Surviving Heart Failure
Heart failure is a growing public health problem in Asia Pacific.
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Although the true prevalence of heart failure in Asia Pacific is unclear, the disease is estimated to affect roughly 64 million people around the world (8.52 cases per 1,000 individuals).1 Additionally, in the region, patients with heart failure are found to be about 10 years younger than patients in Western populations.2 This number in Asia Pacific is expected to increase sharply over the next few decades, largely due to an ageing population and the increased incidence of lifestyle-related diseases such as hypertension, diabetes, and obesity.3
Heart failure not only represents a significant health burden which translates into substantial healthcare costs and loss of productivity, it also takes an emotional toll on those living with the disease and their carers or family members.
[00:34]
During the final days leading up to my retirement in 2018, I started to feel chest pains at night. However, I didn’t understand what the symptom meant.
The following morning, I visited a military hospital as part of a routine check-up. It was during the cardiac ultrasound that they discovered my ejection fraction was very low. I never imagined I was already in the final stages of heart failure.
I was in the hospital with my mom — she came to visit me. She saw her transplant doctor. When he looked at her, then looked at me, he said, “Madam Peng, your daughter has the same condition as you — dilated cardiomyopathy.”
[01:07]
But I never expected to be diagnosed with end-stage heart failure at that time.
I was in and out of the hospital. I was always in bed. I couldn’t even lie down flat because I couldn’t breathe — I had water in my lungs. So I had to sleep sitting up.
It was such a struggle because you just can’t live your life well. You can’t sleep, even when you're sleepy. You can’t eat, even when you’re hungry. You don’t even have the strength to shower. That’s what I faced during heart failure.
I served in the Vietnamese People’s Army for over 40 years. Despite my physically demanding lifestyle, I never considered the possibility of heart failure.
[02:14]
I went for regular check-ups, including coronary artery ultrasounds and general health examinations, but no concerns were raised.
Throughout my life, I never experienced elevated blood pressure, which led me to become somewhat complacent in terms of my lifestyle and adherence to medication.
Although I never smoked, I regularly enjoyed alcohol. I also didn’t follow the doctor’s advice properly when it came to using medication.
On two occasions, I was hospitalized due to fluid retention in my heart chambers — a result of my tendency to consume high-sodium foods.
Through the past ten years, I’ve lost many, many friends who went through this suffering with me. And honestly, I’m one of the few who are still around.
[02:56]
The last one still alive… passed away two days ago. So I don’t have anyone left.
I have fear in making friends with other patients — because the more friends I make, the more I lose them. So I stopped. I stopped getting to know anybody.
It’s very hard seeing everyone just pass on.
Most people with heart disease have to take medication for the rest of their lives — which can be a heavy burden for them and their families.
I hope that healthcare institutions and insurance agencies will provide favorable conditions for these individuals — to ensure access to necessary medical examinations and treatment.
[03:34]
People don’t really know what heart failure is. They think it just means your heart is a little weaker — that’s all.
But people don’t realize how much you suffer, how hard it is to perform daily activities.
Get checked up early — because you never know what condition you might have. And sometimes, when you find out, it’s too late.
You don’t have time to live your life and do what you want to do. Regular check-ups are necessary.
[04:12]
If any abnormalities are detected, a thorough examination should be conducted.
Every aspect — from diet to lifestyle — requires careful attention as you age.
Watch this video of Hung, a 63 year old army veteran from Vietnam, and Serene, a mother of three from Singapore as they share their experience of life with heart failure.
Because symptoms are nonspecific and at early stages can go unnoticed, heart failure can be hard to diagnose.4 Heart failure can happen suddenly or it can progress slowly over months or years.5 This can add to a patient’s physical and emotional stress.
The major concern that doctors face today is diagnosing heart failure based on symptoms alone. Oftentimes, heart failure patients can be misdiagnosed resulting in adverse consequences, such as inappropriate care or treatment, which adds burden for patients and costs to healthcare systems.
Inadequate management and monitoring of heart disease alone can impose billions of dollars of costs on healthcare systems, as well as affect patients in countries where they have to bear significant out of pocket expenses.
Advanced diagnostics and aggregated healthcare data support clinicians in making the right diagnosis at the right time, and can help healthcare systems around the world manage their resources more effectively. Some insights can lead to behavior and lifestyle changes, which can keep a person healthy and out of the hospital. Some tests might reveal an imminent threat and lead to a life-saving decision.6
There is an urgent need for concerted efforts by multiple stakeholders, from patient to physician, to close these gaps and ensure that all heart failure patients receive optimal care. Additionally, multidisciplinary efforts, involving primary care physicians and cardiologists, are critical to implementing new strategies and improving the long-term outlook for heart failure patients.
References
Lippi G, Sanchis-Gomar F. Global epidemiology and future trends of heart failure. AME Med J. 2020;5(0). doi:10.21037/amj.2020.03.03.
Lam CS, Anand I, Zhang S, Shimizu W, Narasimhan C, Park SW, Yu CM, Ngarmukos T, Omar R, Reyes EB, Siswanto B, Ling LH, Richards AM. Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. Eur J Heart Fail. 2013 Aug;15(8):928-36. doi: 10.1093/eurjhf/hft045. Epub 2013 Apr 7. PMID: 23568645.
Sidik SM. Heart-disease risk soars after COVID — even with a mild case. Nature. 2022;602(7898):560-560. doi:10.1038/d41586-022-00403-0.
Understanding heart failure. Accessed June 28, 2023.
British Heart Foundation. Heart failure. Accessed June 28, 2023.
Roche. (2022) The Value of Diagnostics. Retrieved from: