Transcript heart failure - Our Public Health SA

NICK GINA
14050006
KNOWLEDGE MOKOENA
14103045
MOFFAT NDABADIME
14130506
SEAN GOTA
14107784
BONGANI LUKHELE
12021700
NAWAAZ OMAR
13046765
2016
Heart FailureGroup 54
Heart Failure

Heart Failure(HF) is a major worldwide public health problem

It is a clinical syndrome in which structural or functional cardiac
conditions impair cardiac output to the rest of the body at rest or
with exertion1
Heart Failure (cont’d)

Abnormal heart structures:
Left Ventricular Hypertrophy
2
Ventricular Septal Defect3
Heart Failure (cont’d)

In the US alone, 1 in 5 people over 40 years of age will develop
heart failure during their lifetime1

HF is also the leading cause for hospitalization in the elderly

However, HF survival has improved and thus the number of sufferers
over 65 is increasing1
Heart Failure (cont’d)

In younger age groups (patients under 50 years) heart failure is more
common in males

The main causes of Heart Failure are1:


Hypertension

Ischaemic Heart Disease

Valvular Heart Disease

Myocardial Infarction

Other Cardiomyopathies
In the elderly, prevalence of Heart Failure is equal between both sexes
Typical Signs & Symptoms of Heart
Failure1

Dyspnoea at rest or during exercise

Pleural Effusion

Raised Jugular Venous Pressure

Hepatomegaly

Fatigue

Orthopnoea

Peripheral Oedema

Pulmonary Rales
Morbidity and Mortality

Heart failure and coronary artery diseases are currently on the rise in the
African region.

Heart failure has become a major public health problem especially in Sub
Saharan states.

One reason for the most recent rises in heart failure is the aging
population in the region.

There were approximately 80 million adults with hypertension which is a
causative condition for heart failure in the year 2012 and the figure is
expected to double by the year 2025.4
Morbidity and Mortality (cont’d)

Out of the 16 million deaths under the age of 70 due to non-communicable
diseases, 37% is due to heart failure.4

At least three quarters of the world’s deaths from heart failure occur in low and
middle income countries.

The major causes of cardiovascular disease are the smoking of tobacco, a lack
of physical activity, an unhealthy diet and alcohol abuse.

4 out of 5 deaths due to CVD are due to heart failure and strokes 4
Disability

The classic symptoms of heart failure include;4

Chest pain

Shortness of breath

Orthopnea

Swelling of limbs, including both legs and feet

General discomfort of the gut

Pale, clammy and cold extremities
Disability (cont’d)

These symptoms of heart failure amongst others lead to disability.

Heart failure has an impact on individual’s families and overall society in
terms of health care costs as well absenteeism
Descriptive Epidemiology for
Heart Failure
i.e. Who, when, where and by how much?
Who?

Hypertensive patients


Male patients


Studies have proven that CHF patients in more occasions than not had
antecedent hypertension 4
Surprisingly enough males are more predisposed to HF than females4
Elderly patients

Incidence rates of CHF rose markedly with age 4
When?

Age (incidence rates of CHF rose markedly with age) 4 as presented by
the graph below:
Where?
•
Poor regions of the
world: (4 of every 5
deaths globally from
cardiovascular disease
occurred in developing
nations )1
How Much?

Per Gender: The population-attributed risk for cardiac heart failure with an
antecedent hypertension is nearly 40% for males and 60% for females

Per socio-economic status :

i.
4 out of every 5 global deaths from cardiovascular disease occurred in
developing nations.4
ii.
45 % of global acute heart failure cases are in Sub-Saharan Africa.4
Predisposing illnesses: 90% of Framingham participants who developed
CHF had antecedent hypertension.
Levels of Prevention

The nature of heart failure prevention is mostly directed on secondary
prevention and treatment in patients who resemble signs of heart failure5.

The levels of prevention are divided into three categories, namely;

Primary prevention

Secondary prevention

Tertiary prevention
Primary Prevention

Primary prevention are methods of preventing heart failure before an
individual who is at high risk can have it.

This is achieved through combating the main causes of heart failure such
as; 6


exercising regularly

Eating a balanced diet

Reducing alcohol consumption

Cessation of smoking
Education on healthy habits is also a good weapon of primary prevention.
Secondary Prevention

Secondary prevention focuses on minimising the effects of heart failure.

The focus is on detecting and treating heart failure and preventing it from
occurring again.

Treatment strategies include a combination of medication like:

Angiotensin converting enzyme (ACE) inhibitors

Diuretics

Aldosterone antagonists
Secondary Prevention (cont’d)

A surgical procedure is also an option which is used in treating heart failure.

The aim of a surgical procedure is to stop
any further damages to the heart and
improve the function of the heart.

Bypass surgery, heart valve surgery and heart
transplants are some of the many examples
of surgical procedures performed in
heart failure.
Tertiary Prevention

The goal of tertiary prevention is to alleviate the impact of heart failure,
since heart failure is a chronic disease that requires lifelong management.

This involves taking care of the
heart and making follow up
exams.
References
1.
C. Sinescu, L. Axente. “Heart Failure- concepts and significance. Birth of a prognostic model”. Journal
of Medicine and Life. 2010 Nov 15; 3(4): pg 421-429. Published online 2010 Nov 25. Carol Davilla
University Press.
2.
US Heart Specialist [Internet]. Types of Heart Diseases. [updated 2010 Aug 30; cited 2016 Jan 27].
Available from: http://usheartspecialist.blogspot.co.za/p/types-of-heart-diseases_30.html
3.
Raj Udupi [Internet]. Manipal doctors perform rare heart procedure. Udupi Today Media Network;
[updated 2014 Aug 28; cited 2016 Jan 27]. Available from:
http://www.udupitoday.com/udtoday/news_Manipal-doctors-perform-rare-heartprocedure_4416.html
4.
Mahmood SS, Wang TJ. The Epidemiology of Congestive Heart Failure: Contributions from the
Framingham Heart StudyN Engl J Med. 2013 Mar 25; 230(4):274-7.
5.
Javed Butler, “Primary Prevention of Heart Failure,” ISRN Cardiology, vol. 2012, Article ID 982417, 15
pages, 2012. doi:10.5402/2012/982417
6.
M. H. Murphy, S. N. Blair, and E. M. Murtagh, “Accumulated versus continuous exercise for health
benefit: a review of empirical studies,” Sports Medicine, vol. 39, no. 1, pp. 29–43, 2009.