When celebrities fall sick

When celebrities undergo health checks, they also help raise awareness on the ailment.

For creating health awareness one needs to follow the basic principles. Firstly, hit the iron when it is hot and secondly, involve the people who count.

HT Image

What great opportunity the world had when Bill Clinton fell sick and underwent bypass surgery at a hospital in New York City after doctors detected blockages in his coronary arteries.

When Atal Bihari Vajpayee, the then Prime Minister of India, underwent a knee replacement, everybody in the country wanted to know what a knee replacement was. Ever since number of knee replacements in the country has increased manifold. Doctors today do not have to convince their patients and explain about knee replacement surgery.

The Clinton episode has created another opportunity for the people world over to know everything about bypass and why a fit politician and hero of the community like Clinton had to undergo a bypass surgery. Bill Clinton was a non-smoker, non-diabetic and off late had completely controlled his weight by dieting and regularly exercising. Then what made him suffer coronary blockages?

Firstly in 2001, he was found to have high cholesterol and mildly elevated blood pressure. He was prescribed medicines to control cholesterol but he left them in between. During his Presidency, his lifestyle was completely haywire with eating a lot of junk fast food.

High cholesterol, high blood pressure, eating junk food and mild obesity was sufficient for his coronaries to acquire blockages at a slow pace over a period of time which precipitated symptoms and he was forced to undergo angiography and subsequent surgery.

The fact that he had blockages in all the arteries and required quadriple bypass means that he was suffering from blockages over a period of time. Coronary blockages that develop significant enough to cause symptoms may take upto a decade to form.

The first manifestation of a blockage may be a heart attack but that happens only in people with one or two arterial blockages, one of which usually is less than 50 per cent block and the attack comes due to a rupture of a plaque. In most other instances the manifestation is in the form of chest pain on exertion or shortness of breath on exertion.

Any chest pain in the centre of the chest which is of more than 30 seconds and is not localised should be considered cardiac pain unless proved otherwise. Any breathlessness of first onset after the age of 40 is cardiac in origin unless proved otherwise. Clinton had both the warning signals making it easier for the doctors to diagnose the condition early enough.

Politicians should be role models to the society. They have to take care of their health very seriously. Clinton should have been more careful about his diet during his Presidency, avoid all types of junk food and taken his medicines regularly.

Clinton also made statement that he was one of those 10 per cent of the people who otherwise are in good health with a negative stress test but still had problems in their angiography.

He said that people who have a family history, have high cholesterol and high blood pressure should go for angiogram even if there are no symptoms. While this statement may be true for US but is not true for the Indians. In Indians a fair medical trial with life style management should always be tried in asymptomatic patients before subjecting them to angiography or surgery.

(Dr. Aggarwal is President, Heart Care Foundation of India, Deputy Dean, Board of Medical Education, Moolchand Hospital and President Elect, Delhi Medical Association.)