Valve Disease Day

Heart valve disease is a generic term for any instance or event of heart valve malfunction. It includes both congenital and acquired abnormalities and applies to all four of the heart’s valves (aortic, mitral, pulmonary, and tricuspid). The three types of valvular ailments are enumerated below:

  1. Prolapse: When a structure prolapses, it falls down or forward. In the case of a heart valve, this means that the leaflets thereof do not close properly during myocardial contraction, flopping or bulging outwards instead. Often times, this leads to a condition known as regurgitation where blood leaks backwards into the chamber from which it came. In most cases, prolapse is relatively benign, resulting in a mere murmur or mild palpitations and warranting little to no treatment. It is commonly a phenomenon of the mitral valve, but technically, all valves are susceptible.
  2. Stenosis: A stenotic valve is narrowed and hardened. This makes it harder for blood to travel through the valve; consequently, corresponding chambers have to exert more force to achieve their purpose, which, in time, will lead to hypertrophic cardiomyopathy and/or heart failure. Regurgitation can also occur. Generally, stenosis affects the aortic and pulmonary valves (particularly in congenital cases), but it can occur in the other valves as well. Stenosis is a much more serious condition than valvular prolapse, and it is consequently treated much more aggressively. Surgical intervention (keyhole or open heart) is often needed, and although valvuloplasties provide a temporary relief, the aim is either replacement or repair; valvular stenosis can also be the underlying cause of problems that warrant other surgeries including but not limited pacemaker implantation and complete heart transplants.
  3. Atresia: Similar to stenosis, atresia is an abnormal closure of a bodily passage; the term is typically used to refer to mal- or non-formed heart valves where (nearly) solid sheets of tissue disrupt blood flow. It is typically a congenital condition, and it is most frequently seen in the pulmonary valve. Cases of atresia require immediate surgical attention; catheterization treatments include radiofrequency ablation, balloon valvotomy and/or sepsotomy, and stent placement while the open-heart options feature procedures such as shunting, the Glenn repair, and the Fontan procedure; in some cases, a complete heart transplant may be necessary.

All of the above share relatively similar symptoms, including fatigue, dizziness, weakness, palpitations (and other non-perceived arrhythmias), heart murmurs, angina, edema (especially in cases of stenosis), and cyanosis (especially in instances of pulmonary atresia). They also have common risk factors including age, hypertension, diabetes, drug use, and an unhealthy body mass; connective tissue disorders (such as Marfan Syndrome), pre-existing heart disease (e.g. a history of myocardial infarction and/or atherosclerosis), and prolonged infection also predispose patients to valvular illness; congenital defects, although themselves idiopathic, are also causes. If you experience any of the aforelisted symptoms or display any of the above risk factors, consult a doctor immediately. These ailments are diagnosable through uninvasive, relatively inexpensive tests (a physical exam, an EKG, and an echocardiogram). Getting heart-checked does not take long, and it might just save your life–this Valve Disease Day and every day!

World Heart Day

Did you know that heart disease is the leading cause of death globally, killing an appalling 17.5 million people a year? Did you know that every forty seconds one person in America will have a heart attack? Did you know that 657 people in the United Kingdom will have a stroke today? Did you know that over 25% of Australian men suffer from hypertension? Did you know that heart disease costs the Canadian economy over $20.9 billion annually? Did you know that a quarter of all deaths in India can be attributed to cardiovascular disease? Did you know that heart disease takes twice as many lives as cancer in Malaysia? Did you know that over half the Mexican population is at risk for heart disease? Did you know that 278,933 Russian males died of coronary heart disease in 2009? Did you know that 26 million individuals suffer from heart failure? Did you know that 1 in 100 babies is born with a congenital heart defect? Did you know that 42 million women worldwide have a heart condition? Did you know that 98% of people do not survive out of hospital cardiac arrests? Did you know that things are only getting worse?

Heart disease is on rise. There has been a 60 million to 1 billion person increase in cases of uncontrolled hypertension between 1980 and the present. 1 in 10 school aged children are now overweight. 7% of the world smokes cigarettes. 23% of adults do not get the recommended amount of physical activity. Diabetes has increased in many countries by 50% in the past ten years. These risk factors, combined with the aging population, urbanisation, and inadequate prevention, are leading to a cardiovascular epidemic. By 2030, heart disease will have an annual death toll 24 million as well as a global economic burden of $1044 billion. These statistics are terrifying, and it is time we start taking heart disease seriously.

So ask yourself, are you at risk? Is your weight healthy? Do you follow your national heart association’s recommended exercise guidelines? Are you a non-smoker who drinks less then 14 units of alcohol weekly? Is your cholesterol below 200 mg/dL? Is your blood pressure 120/80 or lower? Are your electrolytes and blood sugar within the normal ranges? If you answered no to any of these questions, you are, indeed, at risk. Go see a cardiologist as soon as possible. You should also schedule an appointment immediately if you experience any of the following: chest pain (angina) or discomfort, palpitations, shortness of breath, arm/jaw/stomach pain, any cardiac arrhythmia, fatigue, nausea, and/or sweating. It is better to be safe than sorry.

Please, please be heart smart this World Heart Day. Know your numbers, get heart checked, and commit to a healthy lifestyle. Protect yourself and those you love. I know you may think you’re invincible, but heart disease can happen to anyone; don’t let it be you. Thank you so much for reading, and I hope you have a happy, healthy World Heart Day!

Cupcakes-&-Cardiology-Simran-Frontain-73

Rebirthday

I died on August 29th of last year. My heart stopped, and anorexia killed me. I was technically dead for three minutes.The doctors didn’t think I would make it. I was too far gone. The defibrillators weren’t working; my heart was too damaged; I would never recover from anorexia. Why bother trying? They called my cardiologist to tell her patient had died; she told them to try one more time.

They did, and that’s when the miracle happened. That’s when my heart started beating again; that’s when my lungs started breathing again. That’s when I opened my eyes; that’s when I learned to see. There were sparkles on the ceiling and jewel-drops in my eyes. There was a buzzing in my ears and a million voices in my head; I could hear them all clearly, and they were telling me the truth–the cold, hard, cement-stairwell truth: They told me I couldn’t go on like this; they told me I had to recover. 

And they were right; I knew they were. I couldn’t go on like this, and I didn’t want to. I had to make a change; I had to do this once and for all; I had to recover. 

And so on August 29th, 2016, after ten long years, I finally began my recovery journey. I sought the help of a dietician, psychologist, cardiologist, gastroenterologist, psychiatrist, general practitioner, and liver specialist. I underwent extensive physical and psychological therapy. I gained thirty-eight pounds. I got in touch with my emotions. I learned to eat and exercise in moderation. I found freedom with food and within myself. I broke away from anorexia, and I came back to life.

I was reborn on August 29th of last year. My heart started, and I beat anorexia. I’ve been alive for approximately 525,600 minutes. I survived. The doctors saved me; my heart conditions are now managed with medications; I am recovering from anorexia. Who would’ve thought? I made it out alive, and you can, too. 

Wear It Beat It Day

Today 7 million people in the United Kingdom will fight their daily battles with cardiovascular disease. Today 435 people will lose that battle; today 110 of them will be under the age of 75. Today 530 people will go to the hospital with a heart attack; today 190 of those people will die. Today 657 people will have a stroke; today 109 of them won’t survive. Today 12 babies will be diagnosed with a congenital heart defect; today 1 of them won’t get to grow up. Today 82 out-of-hospital cardiac arrests will occur; today less than eight of them will live to see tomorrow. 

Today 34% of people in the United Kingdom will live with high blood pressure; today over half of them will continue to go without treatment. Today 6% of the population has diabetes; today that number does not include the estimated one million who remain undiagnosed. Today 27% of people in the United Kingdom will be obese; today 34% of them are overweight. Today 25% of people will exceed the national alcohol intake recommendations. Today 39% of people will not get adequate physical activity. Today 25% of people will not eat enough fruit and vegetables. Today 17% of people will smoke a cigarette; today smoking-induced cardiovascular complications will kill 55 people. 

Today you can do something about these numbers. Today you can maintain a healthy weight. Today you can quit smoking. Today you can get cardiovascular exercise. Today you can eat balanced diet. Today you can visit your doctor and get heart-checked. 

Today is Wear It Beat It Day. Today we wear red to raise awareness about heart disease. Today we stand in solidarity with those effected. Today we honor the lives lost and lived to and with cardiovascular disease. Today we donate to fund lifesaving research. Today we fight heart disease. 

Underweight and Underrepresented: The Cardiac Complications of Disordered Eating

We get it. Being overweight is bad for you. Extra weight strains the heart, forcing it to work harder, consequently raising your blood pressure and increasing your risk of myocardial infarction, cardiomyopathies, and stroke. Spending your days on the couch binge-watching Grey’s Anatomy probably isn’t the best lifestyle choice, and a diet of salty, trans-fat-fried carbohydrates cannot possibly be good for you. You do need some exercise to strengthen your heart, and fruits and vegetables are a nutritional necessity, but that’s common knowledge; we all know that already. So, let’s discuss something different; let’s discuss the other extreme–severe emaciation, caloric restriction, and compulsive purging. Underweights are underrepresented by/in the cardiovascular health community, and thusly, I have taken it upon myself to educate you on this equally unhealthy lifestyle.

Bradycardia and hypotension are the two most common cardiac complications of anorexia. In an endeavor to conserve energy, the body begins to shut down, slowing the heart rate and consequently lowering the blood pressure; neither matter is helped by nutritional irregularities/deficiencies (such as B-12, iron, magnesium). Both bradycardia and hypotension are generally benign, but prolonged cases of each can result in confusion, dizziness, fainting, fatigue, heart failure, and tissue death. Many bradycardic and hypotensive patients notice spikes in their heart rate and blood pressure when they stand up; some even experience palpitations, lightheadedness, and collapse. And that’s just standing–imagine what exercise can do!

Exercise in and of itself cannot cause a heart attack, but it can trigger one. The stress on your heart can induce palpitations, arrhythmias, arterial spasms, sudden cardiac death, and, yes, a heart attack. This exercise, while it should strengthen your heart, ends up weakening it because of the atrophic nature of muscles during starvation; you break down the muscle without giving it the energy it needs to build up again. Do I really need to tell you how dangerous this is?

This brings me to the second half of my post, the nutritional component. When deprived of nutrients, the body starts to eat itself. Contrary to popular belief (read: diet industry propaganda), fat is not the first thing to go; on account of their nutritional density, muscles are devoured, and the heart, as one of the largest muscles, is a natural victim. You can literally eat your heart out.

This catastrophic self-consumption leads to many dire results, including mitral valve prolapse, the flopping of the mitral valve, where its flaps collapse and allow for valvular leakage and regurgitation, eventually leading to arrhythmias, left ventricular enlargement, strokes, and heart attacks. Self-consumption is premised by malnutrition, an incredibly harmful state in its own right. A caloric deficit is also a nutritional deficit, since calories are not just energy, but couriers, carrying vital vitamins and minerals, including essential electrolytes. Electrolytes are necessary for heart function, as the heart’s de- and repolarisation is facilitated by ionic channels. A severe shortage of electrolytes can have immediate results like life-threatening cardiac arrhythmias; these, including the frequently fatal ventricular fibrillation, can cause cardiac arrest and, in rare instances (represent!), a heart attack. Consequences can be lasting as well, with electrolyte deficiencies yielding permanent extrasystoles (both atrial and ventricular, including various varieties of geminy) and Long QT Syndrome, the latter of which predisposes one to chaotic heartbeats, and in turn, heart attacks and/or cardiac arrests. It is also worth noting that heart attacks do permanent damage to the myocardial muscle, creating eventual and incurable cardiomyopathies.

Additionally, many underweight individuals are susceptible to vicious binge/purge cycles. A binge’s rapid influx of calories can cause systemic shock, manifesting as cardiac arrest, and self-induced emesis can do the same, with dehydration and the abrupt loss of electrolytes rendering similar effects. The cardiac complications of anorexia can be fatal, and if you are lucky enough to escape them, you are still susceptible to recovery-occurrent ones such as refeeding syndrome, a type of systemic shock analogous to that of a binge. Sounds fun, right?

Please do not do this to yourself. Maintain a healthy weight, eat a balanced diet, and exercise in moderation! Your body will thank you.