Keshan disease, a severe cardiomyopathy linked to selenium deficiency, was first identified in Keshan County, China, where its prevalence highlighted the critical role of trace elements in human health. Selenium, an essential micronutrient, is vital for antioxidant defenses and immune function. Its deficiency compromises heart muscle integrity, leading to progressive cardiac dysfunction.
The disease manifests in four phases: acute, subacute, chronic, and latent, each presenting distinct clinical features. In the acute phase, patients may experience sudden onset of cardiogenic shock, characterized by drastically low blood pressure and inadequate blood flow to organs. This is often accompanied by dizziness, severe nausea, projectile vomiting, and dyspnea. The subacute phase is marked by more gradual symptoms, including malaise, facial edema, and heart dilation, which can progress to cardiac shock.
Chronic Keshan disease presents with long-term complications such as persistent palpitations, chronic cough (sometimes hemoptysis), and fluid retention leading to edema. Enlargement of the heart and oliguria are also common, indicating compromised cardiac and renal function. Latent Keshan disease is milder, with symptoms like fatigue, mild palpitations, and slight heart enlargement, often unnoticed until progression occurs.
The global significance of selenium in preventing Keshan disease has prompted extensive research. Regions with selenium-deficient soils, such as parts of China, Siberia, and New Zealand, have reported higher incidences. However, with improved agricultural practices and dietary selenium supplementation, cases have significantly declined. Despite this, sporadic outbreaks still occur, especially in vulnerable populations with limited access to balanced diets.
Early diagnosis is pivotal. Selenium supplementation, often coupled with supportive therapies like antioxidants and heart medications, can reverse early-stage symptoms and prevent progression. Public health strategies, including food fortification and community health education, have proven effective in mitigating risks.
In summary, Keshan disease underscores the importance of micronutrients in cardiovascular health. Its prevention hinges on early detection, adequate selenium intake, and public health interventions. Addressing selenium deficiency remains crucial in safeguarding vulnerable populations from this potentially fatal condition.
Keshan Disease: A Silent Cardiac Threat
