Aga Khan Hospital, Dar es Salaam (AKHD) treating heart attacks

Dr. Amit Soni, Consultant Interventional Cardiologist from Aga Khan Hospital

What you need to know:

Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. In addition, drug treatment of diabetes, hypertension and high blood lipids may be necessary to reduce cardiovascular risk and prevent heart attacks and heart failures.

Cardiology (from Greek καρδίᾱ kardiā, "heart" and -λογία -logia, "study") is a branch of medicine that deals with the disorders of the heart as well as some parts of the circulatory system.

Cardiology deals with the diagnosis and treatment of such conditions as congenital heart defects, coronary artery disease, electrical conduction system disturbances (electrophysiology), heart failure and valvular heart disease. Subspecialties of the cardiology field include cardiac electrophysiology, echocardiography, interventional cardiology and nuclear cardiology.

Subspecialties of the cardiology field include cardiac electrophysiology, echocardiography, interventional cardiology and nuclear cardiology.

Dr. Amit Soni, Consultant Interventional Cardiologist from Aga Khan Hospital, Dar es Salaam provides detailed information pertaining to cardiology.

When do I need a cardiologist?

The following are the Top 10 reasons you may want to see a cardiologist:

Physician recommendation

If your family-care doctor recommends you see a cardiologist, do it. Don’t put it off. You’ll regret it.

Heart pain

This is pretty much a given. You can see a full list of heart disease symptoms below. If you have any doubts about whether or not you are experiencing a symptom, however, get checked out.

Family history

If anyone in your family has or has had heart problems, you should be aware of heart disease symptoms and consider talking to a cardiologist about them.

High total cholesterol

Total cholesterol is the sum of all the cholesterol in your blood. The higher your total cholesterol, the greater your risk for heart disease (a cholesterol level of 200 mg/dL or higher).

High blood pressure

You have high blood pressure or a high systolic number. The systolic number on your blood pressure reading is the first number. (For example, if your reading is 120/80 (120 over 80), your systolic blood pressure is 120.)

Are or were a smoker

Smoking is a huge risk factor for heart disease. It lowers the flow of oxygen to the heart and increases blood pressure, heart rate, and blood clotting as well as damages the cells lining the arteries.

Diabetic

Unfortunately diabetes can contribute to heart disease. If you experience symptoms of heart problems and are diabetic, you should see a cardiologist.

Difficult pregnancy, preeclampsia

Preeclampsia is often a hidden risk factor for heart disease. The two times a woman is most likely to develop heart disease is during pregnancy or post-menopause.

Starting a new exercise program

You are over the age of 40 and starting a new exercise program. You may already be working with a doctor on being more active, but a cardiologist can check your heart health and recommend exercises that would be good for your heart.

Gum disease

Believe it or not, gum disease can happen when the body is inflamed. Patients with swollen gums often have heart disease.

Many of us are familiar with the symptoms of heart diseases like heart attack or stroke. There are other symptoms of heart disease as well, however, to be aware of:

Severe pressure, squeezing, pain, or discomfort in the chest, Pain or discomfort that spreads into the shoulders, neck, arms, or jaw. Chest pain that becomes more intense, Chest pain that isn’t relieved by rest, Chest pain combined with the following symptoms:

Sweating, cool, clammy skin, and/or paleness, Shortness of breath, Nausea or vomiting, Dizziness or fainting, unexplained weakness or fatigue, Rapid or irregular pulse etc.

Others are Pain in the jaw, neck, upper back, and/or chest, Hoarseness because of pressure on the vocal cords, Difficulty swallowing, Heart palpitations, Anxiety, Low blood pressure. If you have any of the symptoms listed above or if your primary care doctor recommends you see a cardiologist, do it! Your heart is the most important muscle of your body, so take care of it.

Why should we choose Aga Khan Hospital cardiology service?

One of Tanzania’s broad spectrum service provider. Heart attack is a condition which requires a quick recognition and early treatment. If you have chest pain and you visit our emergency department an ECG is done within 10 minutes of arrival to rule out whether the patient is having a heart attack or not.  If there is a heart attack diagnosed urgently he had been taken to catheterization laboratory (room where the blocked artery is opened).

We are continually looking to ensure that patients are provided with the best medical treatment through new equipment up-grades, participation in research and clinical trials, incorporating best practice clinical guidelines into our service.

For Patients

Looking after you is our priority. So, you can expect to be treated with compassion, dignity and respect, every time.

For Medical Practitioners

As a referring medical practitioner you can be assured that we will respond rapidly to your needs fast turnaround of reports and priority service for your urgent patients. We are committed to understanding the needs of our referring doctors so that we continually provide a caring and professional service that exceeds your expectations.

In addition, all of our practices utilize modern cardiovascular equipment, technology and techniques to ensure diagnostic accuracy is maximized.

Our state-of-the-art cardiac catheterization labs at Aga Khan Hospital is equipped with the latest digital imaging technology designed for interventional procedures. Our advanced intracardiac imaging techniques allow us to evaluate and treat every type of coronary artery disease case.

Medical Insurance local / international

At our institution we accept not only local insurance policies as well as International, which guarantees no out-of-pocket expenses for services from The Aga Khan Hospital cardiologists when you're admitted into hospital.

Cardiac Rehabilitation Program

At Aga Khan Hospital we provide a dedicated cardiac rehab program for people who had a cardiac event.

In cardiology, heart attack and heart failure have been the common problems with highest number of reports. Why?

The most important reason behind this is behavioral risk factors of heart disease which are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioral risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of developing a heart attack, stroke, heart failure and other complications.

Cessation of tobacco use, reduction of salt in the diet, consuming fruits and vegetables, regular physical activity and avoiding harmful use of alcohol have been shown to reduce the risk of cardiovascular disease. In addition, drug treatment of diabetes, hypertension and high blood lipids may be necessary to reduce cardiovascular risk and prevent heart attacks and heart failures.

There are also a number of underlying determinants of CVDs or "the causes of the causes". These are a reflection of the major forces driving social, economic and cultural change – globalization, urbanization and population ageing. Other determinants of CVDs include poverty, stress and hereditary factors.

Reputed with unrivalled experience in quality medical service particularly in cardiology within and outside of Tanzania. What could be an underlying secret behind this success story?

I think the hospital administration drew a plan to attract internationally experienced Cardiologists who provide a guideline directed medical therapy with the help of top world class investigation tools, devices at our facility.

Do you offer heart transplant services at Aga Khan? What are the plans?

At present we do not have cardiac surgery services at our institution. I hope that in near future we will have a top level full time cardiac surgery services at our hospital.

How can one prevent heart disease?

Now getting people to prevent disease on their own is not an easy thing, because it takes hard work even though most of it is free. And there are really four major things I recommend to patients to prevent a heart attack.

One is to eat better.

Now, for a lot of people they think they're eating pretty well, and they get a salad, and they put ranch on it and some eggs and a bunch of cheese, and, basically, what they've done is transform their salad into a cheeseburger.

And, that is not a healthful way. Really, it is a low fat, whole foods, plant based, unprocessed diet. These days it’s actually very easy to do with readily available inexpensive ingredients.

Things like oats for breakfast and some brown rice and beans for lunch with a beautiful salsa on top. That kind of meal is an easy way to do it without a lot of trouble. So that’s one.

Two is exercise.

Thirty minutes of brisk activity a day that leads to breathlessness. And, if you have orthopedic issues, swim. If that doesn’t work, bike. Try a recumbent bike. Try an elliptical. If you have trouble with your legs, use an arm bike. Whatever you’re able to do to get to breathlessness is the goal. Obviously, check with your doctor first. So that’s two.

The third thing is stress.

So most people don’t realize, but stress, especially in western society, is incredibly high. People have all sort of stressors, from marriage, to work, to finances, everything. Spend thirty minutes a day, meditate, pray, be introspective, do yoga. Do whatever you have to do to let things go.

Four and final, and this is an interesting one.

Most heart doctors never talk about love. But why is love associated with the heart? Because, they really go hand and hand, and the data suggests that people who have supportive connections in life, a spouse, a family member, a dog, even, they do better. They have less heart attacks. They survive heart attacks better. And, believe it or not, there is an emerging field of science in medicine showing this exact thing. So, to put it all together in a way that people can really remember, live like a poor crop farmer. Now, that may seem strange, but it’s pretty simple.

Eat what you grow, be active your whole life, be one with the earth. Be at peace and connected to others. That’s it and if you can do that, that is the best way to prevent heart disease.

What are some of the challenges you encounter in cardiology? And how do you navigate through?

I believe the first most important challenge is awareness in terms of knowing about or some basic knowledge of heart disease or related symptoms. Second, sedentary lifestyles, food habits and other local cultural believes (nontraditional ways of treatment, either herbal or home remedies or witch doctors or the most fashionable the google doctor).

Solution to this what I see is spreading/sharing knowledge about heart related diseases and informing them that the treatment is available here in our hospital, flying out of the country sometimes might progress the disease.

What strategies do Aga Khan Hospital have for enhancing cardiology service in Tanzania?

Again sharing knowledge and teaching local doctors, different communities locally. Organizing continue medical education seminars for local doctors. Organizing cardiology camps within the country or across as well. Talks on TV and radio.

Any message you wish to leave to all Tanzanians out there?

Please do not wait for disease to come. Today we practice preventive medicine where we prevent the disease not to happen or to delay. A regular yearly cardiac preventive check-up should help to evaluate cardiac risks and plan in order to prevent heart diseases to happen.