One out of five people over 80 years of age is important, such as 'Chopstick Meal Method'
Oct 03, 2024
|
However, when the heart muscle is damaged or weakened due to aging, the pump function cannot function properly, and this disease is called 'heart failure'.
About 1 in 10 of all patients had a Q&A with Professor Lee Hae-young of the Department of Cardiology at Seoul National University Hospital for fatal heart failure that died within a year after diagnosis.
- What is heart failure?
▶Heart failure is a disease in which the heart's function of pumping blood does not work properly as the Chinese characters 'Anilbu' and 'Totally'. About 2.6% of the Korean population suffers from heart failure, and the incidence rate has increased rapidly, especially from those in their 70s and older, and about 1 in 5 people over 80 are heart failure patients. Heart failure can also affect other organs due to insufficient supply of oxygen and nutrients to body tissues.
Heart failure is divided into acute and chronic, acute heart failure occurs suddenly within a week, and chronic heart failure occurs due to a gradual decrease in heart function. Most heart failure is chronic.
-What are the three main causes of heart failure?
▶The first cause of heart failure is 'repetitive myocardial infarction'. Myocardial infarction is caused by narrowing of the coronary arteries that supply blood to the heart muscle. Multiple experiences cause damage to the heart muscle and decrease heart function. The second cause is 'expandable cardiomyopathy', where the heart muscle is naturally weak. With this condition, the function of the heart can quickly decrease with age. The third cause is 'arrhythmia', in which the pulse suddenly becomes irregular. In particular, if arrhythmia, in which the pulse is nearly twice faster than usual, persists, the heart can become tired and heart failure can be caused.
In addition, high blood pressure, valve disease, excessive drinking and stress can cause heart failure, and drugs used in chemotherapy can also cause heart failure.
-What are the main symptoms of heart failure and how to diagnose it?
▶A typical symptom of heart failure is dyspnea. In particular, symptoms of shortness of breath appear when lying down, and coughing may occur. Some patients sleep on several pillows because breathing becomes easier as the upper body is raised. Another symptom is leg swelling. For severe edema, it may take one to two minutes to return to its original state when pressed with a finger.
When heart failure is suspected, the most common and frequently used diagnostic method is echocardiography. Through this test, the left ventricular ejection fraction (the rate of blood flow that escaped from the left ventricle during the heartbeat) can be checked to evaluate heart function. If the blood entering the heart is 100, 50 to 70 is generally pumped out, so the left ventricular ejection rate of normal people is 50-70%. If it is lower than this, it can be said that the heart function has deteriorated.
However, some patients with heart failure may have normal left ventricular ejection fraction levels, which is sometimes accompanied by other tests. In particular, the blood concentration of sodium diuretic peptide (BNP or NT-BNP), which is secreted when the heart increases, is widely used because it is useful for determining the severity of heart failure and the possibility of recurrence. This indicator can be measured through blood tests, and other blood tests are conducted to determine anemia, kidney and liver function, and electrolyte abnormalities. Electrocardiography can check for myocardial infarction and arrhythmia, and if necessary, nuclear medicine, MRI, and angiography are performed auxiliary.
- How to treat heart failure?
▶The most important thing for the treatment of heart failure is drug treatment. It is important for survival and treatment to steadily take drugs that improve the contractility of the heart muscle and help circulation by expanding blood vessels. Because drugs developed to treat high blood pressure are mainly used for the treatment of heart failure, the first person to take them may have low blood pressure or dizziness. If you continue taking medicine while adapting to these symptoms, heart failure can be significantly improved, and in particular, heart failure due to decreased systolic function can be improved in 2 out of 3 patients.
In the case of acute heart failure, people often visit the emergency room, and even the same drug is treated with intravenous preparations. In the case of chronic heart failure, various therapeutic drugs have recently been developed, and the two-year mortality rate, which reached 35% in the 1990s, has recently improved rapidly to a single digit of less than 9%. In other words, if you discuss the treatment direction with your doctor and receive constant medication, you can expect good results.
Meanwhile, severe heart failure, which is ineffective for medication, is treated surgically, such as coronary artery bypass, and some severely ill patients are also treated with cardiac resynchronization (CRT), which aids heart function using an artificial pacemaker.
In end-stage heart failure, heart transplantation is the most obvious way to improve prognosis, but there is a problem with a small number of donors. To overcome this, a step-by-step treatment strategy is becoming more common, in which a type of mechanical pump, LVAD, is surgically inserted, and then a patient maintains daily life while preserving the function of the heart and proceeds to transplant when a donor heart occurs.
- What are the prevention and management methods?
▶To prevent heart failure, you should avoid excessive drinking, stress, and speeding up your pulse. In addition, according to the doctor's instructions, you should undergo periodic checkups while thoroughly following the medication. In health examinations, echocardiography and blood tests are recommended at the same time.
After heart failure, it is important to eat blandly so that salt (sodium) does not accumulate in the body. Reducing the intake of soup with the idea of eating with chopsticks without using a spoon is a way to reduce the total amount of sodium in the body while minimizing discomfort.
To maintain a healthy heart function, smoking cessation and abstaining from alcohol are also essential. Proper aerobic exercise also helps strengthen heart function. In particular, exercise is very important for long-term survival of heart failure patients because it also helps preserve muscle mass. However, excessive exercise should be avoided enough for the heart to beat very quickly, and when the condition stabilizes, it is recommended to gradually increase the exercise amount. It is recommended to exercise a little sweaty on the back with 70% of the maximum exercise ability.
Professor Lee Hae-young explained, "Ten percent of patients with heart failure can go wrong within a year, but on the contrary, 90 percent can maintain their health through proper treatment and management. If you take your medication well, control your daily salt intake thoroughly, and train your heart with steady exercise, you can live with a healthy heart"If families also maintain a less salty diet for patients and help them move regularly, it will be very helpful in treating heart failure," he said.
|
bellho@sportschosun.com
