Act now before your heart breaks!

For the discerning Jamaican palate, no respectable meal is complete without a juicy slab of meat. Former government employee Mark Smith shared this belief, eagerly devouring pork and ham, with a particular fondness for the skin. Little did Mark know that his poor meal choices coupled with a lack of physical activity, were slowly sending him on a collision course with ill health and an early grave. The fat he so passionately craved had never really left him, building up in his arteries and gradually blocking blood flow through his heart.

"Like any other organ in the body, the heart receives its blood

supply, and therefore, its essential nutrients, by way of blood vessels called arteries. These arteries are prone to a condition called atherosclerosis, which is the

deposition of cholesterol and fat deposits along the wall of the arteries over time," explained Dr Handel Emery, consultant cardiologist at the Winchester Surgical and Medical Institute in St Andrew.

In some patients, particularly those with common risk factors such as diabetes, hypertension, cigarette smoking and obesity, atherosclerosis proceeds rapidly, ultimately resulting in some or total blockage of the arteries, compromising blood flow and depriving tissues of essential oxygen and nutrients. Today, cardiovascular disease is the major cause of death in Jamaica, contributing to approximately 40 per cent of all deaths.

Of the group of disorders known as cardiovascular diseases, coronary artery disease (CAD) is by far the most common, followed closely by stroke, and then others such as aortic diseases and hypertension.

Symptoms vary depending on a number of factors, including the severity of the disease, the area of the heart affected, the rate at which the blockages developed, and the presence of complications. Many patients with CAD complain about vague, non-specific, atypical chest pain, while others experience classic angina, shortness of breath, light headedness, dizziness or blackouts. Such patients generally do not require hospital admission and are managed primarily as outpatients. Unfortunately, some patients present with a heart attack, heart failure or life-threatening rhythm disturbances which require immediate monitoring and expedited care.

NOT A DEATH SENTENCE

Although the prospect of coronary artery disease can be scary, it does not have to be a death sentence as a variety of options are available. Patients with atypical chest pain should undergo a cardiac stress test to detect the presence of the disease.

A cardiac stress test is non-invasive, quick and relatively inexpensive. One of the most popular is the Stress ECG during which a patient exercises on a treadmill for an average of 10 minutes while the supervising physician or cardiologist monitors their symptoms, blood pressure, response to exercise and ECG. Other techniques combine this with imaging tests such as echocardiography and nuclear imaging.

Patients with classic angina should undergo a risk-stratification cardiac stress test to determine the extent of their disease and the most appropriate therapy. Most persons will have low-risk disease and should receive medication only. A minority of patients will have high-risk disease and should go on to coronary angiography to define their coronary anatomy, followed by a procedure to restore blood flow, such as placement of a stent, or bypass surgery.

Of course, central to the prevention and management of coronary artery disease is the adoption of a healthy lifestyle.

"The American Heart Association recommends at least 40 minutes of exercise at least four times per week" shares Dr Emery.

"This should be combined with a diet rich in fruits, vegetables, nuts and whole grains, and low in animal proteins, fats, cholesterol, sugar and salt. Additional recommended lifestyle changes include quitting smoking and weight loss. Finally, patients who have been diagnosed with coronary artery disease are encouraged to establish a long-term professional relationship with a physician who can guide them through the difficult and frustrating challenges ahead."

As for Mr Smith, he is now on medication and has swapped his beloved pork and ham for vegetables and steamed fish. He recently purchased sneakers and can be seen briskly walking up and down the busy streets of Kingston.

Having adopted a fit and healthy routine, he warns others that fatty foods are no good; they may not affect you now, but they could cause issues down the road.

= Dr Handel Emery is consultant cardiologist based at the Winchester Medical and Surgical Institute, 3A Winchester Road, Kingston 10. Email: pinnaclehealthcare@hotmail.com or yourhealth@gleanerjm.com.