On Friday, the world will mark this year’s heart day, themed “Small changes can make a powerful difference”, calling on individuals, communities and organisations to share how they power their hearts to inspire millions of people around the world to be heart healthy.
Cardiovascular disease, including heart disease and stroke, is the number one killer. Every year, it is responsible for 17.5 million deaths and, by 2030, the figure is expected to rise to 23 million.
The latest projections suggest that, by 2030, more people in Africa will die from coronary artery disease than from any other cause of death.
The rate of progression in this condition is both remarkable and alarming. The fact that Kenyans in their 20s and 30s are experiencing heart attacks means we can no longer ignore this growing risk to our health and well-being.
The heart is a muscle that pumps blood to the body, including major organs such as the brain and kidneys, and also to itself. The coronary arteries supply blood to the heart. A sudden blockage of a major coronary artery results in a heart attack. One of the common causes of blockage is a blood clot.
If the blood supply to the heart is not urgently restored, the heart may stop pumping, putting one at risk of death.
Signs of a heart attack include discomfort in the chest; often, the sensation is painful. The distress may also be felt in the arms, jaws and neck.
Sometimes, it feels like ‘gas’ in the upper stomach, sweating and shortness of breath. Anyone suffering from these symptoms should seek urgent medical attention.
While at home, the first thing to do is call an ambulance and, for first aid, administer an aspirin tablet.
Aspirin reduces the clumping of the blood clot within 30 minutes. Unfortunately, aspirin is not usually a sufficient remedy.
Upon arrival to a hospital, doctors can use one of two methods to unblock the artery. The most accessible process in Kenya involves using clot-breaking drugs (thrombolysis). However, many health facilities in Kenya do not stock this medicine.
The second method is the “gold standard” of care, which involves specialists using special X-ray equipment to find the clot. If the vessel is blocked, they will physically suck the clot out and may also open the narrowed artery using a balloon or a stent device.
This procedure is called primary angioplasty and takes around 30 minutes using only a small catheter inserted in the leg or wrist.
The main challenge in Kenya is that patients suffering from a heart attack do not receive timely treatment. The gap in care comes from poor knowledge of the seriousness of the symptoms and the condition, poor accessibility of acute medical services for the majority of the population and financial barriers.
As a result, initiatives such as The Heart Attack Concern Kenya (Hack) are moving to address these challenges with a protocol of “systems of care” for efficient management of heart attacks and integrated networks of facilities.
The emphasis is to work with the government, ambulances and medical societies to increase access to timely life-saving treatments.
In partnership with major hospitals, Hack is educating the public and professionals alike on evaluating the systems of care available at the county level, engaging newly developed ambulance and emergency services and incorporating insurance schemes, including the NHIF, to improve access for vulnerable populations.
Hack works in partnership with ambulance teams, major hospitals, including the Aga Khan University Hospital, and heart attack teams.
Dr Jeilan, a cardiologist, is the director of the Cardiac Programme at the Aga Khan University Hospital, Nairobi.