Heart health: Learn the signs

Heart failure and stroke are leading causes of death in adult South Africans, more than four times the number of people who are murdered.

It is the leading cause of hospitalisation in people older than 65. Heart disease, a non-communicable disease, is one of the most serious threats to the health of our nation and it’s mainly due to our lazy, Western lifestyle.

With SA’s current crime statistics being released, it’s interesting to note that while 49 people are murdered in the country every day, a whopping 210 die of heart disease.

Heart failure does not mean the heart has stopped working. Rather, it means the heart’s pumping power is weaker than normal.

With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases.

As a result, the heart cannot pump enough oxygen and nutrients to meet the body’s needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently.

As a result, the kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

Diagnosis

The diagnosis is mainly made by history and examination. The doctor will ask about conditions you have, such as coronary artery disease, angina, diabetes, heart valve disease and high blood pressure.

You will be asked if you smoke, take drugs, drink alcohol (how much, which
drugs). Your doctor may also order tests to determine the cause and severity of your heart failure. These include:

Blood tests are used to evaluate kidney and thyroid function, as well as to check cholesterol levels and the presence of anaemia.

B-type natriuretic peptide (BNP) blood test. BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen and decrease when the heart failure condition is stable.

A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

Echocardiogram, an ultrasound which shows the heart’s movement, structure and function.

The ejection fraction is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present.

An electrocardiogram records the electrical impulses travelling through the heart.

Cardiac catheterisation is an invasive procedure that helps determine whether coronary artery disease is a cause of congestive heart failure.

The Stress Test is a non-invasive way to get information about the likelihood of coronary artery disease.

Causes

Coronary artery disease.
Heart attack.
Cardiomyopathy.
Conditions that overwork the heart.

Symptoms

If you have heart failure, you may have one or all of these symptoms – or none

The symptoms can include:

Congested lungs – shortness of breath, a dry, hacking cough or wheezing. v Fluid and water retention – swollen ankles, legs, abdomen (called oedema) and weight gain. Dizziness, fatigue, and weakness. Rapid or irregular heartbeats. Prevention Keep your blood pressure low.

Weigh yourself daily and check for swelling.

Maintain fluid balance. Your doctor may ask you to keep a record of the amount of fluids you drink or eat and how often you go to the bathroom.

Limit how much salt (sodium) you eat. Schedule regular doctor appointments. Keep records and take them with you to visits. Avoid these medications:

Nonsteroidal anti-inflammatory medications such as Brufen.

Some antiarrhythmic drugs.

Most calcium channel blockers (ask your doctor about these if you are hypertensive).

Some nutritional supplements such as salt substitutes, and growth hormone therapies.

Antacids that contain sodium (salt).

Decongestants such as most flu
tablets. Never stop taking your medications without asking your doctor.

Lifestyle changes

Stop smoking or chewing tobacco.

Reach and maintain your healthy weight.

Control high blood pressure, cholesterol levels, and diabetes.

Exercise regularly.

Do not drink alcohol.

Eat a healthy diet.

Prevent respiratory infections.

Get emotional or psychological support.

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