As February is observed as World Heart Month, THE WEEK speaks to Dr Sandeep Agarwala, a senior cardiac surgeon at Zydus Hospitals.
Q: What are the most common heart-related ailments you have observed in very young patients?
A: Most commonly we see congenital heart disease (i.e. by birth), Hypertrophic Obstructive Cardiomyopathy (HOCM) and Valvular heart disease.
With better antenatal care, heart disease by birth is detected very early in life.
HOCM is underdiagnosed but has an incidence of (1 in 500)...may not give symptoms but in extreme cases can cause sudden death among youngsters. Valve disease in India among youth is primarily rheumatic heart disease, the incidence of which is coming down due to better socio-economic conditions and early treatment.
Of late Coronary artery disease is increasingly seen in people between 30 & 50 years of age. In India, we have a very high incidence of diabetes and BP which is not detected early on due to a lack of routine health checkups. This along with genetic predisposition, tobacco use and a sedentary lifestyle increase the risk of heart attacks among youngsters.
Q: Is a high BMI the root cause of the problem?
A: High BMI is one of the risk factors, especially for Coronary artery disease and heart attacks.
Q: To what extent is the impact of mental or emotional health on the heart, as per established research? Could you explain with anecdotes from your own practice?
A: Mental health and emotional health can impact the heart leading to increased stress hormone secretions thereby causing high BP, irregular heartbeat, irregular lifestyle, unhealthy food choices, and addictions to tobacco use. All these lead to damage to the lining of blood vessels and can cause plaque buildup in arteries causing heart attacks. Vice versa, heart conditions can also lead to anxiety and depression.
We often see patients who have Type A personalities who come to us with heart issues or medical issues like high BP, diabetes and obesity which puts them at higher risk.
Q: Is there a way we could know much earlier about an impending heart disease? Like some tech that can come to the rescue?
A: Yes. People having risk factors like genetic history, abnormal cholesterol, smoking, tobacco use, high BP, and diabetes should get regular cardiac checkups after 40 years of age. Also, those who have multiple risk factors can be screened by basic tests like ECG, Echo and Treadmill tests. Non-invasive scanning like CT calcium score and Angiography can identify higher-risk people early on when remedial measures can be taken.
Q: How often should one get tested or checked to keep one's heart in check?
A: If all is good then once a year should suffice. People undergoing medical treatment for risk factors should keep a regular check of diabetes and BP. Also, healthy food choices and exercise with good weight management can go a long way in preventing early disease. Being happy should also be a consciously practised virtue.
Q: Are our children under 10, doing good as far as heart diseases are concerned? Please elaborate and explain.
Difficult to say if they are doing good. Definitely, awareness is more and information is readily available for young ones. Schools are playing a great role in promoting sports and fitness. Also health checkups at school help in detecting asymptomatic kids having heart issues.
But post Covid things have moved on for the next generation to spend a significant time on social media and online gaming. With instantaneous gratification and increased time on the internet, mental health issues are increasing. Also, this leads to a sedentary lifestyle leading to obesity especially if one is careless about food and has an appetite for junk food.
So parental influence and peers can make a difference to the overall health of kids.
