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Dr A Q Khan
Monday, June 11, 2012
From Print Edition

My apologies to the medical profession. I am not a medical specialist, but I am often requested to write on topics of public importance, as my columns are widely read and this is an easy way of disseminating information.

The information being reproduced below was obtained from:

• The brochures published by PANAH

• “Heart Diseases, Treatment and Precautionary Measures” by Sq. Ldr. Ghulam Abbas of PANAH

• “The Medical Encyclopedia,” Penguin Books, England, 1984

• “Medical Questions and Answers,” Reader’s Digest, Australia 1989

• The British Medical Association Complete Family Health Encyclopedia, Guild Publishing, London, 1990

• Information from the internet.

Forty or 50 years ago the lay person had not heard of such diseases as diabetes, thalassemia, high blood pressure, heart attacks, etc., and hardly any deaths were ascribed to them. A modern style of living, fatty fast foods, everyday tensions and stresses have all led to an increase in the number of deaths from many of these diseases. Here I will discuss only heart attacks, its causes and symptoms, possible available treatment and precautions that can be taken.

About 20 million people around the world die from heart attacks every year. In Pakistan the figure is estimated at 100,000 and has become common even in the younger generation, with about 50 percent of patients below 50.

The heart is a muscular pump in the middle (slightly to the left) of the chest, which, throughout life, beats rhythmically – non-stop – to send blood to the whole body. During an average lifetime, the heart contracts more than 2,500 million times. A large part of the heart consists of a special type of muscle which, given sufficient oxygen and nutrients, contracts rhythmically and automatically without any stimulus. The interior of the heart consists of four distinct chambers. A thick central muscular wall divides the cavity into right and left halves, each half consisting of an upper and a larger lower chamber. Blood vessels from the top and sides of the heart deliver blood to the upper chamber or distribute blood pumped out by the lower chamber. The internal surface is lined with a smooth membrane and the entire heart is enclosed in a tough membranous bag. The two sides of the heart have distinct and independent functions. De-oxygenated blood arrives in the upper right chamber via two large veins, is transferred to the lower right chamber and is then pumped into the lungs via the pulmonary artery to be oxygenated and for the removal of carbon dioxide. The left side of the heart receives the oxygenated blood from the lungs via the pulmonary veins which flows into the upper left chamber, is transferred to the lower left chamber and then pumped to all tissues of the body. The heart can thus be viewed as a dual-purpose pump. One-way valves located at the exits of each chamber guarantee that there is a one-way flow only. The pumping action of the heart consists of three phases, which together make up the cycle of one heartbeat. To work efficiently, the heart must contract in a precise sequence, which is brought about by electrical impulses which emanate from the heart’s own pacemaker situated at the top of the upper right chamber. These electrical impulses are carried along, partly by the heart muscle itself and partly by specialised nerve fibres. To avoid stagnation, the volume pumped at each stroke by the two sides must be exactly balanced. However, resistance to blood flow through the circulatory system is much greater than resistance to blood flow through the lungs. This means that the left side of the heart must contract much more forcefully than the right side. As a result, the muscular bulk of the left side of the heart is greater than that of the right side.

There are many reasons for heart diseases or heart attacks. Foods that are bad for the heart are, amongst others, an unbalanced diet rich in fatty, fried foods, the yellow of eggs, butter, ghee, red meat, coconut oil, brain, paya, ice cream, cream cakes, etc., which not only cause obesity but also raise cholesterol levels in the blood. This causes blockage of blood vessels and can result in a heart attack. Sedentary lifestyles cause lessened oxygen supply to the heart, causing problems. Smoking is also disastrous. Cigarette smoke generates poisonous carbon monoxide resulting in persistent coughs, thick mucous, lung cancer, throat cancer, toothache and high blood pressure. The latter can result in a heart attack. Other important causes are mental worry, tension, family problems, financial problems, uncontrolled temper tantrums, a hectic life style, etc. resulting in a fast heartbeat, contraction of heart muscles, thickening of the blood and increased sugar levels, often leading to chest pains (angina). Should a clot form in the blood, it can lead to a fatal heart attack. Family history also plays a big role as heart disease is hereditary.

There are many tests for determining the condition of the heart and identifying problems – i.e., measuring blood pressure, electrocardiograms (ECG),Thalium scan, measuring the fatty content of the blood (lipid-profile test), determining cholesterol levels, efficiency tolerance test (ETT), echo, ultrasound, etc.

In order to remain fit and to safeguard against heart problems, one needs to exercise regularly (brisk walk for at least 30 minutes), learn to relax and avoid eating fatty foods and the other foods mentioned above. If someone does have a heart attack, the cardiologist can choose from a variety of treatments – i.e., rest, medication, angioplasty, the placing of stents, bypass surgery, etc., depending on the condition of the patient. If you are having chest pains, lie down, rest, loosen restrictive clothing, breathe deeply and slowly and take two tablets of soluble aspirin. Coughing can also help because it increases blood circulation to the heart. See a doctor as soon as possible. Never ignore chest pain, assuming it is only indigestion, acidity, etc. After a heart attack, lifestyle changes need to be made and the doctor’s instructions strictly followed.

Here is some information about PANAH. It is an NGO set up in 1984 by senior army officers as a small unit in the Armed Forces Institute of Cardiology. Its main aim is to create public awareness, give advice on ways to avoid risks and possible treatment. They are planning to establish a state-of-the-art facility in Bahria Town, for which a plot has been donated by a philanthropist. PANAH needs your moral and financial support. Please give your zakat, sadqa and other donations to PANAH Centre, Account No. 027395-5, National Bank of Pakistan, Cantonment Board Building, Rawalpindi. PANAH’s office is located opposite the Skin OPD, Military Hospital. Its address is P O Box 888, AFIC/NIHD, Rawalpindi Cantt. Phone +92-51-9270642 Email and website:panah84@,