The 5-year mortality rate is 50%! Heart failure is divided into 3 categories. Women and elders are more likely to ignore 3 symptoms
1 in 5 people has heart failure! 2/3 of patients in Taiwan are not diagnosed?
Even though the systolic function of the heart is normal, may tiredness, breathlessness, and swelling still be warning signs of “heart failure” (also known as heart failure)? Dr. Zhao Tingxing, deputy CEO of the Heart Foundation of the Taiwan, said that about 60 million people around the world have been diagnosed with heart failure, and 1 in 5 people will suffer from heart failure in their lifetime. Especially for heart failure with normal cardiac systolic function, it is more likely to delay medical treatment because the cause cannot be detected.
Dr. Zhao Tingxing said that based on the highest prevalence rate of 3%, it is estimated that about 700,000 people in Taiwan are suffering from heart failure. However, according to health insurance statistics, only 240,000 people have been diagnosed and received medication, representing 2/3 of heart failure patients. Without correct diagnosis and medication, “the patients identified may be just the tip of the iceberg!”
Heart failure is divided into 3 categories. Systolic function is normal and easy to ignore.
Dr. Zhao Tingxing explained that heart failure can be divided into three categories based on the left ventricular ejection fraction (LVEF): The first is abnormal cardiac contractility (HFrEF), which refers to the systolic fraction below 40%, accounting for about all heart 50% of the failure rate; the second type refers to normal cardiac contractility (HFpEF), with a systolic fraction of more than 50%, accounting for 40% of all patients; the third type of systolic fraction is between 41% and 49%. The patient’s cardiac contractility is slightly impaired, accounting for about 10%.
Dr. Zhao Tingxing pointed out that patients with abnormal cardiac contractility are more likely to be diagnosed with heart failure under cardiac ultrasound. In comparison, patients with normal cardiac systolic function may have problems with diastolic function, which is more difficult to diagnose. The symptoms are similar to those of chest, kidney, and endocrine diseases. Patients are easily referred back and forth between various departments, making it more difficult to diagnose. Consciousness requires going to the cardiology department for examination.
Heart failure has a 5-year mortality rate of 50%. Asthma and swelling will lead to cardiology department soon.
Dr. Zhao Tingxing reminded that heart failure is the most common reason for hospitalization over the age of 65. About one-third of hospitalized patients with heart failure will die within one year, and 50% will survive for less than five years. In addition to the risk of death, heart failure will seriously affect the quality of life, causing patients to be unable to perform housework, exercise, jogging, dressing, and even taking a shower. It is also prone to the risk of comorbidities such as diabetes, atrial fibrillation, hypertension, and obesity.
“About 64% of Taiwan’s heart failure cases are undiagnosed. Doctors must be more vigilant and make good use of tools such as cardiac ultrasound and blood tests for NT-proBNP/BNP. As long as people and patients experience fatigue, breathlessness, and swelling, Remember to seek medical treatment at a cardiology department, especially for heart failure with normal systolic function. The mortality and readmission rates are quite high. Early detection and diagnosis are the most important!”
Be careful if you are breathless and tired at the same time! Women and the elderly should pay more attention
Dr. Wu Yanwen, director of the Heart Foundation of the Taiwan, explained that blood testing for NT-proBNP/BNP has two meanings. When the symptoms are similar but the blood drawing index is low, the suspicion of heart failure can be ruled out. In very severe heart failure patients, NT-proBNP/BNP is used as one of the indicators to track the response. As for heart failure patients with normal cardiac systolic function, it will be found that the cardiac ultrasound examination is normal, but the NT-proBNP/BNP index is high.
Dr. Wu Yanwen reminded that no matter what kind of heart failure it is, “tiredness, breathlessness, and swelling” are the most common external symptoms. Especially when breathlessness and fatigue occur at the same time, you should be more vigilant. Heart failure requires correct diagnosis and classification in order to find appropriate treatment. Especially for heart failure with normal cardiac contractility, women and the elderly are more likely to ignore the warning signs.
“Damaged motor” or “rusty wall”? Differences in types of heart failure
Dr. Wu Yanwen said that the classification of heart failure can be roughly compared to two major types. Heart failure with poor contractility is like a “damaged motor” that cannot transport enough blood. The blood entering the heart cannot be completely discharged and transported to the body. Under cardiac ultrasound, It can be clearly seen that the heart becomes enlarged.
However, heart failure with normal contractile capacity may cause symptoms such as breathlessness, swelling, and fatigue, but the heart contraction is normal under ultrasound, which means that although the heart is pumping blood, its diastolic function is poor and the muscles become stiff, like a “motor failure.” “Rust”, the left ventricle loses its ability to relax normally, the amount of blood entering the left ventricle is reduced, and the amount of blood discharged from the left ventricle is also small, making it difficult to supply the body’s needs.
Dr. Wu Yanwen pointed out that most of these groups with normal cardiac systolic function are girls, which may lead to delayed diagnosis due to neglect of heart failure. In addition, when some elderly patients suffer from asthma, swelling, and fatigue, they may easily think that it is just normal aging. In addition, atrial fibrillation, hypertension, and other diseases may interfere with each other. Women and older people are reminded that early detection and early treatment of heart failure can help improve the prognosis.
What medications are available? Treatment differences for different types of heart failure
According to the treatment guidelines of the European Society of Cardiology, patients with heart failure with poor systolic function will use SGLT2i/Beta-blocker/ACEi, ARB, ARNI/MRA, a total of four drugs as first-line drugs.
Dr. Wu Yanwen said that these drugs are like the four pillars of heart failure and can improve symptoms and heart function. For heart failure patients with abnormal contractility, if there are no other organ diseases or contraindications, all four drugs can be helpful to the condition.
However, for heart failure with normal cardiac contractility, there has been no recommended treatment in the past. It can only relieve symptoms. As long as patients have symptoms of fatigue, breathlessness, and swelling, they should go to the cardiology department as soon as possible to receive a complete medical history inquiry, cardiac ultrasound, blood tests, etc. examine. Once heart failure with normal cardiac contractility is determined, you should discuss the most appropriate treatment with your doctor to help improve prognosis and heart health.
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