Heart conditions: what do they mean?

In the wake of the tragic death of five young people during a recent outdoor concert, news reports have revealed autopsy results indicating that the fatalities died due to “heart attack,” “sudden cardiac death” and even “heart failure.” This unfortunate incident has once again underscored the dangers of illicit drug use. Our heartfelt condolences and prayers go out to the bereaved families.

In the interest of public awareness, our column this week will define common heart conditions.

Heart attack or atake sa puso (myocardial infarction or MI) occurs when one or more of the arteries of the heart (coronary arteries) are blocked, preventing the heart from receiving enough oxygen-rich blood. If the oxygen in the blood cannot reach the heart muscle, the heart becomes damaged irreversibly. Over time, a coronary artery can narrow from the buildup of various substances, including cholesterol, in a process called atherosclerosis. This condition, known as coronary artery disease (CAD), causes most heart attacks.

Sudden cardiac death, also called sudden cardiac arrest, is a sudden, unexpected death caused by loss of heart function—parang nag-short circuit ang puso. It occurs when the electrical system to the heart malfunctions and suddenly becomes very irregular. Sudden cardiac death is usually caused by abnormal heart rhythms called arrhythmias, i.e. wala sa tiyempo ang tibok ng puso. The most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganized firing of impulses from the ventricles (the heart’s lower chambers). When this occurs, the heart is unable to pump blood and death will occur within minutes, if left untreated.

Heart failure or pumapalyang puso is a serious life-threatening condition in which the heart weakens and cannot pump enough blood to fully meet the oxygen demand of the body. Over time, if not treated properly, heart failure leads to a cascade of changes, punctuated by acute episodes, that cause severe fatigue; breathlessness; damage particularly to the heart, kidneys and liver; and ultimately death. CAD and high blood pressure (hypertension) are the most common causes of heart failure.

Heart failure is the most common cause of hospitalization in people aged over 65. One in 25 patients does not survive his/her first hospitalization with HF as the primary diagnosis. One in 10 patients dies within 30 days following hospitalization. In three patients, one dies within one year following hospitalization. Half of all patients die within five years of diagnosis.

Heart failure incidence is rising, driven by deteriorating lifestyle, increased survival after heart attacks and aging populations. Although there are currently no definitive local statistics on the prevalence of heart failure, the latest National Nutrition and Health Survey conducted in 2013 shows that many Filipinos have risk factors for heart failure. These include hypertension, obesity, smoking, high cholesterol and diabetes.

We need to continuously promote public awareness on cardiovascular diseases, which are among the leading causes of sickness and death in the country. With increased awareness, Filipinos can be motivated to adopt a healthy lifestyle and this can also help patients manage their disease.

On a personal note, I must stress that illicit drugs, which include so-called recreational or party drugs, destroy lives and should never be used under any circumstances.

Dr. Alex T. Junia, President of the Philippine Heart Association (PHA) 2015-2016, completed his medical degree at Cebu Institute of Medicine and finished his fellowship in cardiology at the Philippine Heart Center. The PHA is an organization of cardiovascular specialists and lay members that ensure accessible, affordable and quality cardiovascular education and care for everyone. For more information, visit www.philheart.org.