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Know your heart better

12 November, 2024|
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Though heart disease is a leading cause of death, it does not mean you have to accept it as your fate. Although you cannot change some risk factors — such as family history, gender or age — there are some key heart disease prevention steps you can definitely take.

It has been predicted that by the year 2020 there will be an increase by almost 75% in the global burden of heart disease. The situation in India is more alarming. It has been predicted that by 2020 there would be 11% increase in deaths in India due to heart problems. Preventing heart disease means making smart choices now that will pay off the rest of your life.

The heart is a muscular organ about the size of a clenched fist, which pumps blood through the blood vessels to the whole body. The heart is made up of four chambers and has four valves controlling the flow of blood. The heart muscle too needs oxygen and nutrients to function non-stop; this is achieved by special blood vessels called coronary arteries.

The coronary arteries run along the surface of the heart and provide oxygen-rich blood to the heart muscle. Blockage in these arteries causes angina, heart attacks and possibly death. Damage to the muscles of the heart, heart valves and electric conduction within the heart can also cause serious heart diseases.

What can go wrong

  • Heart attack or myocardial infarction: Over the years, cholesterol and fat accumulates in the coronary arteries, which can narrow the arteries supplying blood to the heart. The narrowed arteries are at higher risk for complete blockage from a sudden blood causing heart attack which can be life threatening.
  • Angina: Narrowing of the coronary arteries deprives the heart from receiving extra blood with oxygen needed during exertion. This causes chest pain or discomfort called angina on exertion.
  • Unstable angina: Chest pain or discomfort that is new, worsening, or occurs at rest. This is an emergency situation as it can precede a heart attack, serious abnormal heart rhythm, or cardiac arrest.
  • Arrhythmia: Can cause palpitation, light headedness or collapse. Defect in the electric circuit within the heart can cause either very fast or very slow heart rate. Some arrhythmias are benign, but others are life-threatening.
  • Heart failure: The heart is either too weak or too stiff to effectively pump blood through the body. Shortness of breath, tiredness and leg swelling are common symptoms.
  • Cardiomyopathy: A disease of heart muscle in which the heart is abnormally enlarged, thickened, and/or stiffened. As a result, the heart's ability to pump blood is weakened.
  • Heart valve disease: Valves can get narrowed compromising the blood flow within the chambers of the heart and ability of the heart to pump the blood to the whole body. The valves can also become leaky causing the blood to regurgitate back causing congestion further compromising the blood flow.
  • Sudden cardiac death: Death caused by a sudden loss of heart function (cardiac arrest).
  • Cardiac arrest: Sudden loss of heart function.

What to do in case of a heart attack

The first thing to do is not to wait --- get help quickly. Acting fast at the first sign of heart attack symptoms can save the life and limit damage to the heart. Treatment works best when it’s given right after symptoms occur.

Time is muscle: Every 10 minute delay to treatment results in a 1% increase in rate of death, which rises to 7.5% for every 30 minute delay.

Knowledge is safety: You need to know what the signs and symptoms of heart attacks are. You should also know the appropriate actions and treatment during the heart attack. Finally, you should have a list of dedicated heart attack centers handy.

Following are some of the most common warning symptoms of a heart attack.

  • Chest pain or discomfort: The most classical or common symptom of heart attack is discomfort in the center or left side of the chest. The discomfort usually lasts more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, or pain. It also can feel like heartburn or indigestion. Along with this, the patient may also feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of the stomach (above the belly button).
  • Shortness of breath: This may be the only symptom, especially in diabetic patients or it may occur before or along with chest pain or discomfort. It can occur when while resting or doing a little bit of physical activity.

Other possible symptoms of a heart attack include:

  • Breaking out in a profuse cold sweat
  • Feeling unusually tired for no reason
  • Nausea (feeling sick to the stomach) and vomiting
  • Light-headedness or sudden dizziness
  • Any sudden, new symptom or a change in the pattern of symptoms you already have (for example, if your symptoms become stronger or last longer than usual)

Invisible symptoms: Not all heart attacks begin with the sudden, crushing chest pain that often is shown on TV or in the movies, or other common symptoms such as chest discomfort. The symptoms of a heart attack can vary from person to person. Some people can have few symptoms and are surprised to learn they’ve had a heart attack. If you've already had a heart attack, your symptoms may not be the same for another one.

If you think you or someone else may be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Acting fast can save your life.

Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. Take a nitroglycerin pill if your doctor has prescribed this type of treatment.

Many more people could survive or recover better from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.

The gold standard treatment for heart attack is emergency angioplasty which has proven to be life-saving, reducing the risk of death and long term damage to the heart muscles. This treatment requires skill and excellent hospital setup to provide timely and correct treatment.

Places where this facility is not available or cost is an issue, a clot-blusting injection or thrombolysis is given but the results are inferior to emergency angioplasty and several patients end up having angioplasty even after this treatment.

Recently I have seen young patients having heart attack and dying. Patients as young as 30 years of age are having heart attacks. I recently came across a young 30 year old patient, who walked into the emergency department of a hospital for an ECG as he was having chest pain. After the ECG, he was advised to sit outside and he collapsed instantaneously. Despite resuscitation provided by the medical staff, he could not be saved.

There was another patient in his late 50s who was referred to a hospital with chest pain. That hospital did not have angioplasty facilities. He was having a heart attack. His treatment was delayed. He was later transferred to a bigger hospital as he was unstable. He had already suffered serious damage to the heart. In spite of emergency heart surgery and spending lakhs of rupees, he did not survive.

But all is not dark --- there are many successful stories where young and old patient have received treatment in time and have survived major heart attack and are living normal life with their family. Correct treatment at the correct time is important, but even more important is reducing the risk and preventing heart diseases.

How to prevent heart attacks

Sedentary lifestyle, a poor diet and other bad habits can take their toll over the years. Anyone at any age can benefit from simple steps to keep their heart healthy during each decade of life.

It is important to know your family history. Having a relative with heart disease increases your risk, especially if the relative is a parent or sibling. That means you need to focus on the risk factors you can control to prevent yourself from heart disease.

You can avoid heart problems in the future by adopting a healthy lifestyle today. Here are few heart disease prevention tips or mantras to get you started as advised by American Heart Association.

Work with your doctor: Get a checkup at least once each year, even if you feel healthy. A doctor, will check for conditions that put you at risk for heart disease, such as high blood pressure, high cholesterol or diabetes --- conditions that can go unnoticed for too long.

Exercise: A 30 minute workout on most days of the week helps. Physical activity can help you to lower cholesterol, lower blood pressure and better control of diabetes.

Eat a healthy diet: Decrease the salt in your diet. Be sure to eat plenty of fresh fruits and vegetables—adults should have at least five servings each day

Maintain a healthy weight: Research shows that reaching and keeping to a healthy weight cuts your risk of heart disease, stroke because it helps prevent and manage conditions like high blood pressure, high cholesterol, and type 2 diabetes that put you at greater risk of coronary heart disease. Even if you don't have any of these conditions, it's important to keep to a healthy weight so you don't develop them in future.

Get enough quality sleep: Several recent studies show links between shortened sleep duration, defined as less than six hours of sleep, and increased risk of heart disease. Poor sleep has been linked to high blood pressure, atherosclerosis (clogging or hardening of the arteries), heart failure, heart attack, stroke, diabetes, and obesity

Don't smoke: Cigarette smoking greatly increases your risk for heart disease. If you don't smoke, don't start. If you do smoke, quit as soon as possible.

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