There is a need for individuals to take responsibility for managing their own health.
This was the call to action from the April 21, 2021 webinar on Ischaemic Heart disease for all in Uganda.
The webinar, which featured high-level experts in cardiology, was organized by Uganda Heart Foundation, Uganda Heart Institute, and the African Center for Global Health and Social Transformation(ACHEST). It was chaired by the ACHEST Executive Director, Prof. Francis Omaswa together with Prof. Paul D'Arbela from Mother Kevina Postgraduate School, Nsambya Hospital.
Dr. Barbara Kakande, a Consultant Cardiologist and Uganda Heart Association started off the discussion by defining Ischaemic Heart Disease as a group of syndromes or diseases that occur because of a change or alteration in the structure of the blood vessel that supplies the heart. Because of this, there is an imbalance between the oxygen that the heart muscle is receiving versus the oxygen which the heart is demanding. “So Ischaemic occurs when the demand for blood is higher than the supply. It is also called coronary heart/artery disease. Usually, the left side of the heart is the one which is affected due to many factors including the fact that the left side has a thicker wall compared to the right side,” explained Dr. Kakande.
Approximately one-third to a half of cardiovascular diseases in the world are Ischaemic. Some of the risk factors include aging, smoking, tissue factors, adhesion molecules, and family history.
The signs and symptoms of the disease were elaborated by Dr. Ephraim Batambuze, a Senior Consultant Cardiologist. “Heart diseases start with chest pain, chest tightness(like something is squeezing the patient), chest heaviness sometimes around the breast on the left side; and chest pain which radiates into the left arm, back, or neck. Some patients may present pain at the tip of the tongue and nose, skipping heart whenever they walk, tightness in the calf, shortness of breath, etc,” he said.
Dr. Batambuze described Ischaemic Heart Disease as treacherous, as some patients don’t present any symptoms until the last minute when it is too late to save them.
The experts, therefore, called for the need for medical practitioners to carry out a comprehensive family history investigation for a patient presenting some of the above of symptoms.
“It is not enough to say chest pain equals cardio pain. Let’s take history before referring them to a cardiologist. Don’t just get excited,” cautioned Prof. D’arbela
The investigations for Ischaemic Heart Disease such as blood tests, chest rays, ECHO, ECG, exercise stress test among others, were well explained by Dr. Charles Lugero, the specialist physician and cardiologist at the UHI. He stressed that it was important to repeat investigations, especially among symptomatic patients.
Dr. Emmy Okello Consultant Cardiologist and Head of Cardiology Division, UHI, spoke about referral network and acute management. How soon a patient is saved depends on the quick and appropriate response by the first health worker/ health facility to attend to them (within 10 minutes), access to appropriate medicines, access to ambulances to take the patient to a specialized unit within 2 hours. “Health workers, therefore, need to understand how the referral system works. For instance, you need to call the referral hospital so that they prepare for the patient’s arrival,” said Dr. Okello, adding that the UHI has a network of hubs at different hospitals to help in quick diagnosis and other interventions.
Another topic of interest was on chronic management and prevention by Dr. James Kayima, the Consultant Cardiologist at UHI and senior lecturer at the Makerere College of Health Sciences. He mentioned patient education on physical activity, weight management, diets, and their lifestyle habits as important.
During the discussion, ACHEST’s Director of Health Systems Dr. David Okello called on stakeholders to push for a shift in policy that puts emphasis on disease prevention.
“Processed foods that are rich in highly refined sugars, salts, trans fats, and saturated fats; as well as sugar-rich drinks, alcohol, and smoking are being marketed aggressively in the public media. We need doctors to make noise,” said Dr. Okello
Responding to this concern, Dr. Peter Lwaki, Senior Consultant Cardiologist UHI and President Uganda Heart Association said Uganda already has good policies on health promotion. “The gap is in regulation, enforcement, and financing. We need to engage politicians who control the budgets.”
This was also echoed by Dr. D’arbela, who noted that engaging policymakers would ensure that well-equipped facilities are available.
Dr. Batambuze strongly stated that individuals must take charge of managing their health. He narrated his own story on how he made a personal resolution to stop smoking.
Prof. Omaswa agreed: “Responsibility for health starts with the individual.”
Another participant, Dr. Elizabeth Ekochu called for the establishment of wellness clinics across the country so that the general public can walk in and be tested before it is too late.
Prof Omaswa closed the webinar by saying that subsequent public education webinars would be hosted in due course.
“We can become advocates of better health,” said Prof. Omaswa