Di Somma (Sapienza): ‘Late diagnosis of heart failure problem’

In Italy over 1 million people suffer from heart failure and new diagnoses increase every year: about 20 cases per 1000 people between 65 and 69 years, and more than 80 cases per 1000 people over 85; 190 thousand hospitalizations a year which generate a total expenditure on the NHS of almost 3 billion per year (Aisc data). “However, heart failure is not diagnosed in time. The delay in diagnosis is mainly due to the paucisymptomaticity of the initial stages of the disease; and, for this reason, heart failure is certainly an underestimated pathology ”. Salvatore Di Somma, professor of internal and emergency medicine at the University of Rome La Sapienza – in an interview published on the Aleati per la Salute website (www.alleatiperlasalute.it), the portal dedicated to medical-scientific information created from Novartis Italy – underlines the importance of intervening in a timely manner because, although heart failure is more frequent among elderly people and, statistically, its incidence increases with advancing age, “some cases – explains Di Somma that he is also Scientific Director of the Italian Association of Patients with Heart Failure – they also occur in children due to congenital malformations and in young adults due to diseases of the heart valves or primary heart muscle “.” In our country – he continues – one in 5 people over 40 years will develop heart failure in their lifetime, and 1 in 3 people mistake the symptoms for normal signs of aging. Given these numbers, every person after the age of 40, especially if affected by the risk factors and / or initial symptoms, should undergo a cardiological check-up to assess the possibility that heart failure is present. Certainly, in addition to the ‘official’ patients with heart failure, many others have this disorder but they ignore it ”. Among the most common factors at the origin of heart failure, previous cardiovascular problems: heart attack, coronary heart disease, hypertension, diabetes, dyslipidemia, heart valve diseases, inflammations or genetic diseases of the myocardium, congenital defects, lung diseases. “It is therefore clear – underlines the cardiologist – that all subjects who have already been diagnosed with one of these pathological situations should be considered at risk of being affected or being able to develop heart failure”. Symptoms vary significantly from person to person, especially in relation to the severity of the disease and the incidence that the different factors have had in generating it: shortness of breath, even for light exertion, cough, weight gain and swelling in the lower extremities , especially in the ankles. “In any case – adds Di Somma – these symptoms are not specific only to heart failure and can therefore be confused with other acute pathologies, for example of a pulmonary nature. In the initial stages, however, it manifests itself with very vague and non-specific symptoms such as: a sense of fatigue and tiredness, dizziness and palpitations, tachycardia, loss of appetite and the need to urinate several times during the night. In these cases, given the non-specificity of the symptoms, the possibility is often not considered that this symptomatology could be caused by heart failure and this often delays, therefore, an accurate and timely diagnosis “. In addition to the lungs, Covid-19 attacks other organs, including the heart. For this reason, due to the Di Somma virus there is a risk that patients with heart failure will increase. “Due to the fear of contagion – concludes the cardiologist – many patients with heart failure have delayed the search for medical assistance in hospitals or medical clinics and this has led to worse outcomes, with an aggravation of the clinical condition and, at times, loss of human lives due to an interruption in the continuity of care and indispensable checks, given the chronicity of the disease. Furthermore, in addition to the lungs, the virus also attacks all organs, especially the heart where it can induce more or less acute inflammation of the myocardium and therefore at a distance new cases of heart failure. An increase of about 30% is expected in the near future in new cases of heart failure, a consequence of infections, even if not serious, from coronavirus “. The expert’s intervention is available on: https://www.alleatiperlasalute.it/alla-scoperta-di/scompenso-cardiaco-come-gestirlo