SPECIALIST OFFICE OF INTERNAL MEDICINE

Andrea Džumhur, MD, PhD

Heart weakness, what is it?

Heart weakness (lat. Cardiomyopathy, Miocardiopathy) is a syndrome, or a set of symptoms and signs that indicate an insufficient function of the heart. It mainly manifests itself as anxiety, helplessness, fatigue, runny nose, abdominal pain or cough; It is also sometimes revealed as weight loss, weight gain, depression or anxiety disorder, and is often discovered accidentally (by a routine heart and lung ECG or a heart ultrasound).

This disease can be caused by structural changes in the heart (genetic impairment of heart muscle, damage to heart valves and heart septum or as a consequence of heart failure) or by an illness that does not merely affect the heart muscle, e.g. long lasting unregulated blood pressure, sometimes also after a period of stress. The heart weakness development can indirectly be contributed to diabetes, lung disease, anemia and thyroid disease, as well as to over-consumption of alcohol, the use of some drugs, and to numerous diseases of other organic systems.

The aforementioned diseases affect the heart mainly by increasing the pressure in certain cardiac cavities and blood vessels, along with the increased heart rate (tachycardia), and in some cases also arrhythmia, which cause heart encumbrance. This gradually leads to enlargement of heart cavities and thickening of the heart muscle. Initially this change helps to maintain a satisfactory heart function even if there is a disorder so that the person will have no symptoms. However, if the disorder (the cause of the encumbrance) is still present, it will lead to further enlargement of coronary cavities, thickening of the heart wall and weakening of heart valves, so that the heart will no longer be able to compensate for the overload. After that the blood will gather in the lungs (so called “water on the lung”), in the liver and in legs which will lead to symptoms of heart weakness. Medically speaking, we can say that a decompensation of the heart is present.

Since diseases that can cause heart weakness are nowadays very common, there is a significant incidence of this syndrome. It is estimated that 1-2% of the adult population suffer from heart weakness, and this incidence increases to more than 10% in the population over the age of 70. It is therefore assumed that approximately 23 million people worldwide suffer from it. A reason for concern is also the trend in the occurrence of this syndrome worldwide, which can be explained by an increase of the percentage of the elderly, as well as by numerous chronic heart failure disorders and the survival of such patients which is made possible by treatment.

Early diagnosis (ECG, heart ultrasound, ergometer, ECG holter monitor) of initial cardiac changes and treatment of the encumbrance causes (the placement of stents and bypasses, the treatment of arrhythmia, anemia and thyroid disease, etc.) can prevent the development of heart weakness. A regular use of medicines is also indispensable in prevention of further progression of the disease.

If there is a significant occurrence of cardiac changes which lead to the onset of symptoms, then a more complex treatment of the disease is needed, although it is possible to successfully treat even those cases. This depends primarily on the possibility of treating the cause that led to the onset of this syndrome. In addition to the significant advances in the pharmaceutical industry in this field, there are numerous therapeutic options for such purposes, like interventional cardiology, cardiac surgery procedures, the installation of defibrillators, and more often heart transplantation, all of which significantly improve the quality of life and survival of these patients.

Heart weakness syndrome is also a major public health problem. Approximately 2% of the funds intended for health care is allocated for the treatment of this disease. Given the trend of the increasing occurrence of this disease, further cost increases are expected. However, most of the costs relate to frequent hospitalization due to deterioration of the condition, especially at later stages of the disease.

So, despite all the progress in treating this syndrome, which enables us to slow its progression, the only real remedy is to prevent its onset by a timely diagnosis and the treatment of the syndrome and the diseases causing it.