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Advancement of cardiac care in Bangladesh
DR REYAN ANIS & DR AYMAN JOARDER
In the heart of Bangladesh, where the vibrant tapestry of life unfolds against a backdrop of lush green landscapes, a silent and formidable adversary has been steadily gaining ground—cardiovascular disease (CVD). This tale is a chronicle of the growing shadow of CVD, particularly the relentless march of Coronary Artery Disease (CAD) that is spreading across the country, affecting both men and women, no matter where they live.
More people in urban areas have heart problems compared to people in rural areas. In cities, about 8 out of every 100 people have heart problems, while in rural areas, the commonest heart problem, worldwide, is coronary artery disease, or what we call, in layman’s terms, a heart attack. Coronary artery disease means the deposition of cholesterol in the arteries supplying the heart muscles, which leads to blockage of these arteries. About 21 out of every 100 people are affected by this.
The risk factors for coronary artery disease include high blood pressure, high cholesterol, diabetes, smoking, family history, and obesity. Another very recent addition to this list is often overlooked - vitamin D deficiency. Vitamin D deficiency is a common problem in Bangladesh, as our food is not fortified with vitamin D like in developed countries.
More and more people are now discovering that they have heart problems. Primarily, there are two reasons for this. One of which is better diagnostic facilities for detecting heart disease, and the second is rapid urbanisation and the stress of living in a metropolis. Also, we see an increased incidence of coronary artery disease in foreign wage earners due to stress.
In Bangladesh, now we have all kinds of advanced diagnostic facilities, e.g., echocardiography, computed tomography (CT) angiography, coronary angiography, etc. All these diagnostic facilities are now available in both the private and government sectors throughout the country.
United Hospital in Bangladesh, accredited by the Joint Commission International (JCI), is a shining example of international-standard healthcare. It has been treating millions of heart patients over the past 15 years. The first successful mechanical heart implantation (LVAD) was performed at United Hospital by Dr Jahangir Kabir and his team. Procedures such as minimally invasive cardiac surgery (MICS), ECMO, TAVI, AICD, and CRTD implantation are all done at United Hospital.
It also offers swift and precise medical services, exemplified by its remarkable 90-minute window for stent placement from the emergency entrance, showcasing efficiency and patient-focused care. The hospital’s rigorous “time-out” process, especially crucial in cardiac surgery, ensures that the right patient receives the correct procedure at the designated site, leaving no room for errors.
United Hospital is equally dedicated to maintaining consistency in pre-operative and post-operative care, guaranteeing that all patients receive precise diagnoses and treatments.
Some preventive measure to keep the heart healthy include:
• Keeping body mass index under control (BMI), BMI Ranges Underweight = (18.5; normal weight = 18.5–24.9; overweight = 25–29.9; obesity = 30 or greater.
• Keeping an eye on high blood pressure (hypertension) and high levels of cholesterol (hyperlipidemia)
• Limiting the consumption of excess sodium increases the risk of high blood pressure (hypertension).
• Avoiding a sedentary lifestyle and opting for an active lifestyle by indulging in physical activities
• Monitoring heart health through consultation and awareness programmes
• Eating healthy and balanced diets and avoiding trans-fat and junk foods
• Avoid smoking and alcohol consumption
• Learn to manage the stress and get quality sleep
The writers are Senior Consultant and Senior House Officer of the Cardiology department of United Hospital Ltd.