Keshan Disease

Keshan disease is a type of cardiomyopathy that develops as a result of selenium deficiency and affects the heart muscles. A study reported that Keshan disease showed to affect 2.21% of the population in China.⁽¹⁾ It is a serious condition causing cardiovascular disease, stroke, cancer, and even death of a person.

Keshan disease is not completely curable but can be treated or managed. It can affect anyone, but Keshan disease is mostly known to affect boys and females of childbearing age.⁽²⁾ It is known to affect 13.6% of people under 30 years of age.⁽¹⁾

There are several causes of Keshan disease, which include:

• Deficiency of selenium
• Malnutrition
• Viral or fungal infection
• Environmental toxin
• Seasonal changes

The cause of Keshan disease is most likely due to the deficiency of a trace mineral selenium.⁽³⁾ Studies link it to the lack of selenium in the soil, as Keshan disease is found to be more prevalent in the regions with low selenium in the soil.

However, selenium deficiency alone cannot result in Keshan disease. It can contribute to the mutation in coxsackievirus B3 (CVB3), a pathogen that is linked with acute heart failure and cardiac arrhythmia. A study showed that 80% of people with chronic Keshan disease and 83% of those with acute Keshan disease had mutated forms of CVB3.⁽⁴⁾

Keshan disease is of 4 types:

1. Acute: In this type people may experience cardiogenic shock, severe arrhythmia, and heart failure. The symptom of acute Keshan disease includes dizziness, chills, shortness of breath and loss of appetite.
2. Subacute: Subacute Keshan disease include congestive heart failure, cardiogenic shock, and heart expansion. It is most common in children of 2-5 years of age.⁽⁵⁾
3. Chronic: This type of Keshan disease progress slowly. The acute and subacute variants may develop into a chronic variants. The symptoms may include dilated chambers or congestive or chronic heart failure. People may also experience shortness of breath, fainting spells, hemoptysis, and coughing up blood.
4. Latent: In the latent type of Keshan disease, the person does not even know they have the disease until an autopsy after their death reveals its presence.

The common symptoms of Keshan disease include:

• Blood clotting
• Fever
• Body aches
• Nausea and vomiting
• Stroke
• Cardiovascular disease
• Enlarged heart
• Inflammation
• Fatigue
• Hair loss
• Hypertension

The chronic and latent variants of the disease are most prominent.

In most cases, Keshan’s disease is manageable with proper treatment.

For those with selenium deficiency, the best way to treat the condition is with a selenium compound.⁽⁶⁾ Long-term intake of oral selenium may reverse the effects of the disease and make the symptoms manageable. Also, a balanced diet can be helpful in managing the condition. Selenium-rich foods include:⁽⁷⁾

• Tuna
• Eggs
• Oatmeal
• Cod
• Brown or white rice
• Chicken breast
• Onions
• Garlic

There is evidence that state, adding astragalus root to the soil can be helpful in regions with selenium deficiency. The roots may absorb the selenium from the soil and make it available to humans through edible vegetables.

Apart from taking dietary supplements, cardiac surgery involving stent placement, implant, or heart transplant are other treatment option for Keshan disease.

The exact cause of Keshan disease is still unknown, but the likelihood of occurrence of this condition can be prevented in the following ways:

• Consuming selenium-rich food
• Taking selenium supplements
• Eating a well-balanced diet
• Getting routine cardiac monitoring

Consulting a doctor for any sign and symptom related to the condition

Keshan disease is a condition with a high mortality rate. It is known to be more prevalent in low-income regions, rural regions of China, and areas with selenium-deficient soil. With preventive measures and early treatment, the quality of life can be improved.