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Swine flu may hit heart patients hardest

By Maria Cheng
Associated Press / September 2, 2009

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BARCELONA - Specialists are concerned about the impact the swine flu epidemic will have on people with heart disease, with some doctors warning it could be a deadly mix leading to a worldwide spike in heart patient fatalities.

For that reason, some doctors warned on the sidelines of a European cardiology meeting this week that patients with heart disease - the world’s top killer - should be among the first to receive a swine flu vaccine when it is available. They also should make sure they take all the usual precautions to avoid viruses, like regular hand-washing.

There could be a silver lining: Most heart patients are 60 or older, the only age group that appears somewhat less susceptible to swine flu, a new virus that no one is immune to. Still, while heart patients may be less likely to catch the virus, there could be major complications if they do.

“It’s almost a given that any influenza exposure is going to cause more mortality in heart patients,’’ said Alfred Bove, president of the American College of Cardiology.

In people with weak hearts, the swine flu virus could prove lethal. Patients with heart failure, a condition where the heart can’t pump enough blood around the body, are especially vulnerable.

“For people with severe heart failure, H1N1 influenza [swine flu] might be the last thing that pushes them over the edge,’’ said Joep Perk, a professor of health sciences at Sweden’s Kalmar University and spokesman for the European Society of Cardiology.

In many heart failure patients, fluid builds up in the lungs because blood isn’t pumped efficiently enough. Patients can take drugs to get rid of this excess fluid, but if they catch the flu, the drugs don’t work as well.

In addition, if heart failure patients develop a fever, a common swine flu symptom, the stress of trying to fight that off could put a potentially fatal strain on their hearts. Doctors also worry that inflammation - which happens when the body is struggling with an infection - could worsen heart and vascular problems.

In recent guidelines on who should get the swine flu drug Tamiflu, the World Health Organization named heart patients, HIV patients, and pregnant women as “at-risk’’ groups that should get it as soon as they are suspected of catching swine flu.

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