The Silent Threat: Understanding heart attacks and how to prevent them

By Aisha Naava

A heart is a vital organ that pumps blood throughout the body, ensuring that other organs and tissues receive enough oxygen and nutrients to remain healthy and function properly.

However, unhealthy habits such as increased stress, poor diet, reduced physical activity, excessive alcohol consumption and other lifestyle factors have negatively impacted heart health globally. Understanding the health of our hearts helps us identify risks, make informed decisions and take preventive measures to reduce the chances of developing heart disease.

As healthcare workers, we frequently extend services to communities through outreaches, health camps and other initiatives aimed at bringing healthcare closer to people. These efforts support accessibility and affordability of healthcare services while contributing to Sustainable Development Goal Three, which seeks to ensure healthy lives and promote well-being for all at all ages.

During one community outreach, a middle-aged man approached our team after hearing announcements about the health camp. Initially, he declined to undergo a medical examination, insisting that he only had a headache and did not need to see a doctor.

However, after observing others receiving treatment, he eventually agreed to undergo routine screening.

To our disbelief, his blood pressure measured 218/168 mmHg, indicating a hypertensive crisis, a medical emergency that significantly increases the risk of a heart attack or stroke. He was immediately referred for emergency medical care.

This encounter highlighted the importance of routine health checks, even when symptoms appear minor.

How High Blood Pressure Affects the Heart

High blood pressure forces the heart to work harder to pump blood throughout the body. Over time, this causes the left ventricle, the heart’s main pumping chamber, to thicken and enlarge.

This significantly increases the risk of heart failure, heart attacks and other cardiovascular complications.

What Is a Heart Attack?

A heart attack, medically known as a myocardial infarction, is a life-threatening emergency that occurs when blood flow to part of the heart is blocked, causing damage or death to heart muscle tissue.

Common Causes of Heart Attacks

• Coronary artery disease caused by the buildup of fatty deposits (plaques) in blood vessels supplying the heart.
• Atherosclerosis, which involves hardening and narrowing of arteries.
• Blood clots that obstruct blood flow.
• Coronary artery spasms, often triggered by stress or drug use.
• Embolisms caused by travelling clots or debris.
• Inflammation of blood vessels (vasculitis).
• High cholesterol levels.
• High blood pressure.
• Smoking.
• Obesity.
• Diabetes.
• Physical inactivity.

Addressing these risk factors and maintaining a healthy lifestyle can significantly reduce the likelihood of a heart attack.

Signs and Symptoms of a Heart Attack

Common warning signs include:

• Chest pain or discomfort, often described as pressure, squeezing or fullness in the centre or left side of the chest.
• Pain spreading to the arms, shoulders, neck, jaw or back.
• Shortness of breath.
• Nausea and vomiting.
• Excessive sweating or cold, clammy skin.
• Dizziness or light-headedness.
• Unusual fatigue, particularly among women.
• Anxiety or a feeling of impending doom.

It is important to note that symptoms vary between individuals. Women, for example, may experience shortness of breath, nausea and fatigue without the classic chest pain often associated with heart attacks.

Diagnosis

Healthcare professionals may use several tests to diagnose a heart attack, including:

• Electrocardiogram (ECG).
• Cardiac enzyme tests.
• Chest X-ray.
• Echocardiogram.
• Coronary catheterisation.
• Cardiac CT scans.
• Magnetic Resonance Imaging (MRI).

Treatment and Management

Treatment depends on the severity of the condition and may include:

• Lifestyle modifications.
• Cardiac rehabilitation programmes.
• Medications such as aspirin and blood-thinning drugs.
• Procedures to open blocked arteries.
• Placement of cardiac stents.
• Coronary bypass surgery.

Cardiac rehabilitation programmes also help patients recover and adopt healthier lifestyles following treatment.

The Challenge in Uganda

Uganda has only a handful of facilities offering specialised cardiac services, including the Uganda Heart Institute at Mulago, Kisubi Hospital and Nakasero Hospital.

Unfortunately, specialised cardiac care remains expensive and inaccessible for many Ugandans.

This reality underscores the need for stronger emphasis on primary prevention at community level.

How Communities Can Prevent Heart Disease

Public Education: Communities should be educated about heart disease, risk factors and warning signs through media campaigns, workshops and health outreach programmes.

Healthy Nutrition: People should be encouraged to consume diets rich in fruits, vegetables, whole grains and lean proteins while reducing intake of processed foods, sugar and excessive salt.

Physical Activity: Regular exercise should be promoted through community programmes, walking groups and accessible recreational facilities.

Smoking Cessation: Governments and communities should support smoking cessation programmes and strengthen policies that discourage tobacco use.

Screening and Early Detection: Routine checks for blood pressure, diabetes and cholesterol levels can identify individuals at risk before complications develop.

Stress Management: Communities should promote mental wellness through counselling services, support groups and stress-management programmes.

Improved Access to Healthcare: Strengthening access to preventive and specialist healthcare services remains critical, particularly in underserved communities.

Community Engagement: Schools, businesses, religious institutions and community organisations should actively participate in promoting healthy lifestyles.

Policy Advocacy: There is a need for policies that encourage healthier environments, including better urban planning, improved healthcare access and stronger regulation of unhealthy products.

A Shared Responsibility

Heart disease remains one of the leading causes of death worldwide, yet many cases are preventable through early detection and healthy lifestyle choices.

The story of the man discovered with dangerously high blood pressure during a routine outreach serves as a reminder that prevention begins with awareness and regular health checks.

Protecting our hearts requires commitment from individuals, communities, healthcare providers and policymakers alike.

By making heart health a priority today, we can reduce the burden of cardiovascular disease and build healthier communities for generations to come.

The author is a Nursing Officer at Kawolo General Hospital.