By: Dr. Sekar Wariar - Specialist Cardiology
Lifecare Hospital, Abu Dhabi, UAE
Heart attack happens when there is sudden block of the blood vessel (called Coronary artery) supplying the heart muscle. This can happen in two ways. Firstly when there is a preexisting block, which may or may not have caused chest discomfort to the person whenever he exerted. Secondly there were no preexisting blockages. But in majority of either situation, the person would have one or more risk factors which make him prone to have heart attack. These risk factors may be modifiable or non modifiable. The risk factors one can't modify are increasing age, male gender, and family history of heart disease. The ones one can be controlled include High blood cholesterol, high blood pressure, diabetes, increased body weight and obesity, smoking, lack of physical activity, unhealthy diet and stress. More the number or the severity of risk factors, more the risk of heart attack. Similarly, some risk factors like smoking and diabetes make a person more prone for getting a heart attack. Most of the times, people have no physical symptoms because of these risk factors. They may be detected for the first time during hospitalization for a heart attack or stroke!
Let us understand how the risk factors work. An analogy for better understanding of a heart attack is a driving accident. The risk factors for a vehicular accident include over speeding, careless driving, not wearing seat belts, drunken driving and poor car maintenance. A driver doing all these may still not meet with an accident, due to his good luck. However one cannot dispute that ‘the risk of accident in such a situation is pretty high, the chances of surviving the accident are low and having some residual disability if one survives the accident is significantly high’. That is also the problem with unhealthy lifestyle practices like smoking, not keeping blood pressure, sugar and cholesterol under control, not exercising regularly and not undergoing medical checkups to detect high sugar, high blood pressure, high cholesterol etc. if these risk factors are taken care of, the risk of heart attacks is less, the chance of surviving the heart attacks are more, and residual disability is less likely.
Statistically, the correctness of what we are doing is not decided by what happens when we get away with what we are doing. It is decided by the price we have to pay, if we fail, and whether we can afford that price! Driving carelessly, one may not meet with an accident, but can we afford the price we have to pay if we meet with an accident? If not, drive carefully taking all precautions and so is the need to keep above mentioned risk factors under control. One of my patients put it aptly, that he was lucky to have been detected to have diabetes 35 years back, as he then started walking regularly, stopped smoking, started eating right and began consulting his doctor regularly! This is like having a small accident very early after learning how to drive, which makes us a careful driver.
Another common concern is people not taking care of themselves during weekends or holidays. That is like driving carelessly on weekends and during holidays! Now how reasonable is that? One must always be careful. Finally we can only take the necessary precautions and hope to prevent an accident. There is no guarantee of a positive outcome for every individual doing the right things. Diseases and accidents do happen in spite of all our carefulness. It should be ascribed to fate. If they happen because of our negligence, it is solely our fault. Making right choices is our duty.