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Dr. Sivathasan asserts that in the past, the most widely seen heart condition in Sri Lanka used to be rheumatic heart disease, which was a result of poor housing, sanitation and economic conditions. Although the country has come a long way, different risks have emerged, he adds. Obesity, smoking and a diet rich in fats combined with sedentary lifestyle changes have brought on the dangers of heart disease.
“When we consume a diet rich in fats, cholesterol deposits are formed in our arteries supplying the heart which when narrowed or blocked, cannot let blood into the heart. A heart attack occurs when the narrowed artery gets blocked with a blood clot, resulting in damage to the heart muscles. A heart attack must be treated immediately; we advise that within six hours, hospital treatment must be sought. After which the muscle damage becomes permanent and leads to scar formation. At the hospital, drugs will be used to dissolve the block caused by a clot. When facilities are available, the patient may undergo an angiogram to determine the extent of the blocks. The doctors may also decide to enter a balloon and a stent, which will crush the cholesterol and help open the blocked artery. A drug coated stent is considered a better option since it will prevent scar tissue formation at that site,” Dr. Sivathasan explains.
There are also those whose blocks are too many or are at critical points; they may then have to undergo a by-pass operation in which veins from the leg or arteries from the arm are used to create alternate arteries for the blood to flow. “There are yet others whose hearts are so damaged that they need a heart transplant. Singapore has pioneered heart transplant operations that are normally done on patients not older than 60 years of age in order to minimise complications,” he adds.
However, there are instances when the patient suffers from grave damage caused to the heart and is unable to recover; in such cases, the installation of a Left Ventricular Assisted Device, known as a LVAD is recommended, says Dr. Sivathasan. The LVAD is considered a life saving device that can give a new lease of life to such patients.
LVAD is a “man made heart device’ that utilises cutting edge technology. A device that can be safely placed inside the body, it pumps blood into the heart and handles the heart functions effectively and efficiently. It is powered by a small computer and a battery unit, which must be carried outside the body by the patient.
“Patients with a LVAD can lead fairly normal lives” says Dr. Sivathasan. “They can engage in work routines, go on holidays and engage in normal activities as long as swimming and engaging in contact sports are avoided. When taking a shower, the patient needs to wear a water-proof dressing and in general must make sure not to wet the batteries. Otherwise, they can lead normal lives.”
Singapore was the first country in Asia to offer LVADs, which are ideal for those on long waiting lists for heart transplants and those who are considered too weak or too old to undergo heart transplant procedures by the doctors. “The success rate for LVAD is very high and we have those who have been having it for over five years successfully,” Dr. Sivathasan reiterates. “We live in a society driven by stress and drastically altered lifestyle changes that have spurred on heart disease like never before. Everyone needs to understand the importance of taking care of one’s heart and making sure that a lifestyle of exercise and diet is incorporated into the daily lives. Conditions such as diabetes and high blood pressure can result in endangered conditions for the heart. One needs to be mindful of such conditions,” he says.
LVAD procedure is performed at Mount Elizabeth Hospital in Singapore, says Shuvo H. Director – Parkway Patient Assistance Centre (PPAC) in Sri Lanka. “We at PPAC are able to arrange for Sri Lankan patients to travel to Singapore for this procedure.”
