Mr. A, a 35 year old software professional had been looking forward to a holiday with his family. It would be a much wanted break from his stressful schedule. Work had been hectic and he was doing 14 hour shifts and taking work home. He had always smoked but it only got worse in the last few months. An active sportsman during his college days, he had virtually stopped exercising and has been noticeably putting on weight. His friends were making fun of his “beer belly”. Weekends were for partying with friends to beat the stress. Lunch was mostly at the office cafeteria. Of late he felt tired easily and short on stamina. He had been planning to get his annual health check up; it had been pending for the last 2 years. The last time his doctor had warned him that his sugars and lipids were creeping up and he had to pay attention. That morning he started feeling a nagging heaviness in his chest and a hollow discomfort in the arm. He also had little cold sweat and felt nauseous.
He thought it may be because of the food he had the previous night might caused him acidity. His wife however was worried .She knew he needed urgent attention. She brought him to the Emergency Room at Sakra World Hospital, which was 10 minutes drive from home. After a quick physical evaluation the doctors at the ER did an ECG and found that he was having a heart attack. They were glad that the family had arrived without wasting time because early treatment would mean less damage to the heart and quicker recovery and return to normal life. The doctors assured the family that, though heart attacks are dreadful, with a quick opening of the occluded artery of the heart by doing an angioplasty, risk would be substantially reduced.
Mr .A was taken to the Cath-lab within 20 minutes of arrival and an angiogram was done through his wrist artery (Radial access – lest discomfort compared to the conventional groin artery approach) . His right coronary artery was found totally blocked in its mid part and that was cleared with angioplasty and stent. He had immediate relief of chest pain and the cardiologists were satisfied to see the prompt recovery on the ECG. He spent 2 days in the hospital including one day in the CCU and was discharged .The pre-discharge ECHO (Scan of the heart) showed that the damage was very minimal. He had a near normal Ejection fraction of 55%. EF below 35 % would have put him at risk of heart failure.His wife’s presence of mind and getting him to the right place at the time made a big difference.
Time in treatment is one of the biggest determinants of outcomes in heart attacks as in any life-threatening medical emergencies. Reaching a fully equipped hospital at the shortest possible time is important rather than to go through multiple levels of care in between. Hospitals equipped with a cath lab with 24x7 availabilities of cardiologists, supported by a team of trained nurses and technicians available round the clock can provide the best care for heart attacks. A fully equipped ER run by highly trained Emergency specialists and Nurses helps achieve prompt response to any life threatening emergency.
He has now promised himself that he will create a proper work life balance and have a healthy family time. He has since stopped smoking and reduced alcohol intake. A diet rich in veggies and fruits, healthy nuts like almonds and walnuts, using healthy oils like olive oil, rice bran oil and sunflower oil has replaced fast foods. Rice based diet has been replaced with whole wheat, all bran and oats. He is now walking regularly, at least 45 minutes on most days of the week. Yoga has given him relaxation and peace. He has been advised to strictly follow the medications to avoid recurrences of his heart problem.
Mr.A has taken this episode as a course correction in his life to put him on the path of healthy living. He has taken it upon himself to guide his children to an early adoption of healthy lifestyle .He is amongst the millions of young Indians who because of rapid urbanization and increasing affluence are suffering the consequences of excess without moderation in consumption and no parallel increase in attention to lifestyle .Lifestyle disorders like diabetes, hypertension, high cholesterol and obesity are on the rise and these in turn increases the risk of heart diseases and stroke. Preventive interventions are always more cost effective. These interventions focus on modifiable risk factors like diabetes, hypertension, high cholesterol, smoking, obesity and sedentary lifestyle.
There are other risk factors that are not modifiable, such as advancing age, male sex and family history of Coronary disease. Though heart attacks are said to be less common amongst women, they still constitute a major cause of morbidity and mortality in women. Additionally women are more prone to delayed diagnosis because of absence of classical symptoms of heart attacks. Also women with heart attacks tend to have more complications than men.Heart attacks, though amongst the deadliest of the diseases, are probably also the easiest to prevent.
