Forty-eight per cent of Mumbaikars face the risk of heart attacks because of obesity, more than 50% have unhealthy cholesterol levels while around 64% lead a sedentary life and avoid exercise.
These are some of the disturbing findings of a mega study, conducted across nine Indian cities among 1.8 lakh people, including 29,017 respondents surveyed in Mumbai.
It showed that 70% of urban Indians are at the risk of cardiovascular diseases. The study found people in various cities with different sets of risk factors.
Dr Akshay Mehta, senior cardiologist from Asian Heart Hospital, said, “Sedentary lifestyle, stressful work conditions and compromised diet are leading factors in precipitating the risk of heart disease. This has affected the heart health of the young work force in the 30 to 44 age group.”
In comparison to other cities, Mumbai appears to have fared moderately well when it comes to percentage-wise risk factors. Those in Delhi and Chandigarh, for instance, were found to be more obese at 54% each. Mumbai fared slightly better at 48% whereas all the others, except Kolkata—Ahmedabad, Bangalore, Chennai, Hyderabad and Pune–have people between 49-52% who suffer the risk of heart problems because of obesity. Obesity factor was lowest in Kolkata at 47%.
The study conducted by Saffolalife, also factored in faulty eating habits. Delhi and Chandigarh, again, topped the chart in consumption of processed foods such as noodles, chips and packaged juices. Forty-four per cent of Mumbai’s respondents consumed processed or preserved food more than twice a week.
Delhi and Chandigarh were also high in consumption of fried or fat-rich foods. Ahmedabad, meanwhile, was the biggest defaulter when it came to consumption of vegetables, fruit and salad whereas people from Chennai were found to have the least affiliation with whole grains.
“Diet has undergone major changes depending on convenience. Preference for processed, preserved and fried foods has gone up noticeably. High dependence on the same and a menu devoid of vegetables, fruits and whole grains will only make people more vulnerable to cardiovascular diseases,” said dietician Niti Desai.
Lack of physical activity, too, makes Indians prone to heart problems. The study found that 70% of those who live in Ahmedabad indulged in little physical activity. Those in Pune and Bangalore were found to be most active of all, but only marginally more than others.
“No more eyebrows are raised these days when one hears about people below the age of 40 getting a heart attack. While Mumbai is seeing an increase in the ageing population—which, in turn, directly affects the heart—there are also many attacks in the younger working population,” said Dr Ganesh Kumar, chief interventional cardiologist, Dr L H Hiranandani Hospital.
Its high time we recognize this and eat well and exercise to prevent heart illnesses.
Here are signs that can mean a heart attack is happening:
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
Learn the signs, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms).
Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1 or your emergency response number.
Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room
Heart attack is the lay man’s term for a myocardial infarction. Myocardial infarction is nothing but damage to the heart due to blockage of the artery carrying blood to the heart.
So once the individual is stabilized, what are the medications he/she needs to take to improve his symptoms and reduce long term events (events like chest pain or a repeat heart attack)?
These are as follows:
1. Aspirin: This is blood thinner and prevents clot formation. The dosage recommended is 75 or 150 mg a day. It is preferable to take it after meals to avoid gastric irritation.
2. Statin: This is one of the most popular drug and know to reduce repeat heart attacks and long term mortality (death rates). These are anti-cholesterol medicines which reduce the bad fats thereby reducing blockages in the heart. The commonly used drugs here are Atorvastatin, Rosuvastatin and Simvastatin. The goal of therapy is to achieve a LDL-cholesterol value of less than 100 mg/dl.
3. Beta-blockers: These drugs reduce the heart rate and the blood pressure. This reduces the blood requirement of the heart and thus improves healing. It also reduces events like sudden cardiac arrest and angina pain. The commonly used drugs are Metoprolol, Bisoprolol, Atenolol and Carvedilol.
4. ACE inhibitors: Again a group of drug know to reduce blood pressure and long term mortality. It should be given to patients with heart pumping less than 40%. It reduces the load on the heart and thus prevents further damage. The commonly used drugs here are Enalapril, Ramipril, Lisinopril etc.
All the above drugs should be take only after consultation with your doctor.
Also most of the time, the treatment is Long term!
Most of the patients tend to discontinue their medications. This is not recommended as the benefits with the drugs are immense. So one should consult his Cardiologist and ensure that they are on the necessary medicines. In case of side-effects, there are good alternatives which should be discussed with the Cardiologist.
Cardiac pain: Angina
Chest pain of any intensity should never be ignored. It should promptly be recognized, investigated and treated. The cardiac and vascular causes of chest pain can be fatal and so need to be promptly treated.
Chest pain can be due to a variety of reasons. It can be due to causes related to the heart, the lungs, food-pipe, spine and muscles.
Let us learn about how to differentiate between some of them!
Some of the causes of chest pain are:
- Cardiac pain: is also called Angina. It is caused by blockages in the heart blood vessels due to cholesterol deposition. The pain is classical in nature and easy to recognize. Most of the time it is described as heaviness in chest (compression or a tight feeling). Some of patient may have burning pain in chest. It increases on exercise. It decreases at rest. This is caused by blockages in the arteries which progress slowly over months and so called stable. The pain in this condition is called Stable Angina. They are confirmed by a test in which one exercises and the ECGs are monitored. The test is called treadmill stress test. Sometimes, the blockage gets complicated due to blood clot formation. This causes total occlusion of the artery and is riskier. The pain here is severe in intensity, sudden in onset and even at rest. It does not subside with routine medicines. It is called Unstable Angina. The condition is diagnosed by ECGs and blood tests. If not promptly treated, patients may progress to have a heart attack.
- Lung pain: The covering layer of the lungs produces pain which is sharp and increases on deep breathing. This pain can be due to infection or other causes which need to be investigated. The lung tissues normally do not cause pain but can cause cough and breathlessness. Most of the time it is diagnosed by an X-ray of the chest and can be promptly treated.
- Food-pipe/ Esophageal pain: This is caused by increased acidity and mild erosion of the food-pipe. The pain here is burning type, normally increases on an empty stomach. It is normally associated with belching and sour eructations. The test preferred is a Scopy of the upper gut where in a tube with a small camera is passed into the food-pipe to diagnose the problem. It is easily treated with antacids and drugs to reduce acid secretion.
- Spine problems: Here, the pain is dull or sharp but always localized to the spine. It originates from the spine and most of the time radiates to the sides. Movement of the spine makes the pain worst. An X-ray or MRI of the spine may be necessary to assess the severity of the problem. Most of the time the pain subsides with medical treatment. It is relieved with analgesics and muscle relaxants.
- Muscular pain: These are normally associated with soreness of the muscle and dull aching in nature. They are easy to recognize and so easily treatable with analgesic and some exercises.
These are the common causes of chest pain. One needs to be cautious when it is in the center of the chest and associated with breathlessness.
The take home message is: DO NOT IGNORE CHEST PAIN! SEEK MEDICAL ATTENTION IMMEDIATELY!
Heart Attack! A medical condition which evokes fear in the patients and their relatives.
What causes heart attacks? Are they fatal? Are there any measures which can save your life? What are the treatment options? What medicines to take after a heart attack? These are some of the common questions which most of us have regarding a heart attack. So let’s answer them!
What is a Heart Attack?
A Heart attack is a term applied to injury caused to the heart muscle due to sudden blockage of the artery carrying blood to the heart. The heart is a pump which pumps blood to the whole body. For this the heart needs oxygen which is supplied by three small blood vessels called coronary arteries. When one has sudden blockage of one of these arteries, it is called a heart attack. During the heart attack the artery gets suddenly blocked almost 100% by a blood clot and thus there is less blood supply to the heart. This causes damage to the heart muscle and can be fatal if it is severe.
What are the symptoms experienced by the patient?
The blocked artery causes damage to the heart muscle. This causes severe chest pain in the center of the chest. Some times the pain can radiate to the arms, back, upper part of the tummy and the jaw. Some patients may experience giddiness, palpitations, shortness of breath and sweating. Some patients may experience burning in the chest and stomach with nausea and vomiting. They may delay treatment thinking that it’s a gastric (acidity) problem.
Are all heart attacks fatal?
No. Most of them are not fatal. However, 25% of patients can die if the heart stops suddenly. This is called as Sudden Cardiac Arrest. Majority of the patients survive a heart attack but it needs to be treated promptly.
What can you do at home?
- Remain calm. Do not panic. Do not run. Rest and wait for the ambulance to arrive OR.
- Visit the nearest hospital with an ICU facility by a vehicle. Do not walk down to the hospital.
- If you are breathless, sit upright.
- Chew 300 mg of Aspirin tablet. Or powder it and keep it below your tongue. Do not gulp it down with water
- If you have chest pain, place a 5 mg tablet of Sorbitrate below your tongue. Ensure that you are in a sitting position and do not stand if you are feeling giddy. One can place a maximum of 3 tablets below the tongue at 5 minute intervals. Do not take Sorbitrate if you are feeling giddy.
- Get an ECG immediately and report to the doctor.
How is a Heart Attack Diagnosed?
A Heart Attack is diagnosed by an ECG and a blood test called Troponin. Your ECG will show changes suggestive of less blood supply to the heart. A positive Troponin blood test also suggests decreased blood to the heart.
What are the treatment options?
A heart attack is caused by sudden total (100%) block of the coronary artery. So the main treatment goal is to open the artery. There are 2 ways by which one can open the artery.
1. Angioplasty. During angioplasty, the block is directly opened with a balloon and then a stent is placed in the artery.
2. Clot Buster Injection: This is the medical option called Thrombolysis. Here a Drug is administered intravenously to dissolve the clot and restore the blood supply to the heart. These vary in their charge from INR 2500 to 35000/-. Some of the drugs used are Streptokinase, Tenecteplase (available as Elaxim or Metalyse), and Reteplase etc.).
What other drugs are required subsequently?
Once a patient is stabilized, majority of them will be on the following drugs:
- Blood thinners: like Aspirin to improve blood flow.
- BP medicines: to control the blood pressure and decrease load on the heart.
- Statin: these are medicines to reduce cholesterol levels and prevent heart attacks
- Diabetes medicine: to control your diabetes.
All patients need regular follow up with a Cardiologist and Life-long Medications!
Take care of your heart! Chao!