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How to prevent lifestyle related heart ailments

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A ‘broken young heart’ no longer refers to lost love but a rising case of coronary artery disease (CAD) among the younger generation.

CAD refers to disease of the coronary arteries. Coronary arteries carry blood and oxygen to the heart; therefore any disease which affects the coronary arteries deprives the heart of oxygen — the extreme form of this deprivation occurs during myocardial infarction (heart attack). 

It is believed 60% of the world’s cardiac patients in India. Heart disease affects Indians at a younger age than Westerners. The prevalence of heart disease in India has been increasing over the years.  

There are many factors that are the reasons for the prevalence of heart disease among the young India. In a 2012 study done by World Heart Federation, it was found that 79 % of men and 83 % of women were found to be physically inactive, while 51 % of men and 48 % of women were found to have high fat diets. Some 60 % of men and 57 % of women were found to have a low intake of fruit and vegetables, while 12 % of men and 0.5 % of women smoke.  

Some of the key factors for the spike in cardiovascular diseases are: 

Obesity and over-weight
High Cholesterol values 
Higher incidence of diabetes
Hypertension
Smoking
Defective Diet
Lack of Exercise

The results of the study showed that even among literate middle-class urban Indians there is a low awareness and control rates of these risk factors.

There are 3 critical ailments: 

1. Angina (cardiac pain)

Chest pain that occurs when your heart does not get enough blood/oxygen. There are various signs that one needs to be alert for such as feeling of tightness/heaviness in chest, increased exertion, feeling of pressure/squeezing in chest radiating towards arm and neck, shortness of breath.

Angina can strike you while climbing stairs, carrying groceries or some weight, feel angry or upset, work in very hot or cold weather, eat too much at one time, have sex, emotional stress, exercise.  

Tests to identify: 

ECG, Echo, Stress Test, Coronary Angiogram

What can one do about Angina? 

Change your way of life. Modify risk factors. Start taking medications, Angioplasty or surgery. 

2. Myocardial infarction (heart attack)

Every 36 seconds, someone dies from heart attack in the United States.

Watch out for the warning signs of heart attack: Long periods  of uncomfortable pressure or feeling of squeezing in the chest, pain or discomfort in one or both arms, shortness of breath, cold sweat, nausea, vomiting and light headedness.

What can one do about it?

First and foremost do not panic and immediately call an ambulance/ doctor, Chew an aspirin, take a tablet called Sorbitrate. Tests doctors do for signs of heart attack: ECG, Echo, Cardiac Markers, Coronary Angiogram. 

Medical Solution:

Treatment of heart attack is to re-open the artery by: Drugs/ Injections or Angioplasty. 

3. Heart Failure

It means heart is weak and cannot pump blood as it used to be. Blood backs up in veins while the body holds too much fluid. Heart failure could also happen due to pulmonary congestion. Complains of heart failure will arise out of shortness of breath while lying down, tiredness, fatigue, swelling in ankles, legs and feet, weight gain from fluid build-up, confusion, can’t think clearly. Investigations for weak heart: ECG, Echo and Angiogram. Heart failure is treated with complete bed rest, low salt intake, and daily weight, modify risk factors, regular medications. 

Control of Risk Factors: 

Factor 1: Smoking greatly increases the risk of heart attacks
Factor 2: Control your LDL Cholesterol by low fat diet, exercise and medicines to reduce cholesterol. 
Factor 3: Control your sugar. Fasting plasma glucose (FPG) <126 mg/dl with 8 hours fasting. Diabetes accelerates atherosclerosis and affects all organs. 
Factor 4: Control your diet with frequent small meals laded with low fat and low sugar. 
Factor 5: Control your Blood Pressure by reducing salt intake, exercise and medications. 
Factor 6: Physical health/ Exercise regularly on a daily or alternate days. You can do a brisk walking or jogging for 45 min as it will reduces fats, reduces heart attacks, is good for joints, elevates mood, improves circulation and prevents clots in legs. 
Factor 7: Unstable mental health can trigger heart attacks, and mortality or more. So exercise regularly and meditate. One can get involved get involved in sports or leisure activities. 

Weight instead eat a good breakfast and have small frequent (every 2-3 hours) meals which will fill up. Do not remain hungry and then one tends to overeat. Exercise regularly and decrease food intake. 

Dr Ameya Udyavar is Consultant Cardiologist, PD Hinduja Hospital

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