Mahesh Agrawal was the happiest man as he watched his only daughter walk down the stairs in her bright red bridal dress. His eyes were moist. Father and daughter posed happily for photographs, laughed and joked. Amidst all the happiness and laughter, Mr Agrawal suddenly realized a strange discomfort in his chest. It was more likely an excruciating pain and he started to profusely sweat. The pain had now moved to his neck and he developed shortness of breath almost feeling choked. He held his hand tightly on his chest and slowly settled himself on a chair without letting anyone know.

At this point in time, he remembered his father had a similar heart attack. But, he did not want that scene to cloud the happy scene of watching his daughter getting married. As he watched his daughter get married he bid her a silent goodbye and passed away peacefully with a smile on his face. Unfortunately, it was too late before a doctor was called in.

When everybody got to know what had happened there was a sudden atmosphere of gloom. Nobody was aware what had happened. Today, on World heart Day, let’s try and understand more about our hearts and through this story we could exactly understand what happened to Mr Agrawal and why?

On doctor’s examination, the doctor revealed that Mr Agrawal had suffered a heart attack and that was because he had a Coronary Heart Disease (CHD). A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle is cut off. If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious health problems or death. CHD is the most common of all heart diseases. In the United States, CHD is the #1 cause of death for both men and women. India is not far behind. According to an article by Dr Arvind Kohli, a Cardiac Surgeon, there has been a dramatic rise in heart disease in India.

India will soon be the largest burden of heart disease globally. In India, out of the estimated population of more than 1.27 billion dispersed across various geographical regions, about 45 million people suffer from coronary artery disease. According to current estimates, India will soon have the highest number of cases of cardiovascular disease in the world. It is estimated to account for 35.9 percent deaths by the year 2030, said the article.

Over time, CHD can weaken the heart muscle and lead to heart failure and arrhythmias (ah-RITH-me-ahs). Heart failure is a condition in which your heart can’t pump enough blood to meet your body’s needs. Arrhythmias are problems with the rate or rhythm of the heartbeat.

Knowing the warning symptoms of a heart attack and how to take action can save your life or someone else’s say, doctors. In many cases patients are unaware of the risk factors and that this could be a problem that has developed over the years due to pre-existing heart disease. Several factors such as genetic, metabolic, early-life, conventional and non-conventional risk factors are suspected to cause high CHD morbidity and mortality rates among Indians. Knowing who is at risk helps a great deal. Men have a greater risk of heart attack than women do, and men have heart attacks earlier in life than women. However, beginning at Age 70, the risk is equal for men and women.

Many are of the opinion that heart disease is a lifestyle disease that occurs because one is not maintaining a proper healthy lifestyle. But, you are mistaken. Heart disease could also be due to family history. Here is where the nature vs nurture concept comes in. Did you develop a heart disease over the years, did you already have it and it went undiagnosed or did someone give it to you. In fact, you have an increased risk of developing heart disease if you have a parent with a history of heart disease, especially if they were diagnosed before Age 50. Ask your doctor when it’s appropriate for you to start screenings for heart disease so it can be detected and treated early.

The other common risk factors could include cigarette smoking and exposure to tobacco smoke, high blood cholesterol, and high triglycerides – especially high LDL (“bad”) cholesterol over 100 mg/dL and low HDL (“good”) cholesterol under 40 mg/dL. Some patients who have existing heart or blood vessel disease, and other patients who have a very high risk, should aim for an LDL level less than 70 mg/dL. Your doctor can provide specific guidelines.

The risk of heart disease is also highest among the urban population. A 2013 study concluded that over 70 percent of the Urban Indian population is at the risk of being diagnosed with heart disease. This is mainly due to unhealthy eating habits, lack of physical activity and stress.

High blood pressure (140/90 mmHg or higher), uncontrolled diabetes (HbA1c >7.0), physical inactivity and being overweight (body mass index [BMI] 25–29 kg/m2) or being obese (BMI higher than 30 kg/m2) are other risks for heart diseases. The population of diabetics in India is about 50.8 million, making India the diabetic capital of the world. The prevalence is higher in urban areas (6-8 percent) compared to rural areas (2-3 percent), according to statics provided in Dr Kohli’s article. The increase in hypertension prevalence has been steady over the last 50 years, more in urban than in rural areas. Hypertension is about 25-30 percent in urban and 10-15 percent in rural individuals.

You might be surprised but uncontrolled stress and anger could also lead to CHD. Staying calm helps. Indians like Americans have a higher degree of obesity due to bad food habits. Diet high in saturated fat and cholesterol apart from drinking too much alcohol are also a major risk factor for CHD. The more risk factors you have, the greater your risk of developing coronary artery disease.

Hence knowing the symptoms and risk factors is very important. The most common symptom of CHD is angina (also called angina pectoris). Angina is often referred to as chest pain. It is also described as chest discomfort, heaviness, tightness, pressure, aching, burning, numbness, fullness, or squeezing. It can be mistaken for indigestion or heartburn. Angina is usually felt in the chest, but may also be felt in the left shoulder, arms, neck, back or jaw. All of these symptoms were witnessed by Mr Agrawal.

Other symptoms that may occur with coronary artery disease include:

• Shortness of breath
• Palpitations (irregular heartbeats, skipped beats or a “flip-flop” feeling in your chest)
• A faster heartbeat
• Dizziness
• Nausea
• Extreme weakness
• Sweating

Cardiac surgeons opine that the treatment for CHD involves reducing your risk factors. Change your lifestyle. Get active, exercise and eat right and sleep well. If lifestyle changes aren’t enough to control your heart disease, taking medications as prescribed to treat certain risk factors, such as high cholesterol or high blood pressure helps. Possibly undergoing invasive and/or surgical procedures, and seeing your doctor for regular visits is also good. Treating CHD is important to reduce your risk of a heart attack or stroke. If the problem is detected early lifestyle changes, medicines, and medical procedures can help prevent or treat CHD. These treatments may reduce the risk of related health problems.