India is the diabetes capital of the world and ranks third in the global obesity index. Over 20% of the population is diagnosed with heart failure in India, and patients are ten years younger than the global average. Lack of awareness of the disease is a matter of great concern. There is an urgent need to educate people about heart failure and its management.
To raise awareness and spread knowledge about heart failure, The Times of India launched the initiative
Beat heart failure in partnership with Novartis to transmit not only information to develop a better understanding but also effective management. Leading doctors from Global Hospitals, Mumbai joined the discussion viz.
Dr. Praveen Kulkarni: Senior Consultant Interventional Cardiologist
Dr. Pravin Kulkarni: Consultant Sr CVTS, Lead-Heart Transplant Program
Dr. Praveen Kulkarni went ahead and explained heart failure and its symptoms. He said – Heart failure is the inability of the heart to pump blood according to the body’s needs. The function of the heart is to pump blood with each beat. This results in underperfusion and underdelivery of nutrients to organs, leading to various symptoms when it fails to do so.
But when there is a heart attack, blood flow to the heart is suddenly blocked. Without incoming blood, the heart cannot get oxygen. If not treated quickly, heart muscle begins to die. But if you receive prompt treatment, you may be able to prevent or limit damage to the heart muscle.
In a country with a population of over 135 crore, it is estimated that almost half a crore of India’s population suffers from the disease and needs treatment, Dr Pravin said.
Dr. Praveen explained that the symptoms of heart failure are easily overlooked as signs of old age. Common symptoms of heart failure are easy fatigue, which can gradually increase as the disease progresses. The person may begin to feel tired even at rest. Shortness of breath is another common symptom in the early stages. It can occur during exertion, and gradually it can increase to shortness of breath just by taking a second flight of stairs. People have difficulty doing basic activities as the disease progresses slowly due to shortness of breath. People wake up feeling suffocated and immediately open a window for more air. Other symptoms include swelling in the feet (called pedal oedema), retention of fluid in the abdomen (called ascites), and a bloated feeling in the abdomen. The onset of symptoms can be early (known as acute) or late (more than six months known as chronic). The doctor assesses whether the condition is symptomatic or asymptomatic. Then they check to see if the symptoms correlate with the results.
Talking about the systematic progression leading to the incidence of heart failure, Dr. Pravin explained the different stages – The first is when there are no symptoms. The second step is the injured step; the patient complains of fatigue on exertion. The third stage is confined to the house; a person does not want to leave home because of easy fatigue. Fourth, when a person often has to visit the cardiologist. Fifth, when a person suffers from repeated heart failure and needs to be taken to hospital frequently, followed by the hospitalization phase where the person requires constant monitoring by the doctor and regular medication. Then the person continues to be ill, and the disease worsens and requires artificial support. A heart transplant is an option when no other treatment works.
Common risk factors for developing heart failure include patients with coexisting natural aging with comorbidities such as diabetes, hypertension, obesity, stress, and lack of or excessive exercise. In case of uncontrolled diabetes, a patient may have a silent heart attack where he does not even feel the pain of the heart attack. This symptom is known as autonomic neuropathy or, in simpler terms, damage to the nerves that manage the typical symptoms. Due to the injury, pain signals are not transmitted to the brain and the patient does not know that he is having a heart attack. . Hitting and scaring younger people (men and women) seems to be the heart failure victims of lifestyle choices. More than fifty percent of heart failures in India are due to lifestyle choices.
In urban India, the majority of heart disease is due to obesity, alcohol, smoking or, in simpler terms, poor lifestyle choices. On the contrary, valvular heart disease is more common in rural India or among the lower strata of society, Dr Praveen Kulkarni said. He further added that the valves get weakened due to a condition called rheumatic heart disease which occurs due to bacterial infection. Rheumatic heart disease has been eradicated globally but is still prevalent in India due to poor hygiene and overcrowding. Valvular heart disease is a kind of bacterial infection or harmless throat infection. In a few untreated and undiagnosed cases, this infection attacks the valves, causing the valves to malfunction. The occurrence of valvular heart disease in India is seen in the age group of 5 to 15 years. Dwelling on this aspect of heart failure, the doctor said it was preventable and treatable.
The patient with valvular heart disease feels short of breath going up the slope, with palpitations and swelling of the legs. The cardiologist performs a 2D ultrasound, a simple, non-invasive ultrasound to look at the heart, and classifies it as mild, moderate, severe. If the disease is mild to moderate, the attempt is to preserve the natural heart. Surgical interventions are available in cases of severe heart damage and if the patient has profound symptoms. The surgeon tries to replace the damaged valves with a new one. The surgery will change the course of the disease and the heart will work better, Dr. Pravin said.
In patients who have had a heart attack, timely detection and treatment are paramount in the early hours. It is difficult for people to access a tertiary health center in rural areas. Often their symptoms go undiagnosed or are misdiagnosed as acidity, indigestion, muscle aches, anxiety. It is crucial to treat people in a timely manner before significant damage occurs.
After a heart attack, the blood vessel becomes blocked and damages the muscles of the heart.
A delay in treatment will further increase damage to the heart. Patients end up getting the treatment they need, but the resulting heart is weaker than normal. Treatment options can include medications, lifestyle changes, artificial instrument support, surgical options like bypass surgery, Dr. Praveen Kulkarni explained.
A heart transplant is also a viable option for severely damaged hearts after a doctor’s evaluation that other potions may not work. Indians need to be educated about organ donation to make more organs available for transplantation.
The majority of people with heart disease lead good lives, and the longevity of life depends on the extent of damage to the heart. Even if a person has no symptoms, it is necessary to have basic parameters checked annually, such as lipid profile, kidney function test, liver function test, blood sugar and blood pressure. Depending on the results of these tests, further treatment is planned by your primary care physician, Dr. Praveen Kulkarni said.
Heart failure is not a death sentence and can be treated with lifestyle changes and medication. After being diagnosed with heart failure, people must make specific lifestyle changes that affect their quality of life. Cardiologists suggest basic changes like avoiding packaged foods, eating a balanced meal, controlling sugar intake, exercising regularly, avoiding smoking, and watching your weight. With advances in medical science, many drugs are available to manage heart disease.
Remember that heart failure is not about stopping. It’s about starting life in a new way. Heart failure can be managed with regular treatment and appropriate lifestyle changes. To learn more about managing heart failure, visit https://www.toibeatheartfailure.com/blog
“The views and opinions expressed in the article by the panelists/experts are based on their independent professional judgment and are disseminated in the public interest. These views should not be considered a substitute for professional advice from a licensed physician. The purpose of this article is not to promote medical procedures or medications and/or to recommend a certain doctor. For any specific health concerns, please consult your licensed physician. BCCL, its affiliates and its group publications accept no responsibility for the accuracy or consequences of adhering to their expert opinions. »