That took me back by two years and I was reminded of the incident when my dad got a heart-attack, and also of the tough time that I and the rest of my family had to go through. And that precisely is the reason why my friend came to me seeking answer to few of her queries. I asked her if she was planning to bring her dad to Bangalore, and she replied that she was thinking on those lines. Her dad, in fact, was near Jhansi in Madhya Pradesh, which is not that big a city to cater to any cardiac exigencies. Based on the knowledge that I had acquired in my dad’s case, I strongly asked her not to do any such thing so early.
This, I think, is the right juncture that I share the technical complexities involved and basic precautions that need to be taken whenever somebody has a heart-attack. First things first; let’s see what a heart attack is. Heart attack is a situation in which the blood doesn’t reach the heart in sufficient quantity leading to death of a number of heart-cells and damage to a part of the organ. Why doesn’t the blood reach the heart in sufficient quantity is because the corresponding arteries are choked or much narrowed, and that becomes the basis of the whole problem. The damage or dysfunction of heart may not reveal itself in stages and thus “a single heart-attack can be fatal”; rub the much prevalent myth off your mind that a person can survive two heart-attacks and only the third one could be fatal.
We would come to what chokes the arteries a bit later, but would first see what to do if somebody has had an attack. At the time of the attack, the patient in question feels an acute pain in their heart and/or region above the heart right up to the jaw, and often tend to lose control on the body along with exhibiting other symptoms like nausea, sweating, etc. In case you have few pills of Sorbitol, ask the patient to put one or two beneath their tongue. Don’t make the patient lie down immediately; it’s better if they sit comfortably on ground with their back rested on something (like a sofa). Needless to say, the patient should be rushed to the nearest hospital at the earliest. Now, here’s a big precaution that need be taken. As I mentioned, the root of the attack lies in the choking or narrowing of the arteries. It won’t be wise to think that the arteries just choked or got narrowed instantly or for a mere moment. The problem is that the choking or narrowing went unnoticed and unattended for some time and somehow the person’s body, and the heart within, got in a position so as to fail to deliver. It’s just a matter of grave misfortune that the person got an attack and just a matter of great fortune that they survived. The precaution is that the patient’s body be not allowed to move, and not be put under any kind of physical turbulence. If possible, make use of a stretcher or cot to lay down the patient and move them to the hospital. Another thing is to ensure that the supply of blood to the heart may not fall short again. To this end, put 3-4 pillows beneath the patient’s head so as to tilt the head region towards the heart.
Causes and Cure...
Let’s now see what causes the choking of arteries. The main culprit is the cholesterol deposit in the inner walls of the arteries. The deposition eventually causes a fissure within the artery, to clot which, the red blood cells rush towards the site of the fissure and make a blood-clot; this leads to choking of the artery and a heart-attack subsequently.
Before getting into how to avoid a heart-attack, it’ll be apt to first see what to do next so as to ensure the cure of it. If the patient has had the attack in a place where specialized cardiac care is unfortunately not possible—as was the case with my friend—have the patient attended with preliminary medication in the “nearest credible” hospital. Once the patient’s condition is stable, get them moved to the “nearest credible” hospital where further cardiac procedures can be done. This is probably where my friend erred. She brought her dad all the way from Jhansi to Bangalore despite my insistence to take him to Delhi in such a critical situation. When brought here, her dad had to be admitted immediately in the ICCU, since he was feeling chest in his pain again. The doctor was also not supportive of their decision of making the patient do such a long and strenuous journey. Anyway, by God’s grace, her dad was looked after very well after being admitted. He had to undergo a bypass surgery, after which he’s doing absolutely fine right now.
The first thing that the doctors do on the patient after they’ve got the attack is a test called angiography. Angiography is a procedure in which the current state of the cardiac arteries and blood vessels is captured as something called an angiogram in order to do further analysis. Technically, a coloured dye is introduced into the body, which flows to the heart region along with the blood. The flow of the dye, which is indicative of the flow of blood, unveils the path of blood flow, and the state of arteries.
After the angiogram is seen, doctors are in the best position to decide the further course of action. There are two principal cardiac procedures which can exonerate the heart of the risk of further attacks. The first one that we talk of is called angioplasty. Angioplasty is no surgery per se. Yet, it’s a highly skilled procedure by which the clot in the artery is removed. A thin wire along with an un-inflated balloon tied at one end, called a balloon-catheter, is introduced in the body through the thigh-region. This catheter is also equipped with a spring-like small tube known as stent. The catheter is manually steered to the very site of the clot. The balloon is then inflated so as to widen the narrowed artery and drain off the clot by exerting a large amount of pressure. Once the clot is removed, the stent is installed in the artery so as to give it its normal shape. The catheter, along with the deflated balloon, is then retracted out of the body, and this completes angioplasty.
The second principal procedure is actually a surgical operation called bypass or– in laymen terms—open-heart surgery. If there are multiple arteries that are narrowed or clotted, angioplasty is not the way to go, since the heart requires a much more rigorous procedure. Hence, an open-heart or bypass surgery is deemed necessary. In bypass surgery, as the name indicates, the arteries that have gone dysfunctional are bypassed by grafting another artery—mostly taken from the patient’s leg—for them. This provides for the blood flow to the heart from the grafted arteries, bypassing the original ones.
Prevention is better than Cure...For any patient who has had a heart-attack recently, the doctors first do the preliminary treatment and tests like angiography, and make sure that the patient’s body is ready enough for any further procedure. It’s worth mentioning that these procedures usually employ high risk, yet if done in a competent hospital under specialized doctors, the risk factor is much less—0.25% in case of angioplasty and 1% in case of open-heart. The cost of the procedure varies from one hospital to the other and from one place to the other; in my city of Bangalore, the average cost in the best of the hospitals for angioplasty should be 2-2.5 lacs and for bypass, 2.5-3 lacs. Post the procedure, the patient may soon be normal. In case of angioplasty, the patient may be discharged within 2-3 days, while in case of bypass, in nearly a week. Somebody who has had a heart-attack may very well live a normal life post the procedure. The only requirement of them is that they follow the diet, medication and, most importantly, the exercises suggested by the doctors very religiously, and that they get their check-ups done as per the schedule prescribed.
Heart-attack is avoidable, provided one acts early. Below I cite few of the best-practices that can help one have a healthy heart:
- Exercise at least half an hour daily. This could range from some mild-work out to just a brisk walk.
- Have a less-oily and cholesterol-free diet. Say no to cakes, chocolates and ice-creams as many times as you can. You may relax your diet once or twice a month or so, though. Having a diet-chart prepared by some dietician is no bad thought at all.
- If you’re having problems of blood-pressure, sugar or hyper-tension, look for the advice of your doctor and follow that strictly.
- Quit smoking. I know this could be gravely difficult for some people, but try to lessen it. Know in detail, what harms smoking and/or drinking can cause to your body. Seek advice from some physician as to what kind of smoking or drinking habits could be safe, if at all they are safe.
But these are best to be followed by people who are at a younger age. For elderly people, since it could be a bit late to change the lifestyle, what’s most imperative is that they get their full body check-up done once; people who get their check-ups done regularly are on the right track. A full-body check-up may not cost more than a thousand rupees. The best thing is that if there’s anything alarming in the body that needs further attention, this check-up may very well bring that to the fore, be it something related to heart or anything else, for that matter. Another personal experience is worth citing here. Just after I came across the above matter with my friend, I asked another friend and colleague if her parents get their check-ups done. When she replied negatively, I insisted that she gets it done as soon as possible. She made her in-laws undergo the test, and her mother-in-law’s reports warned of a high level of cholesterol. The doctors suggested further specific tests like Echo and TMT, to all of which her heart didn’t respond well enough. She has been suggested an angiography, which she shall be undergoing soon. I hope and pray that she doesn’t require any cardiac procedure per se and that medications may take care of her. Thankfully, my colleague reacted in time.
The intention of this post is to make people acknowledge that cardiac problems are a much-prevalent reality, and raise consciousness in them to avoid such problems for themselves and for their loved ones. Most of the people are too conceited to admit that they can ever have such big problems in their lives. Probably many people in our society also don’t appreciate the importance of regular check-ups. Yet, I appeal to my wise and vibrant friends to make sure that they act in time and make their parents and other loved ones act in time too.
Your life is precious–not as much for you as it is for your parents. Your parents’ health is precious–not as much for them as it is for you. So for your parents’ sake, take care of theirs and take care of yourself. At the least, we all owe that much to our parents. Don’t we?
Spread Awareness! Spread Happiness!
DISCLAIMER: The information presented in this article is based on my own experiences and some word-of-mouth facts told by some competent doctors. Although the precautions are "general" ones, some or all of them "may" not be fail-safe in certain situations. The technical information shared "may" also not be "absolutely" correct. Some of the information may also be incomplete. The readers are suggested to react with the best of their own knowledge, conscience and belief if posed with any emergency.
