Heart Attack - Causes , Risks & Precautions

Hello Friends! I am Dr. Anupam Goel. I am a senior interventional cardiologist in Max Hospital, Saket, Delhi.

Today we will discuss a very important issue, I am not sure how best you can see this slide, this is just to say that the heart attack complains increase day by day and unfortunately it is affecting young people. By an estimate of WHO, in next 2 years means by the year 2020, in India, we will have maximum patients of hypertension, diabetes and heart disease. So, we are going to face an epidemic of heart disease. So, I just tell you how the heart disease happens. Normally, our heart arteries are very narrow smooth whole tubes structure. But all the year because of disease and cholesterol deposition the blockage happens and the channel for blood carrying, keeps on reducing. So, what exactly happens is less and less blood reaches the heart and heart is not even getting enough blood for its routine functioning. When this blood supply is interrupted that is when the heart attack happens because those cells of the heart don't get any blood. Suddenly and repeatedly, these holes will never be going to function again.

More important than heart attack itself because of awareness not many of us know about heart disease in women. Whenever we think of heart disease, we think about male but unfortunately, as we have more data, the heart diseases in men are reducing.

This is the data from the United State not from our on the country. Because of ignorance or prognosis, societies not aware of heart disease in women, the death in women are increasing because of heart disease. When we see the causes of death in women, cancers are a very important part but much more than that heart and circulatory disorders are the biggest reason any women will die. So, what we have is, heart disease is the no.1 killer in women. And heart disease causes 1 in every 3 deaths in women. Every 3rd one is dying because of heart disease. 90% of women are at the risk of developing heart disease but they are not aware of it. It suddenly affects them and causes the bad prognosis. Let's bust some myths. Most of us believe that the heart disease is of men. But heart disease can affect both men and women, in fact, 50k women in a year die because of heart disease.

The women die because of heart diseases as compared to all the cancers combined together. And because of under-diagnosis and treatment, even the doctors are less aware of it, women face more adverse outcome. And why would it happen? Because none of us relate to heart disease to women. So, they come to an emergency late. they keep on thinking that it could be gastritis or something else and they are busy taking care of each other. And it could also be because the heart disease presents differently in women.

In a man classical signs, you would all know. The heart attack would present as a heaviness or like an elephant sitting on the chest. But in women, it can very vague. They will be like not feeling well, palpitation and just unwell. It can't be just simple chest pain. So, most of the women just confused about their heart attack presentation and would be late in getting treatment. the good thing is 80-90% heart diseases are preventable. So, if we are aware, we are able to take care of the risk factors. There is a large proportion of heart disease which we can prevent.

So, we will discuss some important risk factors which can take care of to prevent disease. Some risk factors are non-modifiable. Like the family history of heart disease. if there is the strong history of heart disease and in one genetics than one is likely to have heart problems. So, it is advancing age. But there are a few risk factors which we can control. Like high blood pressure, high cholesterol, high sugar, smoking, more weight and some newer risk factors like CRP level and clotting factors. few of these which are relevant, diabetes, 2/3 of all diabetics will die of heart disease eventually.

Risk of having a heart problem in women, if she is diabetic as compared to the women who are non-diabetic and in men also, the risk of heart disease increases 3 times, if they are diabetic. So, diabetics have to be more conscious about their heart conditions. Than smoking. Smoking is one single most preventable risk factor which is responsible for heart disease. It is relevant in both male and female. Especially, a young woman who smokes is at the very high risk of heart disease. And if somebody is on oral contraceptive because of their age or anything, the risk of heart disease is compounded with smoking.

So, what smoking does, it causes the plaque. The cholesterol deposits the arteries to burst. They form a clot and causes a heart attack suddenly. it reduces good cholesterol. It gets burned by smoking which causes one to have more heart attack. And smokers who have a heart attack, they are more likely to die young. When one quite smoking, then the risk of developing a heart attack comes to 1/3 in the next 2 years. But you know, it takes almost 10-15 years for the risk to come back to normal as compared to somebody who has never smoked.

So, I request everybody to quit smoking. 3rd is physical inactivity. So, inactivity is a very important factor in our Indian culture to cause a heart attack. We should all exercise not because it burns calories and helps in weight loss but it increases good cholesterol. It helps us in keeping our heart healthy. One should try to stay active physically. Just get up in the morning and walk. Walking is a good exercise which will help you in preventing heart disease. One more important factor is obesity, BMI. if the BMI is less than 25% is normal.

Beyond that, it becomes overweight and predisposes one would have more and more heart attack. Heart attack increases almost 6 times as compared to a normal weight person in those persons who are very heavyweight. So, we should all be very careful about our own body weight. Till very recently we didn't know that women are at the highest risk of heart disease. Thanks to research and data which we have. Now we know women are more likely to have heart disease. The disease starts in early childhood. It is a gradual process. Small changes in our lifestyle can make a big difference. We all need to prevent it. So, we all should start with lifestyle changes but if one has risk factors, it is a good idea to see your doctor at earliest. I am with Max Hospital, Saket. If anybody needs any help for their heart health, please don't hesitate. You can contact me and come and see me.

Thank you so much. Take care of your health and your heart.