World’s Deadliest Killers

Heart attack, Heart failure ,Cardiac arrest and Stroke

Yes, you got it right. World’s number one killer diseases are what we are going to talk about now.

Situation is alarming and it is an absolute necessity for all of us to have a clear understanding of these deadly diseases.

Heart attack and heart failure are about malfunctioning of heart, whereas Stroke occurs due to malfunctioning of brain, though the root cause for both is the same; inadequate supply or total stoppage of blood supply to heart and brain. World Health Organisation (WHO) has classified these diseases as Cardio Vascular Diseases (CVD).Most alarming aspect of the situation is  that CVD is no longer limited to elderly population . Cardiac arrest on the other hand occurs due to electrical problem in heart. People often suffer from Cardiac arrest without having diagnosed with any heart disease before hand  .Even younger people are not spared form heart diseases or strokes. That makes the issue alarming enough to demand everybody’s attention.

The number one killer disease

To start with we shall take a look at the gravity of the situation. Some hard facts will do the job. Globally, this disease led to 17.5 million deaths in 2015.

75% of these deaths took place in developing countries. According to reports published by WHO, the south Asian region has one of the highest Cardiovascular mortality.

In India the age-adjusted CVD mortality rates stand at:

  • 349/100,000 in men
  • 265/100,000 in women

Whereas these numbers for the USA are:

  • 170/ 100,000 in men and
  • 108/100,00

It is to be noted that the figures for India  are 2 to 3 times higher than those for the USA .Some studies revealed that deaths as well as disability from CVD has more than  doubled in India in last 30 years.  It has also been found that while mortality rate on this account is rapidly declining in developed countries, it is increasing in developing countries.

Reason for this is that primary health care services in the developed countries are very well organised which makes early detection and therefore, prevention possible.

In contrast, this service is in shambles in developing countries including India. That’s why every individual in developing economy be better well-informed about the factors responsible for occurrence and be able to identify the early symptoms. Then only he will be able to take appropriate action promptly to save himself and his family from these lethal diseases.

                                                              

In this context, it can be of great help to be aware of the early symptoms displayed by these deadly diseases.  If identified early, chances of recovery is high. Many lives could be saved if medical support is provided before it is too late. But that is possible only if there is a general awareness among people about these diseases and the symptoms to identify the danger. This makes this write up so valuable.

Let’s first understand that in medical parlance these diseases are referred to in different names.  World Health Organisation (WHO) has defined Cardiovascular Diseases as follows:

“Cardiovascular disease (CVD) is the name for the group of disorders of heart and blood vessels, and include:

  • Hypertension ( high blood pressure)
  • Coronary heart disease (heart attack)
  • Cerebrovascular disease (stroke)
  • Peripheral vascular disease
  • Heart failure
  • Rheumatic heart disease
  • Congenital heart disease
  • Cardiomyopathies”

Most lethal among these are heart attack, heart failure and stroke which may lead to death if not detected in time and the patient is not given appropriate medical attention and treatment. We shall focus here on these diseases and try to share with you:

  • What these diseases actually mean,
  • The conditions that trigger  these diseases( risk factors)
  • Symptoms indicative of probable occurrences,
  • Ways to take preventive measures to avert any critical situation.

Heart Attack

This is also called myocardial infraction. The heart is a vital organ of our body made up of muscles. The arteries supply oxygen-rich blood to heart and other parts of the body to keep muscles healthy and active. However, in course of time plaques build up on the inner walls of arteries .This plaque is made up of cholesterol, calcium and other substance present in blood. In course of time plaque hardens and narrows the arteries reducing blood flow to heart .Later, when the plaques split to release blood clots into blood stream and obstructs blood flow to heart muscles. This causes the starving muscles die.

Symptoms of Heart Attack

A feeling of pressure, tightness, pain, squeezing or aching in the chest or arms that may spread to the neck, jaw or back can be a sign of heart attack. Besides, some of the following symptoms may also be observed:

  • Pain in the centre of the heart
  • Coughing
  • Nausea
  • Vomiting
  • Crushing chest pain
  • Dizziness
  • Shortness of breath
  • Sometime face turns  grey in colour
  • Feeling restless
  • Feeling clammy and sweaty
  • Shortness of breath
  • A feeling of terror overtakes the victim that he is facing death.

This pain may persistent or intermittent.

Please note that people may or may not have these classic signs of heart attack. Other symptoms may be:

  • Jaw ache
  • Pain only in the shoulders and arms
  • Shortness of breath when lying down
  • Nausea and vomiting

Heart Failure

Heart failure does not necessarily mean that heart has totally stopped functioning and that it is beyond remedy. It is means heart is isn’t pumping adequate quantity of oxygen and nutrient rich blood to the various parts of the body. As a result, body loses its ability to function properly. It is in fact a chronic progressive condition when the heart can’t cope with its workload. The symptoms and indications of heart failure will be taken up separately.
Indications of heart failure: The likely indications of heart failure are as follows:
• Shortness of breath (dyspnoea) when lying down flat
• Persistent coughing and or wheezing
• Building up of excessive fluid ( swelling of feet, ankle ,legs or abdomen ,weight gain)
• Tiredness and fatigue in everyday activity (climbing stairs, carrying heavy items, even walking)
• Lack of appetite and nausea
• Impaired thinking ability: confused state of mind
• Increased heart bits
Such a situation arises when disturbed electrical impulse or blockage in coronary arteries obstructs, reduces or even stops blood supply to heart.

Most common symptoms of Stroke are:

  • Dizziness
  • Sudden severe head ache of unusual intensity often associated with stiffness in neck
  • Complete black out
  • Sudden loss of vision ( one or both eyes)
  • Inability to understand what others are saying
  • Problem with body balance and coordination ( Staggering while walking)
  • Difficulty in swallowing
  • Numbness in limbs ( generally on one side of the body) or weakness

We shall now share the risk factors that may cause these diseases.

Risk factors for Heart attack and heart failure

Risk factors that cannot be altered

  • age
  • gender
  • family history
  • medical history

Besides, there could be several other non-lifestyle factors, which cannot be altered

  • Age
  • Ethnicity
  • Family history
  • Medical history

Risk factors that can be altered

  • raised or altered levels of blood cholesterol
  • raised triglycerides with low HDL cholesterol
  • high blood pressure
  • diabetes
  • smoking
  • obesity/overweight
  • lack of exercise
  • excessive alcohol intake
  • excessive mental stress

Risk factors increasing the possibility of stroke

  • High Blood Pressure
  • Obesity
  • Cholesterol level
  • Diabetes
  • Smoking
  • Excessive alcohol intake
  • Mental stress

This write up will remain incomplete if we forget to mention the most dreaded and lethal one in this category of diseases, known Cardiac Arrest or Sudden Cardiac Arrest.

Cardiac Arrest

Cardiac arrest is a situation when the heart stops beating and refrain from circulating blood to various organs of the body.  It is caused by an electrical problem in the heart. When this happens, brain cells starved of blood supply may sustain its services only for a few minutes and then succumb to death. This can happen at any age and with or without any history of the patient having been diagnosed earlier with any heart disease.

 This is considered lethal as the mortality rate in such a condition is very, very high (estimated at 95% when it happens outside any hospital).

Indications of Cardiac Arrest:

Following are common signs. The patient may display  one or more of the following symptoms:

  • Losing Consciousness or fainting;
  • No heart beat or pulse can be felt;
  • Dizziness;
  • Chest pain;
  • Shortness of breath( breathing difficulty);
  • Nausea ;

Friends, it will perhaps take some time for you to assimilate the information. I shall call it a day after I have told you how to handle a situation when some-one in the family show early signs of CVD.

Performing CPR

1) First and foremost need is not to panic.

2) Time is very crucial for survival. Time between the attack and commencement of treatment is very important.

3)  However well informed one may be, a lay- man can hardly diagnose a CVD and the level of urgency accurately. So in the event of someone with symptoms of CVD, seek medical advice from a medical practitioner, preferably one who knows the case history. If the doctor can’t visit the patient immediately, tell him the symptoms and ask him what to do.  Act according to his advice.

4) If the conditions persist or aggravate, immediately book an ambulance (preferably from the hospital where you want your patient to be admitted) and rush to the emergency. While booking the ambulance let the hospital know that it is an emergency and inform the symptoms observed.

5) People with multiple risk factors should have an emergency plan ready which includes choice of hospital. Those covered by insurance should check if the Insurance Company is empanelled with the hospital.In case of Sudden Cardiac Arrest, time available before proper medical treatment starts,is absolutely

6) In case of Cardiac Arrest  time available before proper medical procedure can start is of super critical (Should we say 4 to 6 minutes).It is therefore essential for people nearby to try CPR or Cardio –pulmonary Resuscitation .This an emergency lifesaving procedure performed when the heart stops beating. Immediate CPR can double or triple chances of survival after Cardiac Arrest.

What is a CPR?

“CPR is a lifesaving medical procedure which is given to someone who is in cardiac Arrest. It helps to pump blood around the persons’ body when their heart can’t.”(British Heart Foundation). Detailed videos are available in U tube to illustrate the procedure. British Heart Foundation also  has published training videos on CPR  .It is advisable for everybody to learn this procedure which can save the life of their near and dear ones in such an emergency.( This also come handy in drowning cases.)

“To carry out CPR a person has to press at the centre of the victims’ heart (chest compression) in quick succession and gives them a series of rescue breaths (popularly known as mouth to mouth breathing), if trained in CPR. Otherwise apply hands only CPR.

The process of hands only CPR: (source: British Heart Foundation)

  • Check the persons over. If they are not responsive and not breathing, then their heart has stopped working and they are having a cardiac arrest.
  • Now call Ambulance. Then you do Hands only CPR.
  • Lock your fingers together, knuckles up. Then push down, right on the sovereign. Push down five or six times. That’s about 2’inches. Push hard and fast about two times a second, like to the beat of Stayin’ alive. Don’t worry about hurting someone. A cracked rib can be mended- just concentrate on saving a life.
  • Keep this up until the ambulance arrives.”

That’s all for the time being. Please stay alert and act immediately without wasting time.

(Information and statistics furnished in this write up have been sourced from the Websites of WHO, American Heart Association, British Heart Foundation and Heart UK)