Sandy suffers from a number of conditions, all of which impact on the health of his heart.
Atrial Fibrillation
Atrial fibrillation (AF) is a heart condition that causes the heart to beat irregularly and too rapidly. If uncontrolled it can lead to long-term cardiac damage, eventually causing ventricular systolic dysfunction, decreased cardiac output, increased ventricular filling pressures and increased vascular resistance. AF is associated with heart failure and the two often occur together. The combination of the two is related to increased morbidity and mortality compared to each disorder on its own. Although the relationship between AF and heart failure is not fully understood, it can be explained, to a certain extent by the presence of the same risk factors, of which diabetes is one. The prevalence of AF is spreading, along with the growth of the elderly in the general population. Sandy’s diabetes may have been a contributory factor in his AF.
If you would like more information on AF, please visit the HEARTe 8: Atrial Fibrillation module.
Type 2 diabetes
Sandy has type 2 Diabetes Mellitus. Diabetes is regarded as the strongest risk factor for heart failure. The prevalence of diabetes in heart failure patients is close to 20%, compared to 4-6% in the general population. This increased risk is associated with a number of different factors. Diabetes is known to accelerate the development of coronary atherosclerosis. People with diabetes have an increased level of low-grade inflammation of arterial linings. These initiate blood vessel changes which can, ultimately, lead to heart failure. Diabetics, particularly those with type 2 diabetes, have higher level of th blood fats, including cholesterol, which can lead to cardiac problems. It is also thought that there may be a specific cardiomyopathy that contributes to heart failure and makes diabetic individuals more liable to develop the condition.
Asthma
Asthma is a respiratory condition marked by attacks of spasms in the bronchi of the lungs, causing difficulty with breathing. It is often associated with allergens and allergies to particular substances. Although asthma is associated with an increased risk of heart failure, the reasons for this are unclear. There may be a link between the inflammatory processes that occur in asthma and those that take place in heart failure but this link is not fully understood. There is some evidence, also, that the medications taken to prevent and treat asthma may be implicated in the development of heart failure, particularly if an individual is taking multiple medications.
Taken together, Sandy’s AF, type 2 diabetes and asthma put him at increased risk of developing heart failure.
