Human heart beat is the first and last sign of life and heart is a very selfless organ as even though it is filled with blood, it doesn’t take the oxygen from the blood which is there in the chambers. It pumps the blood to the main artery called aorta, from aorta three coronary arteries arise and these coronary arteries supply the oxygen and nutrients to the heart muscle.
The blockages due to cholesterol and or blood clots inside these coronary arteries cause heart attack. The cholesterol deposition happens over decades due to the risk factors like, age, family history, diabetes mellitus, smoking (tobacco in any form), high blood pressure, high blood cholesterol, lack of exercise, unhealthy food habits, stress, excess alcohol etc which means, we have decades of time to control these risk factors to prevent the blockages.
In an interview with HT Lifestyle, Dr Vithal D Bagi, Senior Consultant and Interventional Cardiologist (MD, DM Cardiology, DNB Cardiology) at Apollo Hospitals in Bangalore, explained, “Over and above the cholesterol blockages, clots form which leads total or near total occlusion of the coronary arteries. That results in heart attack means death of heart muscle tissue due to the loss of blood supply.”
He elaborated, “When heart attack happens, the severity or survival depends on criticality of the coronary artery block, the area of the heart muscle supplied by the coronary artery, presence or absence of collaterals, etc. If the large artery is occluded that can lead to decrease in the heart pumping function, water collection in the lungs, low blood pressure, extreme variation in the heart rate, sudden cardiac arrest or death. If the small artery is occluded the patient can have mild or no symptoms or detected during routine evaluation.”
He added, “Heart attack is a medical emergency, where every minute counts. “Time is muscle” as the first two hours from the onset of symptoms or attack is the golden hour. Within ‘golden hours’ the blocked artery should be opened preferably by angioplasty and stenting wherever possible or by dissolving clots, using blood thinners to decrease the muscle damage, to improve the heart function and to increase the chances of survival. Recognising symptoms of heart attack like chest pain, breathing difficulty, extreme fatigue, unexplained sweating, fainting, palpitations and getting treatment in golden hours. We have one life, one heart, we should take care of it.”
Heart attack is the most common cause of death in the world and in India. For the first step in prevention, Dr Vithal D Bagi suggested some lifestyle modification should start very early in life to prevent cholesterol depositions:
• Eating balanced diet (avoiding junk/fast, unhealthy food/preserved food/high calorie food)
• Quitting sedentary lifestyle (Regular exercise at least 30 minutes per day).
• Controlling stress (adequate rest, sound sleep, positive attitude towards life).
• Stop smoking, controlling diabetes, hypertension, high blood cholesterol with medicines.
• Periodic health check-ups including ECG, echocardiogram, treadmill test, CT coronary angiogram to identify blocks in early stage.
Dr Kunal Sarkar, Senior Vice Chairman and Chief Cardiac Surgeon at Medica Superspecialty Hospital in Kolkata, highlighted, “Heart attacks in really young and apparently ‘fit ones’ are being reported with increasing frequency. Unhealthy diet which involves excess of fried and fatty food, obesity, undetected diabetes, high blood pressure, smoking along with unavoidable stress of a demanding urban sedentary lifestyle all contribute to this problem.”
Insisting that we have a habit of not getting a health check-up done unless there are ominous signs and symptoms of trouble, he said, “With the incidence of coronary disease affecting more than 15% of those who are less than 40 years of age, we do not have a choice other than to get checkups done regularly. This should include blood tests, ECG, ECHO and if the doctor advices, a treadmill test along with CT coronary angiogram.”
He advised, “There is no room for guesswork. Let’s try to pack up smoking, check our weight, blood pressure and blood sugar. The catastrophe of a heart attack, hits us unannounced when it is least expected. The first pain is too late. Let’s keep our vigil.”