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Cardiovascular Disease

Cardiovascular Disease
Dr Krupali Tappoo
July 17
18:02 2017

Coronary Artery Disease, also known as coronary heart disease occurs when your coronary arteries gradually become narrowed or blocked due to plaque deposits.

Let’s focus our attention on coronary ar­tery disease, which is causing significant havoc globally and in Fiji as many people continue to die suddenly from heart attacks.

How many times have we heard scenarios such as- the elderly aunty who suddenly collapsed holding on to her chest or the middle aged taxi driver who continued to drive while having chest pain for a few hours then losing conscious­ness before veering off the road?

Or the young executive under enormous stress who indulged in alcohol and cigarettes and end­ed up with chest pain?

This may not be extraneous to many of you who may have lost a colleague, friend, relative or parent from sudden demise.

Most of you may be aware that cardiovascular or heart disease is the leading cause of death in both men and women worldwide.

However, what you may not be aware of is that it is also one of the most preventable diseases.

To give you an idea of the magnitude of the problem, an estimated 17.7 million people died from cardiovascular disease in 2015, represent­ing 31 per cent of all global deaths.

Of these deaths, an estimated 7.4 million were due to coronary artery disease and 6.7 million were due to stroke. Over three quarter of the cardiovascular disease deaths take place in low-middle income countries. (World Health Organi­sation)

Looking at the local scenario, according to the latest WHO data published in May 2014, coro­nary heart disease deaths in Fiji reached 1294 or 24.23 per cent of total deaths.

The age-adjusted death rate is 207.72 per 100,000-population and Fiji ranks number 19 in the world out of 172 countries with regards to mortality rate. Appalled at these statistics? I cer­tainly am.

What are cardiovascular diseases?

Coronary artery disease, also known as coro­nary heart disease occurs when your coronary arteries (arteries supplying oxygen rich blood to your heart muscle) gradually become narrowed or blocked because of plaque deposits (combina­tion of fatty material, calcium, scar tissue and protein).

Plaque gradually builds up on the inner walls of the arteries and this process of atherosclero­sis may start in childhood and can be well ad­vanced by middle age.

Yes, you may be surprised that this process starts so earlier on in life and hence the impor­tant advice that people need to develop healthy eating habits from childhood.

If the arteries become too narrow, the blood supply to the heart muscle is reduced. This may lead to symptoms such as angina-which is a tem­porary pain or discomfort, described as tight­ness, squeezing or gripping and can vary from mild to severe.

It may also radiate to the neck, jaw, and shoul­ders or down the arm. In some instances there is no pain however there may be chest discomfort or shortness of breath.

These symptoms may commonly occur on exer­tion, such as walking up a hill, running, brisk walking and may be relieved by rest.

It is important to realise that these are not triv­ial symptoms and mandates a consultation with your doctor and tests such as an ECG, exercise stress test or even an angiogram. Most people who end up with a heart attack have these symp­toms in the preceding months.

It’s almost a cry for help by your “heart mus­cles” and many times these symptoms are ig­nored. We need to learn to listen to our body as it is always communicating with us.

Then there is the situation when there is the sudden complete blockage of an artery that sup­plies blood to an area of your heart with the re­sult that some of the heart muscles start to die.

When this occurs, the person is suffering from a heart attack or myocardial infarction which can be life threatening.

The longer the blockage is left untreated, the more the heart muscle is damaged. The damage to the heart muscle is permanent if the blood flow is not restored rapidly.

The only way to restore this is by taking the patient to a cardiac catheterisation lab urgently and performing an angioplasty and inserting a stent.

This procedure, which is called primary PCI, is not happening in Fiji at the moment, as there are not enough resources and appropriate spe­cialists.

In most instances, people may be given medi­cations to help dissolve the clot. Whilst, there is a need for much improved tertiary care for car­diovascular disease in Fiji and in the Pacific Is­lands, we really do need to improve our primary care and work on detecting and managing dia­betes, high blood pressure and high cholesterol.

There are too many instances when people con­tinue to wait at home despite symptoms of chest pain or discomfort with associated nausea, vom­iting or dizziness.

Many people are losing their lives, because they wait too long to get treatment for a heart at­tack. If you are experiencing any of these symp­toms, please call the ambulance.

If the ambulance is taking too long, it is best to get someone to take you to the nearest emer­gency department. Do not be afraid to go to the hospital. This is the only place that can save you!

While there is no cure for coronary artery dis­ease, we all need to ensure that we mitigate the factors that increase our risk of heart disease.

Risk factors

The risk factors that are non-modifiable (can­not change) include

  1. Age – As we get older, the risk of heart dis­ease increases
  2. Gender- Men are at a higher risk of heart dis­ease than women. After menopause women are at the same risk as men.
  3. Ethnic background- People of some origins such as the Indian subcontinent, South East Asia and Pacific islands are at higher risk.

So we can see that our health really is in our hands- not just in the hands of the ministry of health, doctors, nurses and health care profes­sionals.

It is time we all realise that we need to make some important lifestyle changes to reduce our risk of cardiovascular disease. Cardiovascular disease- lets beat it.

Wise words by Dean Ornish; an American Phy­sician and researcher “Heart disease could be as rare as malaria today if we put into practice what we already know.”

Till we meet next week, eat healthy, walk daily and have a smoke free week!

 

The human heart

Imprimir

17.7 million

people estimated to have died from cardiovascular disease in 2015.

7.4 million

were estimated to be because of coronary artery disease

Cardiovascular diseases are a group of dis­orders of the heart and blood vessels and they include:

  • Coronary artery disease – disease of the blood vessels supplying the heart muscle;
  • Cerebrovascular disease – disease of the blood vessels supplying the brain;
  • Peripheral arterial disease – disease of blood vessels supplying the arms and legs;
  • Rheumatic heart disease – damage to the heart muscle and heart valves from rheu­matic fever, caused by streptococcal bac­teria;
  • Congenital heart disease – malformations of heart structure existing at birth;
  • Deep vein thrombosis and pulmonary embo­lism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

 

A spoonful of medicine with Dr. K

1294

Number of coronary heart disease deaths in Fiji according to a WHO data published in 2014.

By Dr Krupali Tappoo

The risk factors that are modifiable include:

  1. Stopping Smoking
  2. Treating high Cholesterol
  3. Controlling you Blood Pressure
  4. Managing and controlling your diabetes
  5. Being physically active
  6. Losing weight if you are overweight or obese
  7. Maintaining a healthy diet
  8. Avoiding depression

 

Feedback: maraia.vula@fijisun.com.fj

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