Cardiovascular Disease is steadily increasing in India. The prevalence of the disease which was 2 per cent in 1960, now it has become 8 per cent. So at this rate by 2020, the highest number of heart attacks will occur in India. Cardiovascular disease alone accounts for nearly 25 per cent of total deaths in this country which is really alarming and 1/4th of heart attacks is seen below 40 years of age which is equally disturbing. In this modern age, young and middle-aged Indians are becoming more vulnerable to heart attack.
There are two groups of risk factors – one is ‘non-modifiable risk factors’ and other is ‘modifiable risk factors’. Non-modifiable risk factors include age, sex, family history and modifiable risk factors include smoking, diabetes, obesity, hypertension, high cholesterol, stress, heavy alcohol intake, lifestyle etc.
Heart attack occurs due to narrowing of the arteries because of accumulation of cholesterol deposits.
Symptoms of Heart Attack
The usual symptoms of heart attack are left sided chest pain or burning sensation associated with nausea, vomiting, sweating, tiredness and fatigue but in some patients the pain will not be in the chest, but it can be in the form of throat / jaw pain or upper back and in the stomach region.
In some patients, heart attack can manifest with severe pain in the stomach region associated with mimicking gastritis. On this occasion, confusing this as gastritis, many have died. For others heart attack can manifest without any chest pain, this is called Silent Heart Attack. This is more commonly seen in diabetes and elderly people and those who have undergone Bypass Surgery already.
Management of Heart Attack
The treatment should be initiated as early as possible without any delay. For every 30 minutes of delay, the relative risk of death increases by 7 per cent. Hence whenever there is a suspicion of heart attack, the patient should immediately reach the nearest hospital where there is a facility for such treatment. The maximum benefit is when treatment is given within first 3 hours of the heart attack. Such early treatment will reduce the death rate and improves the survival chances of the patient.
Modalities of Treatment
There are two types of modalities of treatment – one is Clot Dissolving Medicine – this is called Thrombolysis. This treatment could be given in most of the hospitals both in city and urban areas. The most important treatment is Angioplasty and Stenting Procedure. If there is no facility for doing Angioplasty in some of the hospitals, for those patients, this thrombolytic therapy can be given and they can be shifted to places where Angioplasty can be performed. Even this approach will substantially improve the survival.
After suffering from a heart attack, the medicines such as Aspirin / Clopidogrel and Cholesterol-lowering drugs such as Statin should be taken lifelong. Patients who have undergone Angioplasty and Stenting procedure, if they stop Blood thinning medicine (Aspirin / Clopidogrel) for more than 5 days, there will be always a risk of fresh heart attack. In addition, they also have to keep Blood Pressure / Blood Sugar and Blood Cholesterol under control. Optimal management of weight is important and low calories and low-fat diet, rich in fruits and vegetables is advised.
Preventive Measures of Heart Attack
Many a time, the question is asked whether one can predict the occurrence of a heart attack. The patient with some risk factors such as smoking, diabetes, high cholesterol and family history of heart attack whose age is above 45 years should undergo annually blood sugar, blood cholesterol and tread mill test. By Treadmill ECG, one can identify people at a risk of developing this cardiac event. Suppose if Tread mill Test is positive then Coronary Angiogram shall be done. As an initial screening modality in high-risk sub-group, even a Noninvasive Coronary Angiogram can also identify the blockages in early stages.