Jean-Claude Gasigwa, Rwanda’s number one tennis player, collapsed and died on spot on the morning of January 8 this year at Cercle Sportif de Kigali in Rugunga.

According to Cercle Sportif de Kigali officials, the 31-year-old was found dead by his colleagues in a football field where he is said to have been jogging on his own. It is suspected that Gasigwa could have died of cardiac arrest, but that will be confirmed when the postmortem report is released.

Cardiovascular diseases

Medics say that anyone can be a victim of Cardiovascular diseases (CVDs), a group of disorders of the heart and blood vessels. The biggest risk factors for this kind of diseases is an unhealthy diet, physical inactivity, tobacco use, harmful use of alcohol and old age. They add that in rare cases, these diseases can be genetic. Examples include coronary, rheumatic, congenital, peripheral arterial, and cerebrovascular heart diseases.

Signs and symptoms

Pain in the chest is a classic symptom of heart attack, and "the number one symptom that we typically look for,” says Anette Kainamura, a cardiologist at MedPlus clinic in Kacyiru.

Heart-related chest pain is often centred under the breastbone, perhaps a little to the left of the centre. She says the pain has been likened to ‘an elephant sitting on a chest,’ but it can also be an uncomfortable sensation of pressure, squeezing, or fullness.

But not all heart attacks cause chest pain. It can stem from ailments that have nothing to do with the heart, Kainamura adds.

Quite similarly, Kainamura mentions that persistent coughing or wheezing can be a symptom of heart failure — a result of fluid accumulation in the lungs. In some cases, people with heart failure cough up bloody phlegm.

She adds that constant fatigue, especially among women, may be a sign of an imminent heart attack.

However, a person can feel fatigued for other reasons. According to Darlene Mukagasangwa, a physician at MedPlus clinic, pain may also be felt in other parts of the body like shoulders, arms, elbows, back, neck, jaw, or abdomen.

She also lists shortness of breath as a symptom, pointing out that people who feel winded at rest or with minimal exertion might have a pulmonary condition like asthma or chronic obstructive pulmonary disease (COPD). But breathlessness could also indicate a heart attack or heart failure.

"Sometimes people having a heart attack don’t have chest pressure or pain but feel extremely short of breath,” Mukagasangwa says. "It’s like they’ve just run a marathon when they haven’t even moved.”

Also breaking out in a cold sweat is a common symptom of heart attack.

"You might just be sitting in a chair then all of a sudden you start sweating like you have been working out,” Kainamura observes.

Medics say heart diseases can cause swelling often in the feet, ankles, legs, or abdomen as well as sudden weight gain.

In the days leading up to a heart attack, as well as during one, some people experience severe, unexplained weakness.

"One woman told me it felt like she couldn’t hold a piece of paper between her fingers,” Mukagasangwa shares.

She warns against smoking or using tobacco, encourages regular exercise and having a healthy diet as a precaution for reducing heart disease risk.

Local scope

Rwanda had only four cardiologists, as of April last year. Rheumatic heart complication, which is the commonest in the country, usually affects people aged 15 to 25 years.

According to Patton-Bolman, the programme co-ordinator of Team Heart, a group of American specialists from Boston, which has conducted 102 heart surgeries since 2008 in Rwanda, with a success rate of 98 per cent, patients with heart complications in Rwanda are usually discovered late, making treatment expensive since cases are usually advanced.

She decries that for a nation (Rwanda) of 11 million people, there is no cardiac surgery hospital. Yet back in the US for every less than a million people there is one.

Dr Jean Marie Vianney Ganza, a cardiologist with the Rwanda Military Hospital, Kanombe, says although no national survey has been carried out, it is estimated that about a million people have heart related diseases country wide.

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