Take good care of your heart

“I LOVE you with all my heart.”

This is the most often used phrase quoted by lovers and couples. Unknowingly, the phrase is not without essence. Heart is one of the human organs that have no pair, unlike those of lungs, kidneys and other glands. Thus, once damaged, it can cause irreversible damage.

Our heart lies in the center of the chest. The right and the left sides of the heart have an upper chamber (atrium), which collects blood and a lower chamber (ventricle), which ejects blood. To ensure that blood flows in only one direction, the ventricles have an inlet and an outlet valve.

Medical authorities say the human heart weighs eight to 10 ounces. Our heart works in two ways. For one, it carries blood to and from the lungs in a process called pulmonary circulation. For another, it pumps oxygen-rich blood out of the heart to all parts of the body. Doctors call this process as systematic circulation.

Unlike other parts of the body, which relaxes when we are asleep, or just resting, the heart never stops beating. It beats 90 to 100 times a minute in a child, and 70 to 80 times a minute in an adult.

The beating – called heart rate – can be counted by feeling the pulse while resting one’s fingers on the wrist arteries. The rate is faster when you are excited, or during exercise, when the heart works harder in supplying more amounts of blood. At sleep, however, the heartbeat is slower. As such, demand for blood is much, much lower.

Like most vital organs of the body, heart is beset with problems. “Heart problems may come like a thief in the night,” says Dr. Rafael D. Castillo, past president of the Philippine Society of Hypertension and newspaper columnist.

In one of his recent columns, he wrote of the sudden death of a colleague who hardly had any symptom referable to the heart.

“He was athletic, was at the prime of his life and peak of his career,” Dr. Castillo penned. “He was on the way home after making rounds a couple of days before Christmas.”

Dr. Castillo further wrote: “Autopsy to find out the cause of death showed significant blockage of a major artery of the heart. It’s likely that he had a sudden irregularity of the heartbeat called ventricular fibrillation, causing the heart to stop. It’s so sudden that there’s no chance for him to be saved as he had saved a lot of lives in his brilliant career.”

Tens of thousands of Filipinos are dying annually because of fatal complications of cardiovascular disease. A good number of them die before they can even reach the hospital. They are usually proclaimed DOA (dead on arrival) when they’re rushed to the emergency room.

Diseases of the heart and the vascular systems rank first and second top leading killers in the Philippines. Every day, 243 people die of heart diseases.

“With such a prevalent disease, heart disease exerts a tremendous yet unseen burden on the Philippine economy,” comments Dr. Willie Ong, one of the country’s top cardiologists.

Heart attack is one of the most treacherous diseases as it strikes anytime – in the office, while attending a party, or even resting at home.

“A heart attack usually occurs when a blockage in a coronary artery, which supply the heart with oxygen and nutrients, severely restricts or cuts off the blood supply to a region of the heart,” explains The Merck Manual of Medical Information. “If the supply is cut off or greatly reduced for more than a few minutes, heart tissue dies.”

Coronary thrombosis, as heart attack is known in medical parlance, may cause sudden death, usually due to abnormal heart rhythm, which prevents effective pumping. Severe persistent pain in the center of the chest is common and it may lead to shock or lung congestion.

A blood clot is the most common cause of a blocked coronary artery.

“Usually, the artery is already partially narrowed by atheromas,” the Merck manual says.

Atheroma is a degenerative condition of the arteries. The inner and middle coats of the arterial walls become scarred and fatty deposits (cholesterol) are built up at these sites. Blood circulation is impaired, and it may lead to such problems as stroke and heart attack.

Are there telltale signs that a person will know that he’s experiencing a heart attack?

Yes, according to the Merck manual. It says that about two out of three people who have heart attacks experience intermittent chest pain, shortness of breath or fatigue a few days beforehand. The episodes of pain may become more frequent even after less and less physical exertion.

“Such unstable angina may culminate in a heart attack,” warns the Merck manual.

During a heart attack, a person may become restless, sweaty and anxious and may experience a sense of impending doom. The lips, hands or feet may turn slightly blue. An elderly person may become disoriented.

“A heart attack is a medical emergency,” says the Merck manual. “Half of the deaths from heart attack occur in the first three to four hours after symptoms begin. The sooner treatment begins, the better the chances of survival. Anyone having symptoms that might indicate a heart attack should get prompt medical attention.”

Of all the risk factors for heart attack, high blood pressure remains the most accurate predictor.

“Anyone with high blood pressure needs to be under a doctor’s care – not only for regular monitoring but often for medication as well,” says Dr. David Spodick, director of clinical cardiology at St. Vincent Hospital at the University of Massachusetts Medical School.

Based on a study done by the Philippine Heart Association, about 10.5 million Filipinos have hypertension. Of the total figure, only 20 percent are able to control their high blood pressure.

About 50 percent of Filipinos with hypertension are not aware of their condition until they begin to suffer illnesses that have associated complication with hypertension.

“Hypertension per se does not kill, but the complications are the ones that disable and kill a hypertensive,” says Dr. Castillo.

If left uncontrolled, hypertension causes damage to various organs in the body resulting to other diseases. Aside from heart attack, the dangerous complications of uncontrolled hypertension also include stroke, heart failure, kidney failure and blindness or impaired vision.

One of the issues that bug people with heart diseases is not about death but sex. Most doctors said that a person with heart diseases can still have sex but they need to get medical clearance from their doctor first before doing it. The American Heart Association prohibits sex in the following instances: (1) a few days after a heart attack, (2) bothersome chest pains and (3) shortness of breath.

“The reason is that during orgasm, the heart rate dramatically increases from 80 beats to 115-145 beats per minute,” explains Dr. Ong. “The blood pressure also jumps by 40 Hg, so a systolic blood pressure of 130 can reach 170 during climax.”

After a heart attack, a cardiologist would usually request a treadmill test (jogging while being monitored by an electrocardiogram). This test would determine how much physical activity, measured in metabolic equivalents (mets), a patient is allowed before the oxygen supply to the heart is hampered.

“It’s been estimated that a person will expend five mets while making love to his wife,” Dr. Ong says. “However, having sex with someone other than his wife will make him exert twice as much energy at 10 mets. The stress or excitement of having an unfamiliar partner in unfamiliar territory is equivalent to an hour of heavy cycling or rowing. This explains why some people unceremoniously die in motels while ‘in action.’”

Aside from getting clearance from your doctor, Dr. Ong recommends the following: (1) Take your regular heart medicines before sex; (2) Let the healthy partner do the work or be on top; (3) Don’t have sex after a heavy meal. Wait at least two hours; and (4) Schedule the sex act in the morning, if possible.