in 1966, left India to do her internship and residentship at the Providence Hospital Washington, followed by a fellowship in cardiology at the Miami Heart Institute, where her superiors were impressed by her work. One of them introduced her to Dr. Maurice Lev, a pioneer in cardiac pathology who became her mentor, and soon Saroja Bharati found her calling.

Quick to discover that there had been no systematic research on the conduction system and congenital heart disease, she got working on it in earnest. There has been no looking back since.

The outcome of her extensive research thereafter, provided enough material for three books she co-authored with Dr. Lev — Cardiac Surgery and the Conduction System (the third author is Dr. John Kirklin), Cardiac Conduction System in Unexplained Sudden Death, and Pathology of Congenital Heart Disease. She is also collaborating with researchers from Harvard University to study a special type of arrhythmia. She divides her time between teaching and research. (She teaches at all six universities in Chicago — North Western, University of Chicago, Loyola University, Rush Presbyterian and Rush Medical College and Chicago Medical School.)

Blue babies are another area of interest to her. "Blue babies are being operated on with excellent results, particularly in the U.S. (where the mortality is less than two per cent as opposed to 10 per cent elsewhere). Post operatively these babies grow up to lead a more or less "normal" life.

But when you make an incision in the heart, the heart muscle does not regenerate. Weeks later, there will be scar tissue. You may have corrected the heart but the impulses that are generated in one area may slow down at the junction of the scar tissue, causing problems such as palpitation or premature ventricular contraction, sometimes disabling the patient. So by treating blue babies we are creating more problems in some of them. But as technology progresses our methodology of treatment is bound to change."

She is concerned that over the last 15-20 years, obesity is reaching epidemiological proportions in the U.S., especially among children and young adults. "Moderate or marked obesity does affect the conduction system. We first have to rule out genetic causes. Obesity could also be lifestyle related — a majority of people don't eat the right foods and are hooked to the television and computer."

Her personal prescription for a healthy heart is exercise, eating a sensible diet with lots of fresh fruit, vegetables and nuts, substituting red meat with fish and practising yoga.

Rated as one among hundred women who made a difference in Chicago in the year 2000, one wonders how she was received as an Indian in the U.S.? "There is discrimination, but I adopted a healthy attitude to it. The more obstacles I faced the stronger I became."

Not ready to hang up her boots she says, "I will continue to work as long as people think my work is useful. I am interested in teaching because the knowledge that I have accumulated is of no value if I don't share it with others. I want to inspire and motivate youngsters. But when the time does come for someone to take over, I hope to start playing golf."

SUDHA UMASHANKER

Pic by N. Balaji

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