Eleven years ago, when Deendayal Sharma (Name changed on request) , then 42, suffered a heart attack, the implications scared him more than the actual pain. He had seen his paternal uncle die soon after developing heart disease, leaving three children to be brought up largely by his own father. However, today, Sharma says: “I have led a disciplined life, never had a relapse. I've risen career-wise. This year I witnessed my son's marriage and my daughter receiving her M. Tech. God is great!”
And so is modern medicine. In India , world-class doctors and state-of-the-art medical facilities, combined with a patient's appropriate lifestyle, have ensured that heart disease, in most cases, is no longer a death sentence nor the end of a productive career or fulfilling family life. Top heart specialists and countless survivors vouch for that.
Detecting early
Cardiac surgeon Dr. Naresh Trehan, Chairman and MD, Medanta-The Mediciti, Gurgaon, says: “With recent advances in treatment, most heart patients can look forward to an active and productive life. The key to favourable outcome is early diagnosis and prompt utilisation of appropriate invasive and non-invasive methods of treatment.”
Dr. Praveen Chandra, Chairman, Division of Interventional Cardiology, Medanta Heart Institute, Medanta, says: “Heart attack is a life-threatening condition. If no medical help is taken, 30 per cent of patients die in the initial hours. Most patients who survive can lead a normal life after heart attack if it is uncomplicated –– the case with 70 percent of patients.”
What decides the longevity and quality of life after heart attack? “The heart's pumping function, the patient's exercise tolerance, co-morbidities like diabetes, etc. Of these, exercise tolerance is the best predictor. If the patient can walk six to seven km in one hour, his life expectancy is as good as normal, whatever his heart condition. Even those with normal heart function and no heart-attack history but who have undergone angioplasty and surgery have normal life expectancy. Some might develop erectile dysfunction and loss of libido but this is mainly a side effect of medicines and can be corrected with medical help,” Chandra replies.
According to Dr. Praveer Agarwal, Associate Director, Interventional Cardiology, Fortis Escorts Heart Institute, New Delhi , the main factor deciding quality of life post a heart problem is “ejection fraction or heart function. I have hundreds of patients who are back at jobs which even involve heavy exertion.”
Dr. Trehan opines: “The degree of damage to the heart's main pumping chamber and its recovery after treatment matter most. Quality of life also depends on adequacy of treatment, associated conditions like BP, diabetes, weight, emotional status, proper lifestyle.”
Babies born with heart problems have also survived to lead long lives and succeed at school/college, careers, in performing arts, to marry, and have children. That has special relevance for us, considering India produces the largest number of children with heart disease in the world.
Timely intervention
Paediatric heart specialist Dr. Devi Prasad Shetty, Chairman, Narayana Hrudayalaya, reveals this is because one out of 140 children anywhere is born with a heart problem and India produces 28 million babies. “Approximately, we produce about 600 to 800 babies with heart disease everyday, most requiring surgical intervention. But the good news is that 95 per cent of these heart problems can be cured with a single operation and the children can lead normal lives without re-intervention and most don't require medication. Only a small per cent born with major defects (like absence of one side of the heart) need repeated re-intervention and don't have normal life-expectancy. The rest, as I said, lead normal lives –– but again, only if that surgery is done at the right time. However, in India many surgeries get delayed.”
Doctors say the keys to return to normal, fulfilling life are prompt and quality treatment followed by regular check-ups, ideal diet, regular exercise, no-smoking, low-alcohol intake, eschewing negative emotions, and checking problems like diabetes, overweight, etc. An ideal diet is a low-salt, low-calorie one including plenty of salads, fresh fruits, pulses, cereals, also low in oil, red meat, creamy milk and milk products.
Having been traumatised once, many patients display a kind of mild fear to big dread of another problem. So, one impact is psychological –– many patients develop ‘cardiac psychosis'. Dr. Chandra explains: “Patients tend to restrict their activity and become fearful for minor, non-specific symptoms.” However, this fear factor also has a benefit, he says, since most patients tend to quickly give up bad habits like smoking, drinking, and overeating/eating wrong food.
Back to normality
Otherwise, most patients resume normal life. Dr. Trehan has cheering words: “Several patients who came to me in critical condition are back to an active, productive life at work and home. Post-bypass or angioplasty, there are captains of industry leading large companies and working 12 to 16 hours a day including extensive international travel, politicians heading ministries and artistes handling hectic work schedule.”
Many survivors return with renewed enthusiasm for life and greater appreciation for its joys, or a resolve to help the less fortunate. Hyderabad-based D. Shyam Reddy (name changed), a 44-year-old MNC President, says he now attends all his son's school sports functions and daughter's Kuchipudi performances. Ramesh Jain, 61, Kolkata businessman, says he has now doubled leisure time spent with children and grandchildren. “I even accompany my wife for movies and shopping –– something never done in the previous 33 years of marriage!”
Chennai homemaker Charukesi Ramanathan and Mumbai ad-professional Subodh Ganguly (name changed), spend a designated time every week volunteering at spastics society and disabled children's orphanage respectively. Bangalore-based S. Radhika (name changed), MBA student and budding Bharatanatyam artiste, was successfully treated at birth for a congenital heart disease.
For doctors, the biggest gratification is witnessing former patients get back to normal life –– even notching up achievements. When they see former patients resume normal workplace and married life, or leading a peaceful retired life, or getting married/having a child, topping the university or winning in sports, or giving dance/music performances, it's their biggest happiness.
Dr. Shetty reveals one such rewarding moment for him: “Recently when waiting to catch a flight in Kolkata airport, a tall six-ft athlete rushed to me. As everyone watched he touched my feet and opened his shirt to show the scar on his chest. He reminded me that I operated on him when he was a baby!”
