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Doctor's Appointment | Understanding heart disease

Published:Wednesday | June 1, 2016 | 12:00 AM
From left: Dr. Sara Lawrence, host of Doctor's Appointment; Anntonette Cowan-Palmer, NCB Insurance Sales Manager; Dr. William Aiken, consultant urologist and Dr. Lisa Hurlock, consultant cardiologist.

Heart disease is the number one cause of death globally. Heart disease is the cause of 47 per cent of deaths in Jamaica per year. Heart disease, according to Dr Lisa Hurlock, consultant cardiologist and special guest on the 'Doctor's Appointment' TV show, is any disease or disorder affecting the heart or the vessels leading to and from the heart.

Hurlock further outlined the different types of heart diseases. These include:




The most common form of heart disease for which the underlying mechanism is atherosclerosis or blockage of the arteries of the heart, due to fatty deposits on the inner wall of the arteries.




An arterial disease characterised by elevation of the blood pressure.




The sudden death of brain cells in a localised area, due to inadequate blood flow.




This describes a group of short-term (acute) and long-term (chronic) heart disorders that can occur as a result of rheumatic fever. Rheumatic fever normally presents with a sore throat. It is important that this be treated early to avoid developing rheumatic heart disease. A common result of rheumatic fever is heart-valve damage, which may lead to a subsequent valve disorder.




This is a problem in the structure of the heart that is present at birth. Signs and symptoms depend on the specific type of problem. Symptoms can vary from none to life-threatening. This is the most common heart disease among children. An example would be ventricular or atrial septal defect (VSD and ASD), more commonly known as 'hole in the heart' disease, in which babies are born with holes in the septum, that allows blood from both sides of the heart to mix.

In her conversation with the show's host, Dr Sara Lawrence, Hurlock noted, "It is the risk factors which mainly determine if an individual will develop a cardiovascular illness. There are two categories of risk factors - modifiable and non-modifiable. The latter are those which we can't change, such as age and family history."

Modifiable risks, on the other hand, include:

-High blood pressure

- Diabetes and pre-diabetes

- High cholesterol

- Obesity

- Smoking

- Lack of physical activity

- Unhealthy diet

It is therefore recommended that if one has a family history of high cholesterol, then regular checks of one's cholesterol levels should be done. Persons with either high blood pressure (hypertension) or coronary heart disease must get regular evaluations done by a clinician to determine whether they are at risk of developing heart disease as well. Regular check-ups will help to address the modifiable risk factors which generally refer to lifestyle practices, inclusive of diet and exercise habits.

Meals rich in fruits and vegetables need to be the norm and also reducing the intake of animal fat. Exercise also reduces one's likelihood of developing heart disease, with the recommended duration of at least four hours per week or 30 minutes per day.

Smoking is to be avoided as it damages the lining of the arteries, leading to a build-up of fatty material (atheroma) which narrows the artery. This, in turn, can lead to chest pain due to the decreased supply of oxygen to the heart (angina), or more dangerous heart attack or a stroke.

The major presentation of a heart disease is normally a heart attack. Signs that one may be experiencing a heart attack are chest discomfort, or pain behind the chest which radiates to the arms, neck and jaw.

It should be noted, however, that most females will not present with the classical symptoms, but, rather, a slight pain in the chest or extreme fatigue. Other ways in which heart disease might present may be shortness of breath after limited activity or swelling of the lymph nodes, due to an accumulation of fluid in the body as a result of a heart malfunction.




It is important to know and control risk factors:

- If suffering from hypertension, blood pressure must be carefully monitored and regulated through exercise and medication.

- If suffering from diabetes, blood sugar levels should be carefully monitored and regulated.

- Cholesterol levels should be monitored and regulated, if too high, through healthy diet and medication.

Although heart disease may not be cured, treatment can help manage the symptoms and reduce the risk of further problems. Heart diseases can be effectively managed with a combination of lifestyle changes, medicine and, in some cases, surgery. With the right treatment, the symptoms of heart disease can be reduced and the functioning of the heart improved.

This, however, can be very costly, Hurlock noted, as, she underscored, "prevention is less expensive than cure".

- Anntonette Cowan-Palmer, NCB Insurance sales manager, also pointed out that one has to consider the direct and indirect costs. Direct costs being those associated with treatment, while indirect costs, for example, could be the loss of a breadwinner and the consequent fall out. Thus, Cowan-Palmer stated, "It is extremely important that we all have critical-illness protection. With NCB's ProCare plan, there is no waiting period once there are no pre-existing conditions, and coverage can range up to $5 million."

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