Posted on 12 Apr 2018
How should a heart disease patient approach Ramadan fasting?
Author : Dr Rajesh Rajan
Holy
month Ramadan is auspicious for worldwide Muslims and most of them starts fasting
early in the morning up to the sunset in the evening during this entire month.
Heart disease patients tend to fast during Ramadan but they have many questions:
1.
Cardiac patients can fast?
The Holy Quran
exempts sick people from fasting. Fasting is allowed only for stable heart
disease patient and its strictly the discretion of the treating cardiologist.
Common
types of cardiac conditions as follows:
A.
Patients who had heart attack or recent stenting or
open heart surgery
Many
studies comparing Ramadan with other months in cardiac patients shows there is
no significant differences in the incidence of heart attack or typical cardiac
chest pain during Ramadan. Patients with recent acute heart attack, heart
attack equivalent chest pain with high cardiac enzymes, recent stenting, recent
open heart surgery should strictly avoid fasting.
B.
Patients with low pumping of heart
Low
pumping of the heart is one of the common cause of frequent hospitalisations
among cardiac patients. Many studies done in the middle east shows there was no
significant difference in the number of hospitalizations for patients with low
heart pumping during Ramadan. Its almost similar to other months without
fasting. But in this category certain groups of patients cannot fast especially
patients with difficulty in breathing, associated swelling of legs, associated
cough and sudden increase in weight.
C.
Patients with High Blood Pressure.
Most of
the high blood pressure patients on controlled medications can fast during
Ramadan as it will not affect the blood pressure readings and it was proved in
many studies. Certain group of patients with resistant blood pressure who
requires multiple drugs for controlling should consult treating doctors before
Ramadan for appropriate dose adjustments. If dose adjustment is not possible
then for such patients it is advisable to abstain from fasting to avoid cardiac
and other complications.
2. How to take their cardiac drugs during this month?
Stomach ulcer and related complications are common during Ramadan. Hence drugs which can cause gastric irritation (like Aspirin) should be taken as per the advice of treating doctor. Before Ramadan you should consult your doctor and make sure regarding the dose and timing. Medications like water pill (Lasix) to be avoided during fasting.
3. Life style during Ramadan
Avoid
over eating while breaking the fast
Avoid
exercise after a large meal
Stop
Smoking
4. Can cardiac patients do Hajj Pilgrimage?.
Cardiac patients who is certified as stable and fit
by the treating cardiologist can go for Hajj
Full medical work-up is mandatory before Hajj
Patients with recent acute heart attack, heart
attack equivalent chest pain with high cardiac enzymes, recent stenting, recent
open heart surgery are UNFIT for Hajj.
Take Home Message
a. Consult your doctor before Ramadan regarding your
health condition and dose adjustments if required.
b. Comply to medication
c. High risk patients should avoid fasting
d. Unfit cardiac patients should not try Hajj
pilgrimage
Dr.
Rajesh Rajan
PRESIDENT - INDIAN
ASSOCIATION OF CLINICAL CARDIOLOGISTS