By Nkiru Odinkemelu
• Continued from last week
Coronary heart disease (CHD)
This occurs when the coronary arteries – the arteries that supply the heart muscle with oxygen-rich blood – become narrowed by a gradual build-up of fatty material within their walls such that if a piece of this fatty material breaks off it may cause a blood clot to form. If this blood clot blocks the coronary artery and cuts off the supply of oxygen-rich blood to the heart muscle, this is a heart attack. The pain and discomfort the sufferer may feel as a result is called angina.
Risk factors: There are several factors that can increase the risk of developing CHD. The modifiable ones are: smoking, high blood pressure, high blood cholesterol, diabetes, being physically inactive, over weight or obese while the non-modifiable ones are: family history of heart disease, ethnic background; sex – men are more likely to develop CHD at an earlier age than women, age – the older you are, the more likely you are to develop CHD.
Angina
Angina is a pain or discomfort felt in the chest, usually caused by coronary heart disease. It often fells like a heaviness or tightness in the chest and this may spread to the arms, neck, jaw, back or stomach as well. While some people feel severe tightness, others might just have a dull ache. Some people experience shortness of breath too. Angina symptoms are often brought on by physical activity, an emotional upset, and cold weather or after a meal. The episodes usually subside after a few minutes.
Cardiac arrest
A cardiac arrest happens when the heart stops pumping blood around the body. If someone has suddenly collapsed, is not breathing normally and is unresponsive, they are in cardiac arrest.
Causes: The most common cause of a cardiac arrest is abnormal heart rhythm called ventricular fibrillation (VF). VF happens when the electrical activity of your heart becomes so chaotic that the heart stops pumping and quivers or ‘fibrillates’ instead.
Arrhythmia
This is an abnormal heart rhythm; it could either mean that the heart is beating too fast, too slow, or with an irregular pattern. The heart has an electrical system that tells it when to beat and push blood around the body. If there is a problem with this system an individual may experience an abnormal heart rhythm. Atrial fibrillation is the most common abnormal rhythm.
Atrial fibrillation
An irregular pulse could be a sign that one has an abnormal heart rhythm. Atrial Fibrillation (AF) is one of the most common forms of abnormal heart rhythm and a major cause of stroke. Symptoms can include: palpitation, tiredness, shortness of breath and dizziness or feeling faint.
Causes: HBP, heart valve disease and excess alcohol consumption. It is also associated with CHD, although in many patients no underlying cause can be found. Sometimes the AF can be resolved once the underlying condition has been dealt with.
Heart valve disease
There are four chambers in the heart and the valves make sure that the blood flows through them in one direction. If one or more of the heart valves becomes damaged or diseased, it can affect the flow of blood through the heart. A diseased or damaged valve can affect the flow of blood in two ways: If the valve does not open fully, it will obstruct or restrict the flow of blood. This is called valve stenosis or narrowing and can put extra strain on the heart, making it pump harder to force the blood past the narrowing. If the valve does not close properly, it will allow blood to leak backwards -valve incompetence or regurgitation or a leaky valve. This can put extra strain on the heart and may mean that the heart has to do extra work to pump the required volume of blood.
Atherosclerosis
Atherosclerosis is the build-up of fatty material inside the arteries. It is the condition that causes most heart attacks and strokes.
Causes: Fatty material called atheroma builds up in the lining of the artery walls and narrows the arteries. Over time it can grow bigger until the arteries become so narrow that they cannot let enough blood through leading to angina and heart attack.
Risk factors: The risk factors for developing atherosclerosis are the same as for other types of cardiovascular disease. It is more common for people over 65 and those with a family history of heart or circulatory disease. The risk also grows if an individual smokes, have HBP, type 2 diabetes, high cholesterol level, is overweight or obese.
Congenital heart disease
This is a heart condition or defect that develops in the womb, before a baby is born. There are many different types of congenital heart disease
It could be caused, in most cases, if something has gone wrong in the early development of the foetus. Some heart conditions are due to faulty genes or chromosomes. Its risk factors include: history of congenital heart disease, the mother has diabetes during pregnancy, or the mother has taken certain medications while pregnant.
Endocarditis
This is an infection that affects the inner lining of the heart, including the heart valves. It is a rare, but potentially fatal condition that can cause damage to the heart and requires early diagnosis and treatment. It is caused by bacteria or in some rare cases another type of infective organism, like fungi or germs, which enters into the bloodstream and travels to the heart. It can be life-threatening if not treated quickly.
Heart failure
This is a condition whereby the heart is not pumping blood around the body as it used to. It could be that the heart muscle has been damaged, like after a heart attack; and its symptoms are shortness of breath, swelling and fatigue.
Symptoms occur because the heart does not have enough strength to pump blood around the body efficiently. This can cause fluid to pool in the feet and legs. If this fluid is left unmanaged, it can build and spread to the stomach area and sit beneath the lungs. This reduces the lungs’ ability to expand and makes the affected short of breath.
Most common causes of heart failure are: heart attack, HBP, cardiomyopathy.
The condition could also be caused by heart valve problem, alcohol or recreational drugs, an uncontrolled irregular heart rhythm (arrhythmia), congenital heart conditions, a viral infection affecting the heart muscle and some cancer treatments.
Inherited heart conditions
Inherited heart conditions, also known as genetic heart conditions or inherited cardiac conditions (ICC), are passed on through families. They can affect people of any age and can be life-threatening. If left undetected and untreated, an inherited heart condition can sadly lead to heart failure or even sudden death from cardiac arrest. For many families, the first sign is when someone dies suddenly with no obvious cause or explanation.
These conditions are different from most congenital heart conditions, although some inherited conditions can cause congenital defects to form, often as part of a syndrome.
Symptoms of heart diseases
Heart diseases are termed as silent killers because their symptoms are not easily detected. However, some common heart disease symptoms are ranging from dizziness or light-headedness, to chest pain lasting more than few minutes, uncontrolled/irregular heart palpitations and shortness of breath.
In the case of congenital heart disease, symptoms like skin discoloration, swelling in legs and shortness of breath, just at the start of any physical activity, can be experienced or witnessed.
Causes of heart diseases
Different types of heart diseases are a result of various types of causes – congenital, valvular or maybe just a cardiovascular disease, most are stated above.
Risk factors: There are risks one cannot change, such as: Age: As you get older, your risk of heart disease increases; Gender: Men are at higher risk of heart disease. Women’s risk grows and may be equal to men after menopause; Ethnic background: People of some origins have higher risk, either due to genes or lifestyle factors; and Family history: If someone in your family has had a heart attack, speak to your doctor or health practitioner about your risk.
Aside the above mentioned risks, most other heart disease risk factors can be changed, and there is plenty an individual can do about them.
Common habits detrimental to the heart
This explains why the WHO has affirmed that most heart diseases can be prevented by simply addressing behavioural risk factors, such as tobacco use, unhealthy diet, obesity, physical inactivity and harmful use of alcohol, using population-wide strategies.
Smoking and the heart
According to Dr. Owosola Olaniyi Michael, a Ukraine-trained nephrologist and a consultant nephrologist, smoking is dangerous to the heart. “Once an individual smokes, he would be sending wrong signal to the brain to release what is called adrenaline, which is stress hormone. This adrenaline can trigger the blood pressure to be high, which will affect the heart. Smoking also affects the vessels that supply blood to the heart and other parts of the body. It reduces the amount of oxygen in the blood and damages blood vessel walls,” he said.
More dangerous is that cigarette smoke has thousands of chemicals, which include: nicotine – an addictive drug that affects the brain and muscle activity, and increases blood pressure, making the heart work harder; carbon monoxide -a poisonous gas that replaces oxygen in the blood, making the heart beat faster than usual; and tar – a sticky substance that coats the lungs like soot in a chimney, making it hard for the individual to breathe.
Secondhand smoking and the heart: About 40,000 people die of heart and blood vessel diseases caused by second hand smoke, reports the American Heart Association; a second smoker is a person who inhales the smoke from another person’s cigarette.
Second hand smoke has been linked to chronic breathing problems, especially in children and heart disease in people who have never smoked. Children and teens have an increased risk of heart disease as adults because breathing second hand smoke lowers their good cholesterol levels, raises their blood pressure and damages the heart.
Dr. Owosola said: “The effect depends on the proximity. If the person is very close to someone that is smoking, you are likely inhaling the same smoke and this is why smoking in public is not allowed because of the effect on the second-hand smoker. Breathing in other people’s smoke on a regular basis increases your risk of heart disease by about 30%.”
Sedentary lifestyle and the heart: Approximately two million deaths per year are attributed to physical inactivity, prompting WHO to issue a warning that a sedentary lifestyle could very well be among the 10 leading causes of death and disability in the world.
“Sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of high blood pressure,” the report said.
According to the report, there are many health problems that may lead to heart disease, such as hypertension, obesity, diabetes, atherosclerosis, high cholesterol and metabolic syndrome. Many of these conditions can be prevented with proper lifestyle habits like exercise.
Alcohol and the heart: This is a heart damaging lifestyle. This can lead to increased blood pressure, obesity, stroke, because when you take too much alcohol, it increases the rhythm of the heart beat, explained the expert.
Stress and the heart: This releases adrenaline, which can increase blood pressure and too much stress can damage blood vessels in the heart and increase risk of stroke.
Excessive salt intake and the heart: In most people, the kidneys have trouble keeping up with the excess sodium in the bloodstream. As sodium accumulates, the body holds onto water to dilute the sodium. This increases both the amount of fluid surrounding cells and the volume of blood in the bloodstream. Increased blood volume means more work for the heart and more pressure on blood vessels. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, and stroke. It can also lead to heart failure.
There is also some evidence that too much salt can damage the heart, aorta, and kidneys without increasing blood pressure, and that it may be bad for bones, too, noted the Harvard school of public health.
Drug or substance use and the heart: Taking drugs not prescribed and substance use is very bad for the heart; they also have lots of other effects on your brain and body. They can cause raised blood pressure, increased heart rate, and an irregular heartbeat and blackouts.
Unhealthy diet and the heart: A healthy diet is a balanced diet of protein, unsaturated fat, carbohydrate, fruits and vegetables. It should be low in saturated fat, salt and sugar. Thus, an unhealthy diet is one full of high-fat, sugary and salt-laden foods. It can contribute to weight gain, raise blood pressure and increase cholesterol level – all of which are risk factors for heart disease.
Habits that promote a healthy heart
To maintain a healthy heart, Dr. Owosola said, “an individual must eat healthy food, exercise, control the body weight – must not be overweight or underweight, quit smoking or if not smoking, must stay away from smoker to avoid being a second hand smoker, must control their cholesterol, manage stress, drink adequate water, must sleep well – adults 8hours a day and 10 hours for children, must have good dental hygiene and must reduce caffeine and alcohol intake.”
Eat healthy
“This means that you must take your breakfast, lunch and dinner. In all these, you must strive to eat a balanced diet. Whoever skips breakfast has wasted the whole day because the most important food an individual can eat in a day is the breakfast. You must take your breakfast because it gives the energy for the day. You must eat food of high fibre that can give you adequate energy; for the children, foods like cornflakes, oat, pap and bean cake or moi moi, adults too can take this food; you can take your rice and vegetable. You must not eat food that will be too heavy for you.
To be very candid, eating three times a day is not the ultimate. The norm is eating about four to five times a day because you must take vegetable, fruits, all these are the norm. If an individual skips a meal; that means, he is not eating a balanced diet and that is not good both for the heart and body.
The expert advised to always consume the following heart friendly foods: fish high in omega 3 – Salome fish, mackerel, tuna fish; Nuts: Wall nut, almond; berry, black beans, kidney beans, red, yellow or orange vegetables, carrot, sweet potatoes, spinach, Pawpaw, banana, grape, tomatoes, dark chocolate, red wine – one glass.
Manage weight: “For us to say this weight is more than necessary, we must firstly take the BMI, which is the height of the individual and the weight in kilogram. However, let me remind us the when we talk about weight, an individual must not also be underweight. Any adult having a BMI less than 18 is not good. Normal weight is between 18.8 to less than 23 or 24. But when we are having a BMI of about 28 and 29 and above, it is already overweight. Then a BMI of 30 and above to almost 42 is being obese. So once in a while, an individual should dash into a hospital and check his body weight. In fact, if an individual is overweight, such a person will know because he will be more heavy, the body muscle will be more bulky, having pot belly and all that so it is good we always go to hospital to check our weight.”
Cut down on saturated fat: “Most of the time, we just go to market and buy any type of oil we see, this habit is dangerous to the heart. It is very important we know what we are taking in into our system. If you go to supermarket, try and check the content of the oil you are taking. Always ensure you take oil without cholesterol.
Some people will buy red oil and keep it in the house for months. This is not a healthy habit; it is not at this point hygienic enough for consumption because the more the oil stays at home, the more the cholesterol. Always buy small quantity that can last you a little while then when you need again, you can go and get another.
High cholesterol foods can block the arteries of the body, when this happens, there will be a pressure build up in the system and this can cause high blood pressure.
Have a good dental hygiene and heart: “It is good to see our dentist once in six months. Most people practice bad dental hygiene in Nigeria. This can cause accumulation of debris and then lead to infection and infection makes the heart work more than necessary. When an individual has infection, the body fighting agents will come together to make sure they fight it so it good we ensure we have good dental hygiene just because of infection, so that the body will not be infected”, explained Dr. Owosola
Quit smoking: Quitting smoking is the most important way to lower your risk of heart problems. The good news is that once you stop smoking, the extra risk is reduced quickly.
Get physically active: Regular, moderate physical activity is great for your heart health. “Sitting five to six hours without moving an inch is risky for the heart. If you work in an office where you will have to sit all day, I will advise you to stand every hour, take a walk and come back to your seat because when you sit down for long, it affects arteries flexibility and blood flow, said Dr. Owosola.
Drink adequate water: Drink adequate water at least, two litres a day or eight sachets.
Cut down on alcohol intake: Alcohol contains calories; so regularly drinking more than the recommended one drink per day for women and up to two drinks per day for men can have a noticeable impact on your weight. Try to keep to the recommended alcohol daily limit to reduce the risk of serious problems to your heart health.