Coronary Heart Disease
This morning I had an appointment at the Cardiology Outpatients clinic at St. Thomas’ Hospital, in Southwark, London. The hospital, located across the Thames from the Houses of Parliament, is easily accessible from three nearby tube stations (subway), one major train station and numerous buses. As well as having an extensive A&E department, St. Thomas’ also provides a broad range of healthcare services such as maternal medicine, gastrointestinal surgery, ophthalmology, pain medicine and plastic surgery. The hospital specialises in cardiovascular care and was the first to perform a mitral valve replacement on a beating heart. It is also home to nursing and surgical colleges. The current site has served community needs since 1871. The hospital has existed in some shape or form since the 12th century. There is a pleasant ornamental garden outside the main entrance that overlooks the river and Lambeth bridge.
I was at the hospital to have a stress echocardiogram. Two years ago I was diagnosed with coronary arteriosclerosis and this was a routine test to determine if there were any significant changes in my condition. Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to your body while physical, pharmacological, or electrical stress is applied to the heart. In my case I was given the drug atropine to increase my heart rate, while I squeezed a pair of stress balls. The procedure took about an hour and was a little uncomfortable towards the end, due to the elevated heart rate. Fortunately, the results of the test showed only a minor progression of my ongoing heart disease, which can be managed within my current treatment strategy. The results have been sent to my local GP and I may or may not have my dosage of bisoprolol (beta blocker) increased.
There is absolutely nothing unusual about a man of my age (56) having coronary arteriosclerosis. It is a result of your heart's blood supply being blocked or interrupted by a build-up of fatty substances in the coronary arteries. Over time, the walls of the arteries can become furred up with fatty deposits. Furthermore, heart disease of this kind is caused by lifestyle factors, such as diet, smoking and regularly drinking excessive amounts of alcohol. Due to the fact that processed foods make up a substantial part of our diets nowadays, heart disease is very common in the UK. At present, there are around 7.6 million people living with heart and circulatory diseases. This statistic includes everything from conditions that are inherited, to those that develop later in life, such as coronary heart disease, atrial fibrillation, heart failure, stroke and vascular dementia. Here is some further information from the British Heart Foundation.
Around 4 million males and 3.6 million females are living with heart and circulatory diseases in the UK.
We estimate that in the UK more than half of us will get a heart or circulatory condition in our lifetime.
Around twice as many people are living with heart and circulatory diseases in the UK than with cancer and Alzheimer’s disease combined.
Heart and circulatory diseases cause around a quarter (27 per cent) of all deaths in the UK; that's more than 170,000 deaths a year, or 480 each day – one every three minutes.
Around 49,000 people under the age of 75 in the UK die from heart and circulatory diseases each year.
Whenever discussing medical matters, it is important to maintain an appropriate sense of perspective. Since the British Heart Foundation was established in 1961,the annual number of deaths from heart and circulatory diseases in the UK has fallen by nearly half. The UK is at the forefront of heart disease research and the NHS has a proven track record of diagnosing and treating it. I have found over the last two years that coronary arteriosclerosis is entirely manageable. A few sensible changes in diet and lifestyle, along with some common place medicines help maintain the status quo. I take the following tablets each day. Bisoprolol (25mg), atorvastatin (40mg) and aspirin (75mg). As a result, I can still pursue all the same activities that I always have. Sometimes I have to adjust the pace at which I do things and any activity at floor level is challenging but you simply develop techniques to work around these.
I am very fortunate that I live in the UK and as such medical treatment is free at the point of use. The only costs I have to pay for are my prescription fees, which are subsidised. My medication is supplied bi-monthly and I am charged a flat fee £9.90 per item. Hence I pay £19.80 for the bisoprolol and atorvastatin. I buy aspirin “over the counter” as they are cheaper that way. The only other aspect of my ongoing healthcare is a weight loss regime which is very much a work in progress. I say this because to celebrate the positive results of today’s test, I ended up at our local Italian restaurant, which may seem somewhat contradictory to my ongoing medical needs. However, as my heart consultant pointed out, preventative healthcare is about adjusting and managing lifestyles and not necessarily abandoning them by default. Everything in moderation, including moderation, as Oscar Wilde said.
