Heart Failure Awareness Days 2021 – We draw attention to the importance of timely diagnoses and treatment of the disease even during the Covid-19 pandemic

“The Covid-19 pandemic has a dramatic impact on worsening the prognosis of patients with cardiovascular disease. A recent study showed that the short-term mortality of patients with heart failure and coronavirus infection is almost twice as high, with as many as 30 percent of such patients dying¹. It has also been shown that patients with heart failure, probably for fear of infection, do not seek help in a timely manner when their disease worsens. The number of hospital admissions due to heart failure dropped by as much as 50-60 percent in some places during the epidemic^2,3. Thus, treatment is often delayed and consequently leads to a poorer treatment outcome,” said prim. Matija Cevc, Ph.D., president of the Society for Cardiovascular Health of Slovenia.

In Slovenia, we are dedicating a whole month to raising awareness about heart failure

In the period from May 10 to June 4, as part of the Heart Failure Awareness Month, the Society for Cardiovascular Health of Slovenia (Za srce) is organizing various activities. Among other things, they are inviting people to their center ‘Posvetovalnica za srce’ at Dalmatinova 10 in Ljubljana for a preventive examination and consultation, where people will have a chance to discuss the signs of heart failure, prevention and treatment and also get measurements for blood pressure, heart rate, saturation and ECG free of charge. You can apply for the consultation via e-mail posvetovalnicazasrce@siol.net or by phone 01 234 75 55 (Monday and Friday between 8.30 and 9.00 and Wednesday between 14.00 and 14.45). More information can be found on the association's website.

"It does not seem right that during the epidemic people were so frightened by the infection that some did not even dare to see a doctor when their health deteriorated and preferred to suffer a little more. Even now, more than a year after the start of the epidemic, we observe that many people, especially the elderly, are frightened. During this time, we noticed a lot of psychological distress when working with the visitors of the counseling center, when people needed warm and encouraging words, professional and at the same time reassuring, empathetic advice and conversation,” the associates of the counselling center ‘Posvetovalnica za srce’ described their experience.

It is important to diagnose the disease as early as possible and to monitor the symptoms closely

Heart failure is the only cardiovascular disease the frequency of which has been increasing recently. In Europe, about four million patients live with heart failure, in Slovenia, according to the experts, about 30,000.

The heart is a muscle that contracts and relaxes with each heartbeat, pumping blood throughout the body. With heart failure, the heart is no longer able to pump blood efficiently throughout the body.^4-6 When this happens, problems can occur elsewhere in the body as organs and muscles do not get enough oxygen and nutrients. Heart failure can occur due to damage to the heart muscle, which can be caused by high blood pressure, heart valve disease, heart attack, inflammation of the heart muscle, or other heart muscle disease.

The most common symptoms of heart failure are:

• Shortness of breath during activity or even while resting^4-6. Due to shortness of breath at night, there is a need for a higher pillow.
• Swollen ankles, legs or abdomen, which are often more noticeable during the day. When these symptoms worsen, patients find it harder to walk because of the pain.
• Fatigue and exhaustion, which can make patients feel too tired or too weak to perform daily tasks^4-6 or go for walks and visits.

Other symptoms that patients should also monitor include prolonged cough, weight gain, loss of appetite, confusion, dizziness, fainting, and changes in heart rate.⁵

When patients notice that symptoms are changing or worsening, it is a sign that heart failure is progressing.⁵ Even if the changes are very small, the physicians should be notified as soon as possible so that they can adjust the treatment to best suit the patients’ needs.⁴ Appropriate therapy also significantly contributes to a reduced chance of hospitalization due to worsening of heart failure.

We all play an important role in recognizing heart failure symptoms

It happens that patients themselves do not notice symptoms that may indicate heart failure or confuse difficulty with breathing and fatigue with the usual signs of aging or poor physical fitness. If we notice these symptoms of heart failure in our family members or friends, we should talk to them and advise them to go to the doctor as soon as possible. It can save their lives.

References:

1. Doolub G, Wong C, Hewitson L, et al. Impact of COVID-19 on inpatient referral of acute heart failure: a single-centre experience from the south-west of the UK. ESC Heart Fail 2021;8:1691-5.
2. Cox ZL, Lai P, Lindenfeld J. Decreases in acute heart failure hospitalizations during COVID-19. Eur J Heart Fail 2020;22:1045-6.
3. Hall ME, Vaduganathan M, Khan MS, et al. Reductions in heart failure hospitalizations during the COVID-19 pandemic. Journal of cardiac failure 2020;26:462-3
4. Ponikowski P et al. Esc Heart Fail 2014; 1: 4–25. 
5. Heart failure matters: Practical information for patients, families and caregivers. Available at: https://www.heartfailurematters.org/en_GB. Dostopano: april 2021.
6. UW Health. Heart failure with reduced ejection fraction (systolic heart failure).  https://www.uwhealth.org/health/topic/special/heart-failure-withreduced-ejection-fraction-systolic-heartfailure/tx4090abc.html. Dostopano: april 2021.