Heart Attacks: What You Should Know
Heart Attacks can be sudden and if not treated on time, even life threatening. Our experts guide you on the causes and preventive measures.
Heart attacks were considered an ailment of the elderly but not anymore. Increased levels of stress, inactive lifestyles and bad eating habits have affected our hearts’ health adversely. However, ageing remains one huge contributing factor. The onset of nuclear families means most of us stay alone, making it important for us to understand what constitutes a heart attack and how to deal with it.
Silver Talkies roped in Dr. Anoop Amarnath, Geriatrician and Dr.Yogesh Kothari, Cardiologist, Apollo Hospitals, Bangalore, to share with us how to tend to our hearts and understand the symptoms and action steps in case of a heart attack.
As we age, the heart becomes stiffer. Its ability to contract and relax reduces, consequently reducing its ability to pump blood. The blood vessels of the heart become inelastic and the heart’s ability to respond to nervous stimulation lessens. There is also an increased risk of irregular heart beat as we age. In short, in the absence of any heart disease, there is a natural reduction of heart function by 25% between the ages of 20 and 80.
Common heart problems among the elderly
The elderly are more prone to conditions such as
- Isolated Systolic Hypertension – a condition where the systolic (first number in your BP reading) blood pressure is very high.
- Atrial fibrillation- an irregularly irregular heart beat
- Complete heart block – wherein the heart rate is very slow and a pacemaker is warranted
- Ischemic Heart Disease- a condition where the blood supply to the heart is affected. This is the condition which people commonly call ‘heart attack’.
- Heart failure- where the heart is unable to pump enough blood required for the normal functioning of the body.
There are various risk factors contributing to heart ailments. The most important ones are: diabetes, high blood pressure, family history of heart problems, smoking, alcohol consumption, sedentary life style, obesity and food habits. Ageing, in itself, is a risk factor.
The most common signs of a heart attack are chest pain or a severe tightness across the chest, pain in the left arm, shoulder or jaw. However, unlike what our films and TV serials want us to believe, these signs need not necessarily be present always.
In the elderly, symptoms can vary a lot. Heart attack may be silent- i.e. without any symptoms, especially in diabetics. It may also present as tiredness, breathlessness and at times, even as confusion. Loss of consciousness can also be due to an underlying heart attack. Many elderly people complain of ‘gastritis’ symptoms. These could be a manifestation of underlying cardiac problems.
Immediate Action Steps
If a person develops any of the above symptoms suggestive of cardiac problems, it is always advisable to visit the hospital rather than self-medicate or seek advice over the phone. In any cardiac emergency, time is vital. The sooner you receive medical help, the better the outcome.
A number of elderly people, nowadays, live alone. We advise such people to have at least one emergency number of a good hospital at hand. This can either be pasted prominently above the landline or for those who are a bit more technically savvy, have them on their mobiles phone’s speed dial. It would also help to let your family and neighbours know about this number so that, in case you are unable to call for help yourself, they will know which number to call.
Treatment options vary based on the underlying condition. Let us try to put it in a very simple language. The first step is to identify the extent of the problem. In order to do that, we carry out an ‘Angiogram’. This is a simple diagnostic procedure, which is done under local anaesthesia. A dye is inserted either at the wrist or at the groin and it goes through all the blood vessels of the heart. This tells us where the blockages are, the number of blockages and their extent. The procedure hardly takes 15- 20 minutes on an average.
Based on the findings, you could fall into one of the three categories:
- If the extent of blockage is very minimal, the condition can be managed with just medicines. This is your best case scenario!
- If the blockage is more, it may require what is called as a ‘stent’. The stent is a device that unblocks the blocked blood vessel. The procedure wherein a stent is placed is called ‘Angioplasty’. Think of it as a road with traffic jam wherein road- widening eases the blockage.
- If the blockage is severe, you may require a ‘bypass’ surgery. Think of it as a completely blocked traffic junction that requires a flyover to be built.
With advances in medical technology, the procedures mentioned above are simple, and if carried out at the right time, on the right person and by the right doctor, have very good outcome.
Preventive health checks go a long way in detecting underlying heart ailments. These include blood tests, ECG (an evaluation of the electrical activity of your heart), ECHO (a type of scan that evaluates the physical function of your heart) and TMT (Tread Mill Test) – a test that evaluates the electrical activity of your heart when it is put under stress. Although these form the very basic of all tests, based
on your symptoms and condition, your doctor will be able to advise other relevant tests. Ideally, in the elderly, a thorough preventive check-up is advisable on an annual basis.
Secret of a Healthy Heart
A healthy diet, regular physical exercise and periodic medical check-ups form a triad in the prevention of heart ailments. Having said that, as ageing cannot, in principle, be reversed, heart ailments in the elderly can be prevented to a large extent, but it may not be possible to entirely eliminate the risk.
— The doctors were interviewed by Nidhi Chawla