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Myths about the most common female disease
According to S. Glaveckaitė, cardiovascular disease is a female killer no. 1 both in Lithuania and worldwide. According to data from the Lithuanian Institute of Hygiene, in 2018. every second Lithuanian citizen died of cardiovascular disease: a total of 21,922 deaths were recorded. In terms of the situation of women, this cause represents approximately two thirds of the deaths of women in Lithuania each year.
“However, we can be happy at least that women in Lithuania live on average almost 10 years longer than men. This gap is one of the largest in the European Union. Only Latvia has an even bigger one.
What causes such high mortality from cardiovascular disease in women? First, women still find it difficult to find time for healthy lifestyle habits. This is because both women themselves and their health professionals do not classify cardiovascular disease as the main cause of death for women.
Although the disease occurs earlier in men, atherosclerosis in women after menopause begins to develop at a male rate.
Second, the negative effects of most cardiovascular risk factors (smoking, alcohol consumption, or diabetes) are stronger in women in particular.
Third, we must understand that a woman’s physiology is different from that of men, so the nature of the symptoms of cardiovascular disease, the course of the disease, and the response to treatment are also different. The course of cardiac disease in women often differs from that described in medical textbooks, it is more difficult to make a diagnosis, we have less evidence of which treatment is more effective, as only up to 20% are included in trials clinicians. women
Finally, the consequences of the disease are different. Compared to men, women are more likely to end up with complications of heart disease. Although the disease occurs earlier in men, atherosclerosis in women after menopause begins to develop at a male rate. So the prevailing myth that women are protected from cardiovascular disease must be dispelled, “said the cardiologist.
Photo by Josvydas Elinskas / 15min / Sigita Glaveckaitė
Silence to the storm: do patients suffer at home?
Regarding COVID-19 infection, the interlocutor said that women have promising knowledge. Although both men and women are infected with the virus, the death rate from COVID-19 infection in women is 1.5 to 3 times lower than in men.
“This difference is believed to be due to the fact that men have more risk factors (more often they smoke, more alcohol and more alcohol), so at a younger age than women they have a lot of chronic diseases: high blood pressure, obesity, lung disease, etc. t.
In addition, there are biological differences: Women’s immune systems are more resistant to viral and bacterial infections. However, according to Chinese scientists, cardiovascular disease increases the risk of dying from COVID-19 up to 5 times, “said S. Glaveckaitė.
According to the doctor, the current situation is more worrisome because, although there has not currently been an increase in appeals for cardiovascular disease, there may be silence before the storm, as people are afraid to seek medical attention and it is likely that suffer from shortness of breath or chest. pain at home
With the relaxation of quarantine, scheduled consultations will gradually resume, and then there will be a clearer picture of the situation. However, it can already be assumed that delays, cessation of planned operations and interventions, high levels of anxiety, loss of contact with a family doctor, will certainly not reduce the incidence of cardiovascular disease, and mortality data. they can only be estimated after a good year.
While there has been no increase in appeals for an exacerbation of cardiovascular disease at this time, there may be silence before the storm as people are afraid to seek medical attention.
“While emergency care is available, scheduled care is also very important because it can protect against hospital admission when emergency care is already needed. Living with cardiovascular disease is like sitting on a bomb that can explode at any time. And now these patients are trying to stay completely home so as not to cause symptoms, and they are afraid to go to the hospital. This is wrong, because some of them will not receive planned consultations anyway, “said the interlocutor.
Photo by Vida Press / Infarction
Tips for people with cardiovascular disease.
S. Glaveckaitė also drew attention to the fact that due to the pandemic, the level of stress in society has increased, manifestations of depression have increased, and anxiety, as social isolation increases feelings of loneliness and helplessness .
“It is heard during remote consultations, so we encourage patients to stay home, but not to isolate themselves from the world around them, their family and friends.
It is recommended to maintain social contacts virtually or by phone, to avoid constant reports of morbidity and mortality from monitoring the coronavirus, to participate in pleasant activities (reading, playing sports, listening to your favorite music, growing flowers on the windowsill, drinking virtual lessons, meditate, yoga, etc.).
Family members must also not forget to ask their mothers how they feel, if nothing is missing or if they do not need to receive medication, and to do it not only during Mother’s Day, but much more frequently, “urged the interlocutor.
Living with cardiovascular disease is like sitting on a bomb that can explode at any time.
According to her, regular cornerstone of cardiovascular disease prevention, which reduces overall mortality and mortality by 20-30%, is regular physical activity, which has a positive effect on many risk factors: it reduces pressure arterial, “bad” cholesterol (LDL), body weight and blood glucose, improves general well-being and mental health. In addition, physical activity prevents the formation of blood clots in the veins of the legs and the associated complications: pulmonary thromboembolism.
Photo from 123RF.com / Veins of the legs
“Five days a week for at least 30 minutes. Dynamic aerobic physical activity of moderate intensity should be practiced. Moderate physical activity is when breathing increases, but you can still speak in complete sentences. This can be more intense housework, caring for plants at home or on the patio, dancing to music, walking, virtual workouts, or simple exercise.
To encourage people to be more physically active, I recommend activities that are enjoyable and can become a habit. Patients with severe cardiological problems would be invited to discuss planned physical activity with their GP or cardiologist. On the other hand, the recommendation to stay home should also be judged wisely. If a person lives in his own house or farm, why not go for a walk? Finding remote places where there are not many people around is also possible in cities.
The recommendation not to leave is more relevant for mass meetings, shops, public transport, etc. It works well even for medical reasons: when a person is immobile and sitting at home all the time, their blood circulation is further altered, blood clots form in the legs, which can travel to the lungs at any time. Low mobility also promotes the development of other diseases, so we cannot completely avoid movement, “said the cardiologist.
Mortality from COVID-19 infection in women is 1.5 to 3 times lower than in men.
During quarantine, it is important to follow the rules of a healthy diet, as well as limiting the amount of alcohol, not smoking, and avoiding passive smoking, consuming more potassium and magnesium products, more often in the sun, and in no way suspend the use of cardiological medications. The doctor emphasized that there is currently no evidence of adverse effects of certain drugs commonly used in cardiology to treat high blood pressure and heart failure in patients with COVID-19. Low-dose aspirin is as safe as ibuprofen.
In case of doubt, it is recommended to consult a GP or cardiologist remotely at the end of the medication, and in case of threatening symptoms (severe shortness of breath, prolonged chest pain, fainting, weakening of the arm or leg, change of facial symmetry, speech disorder), calling an ambulance or hospital Denying symptoms is really too expensive.
Why the two diagnoses can be confused
According to S. Glaveckaitė, there is data that the virus damages not only the lungs, but also the heart. Therefore, it is sometimes possible to confuse the diagnosis and not suspect coronavirus.
“Coronavirus can harm the heart directly or indirectly. Indirect heart damage occurs when pneumonia increases the load on the heart, a condition that is particularly damaging to a patient with cardiovascular disease. The virus can also directly damage the heart, causing inflammation acute heart muscle and associated arrhythmias or acute heart failure.
There is another mechanism of direct cardiac damage: by activating the immune system, the virus can cause endothelial (internal vascular) dysfunction and cause instability and rupture of existing atherosclerotic plaques, leading to myocardial infarction. Then we can have one of the previous scenarios: arrhythmias, heart failure, myocardial infarction or myocarditis, i. and. inflammation of the heart muscle
The virus damages not only the lungs but also the heart. Therefore, it is sometimes possible to confuse the diagnosis and not suspect coronavirus.
Severe COVID-19 infection is generally associated with inflammation of the heart muscle or arrhythmias, and also increases the risk of blood clots forming in the veins of the legs, which in turn increases the risk of pulmonary embolism.
In any case, the prognosis of COVID-19 in a patient with cardiovascular disease is worse. Because the active form of the disease manifests itself in cough, shortness of breath, chest discomfort, more frequent heartbeat, and not all patients have fever, it is really difficult to distinguish between these two pathologies. Therefore, all patients who come to the hospital for emergency or emergency care are currently being screened for coronaviruses, “said the interviewee.
According to S. Glaveckaitė, doctors work remotely during the quarantine period and it is really possible to contact them and discuss all topics of interest. The good news is that scheduled procedures and surgeries for cardiovascular patients will resume from May.
However, protection against the coronavirus is likely to be needed for a long time. Therefore, the best gift for the next Mother, and later for Father’s Day, is to protect your loved ones from additional contacts, to help them provide basic goods without leaving home, to maintain more frequent contact, although virtual, with them.
“And protecting yourself against cardiovascular disease is a life-long process independent of a pandemic. As it is provisionally estimated that 50 times more people died from cardiovascular disease in Lithuania during the first month of quarantine than from SARS-CoV-2, I think it is worth listening to the recommendations of cardiologists, “said the interlocutor.
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