One in four deaths in the UAE is attributed to cardiovascular diseases. Call it an alarming statistic or a wakeup call, but fact remains that the time for pregnant pauses has long passed. A 2012 study of all the cases of cardiovascular cases admitted to Dubai Healthcare Authority hospitals last year strongly advocated the need for early screening, according to Dr Fahad Baslaib, Consultant Interventional Cardiologist and Director of Rashid Hospital\'s Cardiology Department. Last year, both Rashid Hospital and Dubai Hospital conducted 3,100 coronary angiography and angioplasty cases with the high incidence of diabetes, obesity and hypertension termed as the main culprits behind it. Of the cases, 20 per cent were Emiratis, 60 per cent of the patients were diabetic, 50 per cent of them were hypertensive and had high cholesterol and 50 per cent of them were smokers. As more and more residents are exposing themselves to heart ailments, the medical community across the country is urging people to recognise signs before it’s too late. Emirates 24|7 tell you how... Shortness of breath Do you wake up in the dead of the night or early morning, feeling like a heavy weight is compressing your chest or the even the simple act of deep breathing is causing you distress? This particularly happens when lying down. Other things to take note of are opting to snooze in a chair or a recliner because it’s more comfortable. Or worse, losing sleep altogether due to discomfort. Don’t chalk this down for sleep apnea or indigestion if the symptoms continue. Because heart disease can cause the organ’s pumping mechanism to weaken, blood can back up in the vessels that return blood from the lungs to the heart, causing fluid to leak into the lungs. Chest discomfort Pain in the chest is the classic symptom of heart attack, or so we’ve been told. But not all forms of chest pain can lead to a life threatening medical emergency. Recognise the signs, that a heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. Some call the pain as excruciating as an elephant sitting on the chest. But this doesn’t happen all the time; sometimes, symptoms can be a little more moderate with just feeling of discomfort and squeezing in the chest. Exhaustion or fatigue Are you noticing a sense of tiredness that overwhelms your body more often, of late? Usually dismissed as stress, and more often the case for women, what needs to be recognised is how strong the sense of fatigue can really be. We are not talking about loss of energy to go out for a jog, but the inability to perform even menial tasks such as getting up to eat or walk into the next room. What happens in such instances is that the weakened heart is unable to pump adequate blood, resulting in the body kicking in to fuel the vital organs. In such cases, the muscles are deprived of oxygen, so they tire faster. Sudden loss of appetite Caregivers are more likely to notice the frequency of excuses for not eating a meal due to lack of hunger. This could happen gradually, with portion sizes decreasing or overnight, with an upset stomach condition often being used as a crutch. This sensation of being full may also come hand in hand with nausea, constipation, a general feeling of being sick to the stomach; sometimes, abdominal pain and or bloating in the belly can also be noticed. Fluid retention around the liver and intestines interferes with digestion and can cause bloating. Swelling and fluid retention In many instances, fluid retention goes beyond the abdomen and occurs in other areas of the body, which is considered one of the primary reasons of heart attacks. It can start out suddenly, with clothes tightening and shoes not fitting anymore. You may also notice puffiness in your arms and legs, with your ankles swelling up considerably. As your blood flow slows, blood returning to the heart to back up in the veins. The fluid then builds up within tissues, particularly in the abdomen, legs, and feet, a condition known as congestion. Anxiety Those patients at high risk often complain of being wound up tight in the lead up to a heart attack. Excessive sweating, sleeplessness, and a sense of doom may all be felt in the corresponding few weeks. Many a times, patients put these symptoms off as stress. But if there are no sudden reasons to cause this level of being keyed up, then it is time to consult a doctor. For caregivers, it is imperative to keep track if the person is suddenly prescribed an anti anxiety medication or an antidepressant and there have been no sudden changes in mood. Changes in heart rhythm Repeated bouts of the above mentioned anxiety can also lead up to this, but if a slow heartbeat or racing heartbeat is being recorded, then these are surefire signs that a person may be suffering from cardiovascular disease. In the leap up, patients often complain of rapid and irregular pulse and heart rate, where people find themselves gasping for breath, as their chests thumps like they’ve run up a hill, despite embarking on a leisurely stroll on a straight path. Cough As a patient’s heart condition weakens, another symptom to rear its ugly head is a persistent, nagging cough. This is largely caused as a direct result of fluid accumulation in the lungs. In some cases, people with heart failure can also cough up bloody phlegm. The condition worsens when lying flat. If the onset is sudden, with no signs of improvement, consult a doctor immediately. Pain in parts of the body Many heart attacks victims have complained about pain that goes beyond the chest and spreads to the shoulders, arms, elbows, back, neck, jaw, or abdomen. Men having a heart attack often feel pain in the left arm. In women, the pain is more likely to be felt in both arms, or between the shoulder blades. The pain can come and go, and sometimes occur while no chest pain is occurring. Recognise the lifetsyle risk factors Cardiovascular disease is closely associated with certain health risks, with Rashid Hospital’s Dr Baslaib saying in a statement: “It is a known fact that 80 per cent of these cases are preventable through lifestyle modification. “Yearly 17.1 million people die of heart attacks in the world. This figure is alarming and shows us the magnitude of the problem.\" In fact, 9 out of 10 people with cardiovascular disease have at least one of the risk factors, which include obesity, poor diet, too much alcohol, smoking cigarettes, high cholesterol and diabetes. Dr Baslaib added: “The difference between our region and other places in the world in terms of heart diseases is that we have a high incidence of diabetes and in the Middle East region the average age of heart attacks is 50 to 55 years as opposed to 65 years in western countries. This is a significant difference and advocates the need for urgent lifestyle modification.” Recognise the signs in your lifestyle and make the change before it’s too late.