by Curlan Campbell
- ST-Elevation Myocardial Infarction (STEMI) heart attack is most dangerous
- Diabetics are more prone to experiencing heart attacks without textbook signs
- Four Chambers Heart of Grenada partnered with Grenada National Patients Kidney Foundation
In a heartbeat, a seemingly healthy 40-year-old’s life changed drastically after suffering one of the most dangerous heart attacks. Felix St Bernard, an IT Specialist by profession, started his workday on 22 March 2022 and by all accounts seemed to be just another day at the office, when he noticed that he started to experience signs of what appeared to be symptoms of gas pain.
“I felt nothing before the heart attack. It was by all accounts a normal day for me. However, I started having similar discomforts that one would have with gas. I had just eaten and initially assumed that was it. I tried drinking hot coffee, but it didn’t help. I started feeling tightness in my chest, started experiencing shortness of breath and began to sweat profusely. I was also feeling weak. All the above, I later found out, was happening during the actual heart attack,” St Bernard said.
What St Bernard did not know at the time is that he was experiencing one of the most dangerous heart attacks, an ST-Elevation Myocardial Infarction (STEMI) heart attack, during which one of the heart’s major arteries that supply oxygen and nutrient-rich blood to the heart muscle, is blocked.
Despite suffering a massive heart attack, St Bernard managed to drive himself to the Permontemps health centre before being rushed to the General Hospital. “From the time I started experiencing the symptoms to getting to the ER must have been 3 hours. I was at work at the time. I drove myself from Corinth to Permontemps. When I saw the health centre there, I thought it best to pull over and see the nurses. After I described my symptoms, they gave me an aspirin, hooked me up to a portable EKG, put me on oxygen and phoned ahead to the hospital ER. My wife soon came and got me, then rushed me to the ER,” he said.
The horrific experience of not having the typical signs of a heart attack is quite common, said Cardiologist Dr Elida Batista Herrera. She has worked at The Cuban National Institute of Cardiology in the Ischemic Cardiopathy Service, Echocardiography And Nuclear Medicine Department, and is now on a mission in Grenada to prevent the onset or worsening of heart disease by reducing a patient’s risk factors before a diagnosis or incident.
Dr Batista Herrera has been practicing in Grenada in 2015. She started her own practice in 2019 by establishing Four Chambers Heart of Grenada, a cardiovascular health clinic that provides a number of services including Electrocardiogram, Echocardiogram and Cardiac stress test. Her extensive work in treating patients with cardiovascular disease has shown that there are patients, especially those with diabetes are more prone to experiencing heart attacks without having the typical signs outlined in medical textbooks.
“One of the objectives of our educational activities is to inform people that not always will a patient suffering from a heart attack will get the typical symptoms that the textbook describes, sometimes you develop an atypical presentation and people don’t know that there is a possibility that they may have cardiovascular disease.”
“Not all the time you will have chest pain that is related to your arms, and you are cold sweating. No! Sometimes you have shortness of breath and you never develop chest pain. Diabetic patients are asymptomatic in that way because people who are diabetic, don’t have chest pain because diabetes affects the nerves, therefore, they are not sensitive to experiencing pain, therefore, it is common for a diabetic patient to have a silent heart attack,” she explained.
Dr Batista Herrera is a member of the Cuban Society of Cardiology and Cardiovascular Surgery and the Cuban Society of Atherosclerosis (SOCUBAT). She has taken her campaign for improving cardiovascular health into the nation’s secondary schools and has started hosting a series of seminars entitled “Let’s talk about the Heart” in a bid to lower the risk of heart disease before a diagnosis or incident or reduce the chances of experiencing another episode in patients that have already had a first heart attack or stroke.
Since launching the education and awareness campaign, Four Chambers Heart of Grenada partnered with the Grenada National Patients Kidney Foundation in December last year to host its first health seminar focusing on the topic “Heart and Kidney failure.” A seminar was held at the St Joseph’s Convent Grenville on 14 February 2023, and another is being planned for 25 March 2023 at the Rainbow Inn, Grand Bras, St Andrew.
Through her medical practice, Dr Batista Herrera continues to treat several patients suffering from complications of cardiovascular disease which is most times diagnosed in its late stages. For example, in Grenada, ischaemic heart disease was the most prominent cause of death in Grenada in 2019. In that year alone, around 139 people per 100,000 population died from this coronary condition. Ischemia is a condition in which narrowed heart arteries restrict oxygenated blood from reaching the heart muscle which can lead to a heart attack. Since the vast majority of people with heart failure are only diagnosed after an emergency hospital admission, Dr Batista Herrera believes early intervention is needed.
“When we are talking about ischemic heart disease, the main cause of that is atherosclerosis when you develop some obstruction or blockage in the arteries and they limit the amount of oxygenated blood that circulates in your heart. That creates what we call ischemia and there is a large percentage of patients that complain of chest pain of angina pectoris and ischemic heart disease is very common in the Grenadian population. The second one relating to cardiovascular disease is ischemic stroke,” Dr Batista Herrera said.
The cardiologist is concerned over the excessive drinking and smoking by the younger segment of the population which could lead to heart tissue damage even before concerning symptoms arise and can significantly reduce their chances of surviving a heart attack.
“When you compare Grenada’s population with other populations the use of tobacco is not that high but sometimes you ask the patient if they smoke and they tell you “no” because they only identify smoking with the use of cigarettes, but a high percentage of the population use an illicit drug such as cannabis, and that is considered smoking as well and has direct relations to people being more hypertensive and are at risk to develop cardiovascular disease.”
There is also the concern that patients who suffered a heart attack in the past, are not up to date with their regimented treatment and as such will discontinue their medication once they experience some kind of relief.
“Patients will come in and get the diagnosis and receive the treatment and then after they start feeling better then they decide not to return to the doctor and they discontinue the medication and after a few years they start to develop further complications.” Dr Batista Herrera is advocating for total lifestyle change for the Grenadian population who are at risk of developing chronic non-communicable diseases like hypertension, diabetes and high cholesterol due to their unhealthy obsession with fast foods.
This unhealthy obsession, coupled with the fact that he has been a cigarette smoker since 2003, St Bernard knows all too well, and after surviving a heart attack, almost a year later is cognisant of the need to improve his lifestyle. He has since reduced the number of cigarettes and hopes that one day he can quit the habit. “I was placed on quite several meds: blood thinners, blood pressure meds, statins, etc. In addition to the meds, I was placed on a low-salt diet. I am a lot more conscious of what I eat now. I have greatly reduced the number of fried foods I eat. I think that in general, I’m more appreciative of life. I tend to see things more positively now. For me, the thought is “I could be gone tomorrow, so do what I can today for myself and the ones I love,” he said.
St Bernard advises men to start making better life choices and manage their stress levels to prevent being in a similar life-threatening situation. “Take care of yourself especially as you grow older. Don’t take the people in your life for granted. Don’t let small things bother you. If something has upset you and you ask yourself, “will this bother me a month from now?” and you hesitate to answer, then let it go.”