Cardiology
Amos Mautla suffered heart attacks in 2009 and 2014 and was treated at the Mediclinic Heart Hospital both times.
Amos is now 63 and recalls, ‘I had high cholesterol as early as age 24. I’ve been on various cholesterol medications. Dr Mpe has been my doctor since 2007 and he encouraged me to join the gym. But both times I had a heart attack my weight was high. I had no clue about body mass index (BMI).’
Dizziness and fatigue were some of the warning signs before both heart attacks. ‘In 2014, I struggled even to climb a short flight of stairs. My ankles were swollen and it was almost impossible to concentrate. Dr Mpe told me to go to the Mediclinic Heart Hospital if I noticed any irregularity and he’d be notified immediately. I had an angiogram and the result was positive, so an angioplasty was performed to unblock my arteries on both sides,’ says Amos.
He was anxious the first time and the second time he was scared when he found out about the blockages, but he knew he’d come through an operation before.
Amos has to take medication every day, but he feels healthier than ever. ‘All my numbers are stable – cholesterol, blood pressure, blood sugar and BMI. I do worry about suffering a third heart attack, but I’m committed to exercising, controlling my stress levels, managing my weight and taking my medication.’
Heart attack
‘The importance of managing your cardiovascular risk factors cannot be overstated,’ says Dr Martin Mpe, a cardiologist at Mediclinic Heart Hospital in Pretoria, who sees approximately 150 patients per month which is 1 800 per year. He says there are three pillars:
- Awareness of what the cardiovascular risk factors are.
- Stopping these risk factors from developing in the first place.
- Treating the risk factors that are already present, but that can be changed.
‘There’s a dire need for population-wide awareness campaigns to promote healthy diet, physical activity, a healthy environment and no smoking or harmful alcohol use,’ he says.
Monitoring and controlling your blood pressure is also essential when it comes to heart health, says Dr Mpe. ‘You are thought to have high blood pressure, or hypertension, if you have a reading of 140/90mmHg or higher. Hypertension is a silent killer because it usually has no symptoms and many of us don’t even realise we have it,’ is his sobering warning.
Adults should have their blood pressure taken at least every two years. If you already suffer from hypertension you should be closely monitored by your doctor, who will advise on the frequency of blood tests and talk to you about treatment and lifestyle choices.
‘Some people might only realise they have hypertension when they start developing heart, brain or kidney trouble,’ says Dr Mpe.
Statistics suggest that as many as 75% of people who suffer from hypertension aren’t aware of it. Untreated or undiagnosed, hypertension can cause a range of health problems. This includes the possibility of weakening the heart muscle, which could lead to heart failure.
‘Arteries throughout the body can also develop atherosclerosis or they can weaken, especially those in the heart, brain, kidneys and legs, which can cause a heart attack, stroke or kidney failure,’ says Dr Mpe.
The good news is that although high blood pressure stays with you once you have it, it can be controlled with a healthy lifestyle and the right medication.
‘Hypertension is a silent killer because it usually has no symptoms and many of us don’t even realise we have it.’ – Dr Martin Mpe, Cardiologist at Mediclinic Heart Hospital in Pretoria
Making changes
After two heart attacks, Amos made these dietary and exercise adjustments:
Diet
- Less sugar and salt.
- Four cups of boiled water a day, on an empty stomach.
- High-fibre foods such as wholewheat bread, oats and brown rice.
- Healthy protein like skinless chicken and fish, plus salmon and sardines.
- Beans, soya, vegetables and fruit.
- Dilute dairy products with water.
- No alcohol.
Exercise
- Walking and running daily.
- Aerobic and weight exercises.
- Lots of core and stomach exercises.
‘My diet is now shared by everyone in the house and by our extended family,’ Amos says. ‘Exercise is taken seriously. Our risk factors are monitored regularly, and we are mindful of our sugar and salt intake.’
Globally, more than 10 million people die before the age of 70 every year, due to cardiovascular diseases and cancer.
Are sports people more at risk?
Former Springbok Cornal Hendricks and the young England cricketer James Taylor both suffer from heart disease. Former Arsenal player Fabrice Muamba went into cardiac arrest on the field in 2012. They are proof that an active lifestyle is not a guarantee against cardiovascular disease striking. Sports people generally appear healthy but this could be concealing underlying problems.
‘The risk of sudden death in athletes or sports people is a known and well-established phenomenon,’ says Dr Mpe.
‘It is a rare but devastating event since it occurs in young and apparently healthy individuals. The most common cause is heart rhythm disturbance (malignant arrhythmia). There is usually an undiagnosed underlying cardiovascular disease, caused by structural abnormalities that can be congenital or acquired.
‘Or it could be heart rhythm abnormalities that can only be detected with special rhythm monitoring devices like an ECG. For older athletes, above the age of 35, the risk factors are more often related to acquired cardiovascular diseases, especially coronary artery disease.’
While the sports medicine fraternity has placed an increased focus on early detection through special evaluation protocols and appropriate activity restrictions, more needs to be done.
‘There is great ignorance about the need for cardiovascular screening for athletes and sports people. And access to these services, for both professional and recreational athletes, is limited,’ says Dr Mpe.
Youngsters with a family history of sudden cardiac death, especially in close relatives such as a parent or sibling, are part of another group that is at high risk.