With the help of awareness campaigns over the past few decades, the dangers
of cardiovascular diseases have become common knowledge. In Jordan, 14 percent
of adults between the ages of 45–69 have a history of
cardiovascular disease.
اضافة اعلان
Cardiovascular-related death is the greatest
contributor to global mortality. In Jordan, cardiovascular-related deaths
contribute to 39 percent of all mortality.
One cardiovascular disease is atrial fibrillation
(
Afib), and although it is not inherently deadly, it is highly associated with
other fatal conditions. In this article, we share the signs, symptoms, and
complications of Afib, as well as the work that has been done on Afib in
Jordan.
What is Afib?
The heart is a muscle that
depends on perfectly timed contractions to pump blood. It is comprised of four
chambers: the upper two atria and the lower two ventricles. Each chamber
contracts at a precise time, squeezing the blood and forcing it into the next
chamber or the rest of the body.
It is known as an arrhythmia if there is any
abnormality in the timing or rhythm of these contractions. There are many
causes and types of arrhythmias, but the most common type is Afib. Afib occurs
when atria contract irregularly, akin to a quiver, which greatly impacts blood
flow into the ventricles.
Afib has different classifications based on cause
and duration. Regarding cause, Afib can be divided into valvular and
non-valvular classifications. Valvular Afib refers to Afib caused by issues
relating to the heart valves, whether it be a disorder or prosthetic.
Non-valvular refers to all other causes such as high blood pressure or stress
which is the vast majority of all Afib cases.
In relation to duration, Afib can be divided into
three types: paroxysmal, which happens seemingly randomly and stops within
seven days; persistent Afib, which lasts longer than seven days and may require
cardioversion (i.e., electrical shock that restores heart rhythm); and
long-standing persistent Afib, which is similar to persistent Afib but lasts
longer than a year.
Symptoms of Afib
Afib can manifest in
different ways. People may experience symptoms or not experience any at all.
Two of the most common symptoms experienced are irregular heartbeats and heart
palpitations. An irregular heartbeat can be either too slow, too fast, or
inconsistent.
The normal heart rate at rest is between 60–100
beats per minute. This can vary between individuals, but most people can sense
when their heart rate has become irregular. For those with Afib, irregular
heartbeats are often accompanied by other symptoms and occur frequently. A
heart palpitation is when you can feel your heart beating quickly, fluttering,
or pounding. These sensations have been described as drums pounding, thunder
rumbling, or fish flopping in the chest.
Those with Afib are five times more likely to suffer from stroke, and it is estimated that 15–20 percent of all stroke cases also have Afib.
Afib can be associated with other symptoms, but they
are nonspecific and difficult to diagnose. Chest pain is common with
arrhythmias but may also indicate other cardiovascular conditions that could be
potentially fatal. These symptoms include feeling faint, shortness of breath,
and confusion. If you have no previous history of cardiovascular diseases and
you experience irregular heartbeats and heart palpitations, especially when
combined with symptoms, you should seek medical attention immediately. Since
these symptoms are nonspecific, they could indicate a heart attack.
If you are diagnosed with Afib, differentiating
between a heart attack and Afib can be more difficult. Generally, if the
aforementioned symptoms are combined with excessive sweating or radiating chest
pain into the arm or neck, then it may indicate a heart attack. For more
information, speak to a doctor on the signs and symptoms to expect once
diagnosed with Afib.
Complications of Afib
While Afib itself is not
inherently deadly, it can lead to serious complications that can be fatal. One
of the greatest risks is the formation of clots. Since blood flow from the
atria to the ventricles is impaired, the likelihood of stagnant blood pooling
and forming clots increases. This risk only increases when in combination with
other factors such as hypertension (i.g., high blood pressure), diabetes, and
being older than 65.
The clots formed have the potential to break off and
travel to other parts of the body. One of the most common places these clots
travel to is the blood vessels that carry blood to the brain. As a result, the
clots block blood flow to the brain and cause a stroke. This causes the brain
to be starved of oxygen and results in disability or death.
Those with Afib are five times more likely to suffer
from stroke, and it is estimated that 15–20 percent of all stroke cases also
have Afib.
Another concern of Afib is heart failure. Heart
failure occurs when the heart can no longer pump blood efficiently and cannot
meet the body’s demands. This relates to atria’s impairment of blood flow to
ventricles, ultimately affecting overall blood flow to the body.
Heart failure is chronic and progressive; therefore,
it is more commonly seen in those with long-standing persistent Afib.
Afib in Jordan
Western nations have long
studied Afib, but little research exists in the Middle East. As a direct
result, the Jordan Collaborating Cardiology Group, in collaboration with the
Jordan AF Study Group, set out to evaluate Afib patients in multiple medical
settings. This project is known as the JoFib Study, and its data has resulted
in numerous subsequent studies.
The JoFib study consists of 2,163 Afib patients that
enrolled from May 2019 to January 2021, and their outcomes were assessed over a
year. The results found by the JoFib study allowed subsequent studies in
relation to Jordanians to emerge. One result found that the risk of clots in
Jordanian Afib patients, which was 83.9 percent of women and 78.8 percent of
men with Afib were at high risk for developing clots.
It was also found that within the one-year
follow-up, 7.8 percent of patients had cardiovascular-related death, which was
consistent with other global studies which estimate cardiovascular-related
death between 4–7 percent.
Another study using data from JoFib wanted to assess
the risk associated with Afib and coronary heart disease (CHD). CHD occurs when
fat builds up along the walls of the coronary arteries (i.g., the vessels that
supply blood and oxygen to the heart).
CHD is a major cause of death globally and is the
most common type of heart disease. This study found that 11.35 percent of
Jordanian Afib patients also had CHD and that men were at a higher risk for
developing it.
One of the main takeaways from the JoFib study and
subsequent studies was the risk factors — which are modifiable. The likelihood
of developing almost any heart-related condition can be traced back to
lifestyle. It is important to have a healthy diet and exercise regularly to
control blood pressure and cholesterol while also reducing the risk of diabetes
(which increases the risk of cardiovascular diseases).
Avoiding poor lifestyle choices such as smoking or drinking
alcohol in large quantities can also greatly reduce the risk of developing or
worsening cardiovascular diseases.
Read more Health
Jordan News