BENGALURU: Heart disease is the number one killer all over the world, with 80% of the deaths happening in the developing countries, India being one of them. Immediate care within the first hour of cardiac emergencies is crucial, with almost 50 per cent of deaths happening during this period, mostly due to lack of timely care.
How the heart works
■ A normal heart beats as many as 100,000 times a day, continuously pumping oxygen and nutrition-rich blood and removing impure blood.
■ Though its chambers are full of blood, the heart receives its own separate supply from the coronary arteries.
■ A constant flow of blood from the arteries is crucial to the functioning of the heart since it derives oxygen and nourishment.
■ Sometimes, fat and calcium harden and form deposits of the inner walls of the arteries. Inflammation takes place, thereby narrowing the lumen of the arteries and obstructing smooth flow of blood.
What happens during
an attack?
An erratic lifestyle and unhealthy food habits increase the risk of developing progressive narrowing of the arteries, putting a huge strain on the heart, the culmination of which is a heart attack.
■ An excess of cholesterol, fat, calcium etc. in the bloodstream can lead to the formation of plaque walls of the coronary arteries.
■ As the build-up of plaque keeps increasing, progressively narrowing the arteries, so does the risk of experiencing a heart attack.
■ The plaque increases with time and can rupture resulting in chest pain and heart attack.
■ An attack occurs when blood flow to a part of the heart is cut off due to such a blockage or clot in the arteries depriving the heart of vital oxygen and nutrients.
■ Physical manifestations like shortness of breath and chest pain often go ignored, making the condition worse since increased delay in access to medical treatment causes increased, and sometimes irreparable, damage to the heart muscle.
TEST TO DETERMINE HEART’S CONDITION
■ Electrocardiogram (ECG)
■ Cholesterol and Glucose Blood Test
■ Troponin Blood Test
■ Echocardiogram (Echo)
■ Exercise Tolerance Test (ETT) or Treadmill Test
■ Coronary Angiography
TREATMENT
After a heart attack, the first thing that needs to be done is restore the blood flow to the heart muscles as quickly as possible. An ECG is done to assess the damage done to the heart, and blood thinning tablets are given once it is established that the patient has suffered an attack.
The blocks in the arteries can be removed through various medical procedures like Thrombolysis and Primary Angioplasty.
The author is consultant -Interventional Cardiologist, Fortis Hospital, Bannerghatta Road
MYTHS ABOUT THE DISEASE
Only men get heart attack
In India, because of the widespread belief that heart attacks only happen to men, women often neglect their health and rarely go for check-ups. The result is that cardiac disease goes undetected for a long time and is only diagnosed once it has progressed to an advanced stage. However, this is a totally unfounded myth because according to the World Health Organisation and the Centre for Disease Prevention and Control statistics, women are as likely to get a heart attack as men and are just as susceptible to cardiac problems.
Chest pain is the only symptom
Heart attack has many symptoms, chest pain being only one of them. It includes pain in the chest area as well as in the jaw, shoulder, back and abdomen. You may also have a bloated feeling that is often mistaken for a symptom of gastritis. In fact, 7 out of 10 who complain of chest pain turn out to be actually suffering from a heart attack.
Only old or obese get heart attack
While it is true that obesity, diabetes, bad food habits, hypertension and other such factors increase the risk of heart disease, even people without any of these can fall prey to heart attacks.
Thrombolysis
This procedure dissolves clots in the artery by administering intravenous medication, but is effective only when the heart attack is diagnosed in the early stages. The maximum benefit is observed in those who present within the ‘golden hour’, i.e. from onset of chest pain. Therefore the benefit of medication reduces with passage of time.
Primary Angioplasty
This is the ‘gold standard’ treatment for patients who miss the golden-hour period. There are significant benefits from this modality of treatment, particularly in the reduction of risk of death and stroke. It is the process through which blocks in the arteries are removed in order to restore blood flow through them.