Cardiac arrest kills suddenly. But, before it does, there are signs, which many either fail to recognise or lack the knowledge to ascertain. The Nation put up report on this disease, which experts say is deadlier than most dreaded diseases.
Okon Anselm was working on his laptop, when he felt a need to answer nature’s call. As he stood up, he slumped. He was quickly rushed to the hospital, where he was revived. Medics said he had just experienced partial cardiac arrest, commonly called heart attack. It is a medical emergency. This is because when the heart is not getting enough blood it will shut down. It happens to the rich, the poor, the old and young.
They said he was lucky. Former Ondo State Governor Olusegun Agagu was not that lucky. He slumped and died while peparing to attend a political meeting; so were former Speaker, Rivers State House of Assembly, Tonye Ezekiel Willie Harry and Speaker, Taraba State House of Assembly, Haruna Tsokwa.
According to Dr Akinsanya Olusegun-Joseph, Consultant Physician/Cardiologist at the Lagos University Teaching Hospital (LUTH), Idi Araba, sudden cardiac arrest (SCA), which is also called heart attack, is unpredictable. It can happen at anytime- morning, afternoon, evening, at night or even when resting, walking or doing anything.
What precisely is heart attack?
Dr Olusegun-Joseph said: “It happens when a blood clot suddenly cuts off the blood flow to the heart, preventing enough oxygen from getting to the heart. A lack of oxygen-containing blood flowing to the heart, results in the loss of heart muscle.”He said a blood clot is when a fatty build up, for example, cholesterol, prevents blood from flowing through the arteries to the heart. A fatty build up can also narrow the arteries, reducing blood flow to the heart. He said there were increasing cases of SCA-related deaths in Nigeria.
Cardiologist and Chief Medical Director (CMD) of the Lagos State University Teaching Hospital (LASUTH), Ikeja, Prof Wale Oke, described a heart attack as a section of the heart dying because there was no blood supply to it. “This is also known as coagulation cascade,” he said.
But why is the case increasing in the country? Dr Olusegun-Joseph says it is because factors fuelling it are increasing. Non communicable diseases NCDs, such as diabetes; hypertension and obesity are increasing.
“There are rising cases of cholesterol, especially with the advent of eateries. It is on record that these eateries all over the world use salt massively in their cooking. Likewise fat and oil. All these impede on the heart. People are guilty of inactivity. They do not exercise as required. The type of work they engaged in does not allow them time to do exercise or walk around. They sit in the offices all day long. And the energy is stored up as excess calories that add up to overweight and then obesity.
“People consume energy drinks and packaged juices which are further stored as excess calories on the system. The heart is made to do extra work. And people do not exercise. In fact, their lifestyle has changed from when our forefathers used to trek long distances, like from their farms. You see people now taking lift, bikes or taxis/drop or even drive cars. All these do not allow them to shed weight of stored fat in the body. People also smoke. The effect on non smokers is even worse. It is a good thing that government propagated a policy on smoking in public places.
“Frightening is the way people add salt to their cooking at table. Some do not taste their food at all, and before you blink, they grab the salt shaker and add extra salt to their food. The trend should be stopped. Stress also increases susceptibility to sudden cardiac arrest. Likewise the personality type of an individual plays a role. There are personality Type A, B, C and D. For Type A, they are aggressive, go-getters who will break down wall or himself to achieve a target or goal. That is highly dangerous. He can drive himself to any length, including his health and of course his heart. Always in a hurry. He will rather break down than not get it done. He multi tasked himself and others. He is predisposed to heart attack. Type B personality is okay, easy going set moderate and realistic goals. And keep an easy pace at achieving results. But the danger is that he can swing to Type A, with its attendant results, especially when he is under intense pressure. The effects are sudden. One moment the person is well and bubbling, the next he slumps and dies if medical attention is not sought immediately. Not much has been said about Type C personality in the light of sudden cardiac death. They are cool headed personalities. Type D is also at risk of cardiovascular problem. This is a person that is tired of life. Nothing impresses them. This category slip into depression and not happy and find it difficult relating happily with people and environment or even (positive) developments. Everything to them is dry.”
Symptoms of heart attack
(How does a person recognise warning signs of heart attack?)
Dr Olusegun-Joseph said sudden cardiac arrest will not just jump on a person.
“The symptoms of a heart attack are- difficulty breathing or shortness of breath; sweating; nausea or vomiting; dizziness; feeling tired all the time; irregular heartbeats and fullness, indigestion or choking feeling.
“Heart attacks can cause pain in the: Left side of chest or entire upper chest; neck and jaw; centre of chest and inside arms; stomach; chest, neck, jaw and inside arms; left shoulder and back between shoulder blades. Person may not die if the effect or assault is not much and medical help comes to him immediately.
“Tests available to detect heart muscle damage are physical examination; electrocardiogram (ECG) that records the electrical activity of the heart and various blood tests. Heart attack can be prevented by maintaining a healthier lifestyle because every second counts.
Oke identified chest pain/ discomfort and palpitation as symptoms of heart attack.
“The pain can move to both arms and back, among other parts of the body. Pain is central and it can move to the arm unlike angina pectoris (chest pain), which lasts between 15 to 25 minutes before it disappears,” he said.
Prevention tips
He said the mortality rate of heart attack is very exponentially high, even in the best centres, but if they come promptly to hospital and treatment is commenced, most survive.
A lot can be done to prevent sudden cardiac death at individual level and community level.
He said: “For individual modification, it is very good to cut down on salt intake. Increased salt intake increases chances of hypertension. Once hypertension comes in, the possibility of the heart being overworked are increased. And that can progress to other cardiovascular diseases, like stroke; kidney problems/ prevalence of hypertension have doubled in Nigeria compared to 15 years ago. We have a big problem on our hands.
“Westernisation also comes with its own problems. With it have come taking foods that are injurious to health, like cholesterol laden foods and abysmally high salt; additives and colourings with strange taste. It is as bad as people not being able to experience taste of salt in their food. We discourage keeping salt on the table. It is wrong. When we talk of salt, we include salty spices as well or seasonings.
“If a patient is obese we encourage such to lose weight and if over-weight we say reduce. For those who are inactive, we tell them to become more active by exercising thirty minutes per day for five days in a week, at least to a point where you sweat and not to a point where you tend to collapse or pant or gasp for breath- a point where your system can take you. And with time your body will naturally encourage you to do more; instead of taking the elevator, why not the stairs. Park your car some buildings away from your home of office and take a brisk walk to your destination. During break, walk to the canteen and que up instead of placing order for your food. Drink water instead of fizzy drinks or juice. Cut down on fired food or cholesterol laden food, this is where fast food and eateries come in. People can also switch to cholesterol free oil.
“The simple way to detect good oil is to put in freezer or cooling system over night. Once the oil freezes it is not good for consumption, which is exactly how it will clog up the arteries. Fruits and vegetables are extremely good, and cheaper, accessible and nutritious. They are extremely good for the system. We tell smokers to stop totally. Not reduce from one pack to a stick but totally. Those that drink alcohol should reduce drastically.
“And that brings up the issue of energy drinks. The active ingredients are caffeine and sugar. They impact negatively on the respiratory organs. They dehydrate. Those that drink means they are consuming sugar indiscriminately and can develop diabetes. And it is a killer that predisposes to other conditions like stroke; heart attack; kidney impairment; every organ of the body like the eyes and legs are not spared. The number one major cause of amputation, why people have amputated limbs after fatal accidents is diabetes. Check out the data in any hospital globally. Sugary and sweetened things have a way of impacting on inflammation.
“Energy drink, to add, makes the heart to beat faster. Some of our patients have died. We found out that it causes dehydration. It is meant to supply energy to the body; with the energy supplied there is greater metabolism that leads to increased activities of the system and excretions from skin. That is artificially stimulating the body to function.”
And the community can also help halt cases of sudden cardiac arrest. How?
He said: “Government policies at all the three tiers of government can take us there. For instance, before a promotion is done, it can be recommended that some simple exercise be done and routine screening be done. Circumventing purchase of medical reports can be effected as well. Doctors should be truthful enough to ensuring those screenings are done, by resolving that if I don’t screen this fellow, am not going to sign. No more short cuts. Short cut, short life to death
“It can legislate on salt intake by giving a policy on total amount of salt to be added to food by eateries. Laws can be made but implementation is important. All the strange things other countries ship to Nigeria should be screened and those that are not beneficial to health should be rooted out. It can step up on smoking policy by stepping up on education of its effect
“Recreational grounds should be preserved and more created. Children and adults don’t jog again or relax. Just as we have environmental day, we can also have exercising day. Cardiovascular disease (CVDs) increase with age and lifestyle play major issues. We have patients who are 13, 18 and 25 years old with serious CVDs like kidney problems, heart failures and other serious complications. Age is no protection to not developing sudden cardiac arrest but healthy lifestyle changes or modification.
If you don’t adhere to health beneficial practices you are not immune. Age is no natural protection. Though men from 45 are more prone and women due to their hormone- Estrogen are free until age 55, when they start menopause and become at par with men. Some patients have said their parents are not prone but they have quickly forgotten that such did made good lifestyle changes. Bad lifestyle triggers sudden cardiac arrest. Our common saying is- ‘Genetics loads the gun, environment fires it’.
Prof Oke said people should know their numbers, which are blood pressure, blood sugar and cholesterol level.
Many people, he said, have high blood pressure, which cannot be known until they are measured, describing the heart as a pump, which pumps blood to all tissues in the body, especially the brain.
“It also pumps blood to itself. While it is pumping blood to other parts of the body; it doesn’t pump to itself,” he added.
He said heart diseases can be caused by genetic disposition, unhealthy lifestyle and acute coronary artery diseases. He said most heart attacks can be prevented by engaging in healthy lifestyle, especially healthy diet. “It is difficult to change diet at adulthood but people should desist from food that works against their wellbeing, such as staying off meat from 40 years and exercising regularly, and taking lots of fruits and vegetables.
Treatment
Heart attack, Oke said, could be treated with medication or through coronary artery bypass surgery.
“It can be treated with primary and secondary prevention. Under primary prevention, cardiologists will first manage the risk factors, such as lifestyle. But some are fixed, especially family history/ heredity and age because the older people are the more likely they are to developing the disease,” he said.
Oke said modifiable risk factors hypertension and diabetes should be managed well.
“Hypertension is a major risk factor for heart, kidney disease, stroke and heart failure,” he said.
He identified hypertension, diabetes and obesity as most killer of people but hypertension is the major one.
He said people should stop smoking, avoid eating fatty food and exercise regularly to stay healthy and strong.
CMD, Lagos University Teaching Hospital (LUTH), Idi Araba, Lagos, Prof Akin Osibogun, said there was an increase in deaths due to cardiac problems.
This, he said, may be due to factors, such as lack of equipment and ability to make accurate diagnosis.
He urged the people to walk for health, adding that they do not need to buy anything to walk.
“Jogging and walking are the cheapest forms of exercise,” he added.
Osibogun said people should modify their diet and reduce their salt intake. “They should also reduce the use of oily diet and take more of vegetables, disabuse the use of tobacco, alcohol and drugs. If they did all these, they are likely to prevent sudden death due to cardiac problems,” Osibogun said. Click to signup for FREE news updates, latest information and hottest gists everyday
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Tanx alot The Nation for the write-up
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