Cardiac Ailments is the leading cause of death in India and worldwide killing about 1 in 5 men and 1 in 8 women, According to WHO reports. It is caused by blockage in heart's blood supply by a build-up of fatty substances in the arteries. It is primarily a disease caused by lifestyle habits and conditions such as smoking, overweight, high cholesterol, high blood pressure and diabetes.
Heart attacks were once only associated with old age. Recently, more people in their 20s, 30s and 40s have been suffering from heart ailments. The increasing stress of modern life has exposed even younger people to the risk of heart diseases. While a person's genetic disposition and family history remain the most common and uncontrollable risk factors, majority of heart diseases in the younger generation is due to excessive stress and long working hours coupled with erratic sleep patterns, which cause inflammation and increase the risk of heart disease. Smoking and a sedentary lifestyle further accelerate the risk symptoms in people in the age group of 20 to 30 years.
Everyday about 9000 people die of heart ailments - which mean one in every 10 seconds. Out of them 900 are youths below the age of 40 years. The only way to prevent the Epidemic of Heart Disease in India is to educate the masses otherwise it is set to become the leading killer by 2020.
Cardiac Hospitals in India perform more than 2 lakh open heart surgeries and are increasing annually by 25% but they are not able to control the numbers of heart attacks. The surgeries done are only palliative. Educating the essentials about Heart disease and its risk factors is important to eradicate the casualties from the root.
What are the symptoms?
Not every CHD patient has the same symptoms and angina chest pain as its most common feature. Symptoms may vary from nil to severe, some may have an uncomfortable feeling like indigestion and some cases may be experiencing severe pain, heaviness or tightness. The pain is usually felt in centre of the chest, that spreads to the arms, neck, jaw and even to stomach, and is accompanied by palpitation and unusual breathlessness.
If arteries become completely blocked, it can cause a heart attack that can cause permanent damage to the heart muscle. The discomfort or pain of a heart attack is usually similar to that of angina, but is often more severe and may be associated with sweating, lightheadedness, nausea and breathlessness. This is more common in people with diabetes. Heart attack if not treated straight away can be fatal.
How to do prognosis in advance?
Assessment of a suspected CHD patient involves the medical and family history, assessing the lifestyle and taking blood tests. Further tests to confirm a diagnosis of CHD includes non-invasive tests like an electrocardiogram (ECG) to identify the structure, thickness and movement of each heart valve, X-ray to look at the heart, lungs and chest wall to rule out any other conditions that may be causing symptoms, Treadmill test (TMT) during exercise to know the effect of exercise on the heart, Cardiovascular cartography heart flow mapping, CT angiography and the invasive coronary angiography to identify whether the coronary arteries are narrowed and how severe any blockages are.
How to manage the heart ailments?
Although coronary heart disease cannot be cured, but treatment can help manage the symptoms, improve the functioning of the heart and reduce the chances of problems such as heart attacks. Effective management includes a combination of lifestyle changes, medicines and non-invasive treatments. Invasive and surgical treatments are required in more severe cases. In most cases it is possible to eventually resume normal life. Some simple lifestyle changes include eating a healthy balanced diet, being physically active, doing regular exercise, no smoking and controlling blood cholesterol and sugar levels. These can reduce the risk of CHD, stroke and dementia and also have other health benefits.
Many different medicines are used to treat CHD. Cholesterol, high blood pressure and diabetes can usually be well controlled with medicines. Other medicines aim to slow down the heartbeat, thinning the blood and preventing it from clotting. Some of these medicines can cause side effects such as headaches, dizziness and flushed skin, weakness, body-aches, and affect the memory and sexual drive. When taking any medicine for a prolonged period, therefore it is advised to have periodic blood tests especially for kidney and liver function.
Traditional forms of treatment included open heart surgery as the only surgical method to treat heart ailments, but with several advancements being made in the field of technology and science on a daily basis, newer equipment and surgical methods have become less invasive and proven to be safer.
“Surgical procedures like Coronary Artery Bypass Grafting (CABG), Valve replacement surgeries (mitral/aortic/tricuspid valve replacement), Minimally Invasive Direct Coronary Artery Bypass Grafting (MIDCAB), Thoracic surgeries with VATS and management of patients with heart and lung failure by Extracorporeal Membrane Oxygenation (ECMO) are some of the newer less invasive surgeries performed in patients with high surgical risks, old age, and frail patients. Being minimally invasive the duration of the procedures and the post operative recovery time are very less.
While heart failure sounds dangerous, it can be treated with better care and diagnosis. The only and the easiest way to prevent heart failure is avoiding the lifestyle and food habits that encourage obesity, diabetes, high blood pressure.
Heart Failure or Cardio Vascular disease refers to the fact that your heart is not as healthy as it should be. You have to take better care of it for better functioning. But the best part is that you can prevent it with a healthy lifestyle.
(The Author is Head, Cardiac Sciences and CTVS, Yatharth Super Specialty Hospital, Greater Noida)