By S.N. Venkatnag Sobers

Cardio Vascular Diseases (CVD) is a leading cause of death and disability in the world, claiming 17.9 million lives a year. World Heart Day, observed on Sept. 29 every year, plays a crucial role in changing all of this. It is a vital global platform to create awareness and encourage individuals, families, communities and governments to take measures to prevent fatalities. The theme for this year’s World Heart Day is ‘My Heart, Your Heart’ through which the World Heart Federation is trying to create awareness among people to take care of their heart. This Weekend Star Supplement focuses on how, over the years, Mysuru has emerged as a heart care destination.

Mysuru emerges as Heart Care Destination

Mysuru, the cultural and heritage capital in Karnataka is also the next best place for advanced medical treatment after Bengaluru especially for heart ailments. Many heart care centres and specialty hospitals have brought great relief to heart patients.

Earlier, it was only the K.R. Hospital that used to treat issues related to heart ailments but for major complications one had to visit Bengaluru.

With patients coming from surrounding districts of Mandya, Chamarajanagar, Mysuru, Kodagu and Hassan, the K.R. Hospital had a tough task in hand.

However, a few hospitals which had minimum facilities at that time in Mysuru, could only provide basic treatment for heart attacks and strokes.

In case a patient was referred to Bengaluru, only the wealthy could afford as health schemes such as Ayushman Bharat, Yashaswini, Arogya Karnataka and others were not announced by the Government.

Scene before 2001

Till about 2001, there was no good hospital which could provide complete heart care in Mysuru. It was only after Apollo BGS and Vikram Multispecialty Hospitals were started, patients got access to good quality treatment.  Since the past 18 years, Mysuru has been fortunate enough to have the best of facilities and have the expertise of senior cardiologists and cardiac surgeons who have been providing quality treatment.

Advanced treatment options

Over the past few years, Mysuru has emerged as one of the best centres for heart care with the many private hospitals setting up their own facilities. Hospitals such as Columbia Asia, Narayana Hrudayalaya and Cauvery Heart and Multispecialty Hospital have set up their units. Even the JSS Multispecialty Hospital has also been providing quality healthcare not only to people from Mysuru but Mandya, Chamarajanagar, Hassan and Kodagu.

Complex heart treatments

Speaking to Star of Mysore, Dr. Arun Srinivas, Chief Cardiologist, Apollo BGS Hospital, said, “The coming of private hospital to Mysuru has ensured that around 95-99 percent of complex heart treatments are made available locally. Even very complex and advanced procedures such as rotational Atherectomy, aortic valve implantation, intra-vascular ultra sound and others are now available in Mysuru.”

“Over the past few years, Mysuru has not only developed as a tourism destination but it is also grown as a destination for healthcare particularly in cardiology, gastroenterology, neurology and cancer. Fortunately, various government health schemes have made treatments affordable to common man,” he added.

Blessing for the poor

One of the other major hospitals that have been catering to heart care in Mysuru is Sri Jayadeva Institute of Cardiovascular Sciences and Research. With heart patients multiplying in Mysore region, the institute has come as a blessing for the poor especially those living under below poverty line. Initially, the hospital was started in the K.R. Hospital premises about a decade ago. It was only last year that it was shifted to its new premises at Kumbarakoppal on KRS Road.

Dr. K.S. Sadananda, Medical Superintendent, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru, says that ever since the institute was opened in Mysuru, people started getting heart treatment at affordable prices. The inclusion of various health schemes has also helped get access to best of the treatment. “Incidence of heart disease has been increasing in Asian countries like India, China, Japan and other countries. Compared to the last previous 10 years, heart ailments have increased by at least 2-3 times. Whereas cases related to heart diseases has been decreasing in the Western world as there is more awareness and preventive measures. Unfortunately, we have not been taking preventive measures nor there is any awareness,” he regretted.

Risk factors involved in heart ailment

Heart ailments come unannounced. Normally, there are no symptoms prior to a heart attack. It is important that everyone gets screened for at least once in two years so that complication could be avoided in case a person is detected for any heart-related issues.

Basically, before talking about the basic tests to diagnose heart ailment, it is important to know about the risk factors involved in causing heart diseases. There are basically five risk factors which include blood pressure, diabetes, smoking, cholesterol and strong family history.

Having even one of these, there is a high risk of the person suffering heart issues in the future. Apart from these five, there are some other reasons known as the new or emerging factors which not many people talk about. That includes overweight, poor eating habits, lack of exercises and pollution.

Though there is no control over certain facts like the family history, which in most of the cases passes to the next generation, taking preventive measures can at least postpone a person suffering from certain diseases by at least few years.

Heart Disease Diagnosis

Though electrocardiogram (ECG) is the first basic test done to check fluctuations in the heart beats, it is not the accurate test to detect heart disease in the early stage. However, it immediately shows fluctuations after a person suffers heart attack but readings can be normal even a day before a person suffers the attack.

There are other tests done to diagnose a person with heart ailments:

ECHO Cardiogram: Scanning of the heart which detects holes in the heart and leaking valves. However, it does not detect blockages.

Thread Mill Test (TMT): During which the heart is stressed physically followed an ECG to know if the blood supply is normal. To detect a blockage in the heart a person has to undergo.

CT Coronary Angiogramord: Regular Invasive Angiogram that is done from the hand to find out if there are any blockages in the heart. But every person is not recommended for angiogram and this is why the doctors recommend for ECG, ECHO and TMT tests and if the person shows signs of discomfort in the chest and back pain while walking or climbing the stairs or cannot undergo TMT, such persons are subjected to the angiogram directly.

Earlier, doctors used to recommend for screening of heart once in two years after a person attained the age of 40 years but now it has been reduced to 30 years. Recent studies have shown that people between the age group 30-69 years, of the 1.3 million cardiovascular deaths, 0.9 million (68.4%) were caused by coronary heart disease and 0.4 million (28.0%) by stroke.

Dr. C.B. Keshavamurthy, Chief Interventional Cardiologist, Columbia Asia Hospital, Mysuru, says that it is important for everyone to be aware of their heart health while keeping a regular tab on blood pressure, cholesterol and sugar level.

“Healthy lifestyle with regular exercise, especially outdoor exercise, keeping the body weight in check, maintaining a good body mass index (BMI) level will help in maintaining a healthy heart. Over the past few years, there has been an increase in heart diseases because of the changes in our diet,” he said.

These days, with changes in the lifestyle and increase in the stress level, one can find more number of people suffering from various types of heart ailments. Apart from heart attack, there the other ailment which is increasing in the rapid scale is heart failure, which is the weakness of the heart caused due to uncontrolled hypertension.

Congenital heart disease

Earlier, it was difficult to find out if the child was suffering from congenital heart disease at the time of birth. But today there is routine evaluation of the child in mother’s womb.

They get checked by routine ultra sound or anomaly scan to find out if there are any abnormalities. This helps in terminating pregnancy at an early stage if major anomalies such as underdeveloped brain, defective heart which cannot be corrected by surgery to name a few are detected. There is 4D Ultra Sound which can pick up most of the heart ailments before birth.

What to do when someone around you is having a Heart Attack ?

If someone suspects or sees an unresponsive person, the first and foremost thing is to call for emergency medical services. Begin Cardiopulmonary Resuscitation (CPR) immediately and continue until professional emergency medical services arrive. If two people are available to help, one should begin CPR immediately while the other calls for help.

Cultural beliefs also make people hesitant to perform mouth-to-mouth resuscitation. It is difficult to learn and if performed wrongly it can lead to a lot of harm.

Chest Compression to revive the heart

• The victim should not be shaken, there should be no vigorous movement of the neck as it could cause further harm the patient.
• If the person is not responding, then the rescuer should do a simple manoeuvre of head tilt and chin lift to clear the airway of the person.
• Five cycles of thirty chest compression should be given with both hands placed over the lower third of the sternum.
• Two mouth-to-mouth rescue breaths should ideally be given after each cycle of chest compression.
• If the patient responds, either verbally or by purposeful movement, or is breathing normally, then cardiopulmonary arrest is unlikely. Such victim needs to be monitored constantly and shifted to nearby medical facility at the earliest.

Doctors Say:

‘Prevention and awareness go together’

Cardiac disease is a growing health problem in younger population. It needs emergency attention towards the treatment and prevention. Mysuru has made profound improvement in providing speciality care to these patients.

In last decade there is a significant influx of specialist, technologies and institutions providing specific care in this regard. Awareness programmes and other strategies for the prevention should also go hand-in-hand. Younger population should learn to stay away from stress, sedentary life and smoking. — Dr. S.C. Madhuprakash, Consultant Chief Cardiac Surgeon, Cauvery Heart and Multispecialty Hospital, Mysuru

‘Quit smoking now’

It is always said ‘Prevention is better than cure’. In order to prevent heart diseases, it is advised to quit smoking and do regular exercises. Having a healthy diet involving fresh fruits and vegetarian food helps maintain a healthy heart. Practicing yoga and cycling will also keep the heart pumping.

Common symptoms of Heart Attack includes chest pain, cold sweat, crushing/ heaviness in chest, radiation to back or left arm, severe burning sensation in upper abdomen with sweating and extreme amount of fatigue. People with these symptoms must seek urgent medical assistance to prevent fatalities. – Dr. N.S. Rajendra, Senior Consultant Cardiologist, Narayana Multispecialty Hospital, Mysuru

‘Be a heart hero’

Cardio Vascular Disease is the leading cause of death and disability. Making small lifestyle changes can make powerful difference to our heart health, reduce the risk and improve quality of life. On the occasion of World Heart Day , we can all be ‘Heart Heroes’ by making a promise to our friends, our family, our patients, our employees to live longer, better with heart-healthy lives. — Dr. S. Sunil Kumar, Senior Consultant- Interventional Cardiology,  JSS Medical College and Hospital, Mysore