Men's Articles

Heart Of The Matter


Breast cancer has long been a woman's biggest fear. But your heart health is something that you should be just as concerned about. Although the presence of other factors such as C-reactive protein (it's thought to cause heart disease by increasing inflammation) and the amino acid homocysteine have recently been linked to heart disease, Experts maintains that cholesterol still plays the biggest role in determining your risk. However, keeping your cholesterol levels in check doesn't always cut it. Here are other conditions that could put you at risk when it comes to matters of the heart.

In Your 20s

Congenital Heart Disease

Do you tire easily or feel breathless often? You may have a hole in your heart. Some cases go undetected till a person is in her 20s. This is because heart murmurs (sounds made by blood moving round the heart) are hard for doctors to pick up. Echocardiography, which uses ultrasonic waves to obtain a picture of the heart's position, motion and internal parts, will be able to confirm this condition.

"If the hole is not big enough to cause a stressful flow of blood in the heart, it doesn't generally need to be closed," says doctor. Such patients are put on life-long medication. However, if a hole needs to be patched up, there are various ways of doing so. "There are clamps called ASD closure devices that spring open to close the hole with a membrane," says doctor.

Autoimmune Diseases

These are cases of mistaken identity gone terribly wrong. Instead of turning against foreign matter entering the body (eg dust, pollen, bacteria etc), the immune system attacks the very tissues and organs it is supposed to protect. Autoimmune diseases such as lupus and Takayasu's Disease occur for no apparent reason and seem to favour women in their 20s and 30s. In Takayasu's Disease, the blood vessels and arteries get inflamed and thicken. Lupus patients often suffer from inflammation of the muscle and lining of the heart.

The key to managing a heart problem caused by an autoimmune disease is to diagnose the problem and treat it as early as possible, says doctor. But that's easier said than done. Nondescript symptoms such as fever, gradual loss of weight, joint pains and general fatigue allow many sufferers to slip through the diagnostic net. In fact, many women are diagnosed only in their 30s.

Stents may be required to open up blocked arteries in autoimmune disease patients. Often, treating the primary cause of the inflammation is enough to quell the heart problem. While such patients don't usually die from heart disease, internal bleeding caused by immune-system damaged organs such as the brain, lungs and kidneys often leads to death.

Arrhythmia

That skipped heartbeat or fluttering sensation in your chest is not always romantically induced. It may be arrhythmia, which is an irregular heartbeat. It can be rapid, with a rate of more than 100 beats per minute (tachycardia) or a slow heart rate of less than 60 beats per minute (bradycardia), doctor says. As a result of the rapid heart rate, the heart does not have enough time to fill with blood and it is unable to effectively pump blood to the rest of the body.

The causes of arrhythmia vary - from the use of decongestants for colds, inhaled aerosols for asthma, nicotine and caffeine to coronary artery disease, hypertension and high blood pressure. If you are experiencing heart palpitations for no apparent reason, see a doctor. Treatment depends on the severity and frequency of recurrence.

An electric shock delivered to the chest, called an electrical cardioversion, can normalise the heart rhythm. In cases that are life-threatening, an implantable cardioverter-defibrillator (ICD) is placed underneath the skin. "These devices constantly monitor the heart rhythm and deliver energy to the heart muscle to restore a normal rhythm," says doctor

From Your 30s Onwards

Primary Pulmonary Hypertension

This occurs when blood is pulled to the right side of the heart and has difficulty flowing to the left and out to the rest of the body. The good news: it is a rare condition occurring in one per million. The bad news: women are three times more likely than men to get it, and doctors have no explanation for it.

What they do know is that while primary pulmonary hypertension is generally not genetic, six to 12 per cent of cases are inherited. See a doctor if you have symptoms such as shortness of breath, tiredness, swelling of the legs, palpitations, fainting spells and dizziness when climbing stairs and standing up. "It is unfortunately a condition where the mortality rate is high," says doctor.

"Half the patients die within five years:" New drugs are coming into the market but they're expensive. One cost-effective drug is Viagra, says doctor. "Large doses are given to these patients. We don't know how it works exactly but it does. Perhaps Viagra's vessel dilating ability improves the flow of blood in the heart."

Sudden Cardiac Arrest

You've heard of fit-for-marathon individuals who suddenly collapse while jogging and die. Why does that happen? Blames it on electrical chaos in the heart. "This results in the heart being unable to pump properly. And so, the heart 'freezes' and stops," doctor says. In 80 per cent of such cases, an area of the heart muscle dies or is permanently damaged because of an inadequate supply of oxygen to that area.

In mature victims, coronary heart disease is to blame. "Older women or women with a strong family history of heart disease should find out whether they may have risk factors such as hypertension, diabetes or hyperlipidemia (high fat level in the bloodstream)," says doctor. "These factors may predispose high-risk women to heart disease, which is still the major cause of sudden cardiac death," doctor says.

In younger women, heart abnormalities may be the reason. Adrenaline released during intense physical or athletic activity often acts as a trigger for sudden death when these abnormalities are present. "The immediate treatment is to shock the patient's heart rate back to the normal rhythm," says doctor. "This must be done within three to five minutes, and definitely within 10 minutes. The chance of survival is virtually zero beyond 10 minutes."

Myocarditis

Watch that flu. It may have the potential to stop your heart. Myocarditis, or inflammation of the heart muscle, may be suspected if the symptoms appear within six weeks of an infection. It is most commonly brought on by viruses such as influenza, herpes, hepatitis and diphtheria, says doctor. 

Reactions to medical treatments such as antibiotics, anti hypertensives and radiation therapy, as well as environmental agents such as lead, arsenic and carbon monoxide can also cause myocarditis. Diseases that affect the immune system such as systemic lupus erythematosus (SLE), rheumatoid arthritis, and dermatomyositis are other culprits. Thankfully, it only affects less than one per cent of the population.

What is worrying is that the flu-like symptoms, such as fever, muscle aches and fatigue, "tend to mask the sinister problem", says doctor. Treatments are aimed at the complications (high blood pressure, fluid retention, palpitation) that arise rather than the disease itself. These vary from drugs such as calcium channel blockers, diuretics, angiotensin converting enzyme inhibitors to transplantation.

 

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