Heart Awareness Month: SA still faces a crisis of cardiovascular-disease

The Heart and Stroke Foundation South Africa (HSFSA) is well- known locally, regionally and internationally for dedicating the entire month of September to heart awareness.

Given that Heart Awareness Month is one of the foundation’s key campaign events it aims to make a significant impact on heart disease awareness and, through the campaign strategy, also aims to reduce the burden of cardiovascular disease (CVD).

Sunday 29 September is World Heart Day (WHD), when the HSFSA’s Heart Awareness Month campaign will culminate. The foundation will align with the World Heart Federation on the day. By embracing this global theme, the HSFSA underscores the need for sustained collaboration and collective action to achieve lasting impact.

Taking a comprehensive look at the CVD statistics pertaining to the mortality and morbidity rates in the South African context, it is alarming that South Africa is still facing a crisis of CVD burden.

In 2020, Statistics South Africa highlighted mortality trends, indicating that Diabetes Mellitus, hypertensive disease, cerebrovascular disease and heart disease were marked in the top 10 leading natural causes of death in SA. These conditions added up to an estimated 17% of all reported deaths in 2020.

HSFSA CEO Professor Pamela Naidoo, together with key stakeholders, has realised that the South Africans do not fully understand the complexity of CVD. “There are many medical conditions that constitute the cluster of CVDs,” she explained.

As a starting point Naidoo conceptualised the focus on heart failure given the many misconceptions about what the condition is exactly. Consequently, this year’s awareness campaign’s primary theme is on heart failure and its key risk factors.

Over a four-week period each week will have an exclusive but related theme on heart failure. The themes are as follows: Week 1 – What is heart failure?; Week 2 – The causes of heart failure; Week 3 – Management of heart failure and living with heart failure; and Week 4 – Diabetes type 2 and other risk factors for heart failure.

This week, the HSFSA delves into the first theme . . .

What is heart failure?

Heart failure, or congestive heart failure, is a “serious condition, in which the quantity of the blood pumped by the heart each minute (cardiac output) is insufficient to meet the body’s normal requirement for oxygen and nutrients.”

However, this does not mean that the heart is about to fail or stop completely. During heart failure the organ is not capable of coping with its workload. When the heart does not pump efficiently the heart has to beat faster and gradually enlarge to cope with the workload causing the heart to weaken and the amount of blood pumped to the body to be restricted.

The circulation becomes sluggish causing excess fluid to be retained in the body. When this happens your blood cannot deliver enough oxygen and nutrients to the rest of your body to allow it to work normally.

Heart failure can damage your liver or kidneys and may lead to other conditions including pulmonary hypertension or other heart conditions, such as an irregular heartbeat, heart valve disease and sudden cardiac arrest.

Heart failure may happen suddenly with severe symptoms (known as acute heart failure) or symptoms may appear slowly and gradually worsen (known as chronic heart failure). If not treated heart failure (HF) can be life-threatening. If treated, however, many individuals live with HF for years.

Types of HF may be divided into two categories: Left-sided HF and right-sided HF.

Left-sided HF is when the power of the left heart chamber is reduced, causing the left chamber to work harder to pump the same amount of blood. The left chamber is responsible for pumping blood throughout the body. There are two types:

• HF with reduced ejection fraction, also called systolic HF. The left heart chamber does not have enough force to push enough blood into circulation.
• HF with preserved ejection fraction, also called diastolic HF. The left heart chamber does not relax normally because the muscle has become stiffer and thus the filling of the chamber with blood is impaired.

The term ejection fraction describes the heart chambers’ strength and ability to empty with each beat. Specific left sided HF symptoms may include fluid build up in the lungs, causing shortness of breath, bluish color of fingers and lips, sleepiness or trouble concentrating and an inability to sleep lying flat.

Right-sided HF affects the lower right heart chamber and is responsible for pumping blood to the lungs. Some particular symptoms may include fluid build up and swelling in the abdomen, legs and feet or a pain in the abdomen area.