Often the first symptom of heart disease is a heart attack. Take, for example, a recent patient of mine who came in to see me complaining of tiredness and a heavy chest. Surely, he believed, it was nothing more than a side effect of over-work and jetlag from recent travels overseas. It wouldn’t be anything serious ̶ would it? Possibly not, however, I performed an ECG, which was normal, and ordered cardiac-enzyme testing to make sure that we were not dealing with anything serious. Two hours later, the results were in. My patient had raised cardiac enzymes, which are suggestive of damage to the heart muscles.
My diagnosis? An evolving heart attack. A second ECG done after two hours showed new changes, confirming the diagnosis. Fortunately, we acted swiftly and the patient underwent coronary angioplasty and had stents inserted into his arteries. He is now recovering well.
This story could well have had an altogether different outcome. In fact, 36% of deaths in the UAE are estimated to be due to heart disease and it is the region’s number-one killer.
We have all seen the overly dramatic depictions of heart attacks on television, but what if – like my patient – the symptoms are harder to detect? Perhaps just a general feeling of not being well, a slight shortness of breath, jaw pain, nausea, lightheadedness? In this case, early recognition of possible cardiac symptoms and the undertaking of appropriate measures, may just save lives.
Prevention is better than cure
As its name implies, heart disease is a disease of the blood vessels that supply the heart muscle. It is most commonly caused by a build-up of fatty deposits on the inner walls of blood vessels. This build-up leads to a blockage and further rupture of these fat deposits causes an acute event such as a heart attack.
We can check for the presence of blockages using an angiogram. Contrast dye is injected into the blood vessels and fluoroscopy is used to track the dye’s progress. The patient I mentioned earlier underwent an angiogram and we identified three separate blockages, ranging in severity from 60% to 99%. In his case, urgent treatment was essential for survival. We inserted stents into his arteries to widen them and to ensure the vessels remained opened (a process known as angioplasty).
While my patient was fortunate, in an ideal scenario his health should never have reached such a critical point. In the case of heart disease, prevention is always going to be better than cure.
Risk factors
A major step in preventing heart disease and reducing its burden globally is the identification of risk factors, examples of which include:
- Tobacco use
- Unhealthy diet
- Obesity
- Physical inactivity
We are all aware of the negative impact that smoking, a bad diet, being overweight and living a sedentary lifestyle can have. Preventative measures in the case of these risk factors involves making behavioral adjustments; giving up smoking, improving your diet, losing weight and doing regular exercise. The additional benefit to making such changes is an improvement in overall health and a reduced risk of developing other serious medical issues.
However, other risk factors may be more difficult to manage, these include:
- High blood pressure (hypertension)
- High cholesterol
- Diabetes
- Genetic predisposition
Patients who present with one or more of these factors are classed as ‘high risk’. We work with them to control their blood pressure and cholesterol levels, using medications. We also recommend that patients who fall into the high-risk category undergo regular screening tests so that early warning signs can be identified and managed before serious medical events occur.
Screening tests
I offer various screening tests such as:
- Lipid profile – measuring the levels of cholesterol and triglyceride in the blood. Cholesterol is one of the fatty substances that accumulates on the walls of the arteries causing the blockages characteristic of heart disease.
- Fasting blood sugar – high levels of sugar in the blood can indicate diabetes, or a prediabetic state.
- Thyroid function – hypothyroidism, or a reduction in the activity of the thyroid gland, can contribute towards heart disease.
- Electrocardiogram (ECG) – assesses the electrical behavior of the heart. Abnormalities may be indicative of current or past heart attacks.
- Exercise stress test – ECGs are performed while a patient walks or runs on a treadmill. The heart is put into a stressed state and the coping ability of the heart is a measure of its overall health.
- CT angiogram – this is a painless procedure and at Novomed we have the latest CT scanner that captures precise pictures while exposing you to the least radiation possible.
Screening tests save lives. The self-confessed workaholic –who walked into my clinic believing he was tired and run down – and ended up undergoing major heart procedure – now tells everyone, including his sons, of the value of regular screening.
If you are concerned, visit a cardiologist, talk through your family history and medical background and let him devise a screening and monitoring plan that works for you to ensure optimal heart health.
