When your heart fails

Heart failure occurs when there is a breakdown in the heart's function to circulate blood in the body. It is a major cause of hospitalisation and death and although it affects men and women, tends to affect men earlier in life. Men also tend to have a shorter survival.

Types of heart failure

Right ventricular failure occurs when the right side of the heart fails to fill properly or ejects blood poorly. People affect by right ventricular failure appear swollen, are easily tired, and have irregular heart beats. Left ventricular failure is the more common type of heart failure. In this case, the left side of the heart has poor filling or increased stiffness resulting in impaired ejection of blood. This type is more common in women and occurs especially with old age.

Symptoms and signs

Heart failure represents the final stages of heart disease. Conditions such as hypertension, diabetes, obesity or coronary artery disease lead to poor functioning of the heart. The six-minute walk test is a good indicator of functional status and prognosis in patients with heart failure. It evaluates distance walked; normal values mean walking more than 1,500 feet. Patients who are able to walk less than 600 feet have severe cardiac dysfunction and this translates into a worse short- and long-term prognosis.

Stages in heart failure

The New York Heart Association has described various stages of heartfailure.

Class I: No limitations. Ordinary physical activity does not cause undue fatigue.

Class 11: Slight limitation of physical activity. Such patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitations, shortness of breath or chest pain.

Class III: Marked limitation of physical activity. Although patients are comfortable at rest, mild activity leads to fatigue, shortness of breath, palpitations or chest pain.

Class 1V: Symptoms of heart failure are present at rest; discomfort increases with any physical activity.

Causes of heart failure

Sudden occurrence of heart failure is a medical emergency. Heart attacks, hypertension, diabetes mellitus, arrhythmias, valvular disease, strokes, renal dysfunction, certain lung diseases, and anaemia are among the most common causes for acute heart failure. This may result in hospitalisation and death.

Common factors that precipitate heart failure hospitalisations are noncompliance with medicine, sodium or fluid excess, uncontrolled blood pressure, and common drugs such as ibruprofen. Infections, excessive alcohol or other substance abuse may also bring on heart failure.

Early signs

Anyone who notices progressive shortness of breath or its sudden occurrence should seek out a physician or visit the hospital immediately for evaluation. If heart failure is diagnosed, treatment is available for this serious condition.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.

Health trends

Brown rice fights disease

Rice is generally thought to be a healthy addition to the diet because it is a source of fibre. However, not all rice is equally nutritious, and brown rice might have an advantage over white rice by offering protection from high blood pressure and atherosclerosis (hardening of the arteries), say researchers at the Cardiovascular Research Center and Department of Physiology at Temple University School of Medicine in Philadelphia.

New research by Satoru Eguchi, associate professor of physiology, suggests that a component in a layer of tissue surrounding grains of brown rice may work against angiotensin II. Angiotensin II is an endocrine protein and a known culprit in the development of high blood pressure and atherosclerosis.

The subaleurone layer of Japanese rice, which is located between the white centre of the grain and the brown fibrous outer layer, is rich in oligosaccharides and dietary fibres, making it particularly nutritious. However, when brown rice is polished to make white rice, the subaleurone layer is stripped away and the rice loses some of its nutrients.

Source: StoneHearth Newsletter

Boost broccoli, tomato benefits

A University of Illinois study has demonstrated that agronomic practices can greatly increase the cancer-preventive phytochemicals in broccoli and tomatoes.

"We enriched preharvest broccoli with different bioactive components, then assessed the levels of cancer-fighting enzymes in rats that ate powders made from these crops," said Elizabeth Jeffery, a University of Illinois professor of food science and human nutrition.

The highest levels of detoxifying enzymes were found in rats that ate selenium-treated broccoli. The amount of one of the cancer-fighting compounds in broccoli was six times higher in selenium-enriched broccoli than in standard broccoli powder, she said.

Selenium-treated broccoli was also most active in the liver, reaching a level of bioactivity that exceeded the other foods used in the experiment. Eating broccoli and tomatoes is useful in the controlling some chronic diseases.

Source: StoneHearth Newsletter