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Heart rehabilitation an oft missed aspect of heart failure treatment

Pank Jit Sin
01 Jun 2018
L-R: Professor Chee Kok Han, Iryani Abdul Jamil, Iryani's husband, Dr Anwar Sulaiman

While heart failure is incurable, proper medication and lifestyle modifications will go a long way in improving a patient’s quality of life, says Dr Anwar Suhaimi, a rehabilitation physician at University Malaysia Medical Centre.

Anwar said: “There is currently no known cure for heart failure, but by taking an active role in their heart health, patients can help to reduce the severity of their symptoms—potentially slowing the progression of their disease. Optimal treatment, including medication and physical conditioning designed to suit each patient, can help to increase their capacity for everyday activities and ultimately enhance their quality of life.

Increasing capacity for physical activity, in addition to appropriate medication, is highly beneficial for heart failure patients, said Anwar. It can improve a patient’s heart function by strengthening it to beat more efficiently and help to tackle symptoms of fatigue. He cautioned, however, the need to discuss with doctors or nurses before starting an exercise-based rehabilitation programme as part of heart failure treatment. “[It’s] to make sure you are not putting too much strain on your heart. Patients can begin with basic activities such as walking regularly in a familiar area with shade and spots to rest, and progressing to walking to shops or walking up the stairs, as one gains more confidence over their heart failure symptoms and improves in terms of endurance.”

Diagnose heart failure early to improve quality of life   

Professor Chee Kok Han, consultant cardiologist, also of University Malaya Medical Centre, said that misconceptions surrounding the symptoms of heart failure commonly lead to treatment delay. He said: “Heart failure is a serious, chronic condition that tends to gradually worsen over time and can eventually shorten your life. The progression of heart failure is unpredictable and it reduces quality of life of patients significantly. Modern medicine and lifestyle changes will, however, improve the outlook of the patients.”

Symptoms can be hard to notice as it manifests as shortness of breath, swollen ankles, rapid weight gain (due to water retention) and difficulty in movement. These symptoms can appear slowly and creep up on the patient. Heart failure is estimated to affect more than 60 million people worldwide. [Lancet 2015; 386(9995):743-800] Studies have suggested that the hearts of Malaysians may be at greater risk than other parts of the world, as the prevalence rate of heart failure is higher compared with other countries (6.7% vs 0.5-4.5% respectively). [ESC Heart Failure. 1:4–25] Heart failure in South East Asian patients is also characterized by more severe clinical features, with vascular risk factors such as hypertension, obesity and diabetes. [Euro Heart J 2016;37: 3141–3153] Furthermore, Asian patients with stable heart failure have been shown to be at least a decade younger than European patients, often impacting individuals at the peak of their economical productivity.

 

Anwar and Chee were speaking at a media awareness workshop on heart failure, held in Petaling Jaya, recently.

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Most Read Articles
Pearl Toh, 07 Aug 2018
A home-based, self-applied wearable electrocardiogram (ECG) patch facilitates diagnosis of atrial fibrillation (AF) among high-risk individuals, according to the mSToPS* trial.
02 Aug 2018
Intravenous vasodilator therapy confers survival benefits and superior diuretic response in patients with acute heart failure (AHF), provided that systolic (SBP) reduction is <25 percent, according to a posthoc analysis.
06 Aug 2018
In patients with uncontrolled blood pressure and severe hypertension, microvascular dysfunction is more pronounced and serum C-reactive protein (CRP) and endothelin levels are elevated, a recent study has found.
08 Aug 2018
Early detection of masked hypertension is essential, since young apparently healthy adults already show an increased left ventricular mass index, which indicates higher risk for future cardiovascular disease, according to a recent study.