World Heart Day is celebrated on September 29 every year. It is World Heart Federation’s biggest platform to raise awareness about the cardiovascular diseases as they are the number 1 killer. According to a recent study, in India alone, around 50 percent of Indians under the age of 55 suffer from heart attacks. It is the number one cause of mortality in India. A heart attack is a medical emergency which occurs when a blood clot blocks blood flow to the heart. Adoption of unhealthy lifestyle in the current time is leading to various heart problems. On World Heart Day 2017 we share with you some frequently asked questions answered by Dr Tilak Suvarna, Senior Interventional Cardiologist, Asian Heart Institute. (ALSO READ A Cardiologist Answers Frequently Asked Questions About Heart Attack Recovery). Also Read - Red Meat Can Cause Colon Cancer: All You Need to Know About High Fat Diet And Cancer

What causes a heart attack?

A heart attack, known medically as a myocardial infarction is usually caused by abrupt cessation of supply of blood to the heart due to formation of a blood clot in the arteries of the heart. There are deposits of cholesterol called plaques along the walls of the heart arteries and rupture of one of the plaques can cause a blood clot to develop at the site of the rupture, triggering a heart attack. Also Read - Avoid These 5 Common Foods That Can Hamper Your Immunity

At what age do heart attacks occur?

Heart attacks usually occur after the age of 40 years, though it can also occur in people in their 30’s and even 20’s due to unhealthy lifestyle. Also Read - To Mask or Double Mask? Understanding Effective Mask-Wearing Etiquette

How do you know if you are having a heart attack or stroke?

The symptoms can include chest pain; a sensation of pressure, tightness or squeezing in the center of your chest. Pain in other parts of the body such as arms; it can feel as if the pain is travelling from your chest to your arms (usually the left arm is affected, but it can affect both arms), jaw, throat, neck, back and abdomen. The other symptoms include feeling lightheaded or dizzy, sweating, shortness of breath, nausea or vomiting and an overwhelming sense of anxiety (similar to having a panic attack).

Although the chest pain is often severe, some people may only experience minor pain, similar to indigestion. In some cases, there may not be any chest pain at all, especially in women, the elderly and people with diabetes. It is not uncommon for the heart attack symptoms to be confused with acidity, thus leading to delay in correctly recognizing the symptoms and seeking prompt medical attention, which can lead to fatal consequences.

Is numbness in the arm a sign of a heart attack?

Either arm can go numb during a heart attack, but it is more frequently the left arm. Numbness alone is not a sign of a heart attack and can be caused by a number of other conditions.

How do you detect a heart attack?

A heart attack is usually suspected by typical clinical presentation or symptoms, and is confirmed by carrying out the following tests:

ECG: Also known as electrocardiogram,

Blood test: Cardiac enzymes, which are raised in the presence of a heart attack.

2D-Echocardiogram: is ultrasonographic examination of the heart, which shows sluggish movement of the portion of heart muscle affected by the heart attack.

Coronary angiography: Rarely, this test has to be performed for confirming the diagnosis. It can also help determine the presence as well as the exact location of blockage in the coronary arteries.

What is valvular heart disease?

Valvular heart disease is characterized by damage to or a defect in one of the four heart valves: the mitral, aortic, tricuspid or pulmonary. The heart valves allow blood to flow from one chamber to the other. In valvular heart disease, the valves either become too narrow and hardened or are unable to close completely (incompetent). The causes include rheumatic infection in childhood or age-related degeneration or other causes affecting the valves or their supporting structures.

What is cardiac rehab?

Cardiac rehabilitation is a medically supervised program for people who have had a heart attack, heart failure, coronary artery bypass grafting or angioplasty. It is a process that encourages patients to exercise and self-monitor all their health parameters. It consists of three components which include exercise, risk factor modification, and dealing with stress and depression. Cardiac rehab can improve your health and quality of life and also reduce the chance of readmission to a hospital for a heart problem.

What is congestive heart failure?

Congestive heart failure is a heart condition characterized by reduced pumping efficacy of the heart, as a result of which the heart cannot pump enough oxygen and nutrients to meet the body’s needs. The chambers of the heart may respond by becoming enlarged or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid (water) and salt, leading to fluid build up in the arms, legs, lungs, liver and other organs.

Does smoking increase your risk of heart disease?

Although most people know about the connection between smoking and lung disease, many underestimate the damage that cigarettes have on your body, especially the heart. In fact, more smokers die from heart disease or stroke than from lung cancer. Research suggests that smokers are four times more at risk of developing heart disease than non-smokers. The carbon monoxide you inhale, quickly goes into your blood stream and damages the lining of your arteries. This makes it easier for cholesterol and plaque to stick to artery walls and accumulate slowly.

Also, passive smoking or secondhand smoke is as dangerous as active smoking and can increase their risk of heart disease by up to 30 percent. Banishing this habit is not just good for your own health, but also for your family.

Is hypothyroidism a risk factor?

Hypothyroidism may not directly cause heart attacks. But it could lead to high cholesterol levels which is an important risk factor for developing heart disease.

Are birth control pills a contributor to heart disease?

Birth-control pills or oral contraceptives, which typically contain estrogen, are a risk factor unique to women. Although birth control pills may not increase risk by themselves, when women taking them smoke or have other risk factors like hypertension, diabetes or high cholesterol, it certainly increases their risk of stroke or heart disease. It is recommended that women planning to take birth control pills should be screened for hypertension and treated if they have it.

Birth control pills increase blood pressure in some women. It is more likely to occur if you are overweight, have had high blood pressure during a previous pregnancy, have a family history of high blood pressure or mild kidney disease. The combination of birth control pills and cigarette use may be especially dangerous for some women.

Is heart disease hereditary?

Coronary heart disease is hereditary and a positive family history of heart disease is an important risk factor for developing heart disease. If a first-degree male relative like father or brother has suffered a heart attack before the age of 55, or if a first-degree female relative has suffered one before the age of 65, you are at greater risk of developing heart disease. If your parents have suffered from heart disease before the age of 55, your risk of developing heart disease can rise to 50% compared to the general population.

Is heart disease an irreversible condition?

Though there is no cure for heart disease, it is not necessarily an irreversible condition. Appropriate lifestyle changes along with modern medications and interventional therapies can halt the progression of heart disease and in some instances even reverse it.

How to reduce the risk of a heart attack?

Making lifestyle changes is the most effective way to prevent having a heart attack (or having another heart attack). All that needs to be done is appropriate and timely changes in one’s lifestyle. Timely means making those changes well before you get a heart problem, which could be starting as early as early adulthood, in your early twenties or maybe even earlier. This is because it has been shown that the process of atherosclerosis; the deposition of cholesterol in the lining of the heart arteries, can begin as early as in childhood.

To prevent a heart attack eat a healthy, balanced diet and avoid excess fat, oil and meat. Start including more of green veggies, fruits, nuts, fish in your diet. Avoid smoking and excess consumption of alcohol Try to keep your blood pressure, blood sugars and cholesterol within normal limits and exercise daily. Manage stress in a healthy manner and schedule appointments for regular health check ups with a physician.

What changes in diet do you recommend?

What we eat plays a crucial role in maintaining our heart health. A well balanced and healthy diet can help in reducing your risk of developing coronary heart disease. Consume a diet high in whole-grain fiber, lean proteins and colorful fruits and vegetables, legumes and pulses, low fat dietary products, fish and poultry without skin. Avoid over-consumption of instant and packaged foods, junk food, aerated drinks, sugar and salt.

Do most overweight people develop heart disease?

Not all overweight people would develop heart disease as there are several other risk factors besides obesity which can cause heart disease. But losing excess weight and maintaining an ideal weight would reduce your chance of having heart disease.

Can stress cause heart disease?

Stress is one of the most common patient complaints one encounters in medicine. More and more evidence suggests a relationship between the risk of cardiovascular disease and environmental and psycho-social factors. These factors include job strain, relationship problems, social isolation and personality traits.

It is not known as to how exactly does stress increase the risk of heart disease. Whether stress by itself is an “independent” risk factor or whether stress affects other risk factors and behaviors is a question that is unanswered. Smoking, obesity, physical inactivity, diabetes, hypertension, high cholesterol and family history are known risk factors for having coronary heart disease.

Studies have shown that long term stress causes higher incidence of unhealthy life style. More people with long term work related stress end up having reduced exercise, unhealthy diet, smoking, alcohol leading to obesity. This in turn increases chances of having hypertension, diabetes and high cholesterol. So long term work related stress increases the chances of having heart disease by making one prone to have risk factors for coronary heart disease.

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