Heart attack is a medical emergency that needs to be addressed immediately as it can quickly turn fatal. A heart attack is caused when plaque builds up in the arteries and leads to blockage. When this plaque ruptures, blood clot is formed which causes heart attack. Due to this, the blood and oxygen doesn’t reach heart and irreversible damage starts to happen to heart muscles and become fatal. People with family history of heart ailments are more susceptible to such cardiac events. Those leading unhealthy lifestyle and having chronic issues like hypertension, high cholesterol levels and diabetes may also be at higher risk of heart attack.

Heart attack symptoms include chest pain, tightness, discomfort, fatigue, cold sweat, heartburn, nausea, shortness of breath. Sometimes heart attacks are silent, and symptoms can feel like sore muscle in heart, ache in jaw or arm or upper back, fatigue or indigestion.

Any such discomfort or symptom should not be ignored, and one must approach a hospital’s emergency immediately.

There are a couple of ways one can know if they are having a heart attack:

1. ECG

An Electrocardiogram (EKG) will be performed immediately after you arrive at the hospital. It records the electrical signal from the heart and can detect a heart attack. Not all heart attacks show up on the first ECG. An ECG can also show evidence of a previous heart attack.

2. X-Ray

Imaging tests like a chest X-ray or computed tomography (CT) can also help determine the possibility of a heart attack. One can also be recommended a stress test which can help your doctor determine the amount of damage to your heart.

3. Blood test

“Whenever a heart attack occurs, muscle proteins from the heart get released from the damaged muscle to the blood. Heart muscle proteins like myoglobin, troponin I, troponin R, are released. Various diagnostic tests like troponin assay tests are available to detect and quantify the degree of myocardial infarction. The greater the value, the larger is the myocardial infarction.

These diagnostic tests are useful not only in diagnosing early attacks, but also prognosticates the patient’s prognosis,” says Dr Kala Jeethender Jain, Consultant Interventional Cardiologist.

“These proteins typically rise within 6 to 12 hrs after attack, reaches a plateau and then normalizes after 48 hrs. Proteins like troponins are detected up to 10 days after attack. If the patient has typical cardiac symptoms and troponin test initially is negative, then a repeat test again has to be done demanding the clinical situation because many times a repeat sample turns out to be positive. Nowadays high sensitive troponins (HS trop) are available in emergency rooms which can even detect minor attacks too,” adds Dr Jain.

LUCKNOW The DEN-2 variant of dengue is prevalent among individuals who have tested positive for this mosquito-borne disease in Uttar Pradesh, according to data from the health department.

“Out of 46 samples sent from Gautam Buddha Nagar for genome sequencing, all have tested positive for DEN-2, the second strain of dengue, which multiplies faster. No new variant of dengue has been reported in the state this year,” said Dr Vikas Singhal, joint director of vector-borne diseases in the Uttar Pradesh health department. Samples from Ghaziabad have also tested positive for DEN-2.

So far, over 6000 cases of dengue and seven deaths among dengue patients have been reported in the state. The three districts with the highest dengue cases are Gautam Buddha Nagar (627 cases), Ghaziabad (575 cases), and Lucknow (700 cases).

DEN-2 was the predominant strain, accounting for over 89% of positive dengue cases in 2022 as well. Among the 252 samples tested to identify the strain, 157 tested positive for DEN-2, while three showed a double infection of DEN-2 and DEN-4, according to the data.

There are four strains of dengue (DEN-1, DEN-2, DEN-3, and DEN-4), and among them, DEN-2 is known to infect people the fastest. This year, over 6,000 people have tested positive for dengue in the state, with seven fatalities.

“We are currently in the September-October period, which has historically seen a peak in dengue cases. This year, cases are still being reported daily, but with increased surveillance and follow-up by our field staff. However, the number of patients developing severe symptoms and fatalities has decreased. We hope the peak will pass with even fewer cases,” said Dr Singhal.

Among all the reported cases, Lucknow has documented 415 dengue cases. Dr Abhishek Shukla, secretary-general of the Association of International Doctors, noted a change in people’s perception, stating that individuals are taking fever, the most common symptom of dengue, more seriously and seeking medical attention earlier. This has contributed to the prompt initiation of appropriate treatment. Dr Shukla also emphasised that dengue symptoms should not be taken lightly and typically include joint pain, fever, vomiting, nausea, and headache.

What’s More Troubling Than Dengue?

High fever and prolonged joint pain following a fever are causing significant distress to many individuals. Doctors attribute this condition to ‘pyrexia of unknown origin’ or viral fever. “This type of fever requires further investigation to determine if it is scrub typhus or another viral infection,” said Dr PK Gupta, former president of the Indian Medical Association in Lucknow.

“Fevers lasting more than 24 hours require proper medical attention, especially among pregnant women. With viral infections affecting many individuals, self-medication should be avoided, particularly among pregnant women, children, and the elderly,” said Dr Amita Shukla, a senior gynaecologist at SC Trivedi Memorial Trust Hospital.

Dr Gupta suggested some measures, saying, “There is no need to panic if you have a fever but test negative for dengue. Keep an eye on your platelet count and haematocrit levels, as they can indicate dehydration.” Doctors also pointed out that despite the sunny and hot weather in Lucknow, there is still a risk of viral fever.

“Using air conditioners at temperatures as low as 20 degrees Celsius and quickly transitioning between indoor and outdoor temperatures of around 30 degrees Celsius is risky. It is advisable to maintain a moderate AC temperature of 27 or 28 degrees Celsius,” said Dr Gupta.

While most persons infected with COVID-19 experience minor symptoms and recover in a matter of weeks, the global pandemic caused by the SARS-CoV-2 virus remains a significant health danger.

Some of those infected may develop more severe illness and pneumonia, resulting in a more bleak outlook.

Although techniques for assessing patients’ risk have been created, diagnostic and prognostic tools rely mostly on expensive and less accessible imaging technologies such as radiography, ultrasonography, or computed tomography (CT).

As a result, there is a need for the development of a simpler and more easily accessible prognostic tool that allows healthcare providers to identify individuals who have developed or are at risk of getting severe disease. This would simplify patient triage and allow for earlier intervention, even at home or in primary care settings.

In the early stages of COVID-19, a research team directed by IBEC and Hospital del Mar, with support from the Universitat Politècnica de Catalunya (UPC), CIBER-BBN, and CIBERES, conducted a study based on the analysis and interpretation of cough sounds.

This method is given as a potentially predictive, straightforward, and user-friendly tool for assessing the risk of severe pneumonia.

The study included smartphone recordings of voluntarily coughing sounds from 70 patients with SARS-CoV-2 infection, all taken within the first 24 hours of their hospitalisation.

IBEC performed an acoustic analysis of these recordings, which revealed significant changes in cough sounds depending on the severity of the respiratory ailment, which had previously been confirmed by imaging tests and the requirement for supplemental oxygen.

According to the findings, this approach might be utilised to classify COVID-19 patients as mild, moderate, or severe, as well as to monitor patients with chronic COVID-19. The study used data obtained at Hospital del Mar between April 2020 and May 2021, and the results were published in the European Respiratory Journal Open Research.