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Heart Disease in Nepal : An Expert review on detection, treatment and prevention

2018-08-10


Dr. Om Murti Anil, Senior Cardiologist, Kathmandu, Nepal

Heart disease is the most common cause of death in Developing country like Nepal. Most of these deaths are preventable if heart disease risk factors are detected and treated in time. Young adults of Money earning age group are mainly affected by this disorder, and hereby economical burden is further added to society of under developed nations. 

Lack of good infrastructure, manpower resources and doctors are other important reasons for high morbidity and mortality of heart related diseases in these countries. Even a best and highly qualified specialist doctor can’t do much, unless Patient themselves understand and adopt healthy lifestyle to prevent development of deadly condition like heart attack and other heart diseases. 

Most popular, effective , easy, safe, convenient and cheapest way of fighting heart related problems is prevention. The famous quote, prevention is better than cure, is best suited for heart disease. One of the good things about heart disease is availability of highly advanced treatment facilities and better treatment options even for advanced stages cases.

When to suspect a heart disease 

          When you have chest pain, shortness of breath, palpitation, leg swelling, excessive fatigue, unexplained sweating, dizziness, loss of consciousness or fainting attacks, heart disease is suspected by a doctor. 

When you meet your physician doctor, he may assess probability of heart disease based on your symptom and its relation with physical activity and he may advice you different tests to confirm heart disease. If he suspects, he may refer you to a consultant cardiologist, one who better deals with heart related diseases.

Role of Heart Specialist/ Cardiologist 

          A Cardiologist diagnose heart disease based on risk factors, symptoms and investigations. Most commonly prescribed tests are ECG (Electrocardiography), ECHO (Echocardiography), TMT (Tread Mill Test), Holter, ABPM (Ambulatory Blood Presssure Monitoring) etc.

                                        Most of the heart clinics, hospitals or centres are equipped with these common day-care investigations and it doesn’t take much time. Based on investigations report, a diagnosis of cardiac conditions are made. Depending on the results of these non-invasive reports, sometimes based on clinical indications, invasive investigations are also prescribed mainly coronary angiography (CAG) to diagnose presence of blockage or heart attack. There are many other invasive test like CATH study. 


Depending on the severity of condition, your cardiologist choose the best treatment option for you.

Treatment and Prevention 

        Most trusted modality of dealing with heart disease is “Prevention”. But, most often after diagnosis, patient requires some form of medical treatment in form of medicines. If you improve your diet and lifestyle, there is a better chances of reducing dose of medicine to a minimum level. It’s responsibility of your physician, to minimise the side effects of these medicines with his experience and skill.


                                        Sometime a patient may need invasive treatment in form of angioplasty, pacemaker, ICD, CRT, Device Closure, Radio frequency catheter ablation after EPS tests and other interventions. Some patient may require open heart surgery for coronary artery disease, rheumatic heart disease involving valves, congenital heart disease (holes in heart) seen in children and adolescent.

          Most of the causes of heart disease are preventable. If the causes are identified and treated in time, heart diseases are prevented. Obesity, physical inactivity, unhealthy diet are important risk factors for cardiac diseases. Stopping smoking and limiting alcohol intake are major steps in preventing heart disease. Mental stress and environmental pollution are emerging risk factor for heart disease in  recent times.

 


Written By:

Dr. Om Murti Anil

MBBS, MD, DM Cardiology(AIIMS)


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