[Health Tip] Today is 'Heart Day'... Here's How to Prevent Heart Failure

Every year, September 29th is recognized as "World Heart Day." The heart plays a crucial role in sustaining life by continuously circulating blood throughout the body through repeated contraction and relaxation. However, when the heart muscle is damaged or weakened due to aging, its pumping function may fail to operate properly, a condition known as heart failure.

The meaning of heart failure in Chinese characters is 'the heart (心) is not whole (全) or intact (不).' It refers to a state where the heart's pumping function does not work properly. Approximately 2.6% of the domestic population suffers from heart failure, and the incidence rate sharply increases from the age of 70, with about 1 in 5 people aged 80 or older known to be heart failure patients.

Heart failure is classified into acute and chronic types. Acute heart failure occurs suddenly within one week, while chronic heart failure develops gradually as heart function declines. Most cases of heart failure are chronic. When heart failure is present, oxygen and nutrients are not properly supplied to body tissues, which can affect other organs as well.

The primary cause of heart failure is repeated myocardial infarction. Myocardial infarction occurs when the coronary arteries supplying blood to the heart muscle narrow. Experiencing this multiple times damages the heart muscle and reduces heart function. The second cause is dilated cardiomyopathy, a congenital weakness of the heart muscle. This condition can cause heart function to decline rapidly with age. The third cause is arrhythmia, where the heartbeat suddenly becomes irregular. In particular, if arrhythmia causes the heartbeat to nearly double in speed and persist, the heart can become exhausted, leading to heart failure. Additionally, hypertension, valvular disease, excessive alcohol consumption, and stress are also known to trigger heart failure.

The most representative symptom of heart failure is shortness of breath. Especially when lying down, breathing becomes difficult, and coughing may occur. Since breathing becomes easier when sitting up, some patients sleep with multiple pillows stacked to elevate their upper body. Another symptom is leg edema. In severe cases, pressing the skin with a finger may take 1 to 2 minutes to return to its original state.

The most commonly used diagnostic method when heart failure is suspected is echocardiography. Through ultrasound examination, the left ventricular ejection fraction (the percentage of blood ejected from the left ventricle during a heartbeat) can be checked to evaluate heart function. If the blood entering the heart is 100, a normal person ejects 50-70% of this blood from the heart. Therefore, if the left ventricular ejection fraction is below this range, it indicates reduced heart function. However, even heart failure patients may have a normal left ventricular ejection fraction, so blood tests measuring natriuretic peptide levels, electrocardiograms, nuclear medicine scans, magnetic resonance imaging (MRI), and angiography may also be performed.

[Photo by Seoul National University Hospital]

The most important treatment for heart failure is medication. Patients must consistently take drugs that enhance the contractility of the heart muscle and dilate blood vessels to aid circulation. Since these drugs are primarily developed for hypertension treatment, blood pressure may drop or dizziness may occur when first taking them. By adapting to these symptoms and continuing medication, heart failure can be significantly improved. Two out of three patients with systolic dysfunction-related heart failure show improvement.

For severe heart failure that does not respond to medication, surgical treatments such as coronary artery bypass surgery are performed. Some severe patients also receive cardiac resynchronization therapy (CRT), which uses an artificial pacemaker to assist heart function. In end-stage heart failure, heart transplantation is the most definitive method to improve prognosis, but the limited number of donors is a challenge. To overcome this, a staged treatment strategy has become common, where a left ventricular assist device (LVAD), a type of mechanical pump, is surgically implanted to preserve heart function and allow patients to maintain daily life until a donor heart becomes available for transplantation.

To prevent heart failure, excessive alcohol consumption, stress, and situations that cause rapid heartbeat should be avoided. Additionally, patients must strictly adhere to medication as prescribed by their doctors and undergo regular check-ups. It is advisable to combine echocardiography and blood tests during health screenings. After heart failure occurs, it is important to consume a low-sodium diet to prevent salt accumulation in the body. One method is to reduce soup intake by thinking of eating with chopsticks instead of a spoon.

Smoking cessation and abstaining from alcohol are essential for maintaining heart function. Appropriate aerobic exercise also helps strengthen heart function. Exercise is particularly important for preserving muscle mass, which is crucial for the long-term survival of heart failure patients. However, excessive exercise that causes the heart to beat very rapidly should be avoided, and exercise intensity should be gradually increased once the condition stabilizes. Exercise at about 70% of maximum capacity, enough to cause slight sweating on the back, is recommended.

Professor Lee Haeyoung of the Department of Cardiology at Seoul National University Hospital advised, “90% of heart failure patients can maintain their health through proper treatment and management. By taking medication well, strictly controlling daily sodium intake, and consistently exercising to strengthen the heart, one can live with a healthy heart.” She also explained, “If family members maintain a less salty diet for the patient and help them move regularly, it will greatly aid heart failure treatment.”