2023-07-03 05:19:57
Mijeong Kim is a professor of cardiovascular medicine at Incheon St. Mary’s Hospital, The Catholic University of Korea.
[헬스코리아뉴스 / 김미정] The heart is an organ that pumps non-stop and supplies blood throughout the body. It carries oxygen and nutrients to the blood and sends it from head to toe to maintain life.
Heart failure (heart failure) is a kind of complication caused by various underlying diseases. It is a disease in which the heart function is deteriorated for various reasons and blood supply to each part of the body cannot be properly performed. There are various causes such as clogged blood vessels in the heart (coronary artery disease), unstable pulse (arrhythmia), or weakening of the heart muscle itself (hypertension, diabetes, cardiomyopathy due to genetic abnormalities), just like a car engine or parts malfunctioning. It can be likened to a state where you can’t drive properly if you run out of fuel or run out of fuel.
End-stage heart failure is a more terrifying disease than cancer, with a mortality rate of more than 50% within 5 years, but it is a disease that can be diagnosed and managed sufficiently early as prevention and treatment methods gradually develop.
◇60 years of age or older, underlying heart and systemic diseases, and adult chronic diseases are all at risk of heart failure
According to the Health Insurance Review and Assessment Service, the number of patients who visited the hospital for heart failure in 2021 was 239,682, an increase of 8.3% over four years compared to 221,315 in 2017. More than 85% of all heart failure patients were in their 60s or older, and by gender, women were regarding 1.4 times more than men.
Hypertension and coronary artery disease are more than half of the causes, and valve disease, arrhythmia, and cardiomyopathy are also causes. Recently, obesity due to lifestyle, metabolic syndrome, and heart failure due to diabetes have increased significantly. Obesity, hyperlipidemia, and hyperglycemia cause chronic inflammatory conditions and damage myocardium and blood vessels, leading to heart failure. Even if there is no specific disease, the risk increases with age, and statistics show that 5.5% of those in their 60s and 70s and 12% of those over the age of 80 are diagnosed with heart failure.
Even if there was no special heart problem in the past, heart failure can occur suddenly in elderly people with underlying diseases such as severe lung, kidney, liver, cognitive impairment, autoimmune disease, or cancer, or in a debilitating general condition. Heart failure can occur when people who are sensitive to cardiotoxic drugs, such as anticancer drugs, alcohol, and appetite suppressants, are exposed to these drugs.
Although the survival rate following treatment for serious heart disease such as acute myocardial infarction has increased, some of the resuscitated patients have heart failure. As life expectancy is getting longer and the population of chronic diseases such as hypertension and diabetes is steadily increasing, the number of patients with heart failure is also expected to increase considerably.
◇Suspicious if dyspnea, edema, indigestion, tachycardia, etc.
The most common symptom of heart failure is shortness of breath. This is because when heart failure occurs, pulmonary edema appears, in which blood collects in the lungs. In the beginning, shortness of breath occurs only when moving hard, but when it gets worse, shortness of breath appears even when lying down or sleeping. Also, the ankles and calves are swollen, and if severe, revenge is cold. Some complain of indigestion, which is a symptom that occurs when the pump function of the heart is not sufficiently supplied to the stomach and edema is accompanied.
The sympathetic nerve is stimulated, causing the heart to beat rapidly (tachycardia), and mild cognitive impairment may worsen in the elderly. It is particularly common in the frail elderly and can be mistaken for age. In severe heart failure, muscle is lost, so energy runs, it is difficult to move, and weight is lost due to lack of appetite.
If you find it difficult to make movements that you might do six months or a year ago, you should suspect heart failure. For example, if you can easily run two laps in the park in the past, but get out of breath following just one lap, or go up several flights of stairs easily but get tired, it might be a sign of heart failure. It is important to get into the habit of measuring your fitness regularly for early detection.
◇ Stage 4 end-stage heart failure, higher mortality rate than cancer
Heart failure is classified according to severity, and is divided into four stages, from the early stage with no symptoms and only risk factors for myocardial damage to the late stage requiring heart transplantation.
Stage 1 is an asymptomatic high-risk group, including hypertension, diabetes, obesity, metabolic syndrome, cardiovascular disease (cerebrovascular, peripheral vascular, coronary artery disease), history of exposure to cardiotoxic drugs, and cardiomyopathy gene holders. A healthy lifestyle, such as diet, exercise, and smoking, and treatment that corrects risk factors with drugs that have been proven to prevent heart failure are needed.
In stage 2, there are no symptoms of heart failure yet, but abnormalities in the structure or function of the heart have begun. This is when a blood test detects a number that indicates heart damage, or an echocardiogram shows cardiac enlargement, valve abnormalities, and decreased myocardial contraction or diastolic function. In order to prevent the progression of heart failure in earnest, it is essential to actively correct the causative disease, avoid harmful factors, and use medications that have been proven to prevent heart failure.
From stage 3, symptoms of heart failure begin to appear. Dyspnea and edema interfere with daily life, decrease quality of life, and increase long-term mortality. Therefore, drug treatment to improve long-term survival rate along with drugs to control symptoms such as diuretics is needed. Some patients may need hospitalization and procedures or surgery. Fortunately, research for the prevention and treatment of heart failure is constantly progressing around the world, results are being published, and treatment is advancing.
Stage 4 is a state of end-stage heart failure in which symptoms of heart failure continue despite aggressive treatment, and the mortality rate is higher than that of cancer. Since drugs alone are not effective, heart transplantation or cardiac assist device implantation may be required.
Occasionally, treatment for heart failure may be delayed, may temporarily increase the glomerular filtration rate of the kidneys, or may conflict with long-term medications for diabetes, kidney disease, or arthritis. Therefore, it is necessary to accurately determine the state of the heart and existing diseases and reestablish the goals and priorities of treatment.
Heart failure is a progressive disease with many complications, but if you consistently manage it with a healthy lifestyle and proven medication, you can prevent its progression and enjoy your daily life before you get sick. Early detection and active treatment are essential.
[Tip. 심혈관질환 예방 수칙]
1. Smoking cessation and sobriety
2. Have good eating habits: Reduce salt (soybean paste, soy sauce, red pepper paste) and sugar intake, and eat vegetables, protein, and nuts evenly. Ingredients are fresh and less processed, the better. In particular, the elderly consume enough protein.
3. Be sure to exercise: 3 days a week, exercise enough to sweat for at least 30 minutes. Warm up (stretch) for at least 3 minutes before exercising. If strenuous exercise is difficult, you can walk on flat ground at your own pace. Let’s slowly increase to 7,000 steps a day.
4. Obesity management: Maintain an appropriate weight and waist circumference through regular and steady exercise and diet.
5. Medication: Consistently manage hypertension, dyslipidemia, and diabetes, focusing on medications proven to prevent heart failure.
6. Know the symptoms of stroke, myocardial infarction, etc., and learn CPR for yourself and your family.
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