Obesity is a major risk factor for heart failure and sudden death due to its association with coronary artery disease, diabetes, hypertension, and dyslipidemia.
Three days prior to hospitalization, Mr. Chấn (42 years old, from Đồng Nai) experienced fatigue, chest tightness, epigastric pain, and nausea after meals. He sought treatment at a local medical facility and was diagnosed with gastroesophageal reflux disease (GERD). However, his condition did not improve; fatigue and shortness of breath worsened, and he vomited everything he ate. His family then took him to the hospital for emergency treatment.
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| Overweight and obesity have become a global problem, a global pandemic. |
The patient was admitted with acute heart failure: profuse sweating, labored breathing while sitting, rapid pulse, decreased urination, and narrow pulse pressure (a condition where the difference between systolic and diastolic blood pressure is less than or equal to 20 mmHg) with pulse rates of 120-130 beats/minute and blood pressure of 100-110/70-80 mmHg.
Chest X-ray results showed acute pulmonary edema, bedside echocardiogram revealed large dilated heart chambers, and significantly reduced left ventricular contractility (EF = 10-15%). Electrocardiogram showed signs of acute preapentic-lateral myocardial infarction with elevated cardiac enzymes, renal dysfunction, and elevated liver enzymes. The diagnosis was acute myocardial infarction complicated by multiple organ damage, dilated cardiomyopathy, and grade 3 obesity (110 kg, BMI = 40.75).
Mr. Chấn received intensive care to treat acute pulmonary edema, then was transferred to the DSA room for coronary angiography and emergency reperfusion intervention. The results showed complete occlusion of the anterior interventricular artery with multiple thrombi. The interventional cardiology team performed angioplasty and stent placement at the occluded coronary artery segment.
Dr. Nguyen assessed that the patient's clinical condition was very serious, with a high risk of death due to severely impaired cardiac function, greatly dilated heart chambers, and multiple organ failure. He urgently needed angioplasty and stent placement in the blocked coronary artery segment.
According to MSc. Dr. Vo Anh Minh, Deputy Head of the Interventional Cardiology Department, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, patients with severe heart failure due to dilated cardiomyopathy and acute myocardial infarction have a very high risk of arrhythmias and cardiac arrest during angioplasty.
The doctor decided to use ECMO (extracorporeal membrane oxygenation), placing a counterpulsation bag before and during the procedure to maintain blood pressure, filter blood, and reduce the risk of cardiac arrest on the operating table.
According to Dr. Nguyen, obesity is a major risk factor for heart failure and sudden death due to its association with coronary artery disease, diabetes, hypertension, and dyslipidemia.
Dilated cardiomyopathy in Mr. Chấn is a consequence of long-term, untreated obesity. Mr. Chấn had a sedentary lifestyle, so the symptoms of heart failure were not immediately apparent. In recent years, he occasionally felt tired and short of breath when doing strenuous work, but he dismissed it as being due to his weight and didn't seek medical attention.
If an acute myocardial infarction does not occur and the patient does not go to the hospital, dilated cardiomyopathy will go undetected and continue to progress, causing many dangerous complications such as heart failure, arrhythmias, and sudden death, Dr. Huy affirmed.
To reduce the risk of cardiovascular and metabolic diseases, overweight and obese individuals should seek medical advice on appropriate treatment plans and strive to bring their weight back to a normal range.
Patients should undergo regular cardiovascular function assessments, including blood pressure, blood glucose, and blood lipid checks. If abnormalities such as hypertension, diabetes, or cardiac dysfunction are detected, treatment should begin immediately, even in the absence of symptoms.
Associate Professor Dr. Truong Tuyet Mai, Deputy Director of the National Institute of Nutrition, Ministry of Health , stated that overweight and obesity have become a global problem, a global pandemic. Currently, the rate of obesity is increasing vertically.
Experts from the Institute of Nutrition also acknowledge that there are up to 10 factors that gradually contribute to obesity in humans, including: exercise, nutrition, viruses, hormones, stress, psychology, pollution, technology, food, and social status.
Therefore, controlling overweight and obesity is a much more challenging task than preventing infectious diseases.
The issue here is changing lifestyles and living environments; there needs to be a way to influence policies to address the living environment for children, and how to create space for them to exercise and play sports .
This is also a contributing factor to the fact that the problem of overweight and obesity in children has not improved. In addition, according to Ms. Mai, communication is needed to gradually change lifestyle habits in each family.
Previously, Professor Dr. Le Thi Huong, Director of the Institute of Preventive Medicine and Public Health Training, also stated that the causes of obesity may vary from person to person.
Obesity in some people may be due to overeating or excessive food intake, in others due to lack of exercise, and in some cases, due to medical conditions or genetics. Therefore, treatment requires identifying the underlying cause and addressing it.
Besides having an unattractive physique, obese children also suffer from metabolic disorders of blood lipids and sugars. Therefore, they may develop hypertension and diabetes at an early age. Currently, there are many warnings about the increasing incidence of cardiovascular diseases, diabetes, and musculoskeletal disorders at younger ages.
Lifestyle changes, dietary adjustments, and physical activity are fundamental to treating overweight and obesity. For those who are excessively overweight, weight loss should not exceed 5kg per month, while those with a BMI slightly above 30 should lose weight gradually. In particular, focusing on reducing waist circumference is more important than simply losing weight.
Obesity is also very easy to relapse, so it's always necessary to maintain a healthy diet and exercise to control weight.
According to the World Health Organization (WHO), there are currently 6.5 million obese people worldwide who require treatment, and the cost of treating obesity is enormous. The mortality rate related to obesity is twice the mortality rate of breast and colorectal cancer combined.
According to investigations by reporters from the Investment Newspaper, the number of obese patients seeking treatment at medical facilities is increasing. The majority of cases who come to the hospital are unable to control their obesity through lifestyle changes and do not respond to other treatment methods.
These patients often have several co-morbidities such as high blood pressure, joint pain, primary infertility, diabetes, hyperlipidemia, fatty liver disease, hypercholesterolemia, etc.
According to doctors at Viet Duc Friendship Hospital, obesity is a chronic disease that needs early treatment. Obesity not only affects daily life and appearance, but also poses many risks such as cardiovascular diseases, diabetes, fatty liver disease, cirrhosis, musculoskeletal disorders, infertility, etc.
Obesity and being overweight also increase the risk of death compared to patients with normal weight. The principle for treating overweight and obesity is to increase energy expenditure and reduce food intake.
Being overweight or obese not only affects health, activities, daily life, and psychology, but it should also be considered a medical condition requiring examination and treatment by specialists in gastroenterology and obesity.
There are many methods used in the treatment of obesity, such as lifestyle changes, increased physical activity, medical treatment, and surgery.
Source: https://baodautu.vn/bien-chung-nguy-hiem-cua-benh-nhan-beo-phi-d222460.html
