INCREASED INCIDENCE OF HEART FAILURE HOSPITALIZATION IN ELDERLY PATIENTS AFTER MAJOR EARTHQUAKES

摘要

Acute stress after natural disaster can trigger cardiovascular events, including acute myocardial infarction (AMI), arrhythmias and worsening of heart failure (HF). On April 16, 2016, a series of strong earthquakes struck the Kumamoto region of southern Japan. Aso city is a small rural city with a population of approximately 30,000. More than 30% of the population is over the age of 65. We examined the patients admitted to our hospital for cardiovascular events after the earthquakes in this area. We also compared them to the patients during the corresponding period in the prior 2 years (2014 and 2015) as a control. There were a total of 54 cardiovascular events from April 16 to June 30, 2016 (27 HF, 10 cardiopulmonary arrest, 5 arrhythmias, 4 AMI, 3 angina attack, 3 symptomatic venous thromboembolism, 2 others). The total incidence of HF was significantly higher compared with the average of the past 2 years (27 in 2016 vs 5.5 in the past 2 years, P<0.01). In the patients with HF, 22 patients (81%) were defined as elderly patients (>75 years old). Eleven patients (40%) had a preserved left ventricular ejection fraction. Twenty patients (74%) had a previous history of HF. Disaster influence on deterioration of HF was suggested by patient history in the twenty patients (74%). Precipitating factors included anxiety, sleep disorder, interruption of medication, malnutrition, uncontrolled hypertension, arrhythmias, myocardial ischemia and infection. Our results suggest the importance of preventing HF in catastrophic disasters, especially in elderly
people.