Answer To When The Atria Contracts Th Eblood Flows Obesity – A Cause of Heart Failure?

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Obesity – A Cause of Heart Failure?

Can obesity cause heart failure? The answer, unfortunately, is yes: Being overweight can lead to heart disease through several mechanisms, including ischemic heart disease and congestive heart failure. We proceed to take a closer look at how this happens.

First of all, excess weight increases blood volume in the body. This is only natural, as excess body mass requires adequate blood flow just like any other body tissue. However, this means that the heart must constantly pump large amounts of blood. In other words, the workload on the heart is increased, proportionally as one weighs more.

Like any other muscle in the body, the heart muscle responds to this increased workload by hypertrophying, i.e. increasing its size. This condition is called left ventricular hypertrophy (LVH), and is often associated with some degree of hypertension (raised blood pressure).

Up to a point, the heart can accommodate this and continue to function normally. However, the following problems later develop: As the heart muscle enlarges, the coronary arteries (vessels that supply blood to the heart muscle) cannot expand at the same rate. Although additional coronary branches are formed, their number soon becomes insufficient for the increased mass of heart muscle. Therefore, a relative ischemia (lack of blood) occurs, which manifests itself in highly demanding conditions (physical exercise, febrile illness, etc.). The heart tissue affected by this phenomenon is damaged over time and the ability to contract gradually decreases. Furthermore, the hypertrophied cardiac muscle loses elasticity, and therefore fails to fully relax during cardiac contractions. This causes the heart muscle to insufficiently fill with blood before contraction, reducing the amount of blood ejected during contraction.

Over time, this mechanism can lead to frank congestive heart failure, a condition where the heart does not contract properly and is unable to pump enough blood to the body. In this condition, the residual amount of blood that the heart fails to pump into the circulation accumulates “behind the heart” in the lungs and other tissues of the body, causing pulmonary congestion or edema of the body (swelling, especially of the lower limbs).

But that’s not all. The process described above is just one way obesity can lead to heart failure. In reality, at least 2 other mechanisms are at work: We all know (or should know) that being overweight is associated with high cholesterol and other lipid abnormalities, as well as the development of type 2 diabetes.

In turn, lipid disorders and type 2 diabetes lead to plaque buildup in the arteries, a condition commonly known as atherosclerosis. When atherosclerosis affects the arteries of the heart, we speak of coronary artery disease or ischemic heart disease, the culmination of which is a heart attack. A heart attack, or blood clot in the heart muscle, occurs when a locally formed plaque completely blocks a coronary artery, or when a clot breaks off from a distant plaque source. In this situation, blood flow is interrupted, such that the heart muscle beyond the site of the blockage is deprived of blood. This leads to the death of the relevant part of the heart muscle, a process called myocardial necrosis. The dead part of the heart muscle becomes thin and heavy and does not contract as the heart beats. Because of this, the heart is losing some of its contractile power. A necrotic heart area can also generate abnormal electrical potentials, which can lead to cardiac arrhythmias such as atrial fibrillation, atrial flutter, or tachycardia. Cardiac arrhythmias further reduce the heart’s ability to pump blood, because the rapid heart rhythm does not allow enough time for the heart to fill with blood before each heart contraction.

It is important to know that type 2 diabetes, a common condition in overweight individuals, has a very strong association with ischemic heart disease. That is to say, if a person has type 2 diabetes, that person is likely to suffer from ischemic heart disease (coronary artery disease). Often, patients with type 2 diabetes have silent heart disease, meaning no clinical symptoms until a potentially fatal heart attack occurs. Hence, from a medical point of view, diabetes type 2 is considered equivalent to ischemic heart disease and a patient suffering from type 2 diabetes is considered to be suffering from ischemic heart disease.

Note that type 2 diabetes is a largely preventable condition. It usually occurs in overweight or obese individuals and resolves when the individual regains normal or near-normal weight. The mechanism of type 2 diabetes is related to insulin resistance. In other words, overweight or obese individuals become refractory to insulin, the hormone that regulates blood glucose levels. In such cases, more insulin is required to keep blood glucose in the normal range.

In speculation:

It is clear that overweight and obesity play an important role in the development of cardiovascular disorders, including ischemic heart disease and congestive heart failure. In short, obesity can act as a trigger mechanism for these conditions, which ultimately has a snowballing effect, resulting in more and more heart damage. Therefore, it is wise for overweight individuals to work on weight loss before any signs or symptoms of heart disease appear. At the point where symptoms appear, heart damage can be irreversible.

Copyright 2008, med-solver.com

Disclaimer: This article does not provide medical advice and is not a substitute for professional advice from your doctor. For any concerns regarding your personal health care, please consult your physician.

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