What causes heart disease? A cardiologist explains

The burden is especially heavy in low- and middle-income countries, including Kenya, where reduced access to preventive care and late diagnosis continue to add to the rising number of cases of cardiovascular disease.

Dr. Mohamed Jeilan, an interventional cardiologist at the Aga Khan University Hospital, speaks expansively about heart-related diseases, their causes, available interventions, rehabilitation and his work in general.

Dr. Mohamed spoke exclusively to Dr. Lorine Mengesa, an Obstetrician and gynaecologist at Akira Care.

How do you know you have a heart condition?

According to Dr. Mohamed, the heart does not give many clues, but there are some things to look out for.

Things like discomfort in the chest or pain—shortness of breath and unusual fatigue after little effort, common in women.

You could experience irregular heartbeat or palpitations, back pain, pain in the jaw or neck, nausea or indigestion, very common in women.

Chronic cough or wheezing, cold sweats and dizziness, swelling in legs, ankles, or abdomen due to fluid buildup. 

“If you see some of these symptoms, try and see a cardiologist as soon as possible, to try and establish if it is a serious case that would require immediate intervention,” advises Dr. Mohamed.

“Also, if you experience chest pain that lasts for more than 10 minutes, and you find yourself feeling nausea or sweating, then you should be anxious, and if possible, visit a heart attack center.  There are many in Nairobi and places like Mombasa. The test is done with an ECG, or they may have to do a blood test. The doctors will then prescribe appropriate treatment, which should be immediate,” he says.

What is a heart attack?

A heart attack is caused by a blood clot which has blocked the main blood vessel of the heart. Treatment could be a small tablet, common in small or remote health facilities with no Cath labs, given to dissolve the clot.

In some instances, the unblocking of the blocked vein can be done at a Catheterization lab (Cath lab). This is a specialized hospital room equipped with diagnostic imaging equipment used to visualize the heart's arteries and chambers, perform minimally invasive tests, and treat cardiovascular diseases. Common procedures performed here include coronary angiograms, balloon angioplasty, stent placements, and pacemaker insertions.

The Aga Khan University Hospital has two Cath labs, with a team of specialists all working together to ensure patients receive the best care.

A Cath lab, short form for cardiac catheterization laboratory, is equipped with advanced diagnostic imaging technology used to examine and treat the heart and blood vessels through minimally invasive procedures.

Unlike traditional open-heart surgery, interventional cardiology specialist can access the heart and blood vessels through small openings in the body. Depending on the nature or complexity of the procedure, an interventional cardiologist can access the cardiovascular system through the wrist, groin or shoulder.

The growing demand for these services is reflected in the number of patients being treated daily at the Aga Khan University Hospital.

“On average, we deal with one or two patients in our Cath lab every day,” says Dr. Mohamed – adding that cases have increased almost five-fold in the last 10 years.

The rising number of patients has also placed pressure on hospitals to expand their capacity to provide specialized cardiac care.

What causes heart disease?

Poor diet, smoking, lack of exercise, excessive alcohol consumption, diabetes, obesity, high cholesterol, stress and inadequate or poor sleep are some of the major risk factors for heart disease. Other risk factors are age and a person’s genetics.

Some patients could have underlying risk factors that remain undetected for many years. 

“To mitigate, people should constantly do blood pressure tests, at least once every two years, and also screen for cholesterol,” says Dr. Mohamed.

Rehabilitation and recovery

At home, a heart patient who has undergone emergency procedures needs to know what they can do or not do.

“People who go through a formal rehabilitation program are more likely to be alive at the end of the year compared to those who go home and just try to figure things out by themselves,” says Dr. Mohamed. 

Aga Khan Hospital has a rehabilitation team, well-trained and equipped, who work together with heart patients to help them with recovery and rehabilitation.   

Regular medical check-ups can help detect risk factors before they develop into serious cardiovascular disease. 

The cardiologist is also calling for greater awareness of the warning signs of heart disease.