"Patients must adhere to fluid and salt restrictions, as having liberal salt and fluid intake was associated with worsening symptoms. Ramadan fasting is safe for most patients with chronic heart failure,” says Dr Mustapha Shaaraoui, Consultant Cardiologist and Consultant Cardiac Electrophysiologist at American Hospital Dubai. He cites a study of 249 patients with heart failure, which showed that fasting during Ramadan was associated with no changes or improvement in symptoms in 92 per cent of patients.
One challenge for heart patients can be the lavish iftar buffets, which are often loaded with food that might contain high salt content. “Equally detrimental, they tend to drink a lot of fluids within a short period time, a difficult task for their weakened heart to handle.
Patients should seek help if they develop worsening symptoms of heart failure such as shortness of breath, ankle swelling and fatigue.” Some patients experience difficulty taking their medicine, especially if it’s to be taken more than once daily, he says. Others may reduce their use of diuretics as they are afraid of being thirsty during long fasting hours. “Patients are advised not to omit any drugs prior to consulting their cardiologist,” explains Dr Shaaraoui. “Whenever possible, the physician should try to simplify the medical regimen and adjust diuretic regimen to fasting hours.”
Fasting could be beneficial for patients with stable heart conditions who have no active symptoms such as chest pain or shortness of breath, says Dr Shaaraoui. “The benefits might be related to smoking cessation, weight loss with reduced food intake and heightened spiritual involvement, which might help reduce stress and lower blood pressure during Ramadan.” However, fasting is not advised for patients with active chest pain, uncontrolled heart failure symptoms, uncontrolled blood pressure, severe valve disease, anyone with dangerous rhythm problems, or those who have had a recent heart surgery or suffered a heart attack. “Patients who are on a twice daily blood thinning regimen should be switched to once daily regimen if feasible. Otherwise, they cannot fast, especially if it is a long fasting day of 15 hours.”