Cardiovascular or heart disease is a leading cause of death in India and accounts for 17.8% of all deaths (according to the 2016 Global Burden of Disease Report). Significantly, the figures have risen by 53% as compared to 2005. Over the last 60 years, congenital heart disease (which affects the foetus in the womb) has also increased from 1% to almost 10% in urban areas and has gone from 1% to 4-6% in rural areas.
Types of heart disease
There are several types of heart disease, including congenital heart disease, valvular heart disease, cardiomyopathy, coronary artery disease and arrhythmia. Congenital heart disease can be caused by genetic or environmental factors: mother having some illness or consuming certain drugs during the developmental phase. “If severe, it can cause intrauterine death or severe birth malformation,” says Dr Santosh Kumar Dora, senior cardiologist, Asian Heart Institute, Mumbai.
While the heart has four valves, if one or more of them get affected, it leads to valvular stenosis or regurgitation. “It happens due to infection, chronic inflammation (rheumatic heart disease), degeneration or trauma to the heart valves,” says Dr Dora.
In cardiomyopathy, the heart muscle either gets thickened or thinned, or infiltrated and subsequently gets very weak in contraction. Coronary artery disease is the most common heart disease in adults and among the elderly population. The risk factors for it are smoking, diabetes, hypertension, and obesity. Fatty plaques develop in the arteries supplying blood to heart muscle and when they grow in size, it leads to narrowing of the artery and restriction of blood supply. Arrhythmia causes the heart rate to go very fast or slow down.
Extreme weakness and tiredness even with minimal activity can be a symptom of heart disease.
Symptoms of heart disease
While most people are familiar with the common symptoms of heart disease, such as chest pain, breathlessness and palpitation, there are certain unexpected symptoms as well.
Dr Abhijit Palshikar, HOD-Cardiology, Sahyadri Hospital Pune refers to the case of a 50-year-old patient who visited a dentist for jaw pain that he experienced while walking. “After a visit to a physician, he was referred to a cardiologist. A stress test and angiogram were conducted and symptoms proved to be related to the heart. Reports revealed that he had an 80% blockage in the heart,” says Dr Palshikar.
Here are some of the lesser known symptoms that you need to keep a watch for:
Dizziness: Fainting is commonly attributed to be a neurological condition, but the underlying cause could be your heart. “A person having severe valvular narrowing or a sudden slowing or pacing of heartbeat can feel dizzy,” says Dr Dora.
Swollen feet (oedema): Swelling in the ankle region could be due to the heart. “During heart failure, the heart cannot pump efficiently. So, there is fluid accumulation in different parts of the body. Since the is in an upright position, it bears the maximum burden and oedema often starts here,” says Dr Dora.
Extreme weakness: Extreme weakness can be due to various reasons, but one of the reasons may be cardiac. “In heart failure, the heart cannot pump blood efficiently leading to under perfusion (circulation) to various body organs, including muscles. This leads to extreme weakness and tiredness even with minimal activity,” says Dr Dora.
Patients with coronary artery disease sometimes develop jaw pain during exertion.
Jaw pain: Patients with coronary artery disease sometimes develop jaw pain during exertion. People often mistake it to be a dental problem. “The appearance of pain, especially during exertion, is the clue. If such is the case, immediate cardiac tests are necessary,” says Dr Dora.
Excessive sweating: During heart failure, or severe coronary artery disease, patients may start sweting excessively, even with minimal exertion. “At times, excessive cold sweating is the only symptom of a massive heart attack,” says Dr Dora.
Coughing: A cough can be a common symptom of asthma and respiratory infection. However, it can also happen due to congestion of the lungs. “Lung congestion occurs during heart failure. The cough that becomes more frequent while lying down may be of cardiac origin,” says Dr Dora.
Indigestion/ loss of appetite:This symptom is commonly attributed to gastro-intestinal disorders. However, cardiac conditions like heart failure also can lead to indigestion and loss of appetite. “Due to congestion of the stomach and intestine, people with heart failure often do not feel like eating, or feel bloated even after a small meal. Do a cardiac check-up if there is no obvious gastric cause for loss of appetite,” says Dr Dora.
Loud snoring with intermittent brief absence of breathing (obstructive sleep apnea) is an ominous sign.
Snoring: While mild snoring is common, loud snoring with intermittent brief absence of breathing (obstructive sleep apnea) is an ominous sign. “Obstructive sleep apnea is a serious condition and mandates a detailed sleep study. Persons having this may need continuous positive airway pressure by machine to stabilise the condition,” says Dr Dora.
Back pain: Heart-related issues can cause reactions across the body. It can also be experienced on the right side of the body. “When the location is away from the heart, one may not suspect it to be a heart-related problem. Abdominal or pain in the throat is commonly passed off as acidity, whereas back pain is considered to be muscular pain,” says Dr Palshikar.
Swollen fingers: A crease in the earlobe, fatty bumps around the eyes (Xanthelasma), blue lips or swollen fingers can indicate abnormality of the heart. “Instead of neglecting symptoms, it is advisable to seek the advice of an expert if you have such issues. It can help save your life,” says Dr Palshikar.
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