Heart failure is one of the risk factors or comorbidities associated with death from COVID-19. Heart failure does not happen overnight but can develop over the years.
Many people will not know this but many people are unaware that they have Stage A heart failure.
Medications for heart failure but attention to the underlying cause is the main therapy.
This article is a repost from Aug 7, 2019. Read on and see how you can lower your risk of having severe COVID-19.
The primary purpose of the heart is to pump and supply blood all over the body. To pump an adequate amount of blood, the heart has to be adequately filled with enough blood (diastolic filling) to pump it out (ejection fraction). The heart cannot give what it does not have. If the heart cannot do its job, that is called heart failure.
According to the 2013 American College of Cardiology and American Heart Association Guidelines, if you have any of the following, then you are in Stage A Heart Failure. Even if you do not have any symptoms.
- Hypertension
- Atherosclerotic Disease
- Diabetes
- Obesity
- Metabolic Syndrome
- Use any medication that can affect the heart like anthracyline
- Family History of Cardiomyopathy
Why is it Bad to be in Stage A Heart Failure?
The seven conditions listed above impairs the ability of the heart to get filled with enough blood and weakens the muscles of the heart to effect a proper contraction. The less blood comes out of the heart, the less blood delivered to the organs.
Once the other organs like the kidneys, muscles, brain, and others detect that they are getting less blood, they start to adjust so that they can get more blood. The adjustments lead to salt and water retention to increase the blood volume, a faster heart rate, and constriction of the arteries that leads to higher blood pressure.
However, the heart has a filling problem in the first place secondary to the listed conditions and cannot pump appropriately in the first place. What happens next is that the compensation done by the other organs make heart failure worse. A vicious cycle of excess fluid, higher blood pressure, increased stress, and workload of the failing heart changes the structure of the heart. The heart begins to enlarge (left ventricular hypertrophy). This leads to the worsening of heart failure (lower ejection fraction) and the beginning of heart failure symptoms.
Stage B Heart Failure is when there is structural heart disease without any symptoms. This stage includes patients with previous heart attacks, enlarged heart, and lower pumping ability (low ejection fraction).
Stage C is Heart Failure is when the patient has Stage B but with symptoms.
Common Symptoms of Heart Failure
- Easy fatigability
- Shortness of breath with activity. Walking from one room to another will be difficult, and going one flight of stairs will need a rest in between.
- Swelling of the ankles then the legs and the thighs, abdomen (ascites), and chest (pleural effusion).
- Difficulty with laying flat is common (orthopnea). Patients use more pillows under the head to sleep. Some people sleep in the chair.
- Waking up many times in the middle of the night to urinate (nocturia)
- Waking up with a sense of drowning (paroxysmal nocturnal dyspnea)
Stage D is shortness of breath even without doing anything. Even while sitting. This stage requires frequent hospitalizations despite maximum medical care. This is the part when the doctors will talk to the patient about end-of-life goals.
The five-year survival rate for Stages A, B, C, and D is 97%, 96%, 75%, and 20% respectively.
Take Away Lesson
If you have any of the symptoms of C and D, visit your doctor if you haven’t.
If you have any of the conditions in Stage A, talk to your doctor if you need to be on medications like the ace-inhibitors angiotensin receptor blockers (ARBs) or statins. These are the recommended medications as per the 2013 ACC/AHA guidelines.
Stop smoking if you do. Start a physical activity program, avoid sweets, excess saturated fats, trans fats, and excess carbohydrates.
Stage A is easier to manage than B, C, and D. It is easier to control or maybe reversed with enough motivation by lifestyle changes. Every single condition in stage A leads to many other diseases. Therefore anyone who will make a lifestyle change may avoid many other non-infectious and dangerous diseases. Read about intermittent fasting here and the many benefits of exercise in this article.
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Reference:
- 2013 ACCF/AHA Guideline for the Management of Heart Failure. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Image Credits:
- Heart Failure By National Heart, Lung, and Blood Institute, National Institutes of Health; originally uploaded by Wouterstomp at en.wikipedia. – http://www.nhlbi.nih.gov/health/dci/Diseases/Hf/HF_SignsAndSymptoms.html; transferred from en.wikipedia to Commons by Stevenfruitsmaak using CommonsHelper., Public Domain, https://commons.wikimedia.org/w/index.php?curid=4848343
- Pitting edema of the leg By James Heilman, MD – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11787530
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