World Heart Day 2023: Heart Attack And The Possibility Of A Recurrence: The Need For A Prevention Plan

Heart disease remains the leading cause of death worldwide, with India accounting for one-fifth of heart-related casualties. Among these, sudden heart attacks pose a significant burden on our country, striking suddenly and without warning, often with fatal consequences. Sudden heart attack (SCA) is the abrupt cessation of all heart activity because of an irregular heart rhythm, causing a halt in breathing and rendering the individual unconscious. In the absence of prompt intervention, SCA can ultimately result in a fatality.

Heart attacks can result from various risk factors, including non-modifiable factors, such as age, gender, family history, and modifiable factors like hypertension, diabetes, high cholesterol, obesity, smoking, physical inactivity, poor diet, excessive alcohol consumption and disturbed sleep pattern. Managing these modifiable risk factors through lifestyle changes and medical intervention is essential in reducing the risk of heart attack.

Some immediate and severe symptoms of a heart attack occurrence include shortness of breath, discomfort in chest, irregular heart rhythms, and weakness. It is of utmost importance to contact a doctor in case an individual experiences any of these symptoms. Immediate response to sudden heart attack involves administering cardiopulmonary resuscitation (CPR) and delivering electric shocks to the heart using an automated external defibrillator (AED). Swift and suitable medical intervention can potentially lead to survival in such critical situations.

Prevention of recurring heart attack

Once someone has experienced heart attack, they are at a heightened risk of a recurrence, which can be even deadlier. To reduce the risk of recurrence, a multi-faceted prevention plan must be put in place.

• The foundation of heart attack prevention lies in making lifestyle changes. This includes adopting a heart-healthy diet, engaging in regular physical activity, quitting smoking, limiting alcohol consumption, adopting a positive attitude and regime, and participating in mindfulness session. These changes can help manage risk factors such as high blood pressure, high cholesterol, and obesity, which are all associated with heart attack.
• For individuals at a higher risk of a heart attack due to specific medical conditions or genetic factors, medications and medical procedures may be necessary. This could involve the use of anti-arrhythmic drugs or implantable cardioverter-defibrillators (ICDs) to regulate heart rhythms and reduce the risk of a sudden heart attack. Additionally, it is imperative to follow medical management, especially for high-risk individuals, which involves tailored interventions to address genetic and environmental factors, reducing the risk of recurring heart attacks.
• After surviving a heart attack, participating in a structured cardiac rehabilitation program is essential. These programs focus on physical exercise, dietary counseling, stress management, and education about heart health. They can greatly improve overall cardiovascular health and reduce the risk of recurrence.
• Heart attack can have a genetic component, so it's crucial to educate family members about the risk factors and warning signs. Additionally, shared environmental factors within a family, such as socio-economic status, dietary habits, physical activity, and behavioral patterns, can increase the risk of developing heart issues, as family members often adopt similar patterns. This awareness can prompt early intervention and potentially prevent heart attack in at-risk individuals.
• Post heart attack, individuals should maintain regular follow-ups with their healthcare providers. These visits help monitor their progress, adjust medications if necessary, and ensure that their prevention plan remains effective.

Prevention encompasses lifestyle changes, medical interventions, education, and community readiness. By adopting a heart-healthy lifestyle, using medications and medical procedures when necessary, participating in cardiac rehabilitation, educating families, attending regular follow-ups, and promoting CPR and AED awareness, we can significantly reduce the risk of heart attack recurrence and save lives.

Dr. Ravi R. Kasliwal, Chairman, Clinical and Preventive Cardiology, Heart Institute, Medanta, Gurugram

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