Kashmir likely to witness epidemic of cardiovascular disease: Dr Shahid

Following ‘6 S’ can mitigate risk factors, says Dr Shahid

Stress can cause devastating changes in blood pressure and lead to Intracranial Hemorrhages

Senior Cardiologist and Head Department of Cardiology (Unit-1) JLNM hospital, Rainawari, Dr Shahid Iqbal Tak, who is dealing with heart disorders  from past over ten years revealed that the Kashmir region is likely to see an epidemic of cardiovascular disease. In a candid interview Dr Shahid speaks about measures to curb the disease. Excerpts..!

Kashmir Post (KP): What is the trend of cardiac diseases in Kashmir?

Dr Shahid Iqbal Tak: A variety of disorders of the heart are seen worldwide. Majority of cardiac disorders are related to coronary arteries which lead to ischemic heart disease (IHD). Then we have hypertension that causes detrimental effects on the heart and we call it hypertensive heart disease (HHD). Similarly, we see diseases of muscle of heart named as Cardiomyopathies. A good number of patients have a disease of Valves of Heart called as Valvular Heart Diseases. Similarly, cardiac conduction system diseases are also seen here. A majority of patients have arrhythmias that come with palpitations. All such disorders are seen in Kashmir. But it is IHD and HHD that are more prevalent. A rising trend in IHD is due to rise in its risk factors like smoking, diabetes, obesity, sedentary lifestyle and pollution in both urban and rural areas.

If we will not cut down these risk factors and act at present in near future we are going to see an epidemic of cardiac diseases. Measure need to be taken at both individual and government levels.

RP: What kind of treatment is available for such patients in our hospitals?

Dr Shahid: The treatment is universal for all disorders. We usually follow the American Heart Association or American College of Cardiology guidelines and then modify them according to our resources.

RP: It has been seen that some people suffer a sudden heart attack. Why?

Dr Shahid: Heart attacks usually come suddenly. It is due to the pathophysiological mechanisms involved. Yes, at times stress-full situations, that are so common in this part of the world, make its appearance dramatic.

RP: How much is the role of the stress of the disease in Kashmir?

Dr Shahid: Stress leads to various changes in body physiology that can come in the form of high sympathetic drive. This high sympathetic activity can turn a stable coronary artery disease into acute myocardial infarction. There is one form of myocardial infarction called apical ballooning syndrome that usually occurs in middle-aged females due to stress. Similarly, stress can cause devastating changes in blood pressure and lead to Intracranial Hemorrhages.

RP: What differences are seen among the cardiology patients here and outside?

Dr Shahid: The pattern of cardiac disorders are same everywhere.

RP: What facilities we are lacking in our hospitals?

Dr Shahid: Regarding treatment of cardiac disorders we need first to sensitize our hospital staff to the fact that heart attacks need to be treated as quickly as possible. We need dedicated chest pain units in our hospitals that can be run by simple physicians. Although worldwide treatment of acute cardiac infarction is done in cath labs we lack such facility here.

RP: Our hospitals are not well equipped with facilities to tackle the disease. What needs to be done?

Dr Shahid: We need preventive cardiology to tackle the disease. It means we have to make society aware of the risk factors for cardiac diseases and they have to act upon it. People have to change their lifestyle, abandon smoking, go for walk every day, keep body weight under control, treat hypertension and they have to keep their blood sugar and cholesterol levels under control.

RP: What facilities are being provided at JLNM hospital for such patients?

Dr Shahid:: we have a good non-invasive cardiac set up here which is at par with any center in this country. We have a huge OPDs for cardiac patients. We are doing 2D, 3D transthoracic and transoesophageal echocardiography on Vivid E9 GE system. We are routinely doing TMTs. Although we do not have a dedicated cath lab we use a flouro in surgical theatre to implant cardiac pacemakers in needy patients. We badly need a dedicated Cath Lab to help more and more patients.

RP: From the government side what measures are being taken to protect the patients and educate them?

Dr Shahid: Although awareness programmes are being conducted by the government in both print and electronic media we should include schools and colleges to promote programmes regarding a healthy lifestyle. Similarly, Food and Drug Control department should keep a vigil on the food and medicines available in the market. After all, we are what we eat.

RP: Is cardiology disorders more prevalent among males or females?

Dr Shahid: Hormonal systems of males and females are different thence are diseases. Yes, males have more tendency to get heart attacks although this difference comes down in postmenopausal females.

RP: Does children too get heart attacks?

Dr Shahid:  Usually not.

RP: Does it mean that every household has a heart patient?

Dr Shahid: Yes, cardiac diseases are a universal problem. You will definitely find some in a family at least with hypertension or heart failure or IHD.

RP: Are there any heart disease specific to pregnant women?

Dr Shahid: Yes, women can suffer specifically from heart diseases during and after pregnancy wherein functions of the heart are reduced. This disease is called Peripartum Cardiomyopathy. Most of such cases are reversible however should consult their cardiologist before planning for next pregnancy.

RP: Can smoking cause cardiac problems?

Dr Shahid: Yes, of course.

RP: Can drug addicts suffer heart attacks?

Dr Shahid: There are some particular drugs which affect heart, one such drug that is cocaine. Cocaine also is known as coke, is a strong stimulant mostly used as a recreational drug. Cocaine and heart attacks have a relationship with each other but we have not seen such cases in Kashmir. The drug users can suffer sudden heart attacks and their blood pressure gets high and it can cause death.

There is a possibility of such cases in Kashmir also but they might be hiding their history.

RP: Can exercise help to maintain a healthy heart?

Dr Shahid: Yes 45-minute brisk walk every day is now recommended for every healthy person to maintain his cardiac health.

RP: Suggest some control measures which such patients can do at the individual level?

Dr Shahid:  I will recommend all to remember “6 S”. Decrease your SALT intake to control hypertension. Control your SUGARS. Cut down you STRESS level. STOP Smoking. Find SALOACE in meditation. SWIM daily or go for a briSk walk.