India is the diabetic capital of the world and ranks third in the global obesity index. More than 20% of the population is diagnosed with heart failure in India, and patients are ten years younger than the global average. The lack of awareness about the disease is a matter of great concern. There is an urgent need to educate people about heart failure and its management.
To create awareness and spread knowledge about Heart Failure, The Times of India started the initiative
Beat Heart Failure
in partnership with Novartis to impart not only information to develop a better understanding but also effective management. The leading doctors from Global Hospitals, Mumbai, joined the discussion, namely.
·
Dr. Praveen Kulkarni:
Sr Consultant Interventional Cardiologist
·
Dr. Pravin Kulkarni:
Sr Consultant CVTS, Lead-Heart Transplant Program
Dr Praveen Kulkarni took the lead and explained about heart failure and its symptoms. He said - Heart failure is the inability of the heart to pump blood commensurate with the requirement of the body. The heart's function is to pump blood in every beat. It results in under-perfusion and under-delivery of nutrients to the organs, resulting in various symptoms when it fails to do so.
But when there is a heart attack, blood flow to the heart suddenly becomes blocked. Without the blood coming in, the heart can't get oxygen. If not treated quickly, the heart muscle begins to die. But if you do get quick treatment, you may be able to prevent or limit damage to the heart muscle.
In a country with a population of more than 135 crores, it is estimated that almost half a crore of the Indian population suffers from this disease and need treatment said Dr Pravin.
Dr. Praveen explained that the symptoms of heart failure are easily overlooked as signs of old age. The common symptoms of heart failure are easy fatigue, which may gradually increase with the progress of the disease. The person may start to feel tired even at rest. Breathlessness is another common symptom in the early stages. It may occur during exertion, and gradually it may increase to breathlessness while taking just a second flight of stairs. People have difficulty doing their basic activities as the disease slowly progresses due to breathlessness. People wake up with a choking sensation and immediately open a window for more air. Other symptoms include swelling of feet (called pedal edema), retention of fluid in the abdomen (called ascites), and bloating sensation in the abdomen. The appearance of the symptoms can be early (called acute) or late (more than six months called chronic). The physician assesses whether the condition is symptomatic or asymptomatic. Next, they check whether the symptoms correlate with the findings.
Talking about the systematic progression leading to the incidence of heart failure, Dr Pravin explained about different stages
- The first is when there are no symptoms. The second stage is walking wounded; the patient complains of fatigue on exertion. The third stage is home bound; a person does not want to leave the house because of easy tiredness. Fourth, when a person has to visit the cardiologist often. Fifth, when a person has repeated heart failure and needs to be taken to the hospital frequently, followed by the stage of being hospital-bound where the person requires constant monitoring by the doctor and regular medications. The next is when the person continues to be sick, and the disease worsens and requires artificial support. A heart transplant is an option when no other treatment works.
Among the common risk factors for developing heart failure are patients with natural aging coexisting with comorbidities such as diabetes, hypertension, obesity, stress, and lack of exercise or excessive exercise. In cases of uncontrolled diabetes, a patient can have a silent heart attack where they don't even feel the pain of heart attack. This symptom is known as autonomic neuropathy or, in simpler words, damage to the nerves that manage typical symptoms, and due to the injury, pain signals are not transmitted to the brain, and the patient does not know that they are having a heart attack. Striking & scaring people in the younger age basket (Men & Women) seems to be the heart failure victims of lifestyle choices. More than fifty percent of heart failures in India arise due to lifestyle choices.
In Urban India, the majority of heart diseases are due to obesity, alcohol, smoking, or in simpler words, due to poor lifestyle choices. On the contrary, valvular heart diseases are more common in rural India or amongst lower strata of society, said Dr Praveen Kulkarni. He further added that the valves weaken due to a condition referred to as rheumatic heart disease that occurs due to bacterial infection. Rheumatic heart disease has been eradicated worldwide but is still prevalent in India due to poor hygiene and overcrowding. Valvular heart disease is a kind of bacterial infection or innocuous throat infection. In a few untreated and undiagnosed cases, this infection attacks the valves, causing valve dysfunction. The occurrence of valvular heart disease in India is seen in the age group of 5-15 years. Dwelling upon this aspect of heart failure, the doctor said it was preventable and treatable.
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