8th June 1997

Timely care can beat heart troubles

By Roshan Peiris

In Sri Lanka heart dis ease has beaten cancer as the biggest killer. That is not all, in South Asia that is India, Pakistan, Bangladesh and Sri Lanka in the last few years heart disease has increasingly struck the young.

Dr. Naomali Amarasena who gave me this information could pass off as a pretty school girl. She is charmingly petite but she does not cope with the normal heart disease, that strikes young and pretty girls, love. Being a highly qualified cardiologist Dr. Amarasena is devoted to the heart. She is what is termed an interventional cardiologist.

Dr. Amarasena gives hope that if you have heart trouble you don’t necessarily end up on the operating table to have a by-pass. There are many intervening medical management procedures she said, that could help one recover from heart disease even while staying at home.

The six risk factors, she said, are cigarette smoking, high blood pressure, diabetes, cholesterol, family history of heart disease and stress.

"The more risk factors one harbours in ones body the greater the chance of getting severe heart trouble. Just before I came here, a thirty three year old girl had a by-pass. She had diabetes, stress and family history of heart trouble,"she said.

"As an interventional cardiologist, my job is to assess the condition of a patient who comes with one or more possible symptoms of heart trouble. By-pass is one of the last in medication you can have. Balloon Angioplasty too can be done but unfortunately, the equipment is not available over here at the Sri Jayewardenepura hospital. But thanks to the Chairman Dr. J. B. Peiris and Dr. Lakshman de Lanerolle we got our own cardiology ward in 1995. My own ward has 24 beds for both men and women."

Dr. Amarasena explained that there are three basic arteries. The large one is divided into two and that is how you get three basic arteries. If there is only the narrowing of one artery you can get away with treatment or balloon Angioplasty. Also the heart upto a measure can and does have recuperative properties. So cheerfully she announced "Don’t think that every heart case ends up with by-pass surgery."

Dr. Amarasena explained that Angioplasty consists of passing a very fine wire into the artery. Over it passes a balloon. The balloon has buffer properties that it is made of, and so it can stand high pressure as much as tyre pressure. This cleans up the clogged and narrowed artery so that it begins working normally.

Dr. Amarasena studied for her Post-graduate degree at John Radcliff hospital, Oxford and so is at ease with a cardiology investigative unit. Her husband is a heart surgeon too.

She warns about possible symptoms which people tend to neglect which eventually spell out heart trouble. "First don’t," she says, "neglect any kind of discomfort of the chest such as tightening of the chest." Also she warns "this kind of tightening may not be confined only to the chest." One can get such tightening in the throat, jaw or stomach. Don’t dismiss it as indigestion or gastritis. Go to a cardiologist who could treat you in time and avoid becoming the victim of a heart attack. The old maxim that a stitch in time saves nine applies here."

Also if you suffer from repeated bouts of breathlessness, these are the early symptoms which Dr. Amarasena says can be cured.

The worst is if you are a diabetic. You don’t feel any pain and may undergo silent heart attacks without feeling anything. This is because diabetes has the potential to deaden one’s nerves.

Also if you have recurring pains in both arms or especially the left arm, go see a cardiologist, she recommends.

If you come to a cardiologist, with medical management he or she can help. Medical management consists of looking after and curing and modifying risk factors such as diabetes, cholesterol, smoking etc. You don’t need to sleep in a hospital bed for your treatment. You can be treated at home unless you have had severe angina or a heart attack. She also warned that even if you are resting you can get a chest pain, if you are an acute heart patient.

Finally Dr. Amarasena recommends walking for exercise. But if you walk a short distance and you get a pain or pant, then go see your cardiologist. Also watch your diet and your weight. If you are more inclined towards a vegetarian diet it helps rather than a red meat diet.

So heart trouble does not mean, she says, that you end up with surgery. Timely care by a cardiologist helps. Also remember, she said, the heart itself has certain protective qualities and can heal itself. Good medical care prevents surgery.

Age is not a factor. "In South Asia we have found that it is the younger groups who get heart attacks. Medical investigators are working to find out the reasons. Having regular medical check ups thus is advisable," Dr. Amarasena said.

I wondered why this young doctor so eminently qualified chose to work in Sri Lanka. "I feel that after I have proved I can do well then I should come back and give my knowledge to my country. So does my husband who works at the National Hospital," she explained. With her devotion and obvious dedication to help heart patients who invariably harbour morbid thoughts, she gives hope to many. (Please see Plus page 4 Heart of the matter)

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