Living Well with Heart Disease

Arvind Kohli
If you have heart disease, or think you do, there’s a lot you can do to protect your heart health.
The following are the key steps to control the disease, including how to survive a heart  attack and  prevent serious damage to heart muscle. Caring for your heart is worth the effort. Use the information here to start today to take charge of your heart health.
What is Heart Disease?
Coronary heart disease-often simply called heart disease occurs when the arteries that supply blood to the heart muscle become hardened and narrowed due to a build-up of plaque on the inner walls of the arteries. A heart attack occurs when the plaque bursts and a clot forms over the plaque, blocking flow through the artery and preventing oxygen and nutrients from getting to the heart. Heart disease is a lifelong condition. Even if you’ve had surgery or other procedures to help with blood flow in your heart, your arteries remain damaged.
Their condition will worsen unless you make changes in your daily habits. There is much you can do to control heart disease, prevent a first or second heart attack, and increase your chances for a long and vital life.
Getting Tested
If you have been told that you have heart disease, you may have had one or more screening tests. Tests for blood pressure and cholesterol levels are often done as part of routine physicals. Additional tests that may indicate heart muscle damage or blood flow problems help doctors evaluate the severity of your condition.
Most tests are done outside of the body and are painless. They include ECG. Echocardiography, Stress ECG,CT Coronary and finally Coronary angiography which stays the gold standard test for diagnosis.
Risk Factors
Risk factors are health conditions or habits that increase the chances of developing a disease or having it worsen. Because you already have heart disease, you’ll need to work especially hard to control your risk factors. There are two types of heart disease risk factors-those that are beyond your control and those that can be changed. Those that can’t be changed are a family history of early heart disease and age. For women, heart disease risk increases at age 55; for men, it’s age 45.
The risk factors you can control are smoking, high blood pressure, high blood cholesterol, overweight/ obesity, physical inactivity, and diabetes. While having even one risk factor is dangerous, having multiple risk factors is especially serious, because risk factors tend to”gang up” and worsen each other’s effects.
Heart disease and its risk factors can be treated in three ways: by making heart healthy changes in your daily habits, by taking medication, and in most of cases by having a medical procedure in form of Angioplasty or bypass surgery
IN BRIEF: Making lifestyle changes. Adopting new habits, such as not smoking, following a heart healthy eating plan, maintaining a healthy weight, and becoming more physically active can go a long way in helping to reduce your risk for worsened heart disease. You may need to manage certain risk factors vigorously. For example, having heart disease means that if you have high levels set a type of cholesterol called low-density lipoprotein (LDL), the “bad” cholesterol, your goal should be to bring the level to below 100 mg/dL.
Sometimes, lifestyle changes alone aren’t enough to control heart disease and its risk factors. Medications are often used to treat high blood cholesterol, high blood pressure, or heart disease itself. For instance, medicine may be used to relieve angina, the chest pain that often accompanies heart disease. If you do take medications, it is vital to also keep up your heart healthy lifestyle, because it can help to keep doses of some medications as low as possible. Be sure to take your medication exactly as your doctor advises. (This includes aspirin and other over-the-counter medicines). If you have uncomfortable side effects, inform your doctor. You may be able to change the dosage or switch to another medication (Clopidogrel).
Getting Help for a Heart Attack
If you have heart disease, you are at high risk for having a heart attack. But planning ahead so you know what to do if heart attack signs occur will help you get treatment fast-when it can save heart muscle and even your life.
Know the Warning Signs
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes. It may feel like pressure, squeezing, fullness, or pain. The discomfort may be mild or severe, and it may come and go.
Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw, or stomach.
Shortness of breath. This may occur with or without chest discomfort.
Other signs include nausea, light-headedness or breaking out in a cold sweat.
Angina is a pain or discomfort in the chest that occurs when the heart muscle is not getting enough blood due to the buildup of plaque in the arteries. It is not a heart attack, but if you have angina, you are more likely to have a heart attack. The pain may feel like pressure or squeezing in your chest, or may also occur in your shoulders, arms, neck, jaw, or back. Stable angina-a type with a predictable pattern-can be brought on by a physical or emotional strain, but unlike a heart attack, is usually relieved by rest or medicine. Unstable angina is less predictable, may not be relieved by rest or medicine, and is a sign that you may have a heart attack very soon. If your pain does not go away within 5 minutes after rest and/or medicine, or gets worse. Prepare a Heart Attack Survival Plan
Be sure your family, friends, and co-workers know the warning signs and what to do if you should have a heart attack. Write down medications you take, any medicines you are allergic to, and phone numbers for your doctor and a person to contact in an emergency.
The importance of Cardiac Rehabilitation
Millions of people survive heart attacks or heart surgery and resume active, normal lives. The time it takes to recover from a heart attack or heart procedure will depend on many factors, including successful participation in a cardiac rehabilitation program. Cardiac rehabilitation programs include exercise training, education on heart healthy living, and counselling to reduce stress and help you return to an active life. Almost everyone with heart disease can benefit from some kind of cardiac rehabilitation. Women are helped by cardiac rehabilitation as much as men are.
Exercise training will help you learn to safely participate in physical activity to strengthen your heart and your muscles and improve your stamina. If you are still recovering from surgery, you may worry that exercise could be harmful. In fact, physical activity can help prevent future heart problems. Your cardiac rehabilitation team will plan a program for you that is safe and effective.
Cardiac rehabilitation programs will also help you learn new heart healthy habits, control your risk factors, and offer support to cope with the challenges of adjusting to life following a heart attack or heart surgery. Depending on your needs, a program may help you quit smoking, manage conditions such as diabetes, follow a heart healthy eating plan, lose weight, and manage stress.
(The author is a Heart Surgeon at GMC, Jammu)