In celebration of World Heart Day, many awareness programmes were conducted under the theme “Use Your Heart to Beat Heart Disease”. Global leaders have pledged to reduce mortality from non-communicable diseases (NCDs) by 25% by 2025.
Cardiovascular disease (CVD) accounts for nearly half of all NCD-related deaths, making it the foremost cause of death worldwide. As our community got together in the fight against heart disease, a free webinar was organised by Healthnet in partnership with English Nursing Care, which included eminent cardiologist Dr. Bhathiya Ranasinghe and English Nursing Care Director of Nursing and consultant cardiologist Fiona Eccles who spoke on the topic of “A Healthy Heart”, covering a plethora of topics related to heart health.
Dr. Ranasinghe explained what is commonly known as a heart attack – or in medical terms an ST-elevation myocardial infarction (STEMI) – as a sudden and sometimes fatal occurrence of a blood clot (thrombosis) in a blood vessel supplying the heart (coronary arteries), which results in the death of a part of the heart muscle.
Among the cardinal features, 70-80% will have features that are typically suggestive of a heart attack or a myocardial infarction (MI). However, around 10-20% might not have typical symptoms, and they’re called atypical presentations. Some people may only experience minor pain, similar to indigestion. In some, there may not be any chest pain, especially in women, older people, and those with diabetes.
Most common symptoms of a heart attack:
- Chest pain – often felt as a sensation of pressure, tightness, or squeezing in the centre of your chest
- Pain in other parts of the body – this could be a type of radiating pain where you would feel as if the pain is travelling from your chest to your arms (usually the left arm, but it can affect both arms), jaw, neck, back, and abdomen
- Light-headed or dizzy feeling
- Shortness of breath
- Nausea or vomiting
- A sense of overwhelming anxiety (similar to having a panic attack)
- Coughing or wheezing
Some of the atypical presentations include upper abdominal (epigastric) pain, toothache, and headache.
Any suspicion of a heart attack, usually with symptoms lasting for more than five minutes, should warrant an immediate ECG (electrocardiogram) investigation. Dr. Ranasinghe emphasised that even though older males have a higher tendency to suffer from a MI, age is no longer a determinant as he has seen heart attacks in the very young as well as the very old, adding that hence, across the board, cardiac symptoms at any age should not be taken lightly.
When you experience the signs and symptoms of a heart attack, every minute matters. The first few minutes to hours will determine the short-term and long-term outcome of the patient. Within three hours of the onset of chest pain, 80-90% of the cardiac muscle cells die due to the lack of perfusion, and by about 12 hours, all the muscles supplied by the occluded artery will undergo cell death. Therefore, early diagnosis and treatment are absolutely critical to avoid irreversible cell death due to ischemia, which will determine the ultimate outcome.
Coronary heart disease in women
In general, pre-menopausal women have a lower tendency to develop a heart attack than their male counterparts due to the protective effect of estrogen. They may, however, experience atypical symptoms such as a heart attack with no chest pain, but they might have nausea or vomiting. Hence, it’s often confused as gastritis or acid reflux. After menopause, the risk of a heart attack increases in women.
Life after a heart attack
Once you have a heart attack, there will be a constant worry and anxiety that lingers, especially with regard to experiencing another episode. Becoming active again can promote heart health; however, this should only be done while following proper medical advice. Usual activities can be resumed within a few weeks of having a heart attack, but this is largely dependent on the level of activity you were accustomed to along with your physical fitness before the cardiac episode and the extent of the damage to the cardiac muscles.
Before your discharge, your doctor will discuss what activities you can do at home. Sexual activity can be resumed if the heart attack is mild and you can climb two flights of stairs without getting breathless after two weeks of discharge from the hospital. Another most frequently encountered query is when to resume driving. Dr. Ranasinghe explained that this too depends on your cardiac status; generally, those who are asymptomatic can start driving around two weeks to one month following discharge. If it’s a heavy vehicle such as a bus or a lorry, your cardiologist should give clearance, ideally following a stress test. If you need stenting or a coronary artery bypass grafting (CABG), you will need a bit longer to resume normal activities.
If you are experiencing any of the symptoms discussed above, it’s important to go to the nearest health centre or hospital where they can take the initial steps. If you have chewable Aspirin 300 mg, you can chew it and swallow at home. At the hospital, following investigations such as an ECG and a troponin test, they will provide thrombolysis therapy or primary coronary interventions such as stenting.
Lowering your risk of a heart attack:
- Blood pressure control – as having high blood pressure (BP) puts you at risk of heart disease, it’s important to get your pressure checked regularly. Lifestyle changes to prevent and control high BP should be adopted, such as reducing the amount of dietary salt intake.
- Cholesterol and triglycerides should be kept under check.
- Diabetes or high blood sugar can damage your blood vessels and the nerves that control your heart and blood vessels. Hence, getting your blood sugar under control is an important factor in preventing heart disease.
- Maintain a healthy weight – obesity is linked to heart disease, high blood pressure, high cholesterol levels, and diabetes, which in turn are risk factors for heart attacks.
- Limit processed food and incorporate whole foods such as fruits and vegetables into your diet
- Regular exercise is also important as it has many benefits that promote heart health.
- Limit alcohol and smoking, both of which have negative health impacts and can increase your likelihood of heart disease. Cigarette smoking has been shown to raise blood pressure.
- De-stress by including exercise, recreational activities, and meditation or yoga to your daily routine. Stress has been linked with heart disease in many ways.
- Get enough sleep – make sure you feel rested after a good night’s sleep. Certain conditions such as sleep apnoea can interfere with sound sleep, which might need treatment.
- Several causes such as age, lifestyle, diet, and smoking can contribute to cardiovascular disease. World Heart Day was created by the World Heart Federation to inform those around the globe of cardiovascular disease and stroke which claims 17.9 million lives each year. Hence, by spreading awareness, we can create positive lifestyle changes that will impact the community at large.