September 29 is World Heart Day. Cardiovascular diseases, such as coronary artery disease or heart failure, are one of the most common causes of death not only in our country, but also in the world. How can serious illness be prevented? How can telemedicine help in the prevention of heart disease and in responding to emerging symptoms?

Interview with Prof. dr hab. n. med. Zbigniew Jan Peruga , head of the Laboratory of Invasive Cardiology, Clinic of Cardiology, Hospital. On Bieganski in Łódź and a cardiologist and specialist in internal medicine at Med24.

What symptoms related to heart disease should concern us?

Sometimes these symptoms can be very innocent at first. They don't tease us too much, so we ignore them. And some of them are worth paying special attention to, especially if they are repeated more and more often. These are, for example, deterioration of general efficiency, shortness of breath occurring with everyday activities, chest pains, as well as shortness of breath, or swelling of the lower legs. Most often we blame them on age. We explain all of this with the passage of time and consider it completely natural. Sometimes we also blame overwork and exhaustion. And we should not underestimate them, because these symptoms often portend serious diseases such as a heart attack. That is why systematic prophylaxis, periodic examinations is important, as well as avoiding indefinitely and not postponing an appointment with a specialist or GP, who will order tests when the symptoms disturb us. Nowadays, there is no excuse to postpone taking care of preventive he alth care. Telemedicine helps us in this. Each online consultation begins with an in-depth interview and a referral for research. And during subsequent e-visits, recommendations are made on the basis of research analysis.

What are the most common heart diseases nowadays, apart from the well-known heart attack?

The most common disease that is underestimated by many patients is elevated blood pressure. Hypertension can be asymptomatic, and its consequences can lead to the development of coronary heart disease, heart attack, circulatory failure, and neurological complications such as stroke.

Are heart problems a diseasehereditary or civilization?

The etiology of the disease is complex, multi-factorial. Research confirms that we observe coronary heart disease much more often in patients whose parents also suffered from it. But heart disease is also associated with lifestyle changes nowadays. Limited physical activity, addictions or obesity caused by improper diet, which is an indirect effect of the progress of civilization, have a colossal impact on the earlier disclosure of heart diseases.

Who is most at risk of them? Does age matter?

Until recently, a typical patient was an obese man, over 40, smoking cigarettes and additionally burdened with arterial hypertension. Now this patient profile is changing. Women suffer from heart attacks more and more often, and the age of the patients has also decreased. Of course, people in the 6th and 7th decade of life still dominate, but more often than before, patients under the age of 40 are hit.

Not having time, we put everything off for later. Yet cardiological symptoms should not be taken lightly. How quickly can you check if they are serious or not?

Unfortunately, the time of the pandemic meant that patients were sent to hospitals too late, where they could be treated with modern methods. The reasons for this were various - on the one hand, fear of being treated in hospital during a pandemic and delaying going to the doctor or calling the Ambulance Service, and on the other hand, limiting access to doctors and basic he alth care, especially specialists.

This gap was partially filled by telepaths. Today we also use them more often. Thanks to this, the patient does not have to wait long for an appointment at an in-patient facility. And so, both the first e-visit, which after a medical interview usually ends with the ordering of tests, and the next, where the doctor analyzes the results of these tests, can be made without leaving home. It saves us time, so important in developing heart disease.

During teleportation, the doctor may order ECG tests, heart echo, Holter examination, etc. Exactly the same as during a stationary visit. But it is also worth doing basic blood tests before visiting a specialist.

And what does such a cardiac telemedicine advice look like?

A very important element of the visit is a careful interview - clarifying the nature of the ailments, their dynamics, or the treatment so far. Therefore, you should describe all your symptoms to your doctor in great detail. Even if we consider them to be insignificant from our point of view. It's best to write everything down on a piece of paper, beforee-visit. Previous test results, which the patient can send before the visit, are important so that the consulting physician can analyze them and discuss them with the patient. We are talking about tests such as ECG or heart echo. And if we do not have our results yet, they may be ordered during the teleportation so that the doctor can read them at the next visit and start diagnosing and treating them. in the diagnosis of the disease, even in the case of diagnosed arrhythmia - such as atrial fibrillation, it is very important to promptly initiate appropriate treatment, e.g. anticoagulation.

Recently, in one of the cases during teleportation, a patient sent me a cardiac echo test before the visit, which indicated a very advanced defect. I immediately referred the patient to the Cardiology Center closest to her place of residence, dealing with the treatment of this type of disease. And such treatment, as confirmed by the patient during the next teleportation, was started on time.

Of course, when the symptoms are disturbing, acute in the course of the course or the test results indicate it, an emergency visit to the nearest Hospital Emergency Department is suggested or to the hospital as planned.

Which cardiovascular diseases can be consulted through teleportation?

Virtually all of them, except for the very severe ones, when you should immediately go to the emergency department or call the ambulance. For all other conditions and associated symptoms, the consulting physician can guide the diagnosis and start treatment - or suggest an urgent visit to the hospital - with the patient's test results and an interview with the patient.

How about people who have long-term heart disease treatment? What does telemedicine enable?

First of all, remember that in the case of an already diagnosed disease and treatment undertaken, all guidelines should be meticulously followed. Regular medication intake, constant medical supervision and monitoring of test results are essential. When new symptoms develop, you may seek medical advice. If the information collected by the doctor turns out to be insufficient, he or she will refer the patient to additional tests or a stationary visit. But it is important to be able to contact a specialist quickly. When your medications are low, you can receive an e-prescription via SMS to continue your treatment.

Can we avoid heart disease? Diet? Lifestyle? How important is prophylaxis?

By controlling risk factors such as smoking, an unhe althy diet, and inactivity, at least 80% of premature deaths from heart disease andstroke.

Prevention is key to preventing heart disease. Promoting a he althy lifestyle, research, awareness of risk factors that may lead to premature disclosure of the disease and, as a result, deteriorate he alth and shorten life. All of this should be more disseminated. Here, a special role should be played by the media, publications in the form of guides or the promotion of appropriate habits. It is also a system of self-monitoring of patients - the use of preventive examinations or screening tests in groups of patients particularly at risk of developing the disease.

It is important to popularize the use of medical advice and consultation of all ailments that have raised our concern. Telepaths complement the diagnostics and enable its targeting. Of course, they will not fully replace direct contact with the doctor, but they can direct the procedure and accelerate the start of treatment. Again, time is crucial in this case. And when doubts arise, the consulting doctor can always suggest contacting an appropriate specialist. However, it is important not to delay.

What is a silent heart attack - what are its symptoms?

A heart attack does not always have to be preceded by severe pain. Sometimes it can be shortness of breath or chest discomfort. This is what a heart attack can do, for example, in patients with coexisting diabetes.

It is very important for proper and effective treatment to act quickly. In the event of a heart attack, time is of decisive importance and affects the final effect of the therapy. The slogan "time is a muscle" means that the sooner the patient is treated properly, the more the myocardium will be protected against necrosis and irreversible loss of its efficiency.

Prof. dr hab. n. med. Jan Zbigniew Peruga , head of the Laboratory of Invasive Cardiology, Department of Cardiology, Hospital. On Bieganski in Lodz. Cardiologist, specialist in internal diseases at Med24 (www.med-24.com.pl). He specializes in: diagnosis and treatment of coronary artery disease, coronary angioplasty procedures, qualification for coronary angioplasty procedures, implantation of transvascular valves - Tavi, treatment of structural defects, such as defects in the atrial and interventricular septum.

Category:

Cardiology