Healthy lifestyle changes – a crucial path to preventing heart attack

Jul 27, 2014 News

---

By Sharmain Grainger
Although it might have been his father dying from a heart attack last year, coupled with his own health scare that helped to effect lifestyle changes, Jaishema Gangaram is hopeful that his mere words would be enough to prompt a similar

change among other young people.
The 35-year-old man since earlier this year has not only adopted an improved diet, but also exercise. Keen avoidance of cigarette smoke and alcohol has become a way of life for him. Gangaram related to me that he is on a mission to ensure, as far as possible, that he does not die prematurely, at least not due to any heart complications.
Although he grew up hearing of persons suffering and even dying from heart related issues he couldn’t be bothered by such matters. After all, no one close to him was dealing with such health challenges.
Today he is however convinced that had there been more awareness on heart conditions back in the day his father may have avoided altogether being listed among the heart disease statistics.
Gangaram recalled that his father, a rice farmer, was often too busy in the fields to eat on time. So when he would suffer ‘sticking’ pains to his chest he would easily conclude that it was caused by ‘wind’ accumulated in his stomach. His father knew just the answer for such situations – a concoction, which once swallowed, produced a few belches after which the discomfort was eased to a point that his father believed that it was completely addressed.
This was a regular challenge Gangaram’s father faced.
But little did his father know that his arteries were gradually being blocked.  He would however learn this until he was in his mid-fifties. By this time he had several blockages, an enlarged heart and diabetes was in full effect.
All this was uncovered when Gangaram’s father became severely ill and was forced to seek medical attention. He was diagnosed with advanced coronary heart disease about five years ago.
His diet was seen as a primary reason for his condition. There was hardly anything that could have been done locally to remedy his too many complications. By last October he succumbed to his ailment at the age of 62.
According to Gangaram his father’s death was certainly not in vain. This was in spite of the fact that the pre-condition of his father’s demise hadn’t immediately registered to him.
It was a few months after his father’s death that Gangaram started to experience some ‘sticking’ chest pains, similar to what his father had experienced. He recalled that he had suffered identical pains about a year prior but hadn’t worried too much about them then.
Not wanting to again take the discomfort for granted, Gangaram decided to visit a doctor, a pastime that was not easily embraced by the men in his family.  At a private hospital he underwent a number of tests including an echocardiogram which is a test that uses sound waves to create pictures of the heart.
There was nothing glaringly wrong with Gangaram’s heart and so he was more than reluctant when he was asked to undergo an angiogram which allows the inside of the heart to be examined.
“I refused to do the angiogram because I just started thinking this was a waste of money…They were not finding anything wrong with me and yet they wanted to do more things.”
In addition to the ‘sticking’ pain that seem to run from his chest to his back, he started to experience numbness to his feet and even face.
Gangaram eventually made the decision to visit the same doctor who had diagnosed his father with heart disease. What the doctor found prompted him to refer the young man immediately to the Caribbean Heart Institute (CHI) for further advanced cardiac attention by Resident Cardiologist, Dr Mahendra Carpen.

At CHI, which is situated in the compound of the Georgetown Public Hospital Corporation, Gangaram was again required to undergo an echocardiogram which was able to pick up consistent irregular heartbeats, suggesting that something was amiss.  An angiogram was again recommended.
“I ended up doing the angiogram and it was proven that there were two (arteries) blockages.”
By this time he was a husband and father of two, and the primary breadwinner in his Diamond, East Bank Demerara, home. Taking care of his health was not merely an option, it was imperative.
While recognising that inserting a stent could help to remove the blockages, Dr Carpen was not too keen on performing such a procedure on the young man. Instead he recommended medications to help dissipate the blockages.
Gangaram has been on medication for the past month and, according to him, the attending Cardiologist is optimistic that the blockages will all be gone within a three-month period.
But in addition to medication, Gangaram recalled being warned by the Cardiologist to ensure that he spared no effort to ensure that he only consume healthy foods and exercise regularly.
“It is a whole life change from before, in terms of what I eat, how much I eat and even how much I exercise. He (Dr Carpen) told me if your body is not physically fit, you need to become active and he particularly told me that smoking and alcohol are a ‘no, no’.”
He recalled how the doctor “made it clear to me that if you smoke one or 10 cigarettes the amount of damage that cigarettes do to your body, there is no medication in the world that could cure it…
“Medications can help to ease some of the complications but nothing can fully cure it besides surgery,” Gangaram said that he was told.
As far as possible, the young man, an accountant at Kaieteur News for almost 15 years, has been doing his part to raise awareness about heart disease even as he does everything within his power to live a more healthy life.
And this is especially crucial, Gangaram said, since preventing heart complications might prove to be economically wise. Addressing these conditions could require millions of dollars, a cost that many people may not be able to afford.

HEART ATTACK EXPLAINED
Heart attack, which is brought on by Acute Coronary Syndrome is characterised by any number of symptoms. Statistics from the local Health Ministry suggest that coronary heart disease is the second leading cause of death as at 2012.
And according to Dr Carpen such complications can fall within the categories of symptomatic (showing symptoms) or asymptomatic, the latter occurring without symptoms that affect quality of life or daily activities.
The Cardiologist said, “If you do angiograms or other invasive studies on the population you will find that the majority of people have some type of coronary disease (the most common form of heart disease) but it does not affect them all.”
The majority of these people, he noted, are subjected to changes that are brought on by high cholesterol, diet and genetic predisposition. However, other factors that can influence coronary artery disease are diabetes, hypertension and smoking, Dr Carpen said.
“It isn’t every coronary artery disease process that requires major intervention or does it mean that all of these patients will go on to develop heart attacks.”
Symptoms, according to the Cardiologist, can manifest with chronic but stable angina (a pain that comes from the heart) usually prompted by some level of exercise or physical activity.  There are however, some people who experience what Dr Carpen described as the “classic chest pain”.  And the classic chest pain, he disclosed, has been described as “this tightness or heaviness in the middle of the chest which can sometimes be crushing.”
Although a significant number of patients complain of burning, Dr Carpen explained that there are others who experience what is called the “angina equivalent”.
“They don’t feel the pain but they get severe shortness of breath or air hunger (breathlessness); they have pains in the jaws, pains in the neck but the classic description has been the heaviness or tightness of the chest that radiates to the left shoulder and down to the left arm.”
Persons may also experience palpitations in association with increased sweating, nausea and even vomiting, he added.

PREVENTION
And there are a number of risk factors for heart attack, aside from the lack of exercise and diet that are modifiable, according to Dr Carpen.  The Cardiologist said that persons can also take control of habits such as cigarette smoking that can serve to help prevent the health challenge.
Although alcohol consumption doesn’t contribute to coronary heart disease it however has been linked to the development of hypertension which leads to arrhythmia (irregular heartbeat). “This has indirect effects on coronary heart disease and so can be changed,” asserted Dr Carpen who went on to note that “what you can’t fully change is that as you get older your risk increases, you can’t change that, that is a non-modifiable risk factor…”
Added to this, he alluded to the fact that certain ethnicities are more prone to coronary heart disease and hence this too is not a modifiable risk factor.
He noted that other factors such as diabetes, high blood pressure and cholesterol issues while they can be controlled may not be enough to prevent complications. “Sometimes even with the best control and with everything being on target, you still might have some risk, albeit, not as high as if these conditions were controlled,” Dr Carpen outlined.
But according to him, although there are personal measures that can be taken to address heart related conditions, there is also a great need for persons to seek early medical attention when they have discomforting symptoms, since early attention could mean the prevention of a fatal complication.

---

---