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03 Oct, 19 05:07
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HEARTMATTERS–Above all else, guard your heart for it is the wellspring of the life. Cardiovasculardiseasewas once considered an old-age ailment but has now become a common lifestyle concern. Statistics show that the rate of heart diseases in India is doublethatofthenationalaverages o f th e we s te r n wo rl d . Cardiovascular diseases would be the largest cause of death anddisability inIndiaby2020asperaWorldHealthOrganisation (WHO) report. "In the next five to 10 years around 20 percent of the Indian population would be affected," The precious asset of our nation is its young population; ironically,itisbecomingthemost vulnerabletoCADandmyocardial infarction (MI). Four people die of heart attack every minute in India and the age group is mainly between 30 and 50. Twenty-five per cent of heart attack deaths occur in people less than 40. Nine hundred people under 30 die due to heart disease in India every day. Whileaperson'sgeneticdispositionandfamilyhistoryremain as the most common and uncontrollable risk factors, majority of heart diseases may be caused due to controllable factors like blood pressure, diabetes, smoking, sedentary lifestyle, unhealthy diet, stress and weight issues. In today's scenario, our lifestyle emerges as the biggest risk factor especially in the young population and this brings the focus to create a heart-healthy environment by ensuring that people are able to make heart-healthy choices wherever they live, work and play" i.e. for Everyone and Everywhere – so we need to be vigilant all the times. Let us look at the common Risk Factors being attributed to heart attack in young persons. Smoking What begins as a fashion statement in college days later turnsouttobeanindispensableaddiction.Itis thesinglelargest risk factor for a young individual developing MI.Smokers not only develop MI earlier but are at a two-fold increased risk compared to non-smokers and at a four-fold-increased risk of sudden death due to MI. The corresponding risks are higher in smoking women. Not only smoking, all forms of tobacco consumption are equally dangerous. Once a person quits smoking, it will take approx. three years for the body and heart to recover from the effects of tobacco, so you can imagine the consequences of the person continuing to smoke. High cholesterol levels While some cholesterol is necessary for good health, too much cholesterol is bad. Excess cholesterol deposits enter the inner lining of the coronary arteries gradually, building from tiny crystals into larger deposits making the arteries narrower and consequently blood supply to the heart gets obstructed leading to MI.Though the total cholesterol levels are a predictor of heart disease, many Indians who develop MI have normal cholesterol levels. This is because even though their total cholesterol levels are normal, they have low levels of good cholesterol (HDL cholesterol) and a very unique, dangerous type of bad cholesterol (LDL) which has a higher blood clot forming tendency. Diabetes Mellitus The rampant rise in the incidence of diabetes is a major factor in youngsters developing MI. Compared to non-diabetics, a diabetic with myocardial infarction develops a large MI (a larger portion of the heart is affected), has the risk of sudden cardiac death, responds poorly to treatment and has a higher risk of developing re-infarction. People with diabetes, and/or those over the age of 75 may experience a "silent heart attack".This is one that occurs with no pain at all. Hypertension Changing food habits leading to increased salt consumption, stress and a sedentary lifestyle have all contributed to the rise of young hyper-tensives. Most of us grab snacks such as namkeens and samosas between meals when hungry… not only do they have a high salt content but they are also sources of trans-fat. Obesity We are in the grip of an obesity epidemic. Obesity is a combination of poor physical activity, stress and an unhealthy food culture. With obesity comes the risk of developing diabetes, high blood pressure and high cholesterol. Unhealthy food habits Junk food joints have become hang-outs for college studentsandyoungprofessionals.Wearealwaysundertheimpression that Indian food is healthy because Indians are largely vegetarians. However, the Indian vegetarian recipe calls for liberal use of milk, ghee, oil and decreased intake of fruits and vegetables, leading to a higher intake of refined carbohydrate, saturated fat and trans-fat. Physical inactivity Physical inactivity not only causes heart disease but also hypertension, diabetes and obesity. Physical inactivity starts from school as modern day teaching hardly stresses the importance of physical education. Eighty per cent of our young population is physically inactive; the remaining 20% that frequents the gyms concentrates on muscle building rather than aerobic training. Stress Many studies reveal that the recent stress in personal or professional lives leads to MI. With most of the work happening from the desk and at unearthly working hours and due to poor sleep quality, young IT professionals and BPO employees have high stress and run the risk of developing heart diseases if they also possess any of the above mentioned risk factors. Genetics Indians are genetically prone to heart disease - genetically metabolically inflamed .Even NRIs living abroad for many generations continuetohavetheriskbecauseoftheirgenes.Indians have relatively small coronary arteries, making them more vulnerable to the disease even with less severe atherosclerotic disease than our western counterparts. The gene, if any, that is responsible for CAD is yet to be decoded. Other Risk factors Homocysteine C-reactive protein (CRP) Fibrinogen Lipoprotein (a) Lack of awareness The rural and urban poor are more susceptible because they tend to ignore the disease due to poor access to health care, high cost of treatment, social stigma and illiteracy. Seeking treatment will also mean missing wages and reduced productivity.In case of a heart attack, it has been seen that the lack of knowledge often causes a delay in handling the situation, which could aggravate the damage and in some cases prove to be fatal. Let us understand the symptoms of a heart attack and suggest precautionary steps that can be taken while waiting for medical help. Identifying the Early Symptoms 1. The most common symptom of a heart attack is sharp and constricting pain in the centre of the chest, which radiates to the left side of the body, particularly the left arm, and also to the back and between the two shoulder blades. The pain may also come up to the chin and cause jaw discomfort. 2. The person may sweat profusely. When you experience sharp pain certain hormones are released, your blood pressure and heart rate go up and it leads to sweating. 3. In case of diabetic patients sweating, feeling light headed and momentary black outs are more common than feeling sharp pain and so explaining to the diabetic patients that they have suffered heart attack is many a times very challenging. 4.Breathlessness, dizziness and losing consciousness are some other symptoms. 5. Discomfort in the upper part of the abdomen and a burning sensation, which can sometimes be confused with acidity or heartburn. 6. A strong feeling of nausea is another symptom in disguise, which may also be confused with gastric problems like indigestion. 7. Other warning signs can include unexplained fatigue, paleness, palpitations and anxiety. What Can You Do When a Heart Attack Occurs? 1. The first thing to do is to call for emergency medical help. It is important to say this because in most cases you may try to resort to self-administered treatments, which can worsen the situation. 2. Make the person lie down flat on a firm surface and loosen clothing. 3.Cleartheairwayandallowhimtotakeafewdeepbreaths. 4. The pulse should be checked not on the wrist but on any one side of the neck. When the blood pressure is low, wrist pulse may be absent. Therefore, check for the regularity of the neck pulse. 5. If the person is breathless, try giving him oxygen. 6. If the patient feels nauseous, turn him to one side and allow him to throw up so as prevent the expulsions from entering other parts of the body like the lungs. 7. Raise both the legs of the patient to improve the supply of blood to the heart. 8. If the person is unconscious, perform cardiopulmonary resuscitation (CPR), If you don't know CPR, you can still help. The American Heart Association (AHA) recommends a simplified version of CPR called Hands-Only CPR. What Not To Do During a Heart Attack 1.Thefamousself-administeredtreatmentofcoughingrepeatedly is unlikely to help and is more of an urban legend. 2. Thumping and pumping the chest without knowing the heart rhythm should be avoided. 3. Do not try to feed the patient anything and it is best to avoid oral medication. It is important to note that most lifesaving medications that help in recovering from a heart attack work best when given within one or two hours of experiencing the first symptoms, when the cardiac damage is limited. Therefore, in such situations time is most crucial . Recognizing the early symptoms and immediate medical attention can save many lives. We ask you to take the help of the following tips:- 1.Quit smoking . “If you think you are smoking the cigarette, you are mistaken , its actually the other way round ” 2.Go for the healthy food options :- • A healthy diet low in saturated fats & salts but rich in fruits & vegetables helps preventing heart diseases. • Avoid soft drinks and junk foods. • Rotate the oils/mixture of oils. 3.Active lifestyle :- Just 30 to 45 minutes of exercise / activityonmost-ifnotall-daysoftheweek canpreventheartattacks. Family’s should limit the amount of the time spent in front of the TV to less than one to two hours per day. “What fits your busy schedule better- exercising one hour a day or being dead 24 hours a day?” 4. Routine Healthcheckups • Visit your doctor who can measure your BP, Blood sugar, blood cholesterol level, waist hip ratio or body mass index (BMI) • Once you know your overall risk for heart diseases, you can develop a specific plan of action to improve your heart health.There ia a proverb which says - Misfortunes always come in by a door that has been left open . So be Vigilant and Active . TAKE CARE OF YOUR HEART Dr. Amit Khandelwal,DM (Cardiology),Consultant Interventional Cardiologist

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