Heart disease is often "silent", but it can have devastating consequences on the body. How can we prevent a myocardial stroke? What signs should we be concerned about? What medical investigations are important? Dr. Cristian Alexandru Udroiu, primary cardiologist at the University Emergency Hospital in Bucharest, doctor of medical sciences, President of the Interventional Cardiology Working Group of the Romanian Society of Cardiology, answered these questions, as well as many others, in an interview for Digital Clinics.

If you have any questionss regarding your heart health please talk to a cardiologist online.  

What seemingly trivial signs can betray heart problems?

A trivial but important sign is increased fatigue compared to previous months. For example, we can climb fewer stairs than before, we walk a shorter distance, we feel the need to sit down on a bench more quickly, and our feet swell.

How do I recognize the symptoms of a heart attack?

The typical heart pain is "retrosternal", that is, pain in the middle of the chest, on the breastbone (sternum). The pain can be like a pressure, burning or squeezing and can reach the neck, chin and sometimes the left arm. Typically, it occurs with exertion and disappears when the exertion stops. Pain on the left side, right next to the heart, is very rarely from the heart, although it can be even violent, like an intense stab or like a "claw". This pain is NOT from the heart, although the patient is very agitated and anxious. In 99% of cases, it is just chest wall pain and nothing more.

What can people nearby do for the patient with symptoms of a heart attack until help arrives?

It is important to calm the patient, not to increase their panic, to help them sit in a comfortable position. The patient can also be given an analgesic (for pain) and, if available, a sublingual nitroglycerin (spray or tablet).

Why is prevention important? What investigations, by age group, do you recommend so that heart conditions are not diagnosed late?

Preventing a myocardial stroke is much cheaper than treating it, both in terms of the cost of treatment and actual hospitalization (which is quantifiable) and in terms of quality of life and life expectancy (which are immeasurable).

The essential prevention measures are:

•  stop smoking
•  as much sport as possible. Exercise is needed at least 3 times a week, minimum 20 min, regardless of age and sex. No excuses!
• a healthy diet, without food abuses. You can eat everything, a little, without abusing it, even a coffee, a glass of wine, etc. but without exaggeration.

As for the usual, annual, free tests through the family doctor, are very useful for early detection of diabetes or dyslipidemia. Weight and blood pressure control are extremely important and within everyone's reach. Once diagnosed with dyslipidemia or hypertension, it is essential that the patient takes their treatment for life, without interruption, according to the doctor's instructions. Once the target values for blood pressure, pulse or blood fat values have been reached, it means that the treatment must be maintained exactly the same, not interrupted. It means that the treatment is good and must be continued.

In the conditions of the COVID-19 pandemic, it is extremely important that, when symptoms appear, the patient sees a doctor, seeks solutions, and does not run away from hospitals and medical offices. The ostrich's position, with its head in the sand, only makes the disease worse and the patient ends up in the hospital when it is too late and the complications become multiple and serious.