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HowToPreventHeartDisease.com |
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A Rhythm That Can Be Deadly For Elderly! Atrial fibrillation (AF) is one of the many medical conditions that is common among the elderly. AF occurs when multiple electrical impulses in the upper chambers of the heart (atria) fire rapidly at the same time, causing a chaotic rhythm that is often felt and described as a fast and irregular heartbeat. In addition to such palpitations, people with AF can have symptoms such as chest pain or discomfort, shortness of breath, giddiness and fatigue. For people with AF, blood flow within the atria slows down and might cause blood clots to form. The blood clots could break into pieces and travel to the brain and block the blood flow hence causing a stroke or transient ischemic attack. Should the blood clots flow in a limb or another organ, it could also cause damage, though this is relatively less common. AF could also cause heart failure if the heart rate is too fast and uncontrolled, usually above 120 beats per minute for many years. This is because the heart pumping chambers (ventricles) cannot adequately fill with blood when the heart rate is too fast. Over time, the heart muscle starts to dilate and stretch. For patients already with heart failure due to other heart disease, the start of an irregular heart rhythm could worsen their heart failure conditions and most likely leads to hospital admission. The risk of developing AF also becomes higher if one has other heart problems like high blood pressure, heart failure, valvular heart disease or previous heart attack. These conditions could increase the pressure within the heart, causing the atria to become stretched over time. Over a longer period, the stretching creates scarring and changes in the electrical properties of the atria.
Patients who are older are also at increased risk. Studies conducted overseas showed that 0.1 percent risk of AF for people below the age of 55 and 10 percent for those above 80 years old. An ageing population can mean more people suffering chronic diseases that will increase the risk of AF and stroke. The proportion of local residents aged 65 years and above increased from 7.2 percent in 2000 to 9.3 percent in 2011. It is projected to reach 19 percent by 2030. According to a finding of the Singapore Longitudinal Ageing Study, which is an ongoing long-term study started in 2003 on Singapore's rapidly ageing population, about 6 percent of people aged above 80 in Singapore suffer from AF that can cause a stroke. In the study, more than 2,800 people aged 55 and above were recruited. It was found that 2.6 percent of men and 0.6 percent of women had AF. The actual number could have been higher since most patients who have AF that occurs only intermittently, might not have any AF symptoms at the time the ECG (electrocardiograms) was carried out for this study. The risk of getting a stroke for those with AF can vary according to whether they have other risk factors such as previous stroke or transient ischemic attack or suffered from diabetes, hypertension or heart failure. A 50-year-old man with no other risk factors, for instance, has a risk of stroke of less than 1 percent, whereas an 80-year-old man, who has had a previous stroke and has high blood pressure, diabetes, coronary artery disease and heart failure, has a risk exceeding 20 percent. There is a 1 in 10 case of stroke that is caused by clots travelling to the brain from the heart and most of these are due to AF. Some overseas studies suggested that AF-related stroke resulted in worse outcomes like leading to more deaths, worse disability and a higher likelihood of needing nursing home care, compared to other forms of strokes. Nevertheless, the stroke and heart failure can be prevented provided if AF is detected early and treated with medication or even surgery. AF could be picked up on an ECG, which is inexpensive, safe and easy to do. People who have any symptoms, especially those who aged above 50 should have one performed.
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