Are you setting yourself up for a heart attack?

Prisca Outa was fine the whole day. She went to work, came back home, ate her dinner, then she collapsed and was rushed to hospital. Efforts to resuscitate her failed and she was pronounced dead. It’s called ‘sudden’ death. And when postmortem results came, the culprit is ‘heart attack’.

This script is increasingly becoming common and doctors are concerned. Apparently, most deaths from this condition are never recorded.

Dr Simon Mwangi, a general physician who has more than 20 years experience sees at least 14 patients with high blood pressure in a week compared to the early 1990s when he began his practice.

“I have noticed that there is a significant rise in cases of heart attack compared to 1989, when I began practice as a doctor. That time, I would handle, at most, one patient or none in a week, but now it is different,” says the medic.

He attributes the growing number of heart attacks to an increase in high blood pressure cases across Kenya.

According to medical experts, there are a number of factors that predisposes one to heart attack. The number one risk factor is, however, high blood pressure for heart attack. High blood pressure is when the blood pressure in your arteries is elevated and your heart has to work harder than normal to pump blood through the blood vessels.

So what exactly happens during a heart attack?

Heart attack occurs when a build-up of fatty deposits block blood vessels that supply the heart or the brain (coronary arteries), causing what is medically referred to as coronary heart disease.

This is how it happens medically. The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If you have coronary artery disease, those arteries become narrow and blood cannot flow through them smoothly.

Coronary heart disease is caused by a variety of lifestyle-triggered factors like smoking, a high fat diet, high cholesterol, high blood pressure and obesity.

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At the onset of a heart attack, what happens is that either fat, calcium, proteins, and inflammatory cells have built up within the arteries to form plaques of different sizes. The plaque deposits are hard on the outside and soft and mushy on the inside. When the plaque is hard, the outer shell cracks, platelets (disc-shaped particles in the blood that aid clotting) come to the area, and blood clots form around the plaque. If a blood clot totally blocks the artery, the heart muscle becomes ‘starved’ of oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. That is a heart attack. The human heart is about the size of ones fist yet the strongest muscle in the body measuring about 200 to 425 grams. It’s so critical that it never sleeps.

Worryingly, changing lifestyles have put the organ under immense pressure. Shift from active to sedentary lifestyles and consumption of fatty foods contributes to heart attacks.

“A good number of people have embraced sedentary lifestyle where it’s all about driving everywhere and eating unhealthy. There is need for a total lifestyle change in the general population otherwise it will be a crisis,” Dr Mwangi notes. Interestingly, men are more at risk of heart attack due to higher rates of excessive alcohol consumption, obesity and the fact that they do not know how to cope with stress compared to  women.

Studies show that each extra serving of fruit and vegetable on your plate daily reduces your chances of dying from heart disease by four per cent.

There is need for correct balance of healthy and unhealthy fats, which is critical for the well-being of the heart. One needs to keep away from unhealthy fatty meats, salty and sweet snacks and processed foods. Unfortunately, these ‘sweet and salty poisons’  are more popular especially with young and urbane populations.

Aga Khan University Hospital Interventional cardiologist Harun Otieno, says the most ideal time to seek medical attention in the event of a heart attack is within five minutes if you live next a hospital but 30 minutes is also an acceptable goal. “In many instances, patients wait more than 12 to 26 hours before going to hospital with symptoms mistakenly believing that the pain will subside,” Dr Otieno warns.

“Time is muscle! Time is life! Delays in treatment can lead to death, every minute matters.”

According to Dr Otieno, highly sensitive blood tests can also diagnose even small heart attacks besides tests like the ECG.

Dr Otieno calls for vigilance when complaints of chest pain are reported because it is the leading symptom for heart attacks. Patients often describe it as heaviness or an elephant sitting on the chest for more than 30 minutes.

On treatment, Dr Otieno hails advances in modern medicine where technology has allowed access to the heart arteries through minimally invasive techniques from the wrist, painlessly while the patient is awake. “Successfully treated angioplasty patients can be discharged from hospital in three to five days if no complications arise, “ he says.

And by the way, did you also know that Monday is the day of the week when the risk of heart attack is greatest?  Blame it on Monday blues.