Summer, not for the weak hearted

With harsh summers being predicted for 2017, people suffering from heart diseases have to be extra cautious. They have to make a conscious effort to change their lifestyle, exercise and diet says Dr Sai Sudhakar, senior interventional cardiologist

Q What are the problems faced by heart patients during summer? Why do the hot spells or heat waves have worst impact on those who are suffering from heart diseases?
People with heart problems, have a two-fold chance of being affected by heat. Strenuous activities in this weather can cause heat exhaustion or heat stroke even to healthy individuals and they can die from extreme heat stress. A weaker heart might not pump blood efficiently enough to keep the body cool and keep the blood pressure at a high enough level. As a result, body temperatures may rise to dangerous levels.

Q How do heart patients who aren’t allowed to drink more than one litre of water per day, survive harsh summers?
Many heart patients try to balance the fluid levels in their bodies by taking diuretic medicines that rid the patient’s bodies of excess water and reduce their ability to sweat. Because heat and humidity also reduce the amount of water in the body, patients taking diuretics may need to have their medicines adjusted in the summer months. Also, dehydration lowers your body weight, so weigh yourself every day and write it down. If your weight drops more than two or three pounds from your usual weight, call your doctor to check if your medicines need adjusting.

Q What is the effect of heat waves and hot spells on the people who are suffering from heart diseases?
Heart patients are at a greater risk because they have low cardiac reserve. Their hearts are unable to quickly adjust to the changes the body goes through in extreme heat, such as an increased heart rate. Also, these patients become dehydrated very easily, even by sitting in a house that is too hot or walking outside in hot weather.

Normally, the body cools itself by increasing blood flow to the skin. In hot weather, blood flow to the skin may increases by three times for a healthy person. But, for heart patients, the heart muscle may be too weak and the blood vessels in the skin may not be large enough for the heat to be released through the skin. That means that heart patients have greater difficulty controlling their body temperature. It is vital for them to understand these important factors and ensure that hydration is maintained and the amount of time spent outdoor is reduced.

Q Do a lot of heart patients suffer from high level of blood pressure when they are exhausted or after a physical activity?
Everyone is at risk of heat-related illnesses such as heat exhaustion or heat stroke if he or she does not stay hydrated. But, heart patients are at a greater risk as their heart is not able to quickly adjust to the changes the body goes through. High temperatures can cause blood pressure to fall. Water loss through sweating impacts the body in various ways, including decreased blood volume, low blood pressure and rapid heart rate. Physicians recommend monitoring the usage of any drugs that effect sweat production.

Q What are the basic precautions for those who are identified with uncontrolled hypertension, heart diseases, stent in heart and have had a bypass surgery?

Heart patients must take care of these aspects in summer:

• Continue your usual exercise habits but move indoors to cool or air-conditioned spaces. For example, try walking laps in an air-conditioned mall instead of the park.
• Do not stay in a building or house without air conditioning for too long.
• Do not ride or sit in a car that does not have air conditioning.
• Keep a good hand fan at home.
• Be cautious and take frequent cooling breaks.

Q What food must they eat and what must they avoid?

Fruits are recommended in this season but heart patients have to ensure that they take smaller portions of meals.

• Eat fruits and vegetables for potassium and magnesium.
• Stick to smaller meals that don’t overload your stomach. Cold soups, salads, and fruits can satisfy your hunger and give you extra fluid.

Q What physical activities must they undertake during the month of summer and what must they avoid?
During the summer months, outdoor activity such as walking and gardening should be limited to early morning or late evening. Exercise very lightly in air conditioned room only.

• Try a slow walk or a light bike in a cool environment.
• Cut your intensity and duration to half.
• Practice yoga and meditation instead of strenuous exercise.