Alarm signal from a cardiologist. “More and more young people between the ages of 30 and 40 are suffering from a heart attack”

Dr. Adina Cîmpan (33 years old), cardiologist at the County Emergency Hospital in Zalău, speaks in an interview for “Adevărul” about how we can have a healthy heart and about life-threatening conditions.

The “truth”: How important is prevention in cardiology?

Dr. Adina Cîmpan: The prevention of cardiovascular diseases is defined as a combination of actions, at the level of the entire population, as well as at the individual level, which aim at reducing the risk of these diseases and the disabilities that appear secondary to them. Cardiovascular diseases remain the leading cause of morbidity and mortality, both in Europe and especially in Romania, which is why prevention plays a key role in increasing survival and improving quality of life.

What are the basic rules for maintaining a healthy heart?

I would classify them into three main groups: a healthy diet, constant physical activity, and avoiding toxic substances such as smoking and alcohol. By following these principles and making them a lifestyle, we will keep our hearts as healthy as possible.

What is the connection between diet and cardiovascular health?

Nutrition plays an essential role in the prevention of cardiovascular diseases and, in my opinion, this is also the reason why heart diseases are among the leading causes of death in Romania. In 2017, hypertension caused approximately 30,000 deaths in our country.

When should we make the first visit to the cardiologist?

Immediately after birth, when, at the indication of the neonatologist, most congenital heart malformations can be diagnosed by a cardiac ultrasound. Subsequently, throughout the life, the evaluations made by the family doctor send the patients to the cardiologist.

An early visit to a cardiologist should be made in the following situations: family history of cardiovascular disease or sudden death, high cholesterol and blood sugar; the presence of smoking, obesity, hypertension, unhealthy diet.

What medical tests are recommended for the prevention and diagnosis of cardiovascular problems? How often should they be done?

As in most diseases, we start with a biological balance that can be done by collecting blood. Thus we can detect the presence of diabetes, which, uncontrolled, leads to cardiovascular disease or high cholesterol, and it is involved in the occurrence of heart disease. The simple measurement of blood pressure – performed frequently in the family doctor’s office since childhood – then directs the patient to a cardiologist.

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The cardiological consultation consists, in the first phase, in performing an electrocardiogram and a cardiac ultrasound. Based on this control, the rest of the necessary investigations are established, as well as how often they have to be done. In the case of a healthy adult with optimal blood pressure (ie 120/80 mmHg), it will be measured every five years or more if other conditions occur.

What are the most common serious pathologies in this specialty?

Ischemic coronary heart disease or the well-known ischemic heart disease is the most common serious pathology that we, cardiologists, face. It has been the leading cause of death in the world since the 2000s, accounting for 16% of deaths worldwide.
Another enemy not to be neglected is high blood pressure, that enemy who “shuts up and does”.

To what extent is the genetic factor responsible for the occurrence of cardiovascular disease?

Unfortunately, sometimes the genetic baggage we are born with follows us all our lives. The occurrence of cardiovascular diseases in first-degree relatives before the age of 55 in women and 65 years in men, respectively, is a risk factor for offspring. Also, some heart malformations or genetic mutations in the muscle fiber that lead to heart failure can be inherited. But it is not a rule. A history of sudden death in the family requires regular cardiac check-ups in first-degree relatives.

What is the connection between blood pressure and cardiovascular disease?

Untreated, high blood pressure leads to serious health problems over time, mainly affecting the heart, brain vessels, kidneys and even vision. Ischemic heart disease, arrhythmias, heart failure can sometimes be the consequence of untreated blood pressure.

What are the risk factors for high blood pressure?

The risk factors for high blood pressure are many. I would start by saying that blood pressure falls into two broad categories: essential, ie the blood pressure that occurs with age, if we have an unhealthy lifestyle, we are sedentary, smokers, with excessive salt intake, saturated fatty acids, etc. ., and secondary blood pressure, which occurs in young people and, as the name implies, is secondary to other diseases (endocrine, renal) or the consumption of drugs or substances that increase blood pressure.

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Myth or reality: do coffee and wine increase blood pressure?

Opinions about coffee are controversial. Some studies say that caffeine consumption increases blood pressure for a short time and suddenly, even in patients who do not suffer from hypertension, due to the fact that this alkaloid would stiffen the arteries, later, through the diuretic effect of coffee, producing a mild dehydration – which is why coffee is always drunk with a glass of water. Other studies have shown that this increase occurs only in those who drink coffee occasionally and that in chronic consumers it would not have the same effect, being beneficial due to the high content of antioxidants. I think more studies are needed to solve this mystery.

As for wine, an opinion was formed that red wine would increase blood pressure, while white wine would decrease it. This myth is false, because any alcoholic beverage causes high blood pressure.

Who is prone to a heart attack?

There are several factors that predispose to acute myocardial infarction, the most important of which are unhealthy lifestyle, smoking, the presence of diabetes, obesity, a family history and old age. According to studies, major cardiovascular events occur more frequently at the age of over 60 years.

Myocardial infarction occurs when there is a blockage of blood flow from the arteries that irrigate the heart muscle (coronary arteries), which leads to its suffering due to lack of oxygen and necrosis (cell death). Most often, this happens by detaching an atheromatous plaque, which is deposited on the inner walls of the arteries and leads to the formation of a thrombus (clot).

How do we recognize it and how should we react?

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The most common symptom in acute myocardial infarction is chest pain. The appearance of a strong pain in the chest, which practically encloses the patient and, in most cases, does not let him breathe, with a duration of more than 20 minutes, is an alarm signal that we must call an ambulance. Medical staff will be able to differentiate this symptom from other causes of chest pain.

How likely are young people to have a heart attack?

Unfortunately, more and more young people are suffering from a heart attack. If in the past this cardiovascular event occurred more frequently in the elderly, in the last 10 years, many young people aged between 30 and 40 suffer from a heart attack. From my own experience I say that most are smokers from childhood or adolescence. If we associate obesity, a positive family history and a slightly high blood pressure, the risk increases exponentially.

How much does the life of a patient who has suffered a heart attack change?

Radical. Unfortunately, many patients die. If the evolution is favorable and the procedure is successful through which the artery involved in the infarction is repermeabilized – it being blocked by a clot – the patient will have to take, on average, five types of drugs all his life. If the heart does not recover properly after this event, heart failure occurs, a condition that is often disabling with multiple hospitalizations, limited exercise capacity and increased mortality.

CV Dr. Adina Cîmpan

2006-2012 “Iuliu Haţieganu” Faculty of Medicine and Pharmacy Cluj-Napoca

2013-2017 Resided in the cardiology specialty at the Cluj-Napoca Heart Institute

since 2018 – specialist doctor in the Cardiology Department of the Zalău County Emergency Hospital

from 2019 – PhD student of the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca.

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