The human heart is a vital organ that you can naturally and emotionally hear and feel. It is the first and last sign of life and is one of the few things capable of uniting us all. But the burden of Cardiovascular diseases (CVD) is increasing every day – globally as well as in India. In 2019, nearly 400 million years of healthy life (quantified as disability – adjusted life years or DALYs) were lost due to CVD. This marks a 24% increase in the global CVD burdens compared to 2000 (316.9 million DALYs). In only 30 years, the prevalence of CVD has nearly doubled, from 271 million in 1990 to 523 million in 2019. Approximately 18.6 million deaths (i.e. approximately 33%) occurs every year from CVD. 85% of CVD deaths are due to heart attack and stroke and more than 75% of CVD deaths occurred in low- and middle- income countries. The burden of CVD in India is among the highest in the world.
29th September, World Heart Day will be an opportunity for everyone to stop and consider how best to use heart for humanity, for nature and for you. Beating CVD is something that matters to every beating heart.

80% of premature CVD deaths are preventable by limiting risk factors such as tobacco use, unhealthy diet and physical inactivity. A person who gets a heart attack may experience varied symptoms such as chest pain or tightness over the chest, profuse sweating, giddiness, breathlessness, etc. Many patients ignore this chest pain considering it to be due to acidity and present to casualty late and with complications. We request the patients to immediately report to the nearest health facility whenever they experience such symptoms and not to self diagnose or self treat the symptoms. An ECG is a very helpful diagnostic tool in such situations and is available at every health facility.
Here we should remember that time is Myocardium (heart muscle) and each minute saved, saves the heart muscles. Hence if it is a Heart Attack, we need to thrombolyse such patients as soon as possible (1st hour is the golden hour). To save this valuable time, myocardium and life, our Honourable Health Minister Shri. Vishwajit Rane came up with a revolutionary project called the STEMI (ST Elevation Myocardial Infarction) program for the state of Goa and it is 1st of its kind project in the entire country.
STEMI project was officially launched in December 2018. The project focuses on taking thrombolysis to the periphery using a Hub & Spoke Model. Presently there are 20 spokes (Peripheral Govt. Hospitals) and 1 Hub (Goa Medical College & Hospital) and 3 leading PCI capable private hospitals in state.

Hubs are –
Goa Medical College & Hospital, Bambolim (Govt.)
Apollo Victor Hospital, Margao.
Healthway Hospital, Old Goa
Manipal Hospital, Dona Paula

This is done to ensure that patient reaches the nearest Hub centre in shortest possible time after the patient is thrombolysed at PHC, CHC, SDH or District Hospital. Once diagnosed as STEMI, the patient is thrombolyzed (if not contraindicated) with newer thrombolytics such as Reteplase or Tenecteplase. These drugs costs approximately Rs. 40000/- and are administered free of cost to all eligible STEMI patients at the STEMI spoke centers. Tele – ECG services of TRICOG is also a part of this program. This helps in prompt diagnosis of STEMI in majority of spoke centers where Physicians are not available. The patient, once stabilized and thrombolysed is transferred to the apex (tertiary) institution, Goa Medical College & Hospital or Private PCI Capable hub using either specialized Cardiac/ALS equipped ambulances.
Aims of the STEMI-Goa project:

To reduce mortality from STEMI in the state of Goa
To reduce morbidity resulting from STEMI in the state of Goa
Keeping in line with the objectives of Ayushman Bharat, the STEMI-Goa project aims at taking the best health practices and modern technology to all parts of the State and benefit the rich and the poor alike.
Since January 2019 till March 2022, 1961 patients with heart attack have been thrombolysed at the STEMI spoke centers. North District Hospital, Mapusa has thrombolysed 695 patients with heart attack since June 2018 till date. There were many patients who presented late and couldn’t be thrombolysed. Hence we urge the people reading this article to immediately report to the nearest health facility whenever they experience symptoms mentioned above.

Cardiovascular disease is the world’s biggest killer and some common causes of CVD are smoking, diabetes mellitus, high blood pressure, obesity, air pollution, physical inactivity and unhealthy diet. Air pollution is responsible for 25% of all CVD deaths, taking the lines of 7 million people every year. Each of us can and should contribute to a healthier planet in our own way.

Psychological stress can double heart attack risk. Resisting harmful coping mechanisms and bad habits induced by stress helps maximize our individual heart health.

We should bring about some changes in our lifestyle such as
Cut down on sugary beverages, instead drink water.

Limit consumption of processed foods as it has high content of salt, sugar and fat.

Eat plenty of fruits and vegetables.

Drink minimum 2 liters of water (unless advised against it by your treating Physician for conditions such as Heart Failure, Chronic Kidney Disease etc).

Say an emphatic No to smoking.

Do some physical activity. Some activity is better than no activity simplest is to aim at a total of minimum 150 minutes of brisk walking in a week.

As far as possible try to use stairs and say no to lifts and escalators.

Know your number – BMI, HBAIC, Blood Pressure, Cholesterol levels (lipids). Visit your healthcare professional to know these parameters.

Meditation and Yoga helps in keeping your stress levels under control.

Do not neglect your sleep. Every individual needs minimum 6 hours of sound peaceful sleep.

So this World Heart Day let’s pledge to use Heart for every Heart. Use heart for a world with equality, healthcare access, peace, education, clean air, forest, for reducing waste, to lower BP, for a healthy diet, for physical activity, for planet’s health and yours to realize your full potential and to stay healthy.

Dr. Swapnil Arsekar,
Senior Physician,
North District Hospital, Mapusa.

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