Dr Ali Faizal, an interventional cardiologist, has treated thousands of patients during his decades-long career. However, he gets a shock when examining some patients even now. The reason for the shock could be sometimes good and on other occasions, bad.
"Intervention is started for some patients who suffer a heart attack as a last resort. Miraculously, the heart begins to function normally again. I have felt that some strange power had activated the heart. It is like a clock that had stopped working restarting again. I feel extremely happy in such cases," says Dr Faizal.
On the other hand, he has faced tragedy too. A patient who was found to be normal in the Cath lab would suddenly suffer a cardiac arrest. "I have wondered why this happened and how. I am yet to unravel this mystery. Such cases are very rare. But even though I have saved thousands of patients, I cannot forget such rare failures," he adds.
Gas or attack?
Recently, a youth felt some burning sensation in the chest at night. He thought that it was due to indigestion and gas trouble. Deciding that some exercise would enable quick digestion, he started push-ups. After a few push-ups, he collapsed. Luckily, there were other people with him who rushed him to hospital.
He had suffered a heart attack which was evident in angiogram. It was a major attack and angioplasty was done immediately which saved his life.
"Till a person suffers a heart attack, he or she will never admit that they are at risk. All uneasy feelings felt in the chest area do not mean a heart attack. However, gas trouble developing suddenly in the night hours could be an attack," says the doctor.
A healthy youth who has no obesity, who does not over eat and exercises daily can also suffer a heart attack. This makes people wonder why all the hue and cry is made to change lifestyles. The doctor explains, "All these factors reduce the risk of heart attack. However, the possibility cannot be completely ruled out. Usually, an attack takes place when fat accumulates in the blood vessels and plaques are formed which gradually block the vessels. The time taken for plaque formation, its size and the possibility of blocking blood vessels varies greatly with each person. In young men the stress they face can have a damaging effect which may escape the notice of doctors."
Why he became a cardiologist
Dr Ali Faizal has an emotional reason for pursuing his higher studies in cardiology. His father, Dr M K Muhammed Koya, had founded the Kozhikode Nursing Home, one of the first private hospitals in Kozhikode. Dr Koya suffered a heart attack while Faizal was studying for MBBS. At that time, the treatment was drugs like heparin and pain relievers. Advanced treatment was not available even in Chennai. So Faizal's father was taken to London for treatment. Faizal's mother accompanied him. Dr Koya later returned safely from London.
"During those days, the angiogram result was in the form of a film. I took it to Chennai and checked it and was shocked. It was a massive attack and while returning home from Chennai I decided to become a cardiologist," says Dr Faizal.
Dr Faizal has been in this field since 1991and has several observations to make. "Over these years, the incidence of heart diseases has increased manifold in our state. The main reason for it is lifestyle changes. At the same time, the advancement Kerala has achieved in the treatment of heart diseases over the last 10-15 years is a model for the country," says the cardiologist.
When he joined the Madras Medical Mission, the entire treatment was different. When a person suffered a heart attack, the doctors attempted to give him temporary relief and stabilize him. This took 2-3 weeks. The main treatment started afterwards.
But now, the entire concept regarding treatment has changed. In the past the main instruction regarding angioplasty was that it should not be done on a patient immediately after an attack. However, now angioplasty is carried out as soon as possible. This change was effected based on studies and Kerala was among the first places to implement it.
Good treatment in Kerala
Earlier when a person in Kerala suffered a heart attack, he had to be taken to Chennai for advanced treatment. "When the Madras Mail reached Chennai station, we at Madras Medical Mission will be ready to receive patients. Later heart patients started heading to Coimbatore, too," says Dr Faizal.
However, things began to change in Kerala when good treatment was provided at Thiruvananthapuram, Kochi and Kozhikode. "Moreover, when everyone realized that time was a very important factor in the treatment of heart disease, changes took place more swiftly. Within a few years, cardiac catheterization labs became common in Kerala. Now a patient suffering a heart attack anywhere in the state can be taken to a hospital having facilities for primary angioplasty within one hour. This has saved several lives," says the doctor.
Around 70% of the patients who needed intervention were subjected to open heart surgery in the past. Only the remaining 30% had angioplasty. But now the situation has become reverse. Barely 20 to 30% have surgery. Some patients, however, may need surgery as the first option. Patients seeking a second opinion belong to this category. They want to know whether angioplasty is possible, informs the doctor.
Though several advancements have taken place, Kerala is still to make paediatric cardiology and electrophysiology available. There is much scope in these fields, says Dr Faizal. Even if such procedures are made possible, we should always give stress to disease prevention, he points out. "The key factor is leading a healthy lifestyle," winds up Dr Faizal.