Q: Please explain about mild diseases of proximal LAD. Also advise about the dietary modifications required in these conditions.

A:Mild disease in LAD means that the left anterior descending artery, which is one of the 3 arteries supplying blood to a very important area of the heart (anterior wall and the interventricular septum) has fatty deposits in the wall at a point, which is not compromising the blood flow. Very often the deposits are soft and can be a nidus for formation of a clot at the site within the lumen of the artery leading to catastrophic consequences, This kind of disease does not need Angioplasty/bypass surgery because the blood flow is normal. However, these patients need very aggressive medical treatment with aspirin, statins (a cholesterol lowering drug), ACE inhibitors if there are other risk factors like high BP, diabetes etc. Along with this, one needs to take heart healthy diet (leafy vegetables, fruits, low fat diet, alcohol in moderation, restriction on red meats, use of mono and poly unsaturated oils as cooking medium (mustard oil, canola oil, olive oil, soya oils etc.) and restriction on saturated fats (butter, ghee and full milk products. Tobacco use is prohibited All these measures lead to passivation of the vulnerable plaques often associated with mild disease and can even lead to regression of disease. Regular exercise for at least 30 minutes per day is also recommended as a factor reducing the chance of complications. Such patients should keep their BP < 120/80 mm Hg. Total cholesterol levels less than 150 mgs and triglyceride levels below 150 mgs. Diabetics should have a tight control of blood sugar.