Swine flu, heart disease may be deadly mix

Experts 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 last 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 in all this: 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, if they do, there could be major complications, said Alfred Bove, president of the American College of Cardiology.

Patients with heart failure, a condition where the heart can't pump enough blood around the body, are especially vulnerable. 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.

The swine flu virus may exact a more deadly toll on heart patients than some of the century's last pandemics.

The Asian flu pandemic of 1957, for example, mainly caused infections in the upper respiratory tract. Swine flu, however, seems to infect many people in the lower respiratory tract. That can cause severe respiratory illnesses, which stress the heart as well as the lungs.

In its 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.

WHO has previously estimated that one out of three people might get swine flu by the time the pandemic ends in a year or two.

"There will be a lot of this virus around, so people should do everything possible to avoid it," said Rose Marie Robertson, chief science officer of the American Heart Association.