RHEUMATIC heart disease and coronary heart disease are the two most common forms of heart problem in Myanmar. But the risk of developing these dangerous conditions can be easily minimised, according to Dr Khin Maung Aye, a senior consultant cardiovascular surgeon.
Both are largely the product of an unhealthy lifestyle – poor diet, physical inactivity, smoking and drinking are all contributing factors. Coronary heart disease can also be hereditary, while rheumatic heart disease can be brought on by rheumatic fever.
Rheumatic fever can develop from an untreated sore throat. However, it can be effectively treated by a penicillin injection.
“Rheumatic heart disease is the most common cardiovascular disease in children and young adults and remain a major health problem in Myanmar – just as it is in other developing countries,” said Dr Khin Maung Aye.
The disease often affects children between five and 14 years of age and repeated infections can cause damage to the heart. The patient can then become ill, with their quality of life deteriorating by their late teens or early 20s, he said.
“So, rheumatic fever and rheumatic heart disease need to be diligently treated and prevented in childhood and adolescence,” he said. “Recurrent attacks of rheumatic fever can be prevented by oral penicillin or long-acting benzathine penicillin injections.”
An unhealthy lifestyle, including poor diet, smoking and physical inactivity – adopted at an early age – puts people at much higher risk of developing the disease, which can begin in childhood.
“It is extremely important to encourage children and young people to develop healthy lifestyles, so as to prevent cardiovascular problems in the future,” he said.
Another widespread heart problem in Myanmar and the rest of the world is coronary heart disease (CHD) – also largely the result of lifestyle. It is usually caused by a build up of fatty material, known as plaque, on the walls of your arteries, causing them to narrow.
“Men in their 40s have a higher risk of CHD than women. But, as women get older, their risk increases so that it is almost equal to a man’s risk,” Dr Khin Maung Aye said.
You’re also more likely to develop the condition if someone in your family has had it – especially if they had it before age 50.
To prevent CHD or, at least, lower your risk of developing the disease, you should avoid becoming obese and having high blood pressure. A high intake of “bad” cholesterol and low levels of “good” cholesterol, also increase the risk of CHD.
Menopause, smoking and a lack of physical activity and exercise can also contribute to CHD.
As the coronary arteries narrow, blood flow to the heart can slow down or stop completely, causing chest pain (angina), shortness of breath or even a potentially fatal heart attack. A heart attack is normally caused by a blood clot blocking a coronary artery, restricting blood flow to the oxygen-starved heart.
Dr Khin Maung Aye recommended avoiding or reducing stress as much as possible – a heart attack can be triggered by sudden, overwhelming stress.
But while symptoms of CHD may be very noticeable, sometimes patients have the disease without realising. Similarly, a heart attack can go undetected.
“Although chest pain is a major symptom of heart attack, some people may have little or no chest pain, especially the elderly and those with diabetes. This is called a silent heart attack,” said Dr Khin Maung Aye.
Other symptoms of a heart attack include shortness of breath, nausea or vomiting, anxiety, cough, fainting, dizziness, feeling like your heart is beating too fast and sweating, which may be extreme, he said.
Many tests can help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis.
If CHD is confirmed, your doctor will examine your lifestyle and advise you to change any unhealthy habits, such as physical inactivity. Dr Khin Maung Aye said those of normal weight should get at least 30 minutes of exercise several times a week. If you are overweight or obese, doctors recommend 60 to 90 minutes of exercise daily but you should consult your doctor before starting an exercise routine.
Your doctor will also recommend a healthy diet, particularly one low in saturated fats and “bad” cholesterol.
You should eat well-balanced meals, including several daily servings of fruits and vegetables to keep your blood pressure, blood sugar, and cholesterol under control.
Doctors also recommend eating fish twice a week. Baked or grilled is better than fried fish as frying can destroy some of the benefits. Your doctor will also advise you to avoid or reduce the amount of salt (sodium) in your diet.
