Killer attacks: Heart of the matter

At 23, it was the last thing Saeed Abbas expected.

As he was being rushed to the emergency room of the hospital, he was painfully aware of the throbbing pain in his chest. He thought it was just a case of gastritis.

When doctors told him he was having a heart attack, Abbas felt an uneasy numbness.

"As I heard the words, I went blank. I just couldn't react," said the Pakistani expatriate. Excessive smoking, obesity and junk food caught up with Abbas sooner than he could have imagined.

And his is not an isolated case.

The UAE is facing a worrying situation of heart attacks hitting younger victims – some as young as 18.

"The UAE is witnessing a dangerous trend of more people in their 20s getting heart attacks," said Dr Sharif Baqer, Consultant Cardiologist at Shaikh Khalifa Medical City, Abu Dhabi.

When you consider the fact that heart attacks accounted for 29 per cent of the deaths in Dubai in 2007, it puts the whole scenario in the right perspective.

Worrying situation

Sadly, the situation has only gone from bad to worse. A Dubai-based study has revealed that one in four heart attack patients is less than 44 years of age

Already, in the Middle East, heart attacks are taking place 10 years earlier per person compared to their Western counterparts, pushing the average age to 45 years compared to 55 years in other countries. "But with the recent dramatic rise in the number of 20- to 30-year-old heart attack patients, the condition has worsened," said Baqer.

Cardiovascular disease (CVD) is the leading cause of death globally and causes more fatalities than road accidents.

"The UAE is no different," said Dr Ahmad Gabroun, Specialist Cardiologist at Rashid Hospital. "In Dubai about 45 per cent of deaths in 2006 were due to heart attacks."

But statistics on the ‘big killer' only reveal the tip of the iceberg.

"One in five heart attack patients doesn't reach the hospital alive, so the actual number of CVD deaths is much higher," said Gabroun.

Severe attack

The most worrying scenario in the case of young patients getting a heart attack is the extent of damage. "The earlier the attack strikes, the more the muscle damage it causes," said Dr Quraitulain Zaidi, specialist registrar at Dubai Hospital. "A 30-year-old will face more muscle damage compared to a 50-year-old having a cardiac arrest."

The reason is that youngsters do not have a collateral circulation like adults, said Gabroun. "If one of the main arteries of the youngster gets blocked, he has not developed additional blood vessels that supply blood to the nearby affected muscles," he said.

Dying young

"It is something like not having a parallel road in case the main road gets blocked," said Bakir. "Patients in their 20s and 30s also face higher chances of lifespan reduction, because a second heart attack can take place within the next 15 years".

When Abbas suffered the heart attack this year, he was told by doctors that "there is a 50 per cent chance of another heart attack and a 30 per cent chance that you won't reach the hospital alive".

This, he said, altered his lifestyle completely.

Besides the probability of a repeat attack, younger patients are also more prone to complications such as heart failure by the time they reach the age of 50.

This does not mean a person cannot live a "relatively normal" life after a cardiac arrest, according to Zaidi.

"Patients should control the risk factors, because otherwise the consequences can be fatal."

The first thing after a heart attack is to follow a tightly monitored diet devoid of sugar.

"Twenty–five per cent of patients were unaware that they had diabetes until it triggered off a heart attack," said Gabroun.

Risk factor

Another strong risk factor in a majority of youngsters is smoking.

A study conducted in 2006 revealed that more than half of heart attack patients were smokers.

Stress is also another major threat that can set off a heart attack, said Zaidi,

Treating attacks

1. Clot-busting injections at private hospitals could cost over Dh5,000
2. Angioplasty — a balloon with a metal spring — is inserted into the blocked artery. This remains in the patient's heart and costs roughly Dh10,000-15,000 at private hospitals
3. In some cases an open heart surgery is performed

Hypertension risk

Doctors said that the UAE may have a number of undiagnosed hypertension patients and that they run a high risk of getting a heart attack.

According to the World Health Organisation hypertension is one of the strongest risk factors for heart attacks, heart failures and strokes.

"We are seeing a high level of hypertension cases in young patients," said Dr Azan Ben Drek, Consultant Cardiology & Head of Cardiology Department, Rashid Hospital.

"The problem of undiagnosed hypertension is particularly pressing."

Free treatment in India

The Sri Sathya Sai Institute of Higher Medical Sciences in Whitefield, Bangalore, India, offers free treatment to people who cannot meet the expenses for cardiothoracic and vascular surgery in India, provided they provide detailed medical reports.

The institute, run by a local trust, specialises in the diagnosis and surgical treatment of disorders affecting the heart, aorta and other vessels. In India, heart surgery costs approximately Dh30,000.

Shridhar, coordinator of the institute, said they recommend people come with proper documents.

The institute's surgeons perform more than 1,080 heart operations each year using state of the art technology.

Input from – Sachin Kuray, International News Editor

World heart day

World Heart Day will be observed on September 28. Heart disease and strokes are the world's largest killers, claiming 17.5 million lives each year. The number is higher than the combined death toll caused by diseases like HIV/Aids, tuberculosis, malaria and diabetes, plus all forms of cancer and chronic respiratory disease.

Visit http://www.world-heart-federation.org, to find out more.

Case studies

The Sales Exec

Gopi Krishnan, a 33-year-old Indian expatriate, was ringing in the New Year (2007) with his friends in Ras Al Khaimah when he felt a sudden pain in his chest.

He visited the gastrologist the next day, who promptly called for an ambulance. He was rushed to Dubai Hospital at 8.30pm. Eighteen hours had passed since he first felt a sudden pang in his heart. "I damaged a lot of tissues surrounding my heart because of the delay," said Krishnan, a sales executive.

"A few years ago I had seen a 29-year-old friend having a heart attack on the cricket pitch, but honestly I never thought it would happen to me."

At the hospital, though, his doubts were confirmed. "I had to undergo an angioplasty. Doctors told me smoking and stress were the main reasons for the heart attack. I haven't touched a cigarette ever since.

"Altering my lifestyle was difficult, but I am strictly following the rules because of my fianceé. I was humbled when she stood by me through all this."

The HR Manager

Waleed Jayyousi, 39, a Jordanian, travels from Sharjah to Dubai four times a day because he works in two shifts.

The crawling traffic situation, his hectic work life as a human resources manager, smoking over 30 cigarettes a day and excessive blood sugar – all factors eventually took a toll on him.

A few months back, he drove himself to the hospital after feeling uneasy, and it was found that he was having a heart attack.

"As doctors were taking me into the emergency room, I thought that I might not see my wife and children again. The feeling was more painful than my heart attack," said Jayyousi. A father of two boys aged three and 11, Jayyousi said, "I want to be healthy for them. I cannot imagine life when someone's father disappears."

Now, he has quit smoking, is watching his weight and has also learnt the art of delegation.

"I never distributed my work. It was a major factor that gave me stress because I wanted to control every little thing. I knew I was stressed but ignored the signals. The biggest mistake is when we take our health for granted."

DID YOU KNOW?

Risk factors for heart attacks are Diabetes, Obesity, High blood sugar, High blood pressure, Stress, Family history

45

per cent of deaths in dubai were due to CVD in 2006

57

per cent of heart attack victims were smokers

44

One in four attack cases is below the age of 44