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Ruthless statistics
COVID-19 has already killed more than 3.2 million people worldwide. Meanwhile, more than 18 million people on the planet die each year from cardiovascular diseases.
One of the most complex heart diseases, once diagnosed, does not go away: heart failure. This disease is special because it does not occur in humans during the day. It is a condition in which the heart eventually stops filling properly and expels blood or, more simply, when it gets tired of beating.
According to cardiologists, one in five people over the age of 40 has a chance of developing heart failure. Almost half of patients die within the first five years of diagnosis and only a quarter survive for 10 years. According to data from the Lithuanian Institute of Hygiene, heart failure in Lithuania in 2019. was sick more than 136 thousand. people.
Personal Album Photo Album / Jelena Čelutkienė
According to a cardiologist from the Center for Cardiology and Angiology of the Santara Clinics, president of the Lithuanian Society of Cardiology, Professor Jelena Čelutkienė, patients with cardiovascular diseases are experiencing the challenges caused by a pandemic with great difficulty. Withdrawal or delay of treatment, reduction of the number of procedures and provision of cardiovascular services had a significant negative impact on the health status of some patients.
“During the first quarantine, far fewer patients were hospitalized, although we were referred to more people with more severe symptoms, to doctors, and more deaths were recorded. Due to limited opportunities and fear of seeking help, more patients died from cardiovascular causes. in their homes. All of this progress, which has been made in the last five years in the treatment of cardiovascular diseases, has gone far back in time, “said J.Čelutkienė.
According to the professor, although the situation of patients has been improving little by little in recent times, more and more cardiovascular services are recovering, there is definitely room for effort and greater change. “It is necessary to improve the digital infrastructure, to develop remote services with more force, because a telephone conversation with a doctor still cannot replace a quality consultation,” says the president of the Lithuanian Society of Cardiologists.
According to the interviewee, videoconferences would be very useful, and a more active cooperation between the different levels of institutions, a faster and better data transfer would guarantee a more fluid communication between doctor and patient, a faster and more precise assistance. For some patients, this could avoid a visit to the doctor altogether. And it would be beneficial not just during a pandemic. The professor adds that it is also very important to restore and activate the cardiovascular disease prevention program, ensure the development of heart failure wards and strengthen palliative care.
The well-being of patients was not only affected by the decrease in the provision of necessary services.
Patient participation in their control decreased
Interestingly, the European Society of Cardiology recorded around 40-50% during the COVID-19 pandemic. fewer reported acute myocardial infarctions. What does this mean? The answer is simple. Not all heart attacks were under control, leading to increased deaths, disability, and worse long-term cardiovascular outcomes.
Professor Raimondas Kubilius, a cardiologist and member of the Board of the Lithuanian Society of Cardiologists, is the director of the Kaunas Clinics Rehabilitation Clinic, convinced that
“Due to quarantine restrictions and constant stay at home, the physical activity of patients with heart failure, chronic ischemic heart disease and other cardiovascular diseases has decreased. This is a particularly negative factor that leads to worse well-being of patients. Second, and most importantly, there has been a significant reduction in the involvement of patients themselves in managing their disease and managing risk factors. By providing telephone consultations, doctors were not in a position to examine patients. patients, carry out the necessary examinations, evaluate changes in one or other indicators of their body ”, says R. Kubilius.
According to the professor, it is obvious that in the pre-pandemic period, it was much clearer and easier for patients to manage their risk factors for disease, that is, control blood pressure, cholesterol, blood sugar values, take measurements adequate to correct the latter. Now the situation is a little different: people are locked up at home, some are tense, upset, some suffer from anxiety, fear of infection and are late to seek help. The constant long-term stress caused by the pandemic, the negative psychological background, has a direct impact on overall physical well-being, which is not good in heart failure anyway.
Physical activity is very important in patients.
According to R. Kubilius, it is very important to remember that patients feel good and live as full a life as possible, and in order to postpone the bad outcome of the disease, not only responsibly used drugs allow it, however innovative they be. Non-medical aids are also important: a balanced diet giving up certain products (such as salty foods for heart failure and fatty foods for ischemic heart disease), intelligently planned physical activity, eliminating or at least eliminating harmful habits such as alcohol or smoking. reduction.
“Heart failure patients need at least 150 minutes a week, and preferably 300 minutes of moderate intensity physical activity, that is, daily exercise. If we used to say that any physical activity is better than nothing, now we are emphasizing that activity Moderate intensity physics is better than small.
File photo staff / Head of the Kaunas Clinics Kulautuva Rehabilitation Hospital, President of the Lithuanian Heart Association Raimondas Kubilius
In addition, physical activity should be as structured as possible, for example, so that the patient moves, exercises or walks at an appropriate speed or intensity (the heart rate should be 30-50% higher than at rest) during at least 30 minutes. . per day, repeating at least 5 days a week. By the way, Nordic walking, cycling, walking, during which the required heart rate is reached, are one of the possibilities for physical activity.
Without a doubt, not all patients are equally motivated to form such habits, but adequate physical activity is especially important for the normal functioning of the heart ”, emphasizes the cardiologist.
Regarding harmful habits, especially smoking, according to R. Kubilius, patients with cigarettes tend to stop or at least reduce their daily smoking, but the urge to do so often turns into an unaware knowledge that nicotine is harmful to the heart, but a myocardial infarction, diagnosed with lung or other life-threatening disease, such as oncology. Sad for their choice, unfortunately, not all patients realize that they are primarily responsible for their own health.
“In fact, patients often need the help of a professional psychologist to quit smoking. However, in clinical practice we also see excellent examples when, in case of great desire, the patient’s own motivation is sufficient. Electronic cigarettes they can be used as an aid to quit smoking in some patients.
Unfortunately, smoking non-smoking e-cigarettes even doubles the risk of starting regular cigarettes. Several large-scale studies in recent years have revealed that nearly one in five people who smoke e-cigarettes is likely to have an acute myocardial infarction. Smoking these cigarettes reflexively activates the sympathetic nervous system, increases pulse rate, blood pressure, negatively affects the inner wall of blood vessels ”, explains the professor.
Photo by Gerda Baltrūnaitė / Aistė Štaraitė
The disease must not be allowed to control the life of the patient.
Aistė Štaraitė, president of the Heart Failure Association, echoes the thoughts expressed by cardiologists, who in mid-May of this year assumed the new position of president of the Heart Failure Council of the Global Heart Hub of the International Organizations of Cardiac Patients.
“The pandemic has fundamentally changed the daily life, well-being and opportunities of patients for timely help. However, we cannot allow disease to control our lives. Controlling the disease must be in our hands, – says A . Štaraitė, who suffers from heart failure and is waiting for the donor heart. – We are responsible for our own health and disease control, we can and should dedicate ourselves to self-help at home, we only need to remember the repeated advice of doctors about lifestyle. Let’s increase our physical activity, adjust our diet, stop harmful habits, first of all smoke, and who fails, ask doctors how to reduce the harm of smoking. “
According to the interlocutor, it is necessary to constantly share knowledge about the prevention of heart failure and early detection of the disease, because the latter is extremely insidious. To this end, joining forces with Lithuanian doctors and patients, educational events will be organized in Vilnius from May 27 to 28, which will draw attention to the problem of heart failure in Lithuania and the possibilities of its solution.
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