He is a workaholic - working non-stop throughout his life. Every day it contracts around 100,000 times and pumps over 7,000 litres of blood. We all know what the heart does for us, in this age of pandemics, let's consider what we can do for 'HIM'?
Invariably "number one"
The COVID-19 pandemic has not only shaken health systems around the world, but also exposed their weaknesses. In the public debate, there is increasing talk of syndemics, the superimposition of a coronavirus epidemic on other co-occurring chronic diseases. This is most evident in the case of heart disease, which invariably remains the leading cause of mortality in Poland. In the pandemic year, the increase in deaths in this area was almost 17 per cent!
Several reasons were behind the increase in cardiovascular mortality, experts point out. On the one hand, many patients avoided healthcare facilities for fear of coronavirus infection; on the other, access to medical care was limited. Although teleportation proved to be a good solution for maintaining continuity of treatment, it was not appropriate for first-time patients or those with a marked exacerbation of symptoms.
The fact that the pandemic has made it more difficult to 'treat our hearts' is evident from the figures - planned treatment for invasive coronary heart disease fell by more than 70 per cent between March and May 2020 compared to 2019. In contrast, the number of interventional heart attack treatments fell by 35 per cent, meaning that many patients experiencing chest pain stayed at home instead of calling an ambulance.
Unfortunately, a myocardial infarction will not wait - untreated it carries a 40 per cent mortality rate. Even if the patient survives, an acute coronary incident usually leads to extensive damage to the heart muscle. This translates into poorer contractility of the heart and eventually leads to the development of heart failure - a condition that significantly impairs quality of life and is difficult to treat.
It is also worrying that successive lockdowns have contributed to changes in our lifestyle and the prevalence of cardiovascular risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity, poor diet, alcohol abuse and smoking.
So the answer to the question: how much is the health debt in cardiology is pessimistically: more than we think... It will take us not months but years to pay it off.
Challenges for cardiology
However, the most topical question is a different one: how do we stop the health debt in the face of the spectre of further waves of coronavirus? Experts are in no doubt that the absolute priority is to limit the direct and indirect effects of the pandemic, i.e. speeding up hospital admissions, increasing the number of treatments and operations, fully opening clinics and outpatient clinics to patients.
Equally important is the strengthening of prevention activities, including media awareness campaigns such as 'Don't Stay Home with a Heart Attack' and '#SzczepimySię'. Promoting vaccination among cardiac patients is particularly important, given that there is a group particularly vulnerable to coronavirus infection, who not only undergo the disease more severely, but also die more often from COVID-19.
Furthermore, as we know, the SARS-CoV-2 virus itself can irreversibly damage the heart, resulting in an increased likelihood of post-inflammatory heart failure - both as a first diagnosis of the disease and as an exacerbation of pre-existing chronic heart failure. Complications following COVID-19 also include pulmonary embolism, acute coronary syndrome or cardiac arrhythmias.
What can you do for "HIM"?
The challenges facing the health care system are one thing, the challenges facing the patient himself are another. We know that the main causes of cardiovascular disease are poor diet, physical inactivity and smoking, but also genetic conditions and lipid disorders. Both hypertension and hypercholesterolaemia are diseases known as 'silent killers', meaning that they can develop over many years without any symptoms. This is why it is so important to have regular preventive examinations: blood pressure measurements, ECG, blood count, lipidogram, glucose levels and assessment of kidney function.
Experts agree that during the months ahead, the fear of coronavirus infection must not be an excuse for neglecting chronic disease management. It is crucial to follow the doctor's instructions and take medication conscientiously.
Already at the beginning of the pandemic, the Heart Failure Section of the Polish Society of Cardiology (PTK) dismissed information implying that commonly used cardiac medications put patients at risk of coronavirus infection and worsen the course of COVID-19 infection. Its position, as well as that of the American and European Experts, is unequivocal - patients should use their existing treatment as prescribed by their doctor. Taking medication regularly will reduce the number of health complications and therefore minimise the need for additional medical visits, as well as the number of hospitalisations.
Furthermore, it is very important - also in terms of the risk of a severe course of COVID-19 - that clinical symptoms and cardiovascular parameters are correctly compensated. The patient should adequately monitor blood pressure and heart rate values, take previously prescribed medication for hypertension or hyperlipidaemia, treat symptoms of heart failure, and conscientiously take medication after a myocardial infarction. Cardiologists also emphasise that when we run out of the medicines recommended by the cardiologist, we can obtain an e-prescription during the teleprescription, which we can fill at the pharmacy.
On the other hand, in cardiac emergencies (severe chest pain, especially radiating to the arm or jaw, increased sweating, palpitations, shortness of breath, increasing swelling of the lower limbs, loss of consciousness), we should never delay calling for help. The guidelines of the European Society of Cardiology are clear: if intervention is undertaken quickly, i.e. within two hours of the patient's first contact with medical personnel, there is a good chance that the heart will be less damaged.
Prevention, i.e. the modification of cardiovascular risk factors, will also help us to take care of our hearts. As early as yesterday, we should say goodbye to smoking (every cigarette smoked promotes atherosclerosis) and reduce alcohol consumption. The next step is a healthy diet and increased physical activity, essential for maintaining a healthy body weight (BMI < 25).
Research to date shows that the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets are best for the cardiovascular system, with implications for the prevention and compensation of hypertension. Common points? Vegetables and fruit (5 portions a day recommended), whole-grain cereals, fish, preferably sea fish, limiting salt and sugar, and giving up saturated fats.
As far as physical activity is concerned, its choice should be adapted to our age, state of health, fitness and physical capacity. We recommend first of all endurance efforts of dynamic character: fast walking, Nordic walking (walking with poles), running, swimming, cycling, stepper walking, aerobic classes. Training should always start with a warm-up and end with 10-15 minutes of low-intensity calming exercises.
Let's remember that our heart is a muscle and it needs movement like we need air. According to World Health Organisation guidelines, you should be physically active at least five times a week for at least 30 minutes.
Finally, let's try to reduce stress at work and in family life - anxiety and depression lead to a faster development of cardiovascular diseases. Therefore, during this difficult time, let's find a moment for ourselves and think about the heart.
Source: medonet.pl