Heart Failure in Young Adults: A Growing Concern All Over the World

A decade ago, the sight of a family or friends bringing a young adult to the hospital because they had a heart attack was the rarest of cases. Unfortunately, the situation is not the same any more. The growing instances of heart attack and failure in young adults all over the world is alarming, to say the least. Gone are the days when heart attacks were mostly experienced by older individuals, as today, the chances of a heart attack even in the 20s cannot be ruled out.

In March 2023, A 45-year-old male was wheeled into the emergency room as he was experiencing breathlessness for the last 2 days, which gradually increased while lying down, especially during the night. Already a Chronic Kidney Disease patient and on dialysis for the past 3 years, the breathlessness he felt was due to heart failure. This is secondary to a silent Heart attack that had damaged his heart muscle by 50%, a condition that can also be a main reason for cardiac arrest. The patient was stabilised with medicines, following which a coronary angiography revealed a 100% blockage of his main artery. He underwent successful angioplasty surgery and stenting and is now doing well.

Like this patient, we come across many people in their 30s and 40s, or even younger, who suffer from a heart ailment. Heart failure can happen to anyone, at any time. 

Causes of Increasing Heart Failure in Young Adults

The recent increase in the incidences of heart attacks among young adults can be attributed to a range of factors, including lifestyle choices, environmental influences, genetics, and underlying health conditions. According to heart specialists, the common causes of increasing heart issues in young adults include:

Unhealthy Lifestyle Choices

Young adults today often lead sedentary lives, spend extended periods sitting, and consume diets high in processed foods, added sugars, and unhealthy fats. These habits can lead to obesity, high blood pressure, and diabetes, all of which are risk factors for heart failure.

Substance Abuse

Excessive alcohol consumption and illicit drug use, particularly stimulants like cocaine and methamphetamine, can have detrimental effects on the heart. These substances can lead to cardiomyopathy, a condition where the heart muscle weakens, which can lead to a heart attack.

Smoking

Despite increased awareness of the risks, many young adults continue to smoke or use e-cigarettes. Smoking is a major risk factor for heart disease and can accelerate the development of heart failure.

Stress and Mental Health

High levels of chronic stress, anxiety, and depression can activate the body's stress response, leading to increased blood pressure and inflammation. Prolonged exposure to stress can contribute to heart disease and heart failure.

Undiagnosed Conditions

Congenital heart defects, valvular abnormalities, and arrhythmias may go undiagnosed in young adults. These conditions can progressively weaken the heart and eventually lead to heart failure if left untreated.

Delayed Medical Care

Young adults may not recognize the symptoms of heart disease or may delay seeking medical attention. This delay can allow underlying heart conditions to progress unchecked.

Environmental Factors

Exposure to environmental pollutants, such as air pollution and toxins, can increase the risk of heart disease and heart failure, particularly in urban areas with poor air quality.

Also, Read - Unveiling the Impact of Air Pollution on the Lungs and Heart

Lack of Awareness

Many young adults may underestimate their risk of heart disease, assuming it primarily affects older individuals. This lack of awareness can lead to a lack of preventative measures and regular check-ups.

Factors Increasing the Risk of a Heart Attack

While some risk factors are not controllable and require medical intervention, others can be controlled with lifestyle changes. The factors include:

High Blood Pressure

High blood pressure, also known as hypertension, is a condition in which the force of blood against the walls of the arteries remains consistently elevated. This prolonged high pressure can result in damage to the arteries, increasing their vulnerability to blockages that may lead to heart attacks, even in young adults

Obesity

Significant excess weight places additional strain on the heart. Excessive body fat can contribute to the development of conditions such as diabetes and high blood pressure, both of which elevate the risk of heart attacks in young adults.

Blood Vessel Tears

When blood vessels in the body experience tears or ruptures, it can trigger the formation of blood clots. These blood clots, in turn, can lead to the occurrence of heart attacks, which are potentially life-threatening events. Recognizing the importance of preventive measures and promptly seeking medical attention upon observing any symptoms of a heart attack is crucial

High Cholesterol

Elevated levels of cholesterol, particularly the 'bad' LDL cholesterol, can accumulate on the walls of arteries, resulting in the formation of plaques. These plaques narrow and obstruct blood vessels, thereby increasing the risk of heart attacks among young adults.

Kidney Disease

The kidneys play a crucial role in regulating blood pressure. When they don't function properly, blood pressure can rise, placing strain on the heart. Additionally, kidney disease can lead to an imbalance of minerals in the blood, which can affect heart health.

Diabetes

A lot of people are unaware, but Diabetes is also a major risk factor when it comes to heart failure. People suffering from diabetes have higher chances of experiencing a silent heart attack and damage to the heart muscles. Therefore, Diabetes is not only about blood sugar control, but also about assessing overall Heart health.

Sleep Apnea

Sleep apnea is another under-recognized cause of Heart failure. The inability to breathe properly while sleeping at night results in low blood oxygen levels and an increased risk of Heart attack and heart failure. Sleep apnoea is commonly associated with obesity.

Genetic Factors

Some young adults may have a genetic predisposition to heart conditions, including cardiomyopathies and arrhythmias. These genetic factors can lead to heart failure even in the absence of traditional risk factors.

It is essential for individuals of all ages to prioritise their heart health and periodically consult a heart doctor to identify and manage heart problems at an early stage. 

Read More: Is Heart Disease More Prevalent in Young People?

Symptoms of a Heart Attack

The symptoms of a heart attack are more or less the same as older adults, but recognizing them at an early stage can be challenging, as they can be subtle and easily overlooked. That said, early identification is crucial for timely intervention and management. The symptoms include:

• Fatigue: Experiencing excessive tiredness or a significant decrease in energy levels, even after adequate rest or sleep.
• Shortness of Breath: Breathlessness, especially during physical activity or when lying flat, which may be relieved when sitting up.
• Rapid or Irregular Heartbeat: Palpitations, characterised by a racing or irregular heart rate.
• Swelling: Edema or fluid retention, often noticeable in the legs, ankles, feet, or abdomen.
• Persistent Cough or Wheezing: A chronic cough that may produce white or pink mucus, or wheezing due to fluid accumulation in the lungs.
• Reduced Exercise Tolerance: Difficulty engaging in physical activities that were once manageable.
• Chest Pain or Discomfort: Although less common, some young adults with heart failure may experience chest pain or discomfort.
• Weight Gain: Unintentional weight gain due to fluid retention.

Preventing Heart Attack in Young Adults

Preventing heart failure in young adults requires the adoption of a heart-healthy lifestyle and addressing risk factors that can contribute to heart problems. Here are some steps you can take to reduce the risk of heart failure:

Maintain a Healthy Diet

Consume a balanced diet that includes plenty of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products. Limit your intake of saturated and trans fats, cholesterol, salt, and added sugars. Pay attention to portion sizes to avoid overeating.

Maintain an Active Lifestyle

Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week. Regular physical activity helps maintain a healthy weight, lower blood pressure, and improve overall heart health.

Maintain a Healthy Weight

Achieving and maintaining a healthy weight reduces the strain on your heart and lowers your risk of heart problems. If you are overweight or obese, collaborate with a healthcare provider to develop a personalised weight loss plan.

Don't Smoke and Avoid Second-hand Smoke

Smoking is a significant risk factor for heart disease. Seek assistance to quit if you are a smoker. Avoid exposure to second-hand smoke, as it can also harm your heart.

Avoid Alcohol

While it is now proven that alcohol is harmful in every quantity; if you consume alcohol, do so in moderation, which typically means up to one drink per day for women and up to two drinks per day for men.

Manage Stress

High stress levels can contribute to heart problems. Practice stress-reduction techniques such as mindfulness, meditation, yoga, or deep breathing exercises.

Control Underlying Conditions

If you have diabetes, high blood pressure, or other chronic conditions, collaborate closely with your healthcare provider to manage them effectively. Take medications as prescribed and attend regular check-ups.

Get Regular Check-ups

Visit your heart hospital for regular check-ups, even if you feel healthy. Discuss your family history and any concerns about your heart health.

The Role of Friends and Family in Heart Attack Recovery

Friends and family are crucial in supporting a loved one's recovery from a heart attack. Here are some ways they can provide assistance and emotional support during this challenging time:

• Encourage Medication Adherence: Ensure that the individual with heart failure is taking their prescribed medications as directed by their healthcare provider. Help organise pillboxes, set reminders, or accompany them to doctor's appointments.
• Promote a Heart-Healthy Lifestyle: Encourage and participate in heart-healthy activities like cooking nutritious meals, regular exercise, and reducing salt and sugar intake. Make these changes as a family to provide a supportive environment.
• Emotional Support: Offer emotional support by listening, empathising, and being there to talk when needed. A heart failure diagnosis can be emotionally challenging, and having someone to talk to can make a significant difference.
• Help with Daily Tasks: Depending on the severity of the condition, individuals with heart failure may struggle with daily tasks. Friends and family can assist with chores, grocery shopping, transportation to medical appointments, and other practical tasks.
• Encourage Stress Reduction: Help the individual manage stress through relaxation techniques like meditation or yoga. Reducing stress can improve overall heart health.
• Promote Social Interaction: Encourage social activities and interactions with friends and family. Isolation can lead to depression, which can worsen the overall health of someone with heart failure.

Healthy Heart Tips

Maintaining a healthy heart is essential for overall well-being. Here are some tips for keeping your heart healthy:

• Consume plenty of fruits, vegetables, whole grains, and legumes.
• If you're overweight or obese, work on gradual, sustainable weight loss.
• Incorporate strength training exercises at least two days a week.
• Drink plenty of water throughout the day to support overall health.
• Aim for 7–9 hours of sleep per night. Poor sleep can contribute to heart problems.

Advancements in Heart Health Management

In the last few years, there has been a great advancement in the management of Heart attacks, valvular Heart disease, and congenital Heart disease. There has also been a tremendous development in the management of Hypertension (high blood pressure), Diabetes, and cholesterol disorders, which are major risk factors in causing Heart disease.

Patients who suffer from a heart issue shouldn’t lose hope, as heart failure treatment is continuously advancing, offering improved outcomes. There has been phenomenal development in the management of the disease with newer and effective drugs, devices, and interventional procedures. With proper education, lifestyle modification, compliance, discipline, regular checkups, and support from family and healthcare systems, patients with Heart failure can lead a normal life.

The need of the hour is to nip the problem in the bud. This can be achieved by educating the community at large, about the risk factors and signs and heart failure symptoms. Awareness about the situations, in which a specialist needs to be consulted, must be strongly addressed.