The book Heart failure, a silent pandemic by former President of the Republic Alfredo Palacio, published this year, identifies the problems that persist around this syndrome.
The analysis derives from several previous research works in which it was determined that between 2012 and 2016 mortality due to heart attack increased only in Ecuador. “In no other country in the region did this happen and worldwide it decreased. The increase (in the country) occurs despite the fact that there is now much more advanced surgical or interventional cardiology technology to dilate arteries”, as well as more pharmacological treatments, indicates Palacio.
The problem, he adds, is that The country has a health system with poor primary care, which implies a setback in the detection and treatment of these casesbut there is also an influence of lifestyles.
‘(To Rafael Correa) I left him a mountain of money to transform the country into a Singapore, but he spent it on other things,’ says Alfredo Palacio about his successor, whom he considers catapulted into politics
In the previous study, it was determined an accelerated increase in death rates from myocardial infarction, which is more pronounced in the male population of the urban coastal region.
This can be attributed to an urban lifestyle, says the publication. The Median age of death from myocardial infarction was 73 yearsamong the mestizos.
“Plus those who were saved ended up with a disabling disease that at 5 years already has a mortality of 65%, but it is not taken into account as a cause of mortalitythen the figures are underestimated”, indicates the former president.
One of the conclusions is that heart failure has four degrees of severity. Those who only have risk factors, those who do not develop symptoms, those who already have them and those who have very severe symptoms. “But cardiologists see only the last two, not the first two, so they are not recognized, if they were observed in time they could stop and not happen here (to the most serious cases), but since they are not done and therefore increases mortality”, explains Palacio.
The 126-page book, presented at the University of Espiritu Santo Specialties (UEES), is co-authored by specialists María José Espinosa, Ana Palacio, Leonardo Tamariz and Juan Pablo Zambrano.
One of the objectives, indicated in the preamble of the book, is to encourage research to solve these problems around heart failure.
“The most serious thing about this silent pandemic is the global ignorance that -despite recent scientific advances- persists, seriously accentuated in developing countries like ours, where heart failure is often clinically unrecognized, especially in its early stages”.
“I have the heart of a 90-year-old man and it only works 45% since I had my heart attack, at first I thought it was gastritis,” says Jorge, who at 59 years of age has permanent sequelae
The situation of mortality from ischemic heart disease has continued in recent years with the exception that total deaths increased due to the incidence of COVID-19, according to official statistics.
Ischemic heart disease is the leading cause of death in Ecuador each year and occurs when the arteries that supply blood to the heart muscle become clogged; Its main manifestation is myocardial infarction.
Even the number of deaths from this cause was slightly higher than the total number of deaths confirmed by COVID-19 during 2020.
As of March 20, 2020, a significant increase in deaths was recorded. During that year, 115,998 people died in the country.. The excess over the average of the previous five years is 46,656 people.
The number of deaths increased by 58% in 2020 compared to the total number of deaths in 2019indicates the analysis of the Social Observatory of Ecuador.
During 2021, a total of 104,513 deaths were counted in the countryan excess of 35,353 people when compared to the average recorded between 2015 and 2019. But compared to the number of deaths in 2020, there was a 9.9% reduction in deaths over the past year.
“After the sustained decrease in the excess of deceased people that was registered between May 4 and the end of October 2021, Ecuador began to register a slight increase in the number of daily deaths from November and with greater intensity after the first confirmed case with omicron that occurred on December 14 last “, indicates the Social Observatory of Ecuador.
The excess of deceased during the pandemic from January 1, 2020 to last January is 84,747 people, according to the analysis of the Social Observatory of Ecuador. “When analyzing deaths at the national level, from January 1, 2020 and to date (last January 27), according to the administrative registry of deaths of the Civil Registry, Identification and Cedulation of Ecuador, the excess of people deaths during the pandemic is 84,747 people, when compared to the historical average recorded between 2015 and 2019.
And between January 1 and 27 of this year, a total of 8,084 deaths from all causes are registered, an amount that represents 2,738 deaths in excess of the average between 2015 and 2019.
COVID-19 made it difficult to care for cases of myocardial infarction, especially during the first months of the pandemic and due to the high percentage of occupancy in the Intensive Care Units (ICU).
Luis Mera Ronquillo, 76 years old and inhabitant of the Petrillo commune, in the Nobol canton in Guayas, felt this reality.
On the night of Thursday, July 29, 2021, he received care at the Nobol toll station because he had severe chest pain that passed through to his back, says Otilda Mera, daughter of the affected person.
There they told him it was high blood pressure and they took him home, but the pain persisted the next day. “I couldn’t even raise my arms or breathe.” It was there that they took him to the Peasant Social Security subcenter in Petrillo, where they asked that he be transferred urgently to the IESS (Ecuadorian Institute of Social Security) hospital in Los Ceibos, in the north of Guayaquil.
The transfer was made in an ECU911 ambulance. “After they stabilized him, they transferred my dad on July 31 by referral to the Interhospital (private) where they did the catheterization a day later (August 1). There they realized that the arteries that carry blood to the heart were not working well, it was a lower myocardial infarction”, indicates Otilda.
Luis is diabetic, suffering from high blood pressure, and received initial and specific care based on what he had four days after his chest pain developed.
The surgery to place the bypass was finally done on Wednesday, August 4, 2021. “The IESS covered the expenses because my father is retired from the Peasant Social Security,” says Otilda.
Recovery has been slow, Luis walks 30 minutes a day and cannot make sudden movements. His story reflects the importance of detecting a myocardial infarction in primary care so that patients are more likely to survive with the fewest possible sequelae. (I)
Source: Eluniverso
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