Q: I am a 56-year-old man who has been diagnosed with hypertension.
What are the common causes of heart failure and can it be reversed? My father died from a heart problem.
Will I suffer from heart failure too? What are the symptoms and signs? Are there any changes I should make to my lifestyle?
I usually eat out and love to order fried food. I work late and eat dinner at around 9pm. But I take a 15-minute walk around my neighbourhood after dinner. Is this enough?
A: The common causes of heart failure are uncontrolled high blood pressure, blockages of the heart arteries, poorly controlled diabetes mellitus, a recent or past history of a heart attack, irregular heart rhythm and malfunction of the heart valves.
A relatively common cause is the inflammation of the heart muscle due to a recent viral infection. This is commonly referred to as myocarditis.
Less common causes are thyroid disorders, severe systemic infections, emotional crises, certain types of cancer, anti-cancer drugs and genetic mutations.
Just because your father had heart problems does not mean you are at high risk of developing heart failure.
It depends on the cause of your father's heart problem.
An inheritable form of heart failure is very rare. This is usually due to a cardiomyopathy, a condition in which the heart muscle thickens.
More commonly, you may have the same risk factors for developing heart disease, such as high blood pressure or high cholesterol levels.
You can mitigate the risks by leading a healthy lifestyle.
The symptoms of heart failure can vary widely. There are people whose heart function has been weakened, but because their bodies are able to compensate for the weaker heart, they do not have any symptoms.
Mild symptoms of heart failure are breathlessness during exertion and a decreased exercise capacity.
For instance, the patient may notice that they are unable to climb the same flight of stairs as before.
Severe symptoms include breathlessness during rest, fainting spells, giddiness, swelling of the legs, low urine output and waking up at night due to breathlessness.
A person's lifestyle can have a great impact on the health of the heart arteries. Fried foods contain high amounts of saturated fat which, when taken in excess, will be converted to cholesterol that clogs up the arteries. It is better to order soupy dishes, which contain less oil and fat than fried food. But the time of the meals do not matter much.
Meanwhile, one should exercise 20 minutes a day, five times a week.
Walking is an acceptable form of exercise. It should be done at a brisk pace, such that you feel a little breathless, to burn more calories and improve your exercise capacity.
The main consequences of heart failure are death from progressive heart failure, sudden cardiac death due to abnormal heart rhythm and severe breathlessness, leading to an inability to move much.
There is hope because medical therapy is now very advanced.
Over a period of 20 years, with the advent of new types of medication, we have been able to halve the yearly death rate for heart failure.
There is also hope for the heart function to improve. In about 30 per cent of patients, their heart function would return to normal over a period of six to 12 months once medical therapy has been instituted.
In patients whose heart failure is due to blockages of the heart arteries, relieving those blockages can also improve their heart function.
DR KENNETH NG
Cardiologist at Novena Heart Centre
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