September 29 is commemorated as World Heart Day, a day to generate greater awareness among people regarding heart diseases. The heart is one of the most vital organs of the body and functions nonstop throughout life to keep the body parts well perfused with blood. Blood carries oxygen to each and every part of the body. Therefore, any malady affecting the heart reduces amount of oxygen reaching the body parts, affecting them. Long standing heart disease affects the functioning of the gut, kidneys and all body parts. This results in reduced appetite, nausea, vomiting and malnutrition due to reduced absorption of nutrients. Impaired functioning of the kidneys causes swelling all over body and renal failure. Similarly, reduced blood supply to the liver leads to cirrhosis and liver failure. All make a person sicker. Cure consists of surgical correction in cases where feasible. The surgery is expensive and not easily accessible. Alternate therapy is by medicines for life to keep the patient stable. But over time, every individual tends to develop side effects due to these medicines, which adds to the misery. Therefore, it is important for people to be aware of different kinds of heart diseases so that they can be prevented possibly, and on occurrence, can be treated at the earliest. Congenital heart diseases occur due to malformations in the heart present since birth. Usually, these develop when in the mother’s womb due to some infections or drugs. The baby born fails to suckle adequately and may turn blue while crying. These features should alert one to the possibility that the baby has a heart problem. A pregnant woman has to be very careful, particularly during the first three months, as this is the time when the body of the child is formed. Abusive substances like alcohol, tobacco, and etcetera, during pregnancy increase risk of heart diseases in the child. Rheumatic fever and its resultant damage to the heart valves is a cause of heart disease in adolescents and young adults, more so in developing countries. It is important to educate the masses about rheumatic fever and that it is the result of untreated or poorly treated streptococcal sore throat infection. Prevention and timely treatment of this will definitely bring down the prevalence of rheumatic heart disease. High blood pressure is yet another disease affecting the heart, the prevalence of which is rising across the globe along with development and related stress. People need to understand the need for adequate treatment of hypertension by suitable diet, exercise and if needed, medications. Coronary artery disease (CAD) is the number one cause for sickness and untimely deaths in developed and countries. It is multi factorial. Fat rich diet, obesity, lack of exercise, high blood pressure, diabetes, alcohol, and smoking and stress, are all implicated in causing coronary artery disease. All these factors can be controlled very well for preventing CAD. An individual may develop CAD due to one or more of these factors and it can be passed on to the offspring through genes, thus a family history of CAD is yet another risk factor, but one which cannot be modified. Therefore, a person having a parent or blood relative suffering from CAD has to be more careful and avoid other risk factors to prevent development of CAD. The heart and its layers can be affected by infections like TB or viral infections like any other part of the body. Resulting symptoms are the same as for other types of heart diseases. Timely treatment of the infection can lead to normal functioning of the heart again. Ministry of Health is doing a great job in collaboration with Rwanda Heart Care Foundation and voluntary teams in providing free cardiac surgeries for children and young adults affected by congenital and rheumatic heart diseases. Greater awareness about these diseases at grass roots level would be helpful so that these diseases can be prevented. If required, adequate treatment in time can prevent irreversible damage to the heart. Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk
