2023-10-05 20:26:52
Cardiovascular diseases… treatment options and interventions
Cardiovascular diseases (CVDs) are the leading cause of death globally; It kills an estimated 17.9 million people every year. These diseases are a group of cardiovascular disorders, including coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions.
Behavioral risk factors
According to World Health Organization reports, more than 4 out of every 5 deaths due to cardiovascular diseases are due to heart attacks and strokes, and a third of these deaths occur prematurely in people under the age of 70 years.
The most important behavioral risk factors for heart disease and stroke are unhealthy diet, physical inactivity, tobacco use, and harmful use of alcohol. Individuals may have the effects of behavioral risk factors, such as high blood pressure, high blood glucose, high blood fats, overweight and obesity. These “moderate risk factors” can be measured in primary care settings and indicate an increased risk of heart attacks, strokes, heart failure and other complications.
Dr. Zahid Khan – Dr. Khaled Al-Habib
Stopping tobacco use, reducing salt in the diet, eating more fruits and vegetables, engaging in regular physical activity, and avoiding alcohol use have been shown to reduce the risk of cardiovascular disease. Health policies create enabling environments for making affordable and accessible health choices, essential for motivating people to adopt and maintain healthy behaviours.
Identifying those most at risk of cardiovascular disease, and ensuring they receive appropriate treatment, can prevent premature deaths. Access to non-communicable disease medicines and basic health technologies in all primary health care facilities is essential, to ensure that those in need receive treatment and counselling.
World Heart Day
On World Heart Day 2023, the World Health Organization asked the world to: “USE KNOW”, which is a call to know hearts first and then care for them, as the organization is certain that knowledge about heart health in the world is limited, and policies are insufficient or non-existent. It aimed to break down barriers and empower individuals to take control of their well-being. Thus, the organization launched a global call to raise awareness about heart health, and accelerate measures aimed at preventing, detecting and managing cardiovascular diseases. The organization also aimed to draw people’s attention to heart diseases and the range of health issues associated with them, to promote various preventive steps and lifestyle changes. To avoid any cardiovascular diseases, such as heart attack, stroke, heart failure and any other associated condition. On average, more than 18 million people die from heart-related diseases each year. This is more than the number of people who die from HIV, malaria and cancer.
Locally, the website of the Saudi Ministry of Health indicated that cardiovascular diseases are the main and first cause of death, and most of them can be prevented by controlling behavioral risk factors, such as: smoking, unhealthy diet, obesity, and physical inactivity.
He pointed out that heart disease is often the result of an accumulation of several reasons, such as: age, lifestyle, dietary style, and smoking. It may eventually lead to the heart stopping. This necessitated developing plans that would contribute to quitting smoking. And carry out campaigns that encourage a healthy lifestyle, good eating habits, and exercise, to reduce the risk of heart disease and reduce the prevalence of high blood pressure.
“Nabadat”… participates locally
Professor Dr. Khalid bin Fayez Al-Habib, a consultant in adult heart diseases and catheterization, at the King Fahd Center for Cardiac Diseases and Surgery, at the College of Medicine, King Saud University, and president of the Heart Disease Control Society (Nabadat), spoke to “Your Health”, explaining that more than 30 percent of deaths in… Saudi Arabia is due to cardiovascular diseases. The main risk factors for developing coronary heart disease in us are high cholesterol, smoking, high diabetes, high blood pressure, and especially hereditary cholesterol. Because its height may be without any symptoms.
Therefore, the Society for Combating Heart Disease (Nabadat) raises community awareness to prevent heart disease, in addition to treating heart disease patients. The association also undertakes health education and awareness for the community and individuals, through the latest means, using mobile vehicles containing the latest medical devices. Individuals are comprehensively examined and educated on healthy habits to maintain a healthy heart. Therefore, the “Nabadat” Association commemorates the event of World Heart Day, through community awareness to prevent heart diseases, in addition to treating indigent heart patients.
It is very important for patients to adhere to a healthy lifestyle, and completely avoid bad eating habits as well as smoking, while exercising regularly and continuously. This has proven to be very effective in achieving very significant therapeutic benefits.
Cardiovascular diseases
“Heart disease” is a broad and broad term used to describe a group of diseases that affect the heart, which includes the following various diseases, according to the World Heart Federation (WHF):
Cardiovascular diseases – arrhythmia – diseases of congenital heart defects – cardiomyopathy – heart diseases resulting from infections of the heart membranes – diseases of the heart valves.
Symptoms of heart disease vary depending on the type of disease. For clarification, the following are examples of the most common:
• Cardiovascular diseases: A group of disorders that affect the heart and blood vessels, causing narrowing or blockage of blood vessels. It prevents blood from reaching the heart, brain, or other parts of the body, and getting enough blood. These disorders include:
– Coronary heart disease, diseases affecting the blood vessels that supply the heart muscle.
– Cerebrovascular diseases, diseases that affect the vessels that feed the brain.
– Peripheral arterial diseases, diseases that affect the blood vessels that supply the arms and legs.
Symptoms of cardiovascular disease are characterized by: chest pain (angina), shortness of breath, numbness in the legs and arms, and irregular heartbeat.
• Arrhythmia: Its symptoms are characterized by: rapid heartbeat (feeling that the chest is trembling) – slow heartbeat – chest pain – shortness of breath – dizziness – fainting.
Coronary artery disease
Dr. Zahid Khan, Consultant and Head of the Department of Cardiac Surgery at Al Mana Hospitals in the Eastern Province of the Kingdom, spoke to “Your Health.” He pointed out that coronary artery disease, also known as ischemic heart disease, is one of the most common heart diseases that occurs in older age groups, but it can occur at a younger age when there are some risk factors, such as a family history. Or diabetes, blood pressure, or smoking. Coronary artery disease is more common in males and less common in women, due to female hormones that contribute to protecting against the disease and preventing its increase in incidence after menopause.
Dr. Khan added that a recent phenomenon is that we have recently seen an increase in infection cases in younger patients, due to increased risk factors, lack of exercise, and stress.
He stressed that the increase in heart disease in the modern era is linked to lifestyle and wrong practices, the most important of which are not exercising and eating too much fast food.
Modern therapeutic interventions
Dr. Khan says the latest developments in the world of cardiology include percutaneous intervention using a drug-eluting “stent,” and minimally invasive heart surgery if only one artery is affected; Especially when the left anterior descending artery is injured and a stent cannot be installed.
More than 18 million people die from heart-related diseases every year
The treatment plan is decided after coronary angiography; The best treatment methods are discussed and evaluated in a meeting involving the entire cardiac team, which includes a cardiologist and cardiac surgeon, in accordance with international guidelines and scoring systems.
Treatment options include:
• Bracing: may be sufficient most of the time.
• Coronary artery bypass grafting: Sometimes the stent serves as a bridge to surgery after opening the causative artery, if the patient suffers from multi-vessel disease that requires coronary artery bypass grafting, using the Coronary Artery Bypass Grafting (CABG) procedure, which It aims to improve blood flow to the heart.
“We recommend CABG for patients with three-vessel coronary artery disease, most cases of left main trunk disease, and some bifurcation lesions, especially if the patient is diabetic,” says Dr. Khan.
• Minimally invasive heart surgery: It is one of the recent developments in heart surgery, and is performed with or without the help of robots. Minimally invasive surgery is primarily intended to repair and replace valves, and coronary bypass surgery remains open-heart surgery unless it involves the anterior descending artery (LAD) only; The left internal mammary artery (LIMA) is transplanted to the left anterior descending artery.
What happens to the patient after the stent is placed? Is it possible for the disease to recur?
Dr. Khan answers: “Yes, it is possible for the disease to recur in the artery supplied with the stent, due to the aggressive nature of the disease, the patient not taking medications regularly, and the uncontrolled risk factor. Usually, in this case, coronary artery bypass grafting (CABG) may be required.
He added that there is also the possibility of re-stenosis due to many of the factors discussed above.
How can coronary artery disease be prevented?
To avoid coronary artery disease, Dr. Khan advises the following:
• Follow a healthy lifestyle, commit to eating a balanced diet, avoid smoking, and exercise.
• If there are risk factors, the patient should talk to a doctor to discuss the best treatment methods, especially in cases of other diseases, such as diabetes, cholesterol, and blood pressure.
* Community medicine consultant
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