“If the disease (coronary atherosclerosis) is picked up early, then much can be done both in terms of primary prevention as well as managing an existing condition.”
Bhagat says chest pain is a very common condition of his patients. The most important aspect of chest pain control is to rule out whether it is coming from the heart or not. He says that what is not known is that often, the pain from the heart ironically does not always arrive from the left side of the chest. For example, pain arising from the left jaw, under the left side of the breast, down the left arm, and occasionally down the right arm can indicate a heart disease, which needs to be addressed.
The ability to feel pain is blunted in some patients with heart diseases, particularly diabetics. As a result, they do not experience chest pain but simply fatigue, sweating, dizziness, and a feeling of being unwell. This again may be a symptom of heart disease, which needs to be addressed.
With the understandable emphasis on HIV/AIDS, there has been perhaps an increasing marginalisation of other health problems. It is therefore mandatory to raise awareness of these diseases in Botswana.
It is estimated that by 2010, people in Southern Africa will have a greater risk of dying from heart diseases or diabetes than HIV.
Globally, heart diseases are the number one killer. The WHO estimates that by 2010, over 300 million will have diabetes.
In China, there will be over 80 million diabetics in four years’ time. Botswana is not spared from this epidemic. Available statistics show a silent but rapidly unfolding epidemic of heart diseases and diabetes.
Unfortunately, chest pain (related to heart disease) is often the end result of poorly managed or undetected heart disease. Chest pain coming from the heart occurs as a result of lack of oxygen to the muscles of the heart. The oxygen is supplied by the coronary blood vessels.
These become narrowed, thickened, and occasionally blocked initially by cholesterol and ultimately by a blood clot. The cause of cholesterol (fat) deposits on blood vessels is a result of the increasing poor diet - fatty food, fast food, and lack of exercise.
Provided it is detected early, heart diseases can be controlled by lifestyle initiatives, drug therapy, and ultimately if necessary interventional procedures which are accessible in Botswana. “However, the first port of call is public awareness of what chest pain means and how to get treatment.” Bhagat says the end result of unmanaged chest pain is a heart attack.
Investigating heart problems include a physical examination, blood pressure checking, sugar and cholesterol testing, ECG (an electronic investigation demonstrating how the heart is communicating with the brain). Other more sophisticated techniques in a cardiac centre involves the scanning of the heart, exercise tolerance test and 24-hour blood pressure.
