Dr. Shirish M. Dhoble
Heart illness is on an alarming rise in our country more so in our urban population, this reality owes a lot to the present day life style of our masses and the stress it brings along, it also to a certain extent is related to the economic growth of the people and their ability to lead a life of physical comfort cutting directly into their willingness motivation and also leisure time to take up any kind of physical exercise, while on one hand we have this strata of our population which deals with conditions like diabetes, high blood pressure, obesity and anxiety and end up with disease of the heart which is also known as Coronary Artery Disease or CAD. And on the other hand we, in our notion still have many who deal with poverty, lack of hygienic condition of life, inadequate nutrition, this lot suffers or stands to suffer from Rheumatic heart disease or RHD. RHD stems from a childhood infection of throat when not adequately treated in time. This leads to structural destruction or distortion of heart valves leading to significant limitations later in life, due to incremental weakness of the heart which , reduces the person’s ability of work. Both the illness; CAD & RHD, are acquired to a large extent due to our life style and living condition and a large percentage of people who are unfortunate to have these diseases will have been avoided, if their life style would have been healthy or if their living conditions had been more hygienic and their food would have been more nutritious so as to enable them to fight common childhood infection. In a nutshell these two major disease of young and old are acquired by population over a period of time in their lives. Unfortunately both CAD and RHD affect the people in the prime of their lives cutting down their productive years and are a great threat to their social, psychological and last but not least financial status. RHD has always been a disease which affects in 2nd,3rd and 4th decade of life, But in recent times, the trend of CAD also suggests that it has started striking people as early in their 3rd and 4th decade of their life.
In addition to these two difficult situations there is also an occasional child who is born with a defect in the structure and functioning of the heart, ranging from single to complex needing corrective surgeries for the cure. These children also constitute a strain on the fabric of a family and society.
Fortunately parallel to the rise of such illness the awareness of the problem has also risen significantly, but it still falls short of the mark in the sense that an average citizen does not quite grasp the importance of the preventive aspect of the diseases. A healthy life style which includes proper attention to the
1. Cycle of Sleep and awakeness.
2. Eating habits and the type of the food which is consumed.
3. Role of physical exercise in life
4. Avoiding the stress or at least developing a healthy way to deal with it.
Certain risk factors for developing CAD are well recognised and these are Smoking, High blood pressure, Diabetes, obesity, high level of cholesterol in blood and a strong family history. It will be obvious to the reader that perhaps they can’t do too much about the family history of the disease but can certainly do a lot about the rest, like by not starting to smoke or simply quitting to smoke, by taking care about their food, blood pressure, diabetes. By striving to achieve a normal body weight and exercising and by making healthy eating choices, shall result in the reduction of the risk to a large extent. As far as RHD is concerned, we hope that a general upliftment of society will reduce the burden of Valve patients in the meanwhile prompt treatment of minor ailments in children shall save them from the devastating consequences of RHD. It is possible in the present scenario to have unborn babies to be evaluated for any heart diseases that they may be born with and thereby perhaps preventing the psychological trauma which prospective parents would have eventually undergone.
Such is the vastnet of the heart disease that despite all the efforts it will essentially affect a certain number of people and then the issue of healthcare comes in the picture.
Conditions like CAD and RHD and birth defects are amendable to treatment and patients can return to the fold of society in a very productive manner following the treatment.
CAD, fortunately, can be picked up early, necessary tests to evaluate the disease (which essentially affects the arteries carrying blood to the muscular pump of the heart in a manner that they become either narrowed or completely closed off) Such as ECG, Exercise tolerance test, coronary angiography will accurately produce a diagnosis and from then on a treatment plan(Either a stenting procedure or coronary artery bypass grafting, CABG) can be tailored to fit the neck of the patient.
Similarly RHD can be evaluated almost all of the times by echo cardiology and the disease can be treated by surgical repairs or replacement of the valves.
(The author is a Senior Consultant
Dept. of Cardiac Surgery, Shri Mata Vaishno Devi Super Speciality Hospital; Kakryal-Katra)
