Every year international campaigns turn the spotlight on better heart health on World Heart Day, citing cardiovascular ailments (heart disease and stroke) as the world's biggest killer disease. But not only is heart disease preventable with lifestyle modification but timely treatment by identifying symptoms and seeking medical attention can prevent death due to heart disease and salvage heart muscle.
“Much of the problem lies in denial of symptoms and delay in treatment,” says M.Chenniappan, senior cardiologist and president, ECG-ECHO Club. “Treatment within 30 to 60 minutes from the onset of attack, called as golden hour, can not only prevent death but save the heart muscle. Delay in treatment may save the patient's life but would leave him with poor quality of life and reduced heart health.”
“Though thrombolytic drugs can be administered up to 12 hours of the attack, immediate attention adds quality and quantity to a patient's life”, reiterates Nallusamy Senthilkumar, cardiologist, KMC Hospitals.
Though all chest pain is not identified with cardiac pain ( ulcer, muscle and bone pain being other causes) it is important to seek medical care at the nearest treating centre if pain persists for over 20 minutes. Cardiac pain is usually compressive and is accompanied by perspiration and palpitation.
Those who experience symptoms for the first time would do well not to ignore it even if chest pain is of the pricking, burning or pressing kind, warns Dr. Senthilkumar.
Symptoms are not similar
Noting that diseases don't read textbooks, Dr.Chenniappan cautions symptoms are not of a similar pattern. “Don't diagnose or decide treatment if you fall into the high-risk category: smokers, persons with diabetes, hyper tension, high cholesterol, obesity or mental stress.” Heart attack symptoms are also usually typical in diabetics characterised by unusual tiredness and hiccups, which can be confused with low sugar symptoms.
Dr.Chenniappan stresses on the need for multi-specialty hospitals to adopt a special policy to handle chest pain in order to achieve best results. “Chest pain cases should be attended promptly instead of putting the patient through prolonged emergency procedure. Even angioplasty is effective if performed within 120 minutes of heart attack.”
Improving care in periphery and rural areas is a prerequisite to ensure that someone who has a heart attack does not suffer due to lack of access to a cardiologist, he adds.
The ECG-ECHO club trains general practitioners in rural pockets to administer preliminary treatment for cardiac emergencies. By networking with physicians in tertiary care hospitals, advanced care is provided with minimised time delay as practitioners apprise counterparts in city hospitals and arrangements are put in place before patients reach the hospital.
Prevention
According to Dr.Senthilkumar, smoking is the major cause for heart attacks in persons below 40, while Dr.Chenniappan says that mental stress as a contributory factor cannot be underestimated. It is lifestyle modification and public education, not advanced technologies, which have brought down heart attack rates in some parts of the world, he adds.
A State government initiative to combat heart disease by screening patients above 30 for diabetes and hypertension has been introduced in government hospitals under the Tamil Nadu Health Systems Project.
