Ways To Ensure A Good Health Of The Heart:
The Magnitude of the problem:
A 45-year-old man wakes up at 4.30 a.m and complains that he feels some discomfort in the chest, it may be “gas”, he surmises. His wife says we can go to the doctor after breakfast, drink some water and go to sleep. He went to sleep never to wake up; this is a real-life incident.
The leading cause of death in India is coronary heart disease. Added to this is a significant burden of congenital heart diseases, rheumatic heart disease, degenerative heart disease and arrhythmia-related cardiac problems.
The burden of heart disease is rising rapidly in India with the westernisation of our diet/reduced physical activity and a genetic predisposition to develop blockages in the blood vessels.
We have a high incidence of diabetes/hypertension/central obesity which contributes to coronary artery disease at a younger age and more severe disease as compared to a Caucasian/Chinese/African population.
Action to be taken -
Awareness: As a doctor, the most important problem faced is one of suspicion and denial. People are unable to accept that one of them or a dear one can possibly develop a heart attack. "He was fine till 2 hours ago", is the usual refrain. Unfortunately, most heart attacks happen suddenly. ”Time is Muscle” - the sooner you treat the better are the outcomes. Going from one hospital to another in an emergency wastes precious time. One should go to the nearest facility which is equipped to handle these situations.
In chronic conditions, there is enough time and scope for multiple opinions and hospital visits.
Prevention: The old adage prevention is better than cure is very appropriate in this context.
Ischaemic heart disease occurs due to plaque formation in the coronary arteries. It cannot be attributed to one single cause but is usually due to multiple risk factors.
Some of them are modifiable and therefore more relevant. These are,
The Non-modifiable risk factors are:
Diabetes: Diabetics are 3-5 times more prone than non-diabetics to develop IHD. It is important that people with diabetes should have their cholesterol levels checked and treated appropriately. Good blood sugar control has also been associated with lesser cardiac events.
Smoking: Smokers have a 3-5 fold higher risk of IHD. They develop blockages at a younger age and have a higher propensity to develop plaque rupture and acute heart attacks. SMOKING CESSATION is the single most important health intervention that can be done with least cost to the individual.
Hypertension: All individuals should know their blood pressures and check it periodically. High blood pressure is a silent killer as it is mostly asymptomatic and inflicts damage gradually. All individuals should know their blood pressure and should be treated appropriately if it is high.
Physical Inactivity: With the advance in technology and availability of gadgets for every need, physical inactivity has become rampant. Lack of physical activity causes diabetes/hypertension/ high cholesterol and increased risk of heart attacks.
The moderate physical activity of 30- 45 minutes are recommended to maintain a healthy heart.
Obesity: Obesity is a rising pandemic in Asian countries and all efforts should be done from childhood to avoid obesity. Obese individuals have a much higher likelihood of hypertension, diabetes and heart disease. Non-alcoholic Steatotic hepatitis, osteoarthritis, sleep apnoea are some of the other drawbacks of obesity.
Cholesterol: High cholesterol is a major cause of heart disease. Checking one's cholesterol values at least once in
5 years and taking remedial action (Lifestyle changes and/ or medications) is a very important step in reducing heart disease.
When should I seek medical attention?
Easy fatiguability can be a symptom of heart disease.
Bluish extremities, Loss of consciousness can be due to heart-related problems.
Any of the above-mentioned symptoms should alert one to a possibility of heart disease.