~World Heart Day Special~

What causes cardiovascular diseases?

There are many risk factors that contribute to the development of cardiovascular disease. Some people are born with conditions that predispose them to heart disease and stroke. Most people, however, develop cardiovascular disease because of a combination of factors such as poor diet, lack of physical activity and smoking, to name just three. The more risk factors you expose yourself to, the higher the chance of developing cardiovascular disease. An estimated 17.3 million people die of cardiovascular diseases every year globally. 80 per cent of the deaths occur in low and middle-income countries.

I have no signs of heart disease. How would I know if I am at risk?

The signs of heart disease are not always obvious, and a heart attack can often be the first indicator. There is no single cause of heart disease but there are risk factors that increase your chance of developing it. Risk factors include lifestyle choices, such as smoking or being overweight, as well as high blood pressure, high cholesterol, diabetes and a family history of heart disease.

These risk factors often don’t have symptoms. So, how can you find out if you are at risk of heart disease? Visit your doctor to get a heart health check, which involves discussing your heart disease risks with your GP and getting your blood pressure and cholesterol levels checked periodically.

How is coronary heart disease diagnosed?

There different ways to diagnose coronary heart disease.

  • Electrocardiogram or ECG: This test records the electrical activity of your heart. It measures the rate and regularity of heartbeats, the size and position of the heart chambers, the presence of any damage to the heart, and the effects of drugs or devices used to regulate the heart. It is a non-invasive procedure.
  • Echocardiography: This test helps visualise the heart’s valves, its size, and its pumping capacity.
  • Non-invasive stress tests: There are a number of non-invasive stress tests which help doctors to know if the blood circulation to the muscles of the heart is compromised or not.
  • Coronary angiogram: In this test, a dye is injected into your arteries and then an X-ray is taken to see how the blood flows through your heart. The image, or angiogram, will show any atherosclerotic blocks. This is the most definitive and gold standard test.

How do symptoms of heart attack differ in men and women?

The symptoms of heart attack in a man are intense chest pain, discomfort in the left arm or jaw and difficulty in breathing.

A woman may have some of the same symptoms, but her pain may be more diffused, spreading to the shoulders, neck, arms, abdomen and even her back. A woman may experience discomfort like indigestion as well. In her case, the pain of a heart attack may not be consistent. Alternatively, she may not experience pain, but, instead, suffer from unexplained anxiety, nausea, dizziness, palpitations and cold sweat. Heart attack in women may also be preceded by unexplained fatigue. Women who are diabetics [especially long-standing ones] may experience breathlessness, rather than chest pain, as a symptom of heart attack.

Compared to men, women tend to have more serious first heart attacks, often leading to death.

How is heart disease treated?

Treatment for coronary heart disease [CHD] usually is the same for both women and men. Treatment may include lifestyle changes, medicines, medical and surgical procedures, and cardiac rehabilitation. The goals of treatment are to:

  • relieve symptoms
  • reduce risk factors in an effort to slow, stop, or reverse the build-up of plaque
  • lower the risk of blood clots [Blood clots can cause heart attack.]
  • widen or bypass plaque-clogged coronary [heart] arteries
  • prevent CHD complications.

Is heart disease hereditary?

Heart disease can be hereditary. But even if you inherit the risks factors that predispose you to heart disease, such as high blood cholesterol, high blood pressure, diabetes, or being overweight, there are measures you can take that will help you avoid developing cardiovascular disease.

What can I do to prevent heart disease?

Heart disease is largely preventable. You can reduce your risks of heart disease by living a healthier lifestyle. Try to:

  • be smoke-free
  • enjoy healthy eating
  • stay physically active
  • manage your blood pressure
  • manage your cholesterol levels
  • achieve and maintain healthy body weight
  • maintain your mental health and wellbeing
  • take any medicines as prescribed.

What are the innovations and advancements in treating heart disease?

There is always research going on that focusses on developing new ways of treating heart disease. However, here are some of the latest and most trusted techniques.

  • Bioresorbable Vascular Scaffold [BVS]: It is a non-metallic mesh tube designed to treat coronary artery disease. The prospect of a temporary vascular stent has always been the goal of the interventional surgery community. Such a device would provide support by opening the narrowed artery to restore blood flow to the heart. BVS gradually dissolves once the artery gains the ability and strength to stay open on its own. This is similar to the way a cast supports a broken arm and is then removed.
  • Heart transplant: This is a modern and relatively recent advancement in treating end-stage heart disease. A heart transplant is needed when a person’s heart can no longer work effectively on its own. It is considered a viable option if other treatments fail, or if the person’s heart muscles are weak, potentially putting his/her life at risk. Due to the advances in treatment, the risks associated with having a heart transplant have been reduced, but not eliminated. Unfortunately, the poor response of organ donors [lack of awareness] has led to heart transplantation being not yet picked up well in India, though some centres have initiated the practice of transplantations.
  • LVAD [Left Ventricular Assist Device]: This is a sort of an artificial heart that can help a weakened heart. Earlier, the LVADs were used as a bridge to cardiac transplantation—as a temporary support device till the patient gets an organ donor. However, the newer generation LVADs can now be used as long-term, permanent treatment for heart disease. This is termed as ‘destination therapy’ for heart failure. The biggest challenge for LVAD at this stage is the prohibitive cost, but I am sure the costs will come down with more usage and time.

This was first published in the September 2015 issue of Complete Wellbeing.

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