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Don’t break the heart that loves you

Published: 29th September 2012 08:42 AM  |   Last Updated: 29th September 2012 12:35 PM   |  A+A-

‘One world, one home, one heart’, the year of Cardiovascular Disease (CVD) prevention among women and children is the theme for World Heart Day 2012.  CVD causes 30 per cent of all deaths globally each year, making it the world’s number one killer.  As a hub for family activities, and as a focal point in everyone’s life, the household is the perfect place to start taking action to improve heart health.

By taking various steps, one can reduce the burden of CVD wherever he or she is in the world.  It is vital that women learn the truth about their CVD risk and take action to protect themselves and their family.  Every year, 17.3 million lives are claimed by the global burden of CVD, with 82 per cent of deaths occurring in low and middle income countries.

Heart attack deaths are 10 times more common in the age group of 30-40 years in the Indian population as compared to the developed countries, of which it is a number one killer for women and accounts for 1 in 3 female deaths.  This excessive number of deaths is particularly saddening, since through steps such as eating a healthy diet, maintain proper lifestyle, regular physical activity and avoiding smoking and drinking, as also periodic medical checks especially reducing high cholesterol levels and high blood pressure, the majority of these deaths could be prevented.

However, not all heart events are preventable.  If you suspect a family member of having a heart attack, myocardial infraction or stroke, you seek medical help immediately.  Over 70 per cent of all cardiac and breathing emergencies occur in the home when a family member is present and available to help a victim.  There are treatments available.

THIS YEAR’S THEME

World Heart Day was created in the year 2000 to inform people around the globe that heart disease and stroke are the world’s leading cause of death, claiming 17.3 million lives each year and the numbers are rising.

 By 2030, it is expected that 23 million people will die from CVDs annually — that is more than the population of Australia.  This year the focus is on cardiovascular disease (CVD) prevention among women and children because:

* Women/children and CVD are not synonymous

* CVD is commonly considered an “older persons” and a ‘man’s’ disease

* Women underestimate their CVD risk; even though almost half of the 17.3 million annual deaths occur in women

* Children are particularly at risk, since they have little control over their environment and can be limited in choices to live heart-healthily

* Unless action is taken to enable heart-healthy activity, the children of today are at increased CVD risk at a later stage in their life. Dr V S Prakash, vice president, head of cardiology and senior consultant, M S Ramaiah, Narayana Hrudayalaya Heart Centre emphasises the importance of Primary Angioplasty in Myocardial Infraction (PAMI) for heart attack patients.

 PAMI is the safe and effective treatment for heart attack patients in which chances of survival are higher due to reduction in mortality. Primary angioplasty is the preferred treatment for Myocardial Infraction if it can be provided promptly, with patients being taken directly to the catheter laboratory of the nearest heart attack centre rather than to a local hospital or emergency care.

 “PAMI is safe and causes minimum damage.  Moreover, chances of reoccurence of heart attack are significantly less as compared to Thrombolytic therapy, in which we give clot busting injection to the patient, which is effective only in the first 3 hours after onset of chest pain, whereas PAMI can be effective even upto 12 hours after chest pain onset. PAMI is not a planned angioplasty; it is decided there and then and offers better quality of life to the patients with early and definitive recovery.  In PAMI, we use stents to open the blocked artery which ensures immediate blood flow,” explained Dr Prakash.

 As compared to thrombolysis, primary angioplasty results in a lower mortality, or an absolute benefit of two lives saved per 100 patients treated with angioplasty compared with thrombolysis.  The reduction in the combination of death or non-fatal reinfraction after angioplasty compared with thrombolysis is even more striking.  With respect to safety, stroke was reduced from 2 per cent with thrombolysis to 0.7 per cent with angioplasty.

 The rates of readmission for heart failure and ischaemia are lower in patients from the angioplasty group than in the streptokinase treated patients.  “However, even in a country like India, where large numbers of percutaneous coronary intervention are performed, thrombolytic therapy is still used far more often, in daily practice.  This is caused by issues such as logistical difficulties, reimbursement, variability of angioplasty results and safety and feasibility of inter hospital transportation.  As the large majority of patients with acute ST elevation myocardial infraction are presented to hospitals without the capability to perform acute coronary angiography and angioplasty, inter hospital transportation plays a central role,” said Dr Prakash.

 So, it is important to take the patient to the hospital which has the facility to perform primary angioplasty or to the hospital which has better inter hospital transportation facility.



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