The heart failure (HF) is the leading cause of death from cardiovascular disease (CVD) in Argentina. It is also one of the great factors that usually trigger a sudden death. As with all CVDs, the risk of HF increases with age. However, specialists consulted by THE NATION warn that the middle-aged people (45 to 55 years old)due to the increased incidence of risk factors generated by the coronavirus pandemic, such as a sedentary lifestyle, alcohol consumption or being overweight, they must also be alert to avoid heart problems that could later lead to HF.
According to him Ministry of Health of the Nationduring 2020, latest figure available, More people died from HF (24,008) than from an acute myocardial infarction (18,881). Specialists indicate that this is so because HF treatment is complex and requires exhaustive follow-up, something that not all patients undergo.
In fact, at the local level, deaths from HF represent 25% of all deaths from CVD (97,231). Data from 2020 indicate that deaths from this insufficiency grow exponentially from the age of 60. But according to Florence Renedocoordinator of Heart Failure, Mechanical Circulatory Assistance and Intrathoracic Transplantation of the Favaloro Foundationare being observed more frequently heart attacks in younger people due to the high incidence of risk factors such as sedentary lifestyle, stress, alcohol or tobacco consumption, and being overweight, among others. That heart attack can then lead to HF, as most heart conditions do if not treated properly.
Mirta Ten, Head of the Heart Failure and Transplantation Program ICBA Cardiovascular Instituteexplains that heart failure occurs when the heart cannot pump blood properly. This happens because the left ventricle cannot contract properly or cannot relax due to a “hardening” of the heart.
The specialist points out that this pathology manifests itself in the following ways: “The symptoms that allow us to think that the patient has HF are shortness of breath during exercise, which may also manifest itself, if the condition progresses, when the patient is at rest. IC can also cause a feeling of tiredness, dizziness, loss of consciousness, swelling in the feet or difficulty urinating.
Diez adds that the most common is that HF is reached after suffering a heart attack caused by obstructions in the coronary arteries or other risk factors such as being overweight, high blood pressure, and diabetes, among others. All of these, warns the specialist, they are also risk factors that affect young people.
However, Diez clarifies that there are other risk factors that lead to HF without the need to have suffered a previous heart attack. Those factors can be genetic cardiomyopathies; diseases such as Chagas and substance abuse or the so-called “toxic causes”, generated by chemotherapy after cancer treatment. Nicholas Atamañukhead of Heart Failure and Hypertension of the Hospital Australpoints out that within substance abuse, the one that is most seen among patients is excessive alcohol consumption.
“Alcohol consumption in different registries was associated with a decrease in cardiovascular risk. But, there is a point where the person consumes too much and that is when the opposite happens, the risk begins to increase and directly affects the myocardium. However, toSome patients, after stopping drinking alcohol, in approximately six months, manage to recover normal ventricular function.”, describe Atamañuk.
The specialist adds that in those under 40 years of age, the most prevalent cause of HF is not heart attacks, but heart disease whose causes are not easy to establish. He also points out that, although unusual, there were young patients who went through a coronavirus case that generated myocarditis that could later lead to HF.
“That is why we recommend that patients who have had Covid-19 have a cardiovascular check-up. In addition, being locked up led many to have an inadequate diet and consume alcohol in high quantities. All of this, added to a sedentary lifestyle, produces an increase in risk factors”, remarks Atamañuk.
“HF grows notably in those over 70 years of age, but there are young people who have congenital heart disease or who have had cancer treatment and could develop HF. On the other hand, every time we live in a world that makes us be more still, we have stopped moving and that increases cardiovascular risks. The coronavirus pandemic deepened all these risk factors and, in addition, caused many people to postpone their controls”, says Renedo.
According to Diez, death from HF occurs when this condition progresses and generates a picture in which the patient is short of breath at rest, retains fluids and suffers from a lack of blood supply to the organs, especially the kidney and liver.
Another relevant aspect about HF is that it is one of the main causes that trigger sudden death. This is defined as a death where the person did not present symptoms in the 24 hours prior to death. “HF generates sudden deaths due to arrhythmias originating in the ventricles such as ventricular tachycardia and ventricular fibrillation. There are many other causes that generate sudden death, such as genetic issues, but HF, especially when there is a deterioration in heart function, can lead to sudden death”, indicates Diez.