By Dr Iresh Shetty

Mangaluru, Feb 10: Ischemic Heart disease is considered to be the leading cause of death not only in India but across the world. Previously thought to be a disease of the elderly, many of us now know that it a disease that affects a wide spectrum of age groups even as early as the 3rd decade of life. So, should we be worried when we hear the news of heart attacks in the younger age group? To a certain extent, yes. But not to the extent of unnecessary panic. There are several ways to find out if you are susceptible to Ischemic heart disease and many ways that you can modify your lifestyle to reduce the burden of your disease.

Early detection of heart disease is driven by your ability to recognize symptoms and to not ignore such symptoms. Ignorance is definitely not bliss in this case. Common symptoms of ischemic heart disease can include:

- Chest Pain

- Shortness of breath

- Easy Fatiguability

- Palpitations

- Sweating

- Nausea

There are several causes for ischemic heart disease and you can also be susceptible to in case of other co-existing diseases such as

- Diabetes Mellitus

- Hypertension

- Dyslipidemia

- Obesity

Family history of ischemic heart disease is a strong factor that warrants regular and early investigation. Bad social habits including smoking, consumption of alcohol, irregular and unhealthy diet can all lead to heart disease.

Rarely, we have seen children suffering from ischemic heart disease which is unfortunately due to congenital heart disease (by birth).

But many people do not have any of the causes or co-existing factors mentioned above but still happen to suffer from heart attacks and the question will always arise, “Why?”. This is where the silent killer of society comes into play, which is none other than Stress or a stress-inducing environment. Stress due to personal, professional or any other reasons puts a strain on your heart that over time can induce ischemic heart disease.

Lifestyle changes are equally important in preventing the progress and severity of the disease and these are modifications that are possible by strict discipline from our side. Diet and exercise are words that are thrown in the air too often and everyone seems to be dieting or exercising in some form but still suffering from the disease. The keyword here is Moderation. Moderate exercise and not heavy exercise such as high intensity interval training (HIIT) is more than sufficient. Of course, this is meant for people who are not used to heavy exercise or training or have just started to

exercise and not to discourage people who have been training their whole life such as athletes and bodybuilders.

Moderation in consumption of food is of utmost importance as this is a game changer. A healthy and balanced diet is the key and it can be gained from locally sourced food and need not involve expensive nutritional supplements.

Once we are aware of the symptoms and the causes of heart disease, we should know what tests can be done to confirm the same. Simple tests such as an electrocardiogram (ECG) and an echocardiogram (Echo) can give us an idea about the presence of the disease. Further testing such as a Treadmill test (TMT), CT Coronary Angiogram and/or conventional Coronary Angiogram can confirm the diagnosis of ischemic heart disease.

If detected, the necessary treatment can be started depending on the severity of the disease. These include medications, Angioplasty (coronary artery stenting) and/or Cardiac (heart) surgery (Coronary Artery Bypass Grafting).

Cardiac surgery for ischemic heart disease is not always an emergency procedure and can be done electively but without delaying it for too long. The stigma or fear around heart surgery being dangerous and life threatening should be banished. Cardiac surgery has come a long way from the time the first successful CABG was performed in 1960 and has been currently standardized around the world. Whether it be by conventional open-heart surgery, minimally invasive surgery or robotic and robotic assisted surgery, CABG is one of the commonest heart surgeries performed in adults worldwide. Fear of surgery might unnecessarily defer very necessary treatment. The indications of surgery, risks involved both in surgery and due to delay of surgery and the procedure itself can all be explained to you by your friendly neighbourhood Cardiothoracic Surgeon. The internet and AI might give you an equally good explanation but ultimately, every patient or individual is different and the internet doesn’t account for that like your doctor does.

At the end of the day, the take home message is that heart disease is the most common cause of death globally with India having one of the highest burden of disease. Early detection, lifestyle changes and initiation of necessary treatment is key to preventing the progress of the disease. If the disease does progress, the various treatment options are readily available and have to be availed at the earliest whether it be non-surgical or surgical. Fear of treatment is a huge barricade that is obstructing our path to a healthier life and world. By just getting past that hurdle, we can move forward towards a happier and heartier life.

Dr Iresh Shetty, Consultant Cardiac Surgeon, KMC Hospital Mangaluru.