A surprising deficiency caused this man’s heart to fail

The patient: Alberto*, a 33-year-old lab technician in Chicago

The symptoms: Swollen legs and shortness of breath

The doctor: Dr. Nir Uriel, director of heart failure, transplant and mechanical circulatory support at the University of Chicago Medicine

Alberto was diagnosed with Crohn’s disease in his early 20s but controlled flare-ups in his digestive tract with a restricted diet and drug therapy. In May 2014, two years after he’d started a regimen of methotrexate, an immune-system suppressor that reduces inflammation, he noticed that his legs looked swollen. He also felt fatigued and started losing weight. The doctor he consulted diagnosed him with cirrhosis—the medication he’d used to treat his condition had caused irrevocable scarring to his liver. These everyday habits make Crohn’s disease worse.

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18. Romaine lettuce

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17. Artichokes

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16. Cauliflower

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15. Green pepper

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14. Tomato

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13. Corn on the cob

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12. Okra

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11. Carrot

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10. Green peas

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9. Cabbage (raw)

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8. Brussel sprouts

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7. Winter squash (baked)

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6. Broccoli

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5. Mixed vegetables

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4. Kale

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3. Spinach

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2. Potato, baked

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1. Sweet potato

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Alberto was prescribed a different anti-inflammatory, which should have resolved his symptoms. But instead, his legs and hands ballooned, and his skin appeared puffy and stretched. He had edema: swelling caused by excess fluid in the body’s tissues. Within seven months of his cirrhosis diagnosis, Alberto was having trouble walking and was short of breath. His doctor sent him for an echocardiogram, concerned that the latter symptom suggested a heart-related problem. Don’t ignore these silent signs of heart trouble.

The test revealed that Alberto had reduced ejection fraction—a measurement of the amount of blood pumped out of the heart each time it contracts. He was diagnosed with acute decompensated heart failure (a sudden worsening of symptoms), but cardiologists couldn’t figure out why. He had no family history of cardiomyopathy (a condition distinguished by abnormalities in the heart muscle); there were no signs of inflammation; and an angiogram showed only healthy-looking arteries.

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The most unhealthy jobs in America

34 (tie). Radiologist

Radiologists examine and diagnose disorders and diseases using X-rays and radioactive materials.

Median annual salary: $206,920 

Overall unhealthiness score: 52.8

Top three health risks:

1. Exposure to radiation: 87
2. Exposure to disease and infections: 85
3. Time spent sitting: 74

Photo credit: Getty

34 (tie). Metal-refining furnace operators and tender

Metal-refining furnace operators and tenders operate or tend furnaces to melt and refine metal before casting or to produce specified types of steel.

Median annual salary: $41,040

Overall unhealthiness score: 52.8

Top three health risks:

1. Exposure to contaminants: 100
2. Risk of minor burns, cuts, bites, and stings: 96
3. Exposure to hazardous conditions: 94

Photo credit: Getty

34 (tie). Embalmer

Embalmers prepare bodies for burial in conformity with legal requirements.

Median annual salary: $40,150

Overall unhealthiness score: 52.8

Top three health risks:

1. Exposure to disease and infections: 83
2. Exposure to contaminants: 83
3. Exposure to hazardous conditions: 75

Photo credit: Getty

34 (tie). Elevator installers and repairer

Elevator installers and repairers install and repair elevators.

Median annual salary: $78,890

Overall unhealthiness score: 52.8

Top three health risks:

1. Exposure to hazardous conditions: 98
2. Exposure to contaminants: 82
3. Risk of minor burns, cuts, bites, or stings: 61

Photo credit: Getty

33. Nuclear medicine technologist

Nuclear medicine technologists prepare radioactive isotopes for use in diagnostic medical procedures.

Median annual salary: $74,350

Overall unhealthiness score: 53.0

Top three health risks:

1. Exposure to radiation: 100
2. Exposure to disease and infections: 93
3. Exposure to contaminants: 44

Photo credit: Getty

32. Refrigeration mechanics and installer

Refrigeration mechanics and installers install and repair industrial and commercial refrigerating systems.

Median annual salary: $45,910

Overall unhealthiness score: 53.3

Three biggest health risks:

1. Exposure to hazardous conditions: 93
2. Exposure to contaminants: 91
3. Risk of minor burns, cuts, bites, and stings: 71

Photo credit: Getty

31. Critical care nurse

Critical care nurses provide advanced nursing care for patients in critical or coronary care units.

Median annual salary: $68,450

Overall unhealthiness score: 53.5

Top three health risks:

1. Exposure to disease and infections: 99
2. Exposure to contaminants: 65
3. Exposure to radiation: 61

Photo credit: Getty

29 (tie). Service unit operator (oil, gas, and mining)

Service unit operators operate equipment to increase oil flow from producing wells or to remove stuck pipe, casing, tools, or other obstructions from drilling wells and other mining operations.

Median annual salary: $48,610

Overall unhealthiness score: 53.7

Top three health risks:

1. Exposure to contaminants: 94
2. Exposure to hazardous conditions: 89
3. Risk of minor burns, cuts, stings, and bites: 77 

Photo credit: Getty

29 (tie). Chemical plant and system operator

Chemical plant and system operators control or operate chemical processes or systems of machines.

Median annual salary: $59,920

Overall unhealthiness score: 53.7

Top three health risks:

1. Exposure to hazardous conditions: 99
2. Exposure to contaminants: 96
3. Risk of minor burns, cuts, bites, or stings: 71 

Photo credit: Getty

27 (tie). Continuous mining-machine operators

Continuous mining-machine operators operate self-propelled mining machines that rip coal, metal and nonmetal ores, rock, stone, or sand from the mine face and load it onto conveyors or into shuttle cars in a continuous operation.

Median annual salary: $51,840

Overall unhealthiness score: 54.0

Three biggest health risks:

1. Exposure to contaminants: 100
2. Exposure to hazardous conditions: 98
3. Risk of minor burns, cuts, bites, and stings: 64

Photo credit: Getty

27 (tie). Emergency medical technicians and paramedics

Emergency medical technicians and paramedics assess injuries, administer emergency medical care, and extricate trapped individuals. Transport injured or sick people to medical facilities.

Median annual salary: $32,670

Overall unhealthiness score: 54.0

Top three health risks:

1. Exposure to disease and infections: 89
2. Exposure to contaminants: 73
3. Risk of minor burns, cuts, bites, and stings: 53

Photo credit: Getty 

26. Refractory materials repairers (except brickmasons)

Refractory materials repairers build or repair equipment such as furnaces, kilns, cupolas, boilers, converters, ladles, soaking pits, and ovens, using refractory materials.

Median annual salary: $45,230

Overall unhealthiness score: 54.8

Top three health risks:

1. Exposure to contaminants: 100
2. Exposure to hazardous conditions: 85
3. Risk of minor burns, cuts, bites, or stings: 85 

Photo credit: Getty

25. Refuse and recyclable material collectors

Refuse and recyclable material collectors collect and dump refuse and recyclable materials into trucks.

Median annual salary: $35,270

Overall unhealthiness score: 55.0

Top three health risks:

1. Exposure to contaminants: 97
2. Time spent sitting: 69
3. Exposure to disease and infections: 63 

Photo credit: Getty


 

24. Nuclear equipment operation technicians

Nuclear equipment operation technicians operate equipment used for the release, control, or use of nuclear energy to assist scientists in laboratory or production activities.

Median annual salary: $79,140

Overall unhealthiness score: 55.2

Top three health risks:

1. Exposure to radiation: 89
2. Exposure to hazardous conditions: 77
3. Exposure to contaminants: 65 

Photo credit: Getty

22 (tie). Medical equipment preparers

Medical equipment preparers prepare, sterilize, install, or clean laboratory or healthcare equipment. May perform routine laboratory tasks and operate or inspect equipment.

Median annual salary: $34,400

Overall unhealthiness score: 55.7

Top three health risks:

1. Exposure to contaminants: 94
2. Exposure to disease and infections: 92
3. Exposure to hazardous conditions: 64 

Photo credit: Getty

22 (tie). Airline pilots, copilots, and flight engineers

Airline pilots, copilots, and flight engineers navigate and pilot the flight of fixed-wing, multi-engine aircraft, usually on scheduled air-carrier routes, for the transport of passengers and cargo.

Median annual salary: $127,820

Overall unhealthiness score: 55.7

Top three health risks:

1. Time spent sitting: 93
2. Exposure to radiation: 73
3. Exposure to contaminants: 68 

Photo credit: Getty 

21. Derrick operators (oil and gas)

Oil and gas derrick operators rig derrick equipment and operate pumps to circulate mud through a drill hole.

Median annual salary: $48,130

Overall unhealthiness score: 56.0

Top three health risks:

1. Exposure to contaminants: 100
2. Exposure to minor burns, cuts, bites, or stings: 93
3. Exposure to hazardous conditions: 91 

Photo credit: Getty

20. Veterinary technologists and technician

Veterinary technologists and technicians perform medical tests in a laboratory environment for use in the treatment and diagnosis of diseases in animals and prepare vaccines and serums for prevention of diseases.

Median annual salary: $25,250

Overall unhealthiness score: 66.5

Top three health risks:

1. Exposure to disease and infections: 87
2. Exposure to contaminants: 82
3. Exposure to minor burns, cuts, bites, or stings: 77 

Photo credit: Getty

19. Medical and clinical laboratory technologist

Medical and clinical laboratory technologists perform complex medical laboratory tests for diagnosis, treatment, and prevention of disease. 

Median annual salary: $61,070

Overall unhealthiness score: 56.7

Top three health risks:

1. Exposure to disease and infections: 96
2. Exposure to contaminants: 91
3. Exposure to hazardous conditions: 79 

Photo credit: Getty

18. Surgical technologists

Surgical technologists assist in operations, under the supervision of surgeons, registered nurses, or other surgical personnel.

Median annual salary: $45,160

Overall unhealthiness score: 57.3

Top three health risks:

1. Exposure to disease and infections: 82
2. Exposure to contaminants: 81
3. Exposure to hazardous conditions: 59 

Photo credit: Getty

17. Stationary engineers and boiler operators

Stationary engineers and boiler operators maintain or operate stationary engines, boilers, or other mechanical equipment to provide utilities for buildings or industrial processes.

Median annual salary: $59,400

Overall unhealthiness score: 57.7

Top three health risks:

1. Exposure to contaminants: 99
2. Exposure to hazardous conditions: 89
3. Exposure to minor burns, cuts, bites, or stings: 84 

Photo credit: Getty

16. Surgical assistant

Surgical assistants help surgeons during surgery by performing duties like tissue retraction, insertion of tubes and intravenous lines, or closure of surgical wounds.

Median annual salary: $41,070

Overall unhealthiness score: 57.8

Top three health risks:

1. Exposure to disease and infections: 87
2. Exposure to hazardous conditions: 70
3. Exposure to contaminants: 69 

Photo credit: Getty

14 (tie). Water and wastewater treatment plant and system operator

Water and wastewater treatment plant and system operators operate or control an entire process or system of machines, often through the use of control boards, to transfer or treat water or wastewater.

Median annual salary: $45,760

Overall unhealthiness score: 58.2

Top three health risks:

1. Exposure to contaminants: 97
2. Exposure to hazardous conditions: 80
3. Exposure to minor burns, cuts, bites, or stings: 74 

Photo credit: Getty

14 (tie). Veterinarian

Veterinarians diagnose, treat, or research diseases and injuries of animals. 

Median annual salary: $48,500

Overall unhealthiness score: 62.3

Top three health risks:

1. Exposure to contaminants: 88
2. Exposure to disease and infections: 77
3. Exposure to minor burns, cuts, bites, or stings: 69 

Photo credit: Getty

13. Histotechnologists and histologic technicians

Histotechnologists and histologic technicians prepare histologic slides from tissue sections for microscopic examination and diagnosis by pathologists.

Median annual salary: $61,070

Overall unhealthiness score: 59.0

Top three health risks:

1. Exposure to hazardous conditions: 88
2. Exposure to contaminants: 76
3. Exposure to disease and infections: 75 

Photo credit: Getty

12. Immigration and customs inspector

Immigration and customs inspectors investigate and inspect people, common carriers, goods, and merchandise, arriving in or departing from the US or between states to detect violations of immigration and customs laws and regulations.

Median annual salary: $78,120

Overall unhealthiness score: 59.3

Top three health risks:

1. Exposure to contaminants: 78
2. Exposure to disease and infections: 63
3. Exposure to radiation: 62 

Photo credit: Getty

11. Podiatrist

Podiatrists diagnose and treat diseases and deformities of the human foot.

Median annual salary: $124,830

Overall unhealthiness score: 60.2

Top three health risks:

1. Exposure to disease and infections: 87
2. Exposure to radiation: 69
3. Exposure to contaminants: 67 

Photo credit: Getty

10. Anesthesiologist assistant

Anesthesiologist assistants help anesthesiologists administer anesthesia for surgical and non-surgical procedures. They monitor patient status and provide patient care during surgical treatment.

Median annual salary: $101,480

Overall unhealthiness score: 61.3

Top three health risks:

1. Exposure to disease and infections: 97
2. Exposure to radiation : 72
3. Exposure to contaminants: 71 

Photo credit: Getty

9. Anesthesiologist

Anesthesiologists are physicians who administer anesthetics prior to, during, or after surgery or other medical procedures.

Mean annual salary: $269,600*

Overall unhealthiness score: 61.8

Top three health risks:

1. Exposure to disease and infections: 90
2. Exposure to contaminants: 81
3. Exposure to radiation: 72

* Exact median annual salary is unavailable for this occupation. 

Photo credit: Getty

8. Flight attendant

Flight attendants provide personal services to ensure the safety, security, and comfort of airline passengers during flight. They greet passengers, verify tickets, explain use of safety equipment, and serve food or beverages.

Median annual salary: $48,500

Overall unhealthiness score: 62.3

Top three health risks:

1. Exposure to contaminants: 88
2. Exposure to disease and infections: 77
3. Exposure to minor burns, cuts, bites, or stings: 69 

Photo credit: AOL

7. Prosthodontist

Prosthodontists construct oral prostheses to replace missing teeth and other oral structures to correct natural and acquired deformation of mouth and jaws, to restore and maintain oral function, such as chewing and speaking, and to improve appearance.

Median annual salary: $126,050

Overall unhealthiness score: 63

Top three health risks:

1. Exposure to disease and infections: 88
2. Exposure to contaminants: 74
3. Time spent sitting: 66 

Photo credit: Getty

6. Nurse anesthetist

Nurse anesthetists administer anesthesia, monitor patient's vital signs, and oversee patient recovery from anesthesia.

Median annual salary: $160,270

Overall unhealthiness score: 63.7

Top three health risks:

1. Exposure to disease and infections: 96
2. Exposure to contaminants: 87
3. Exposure to radiation: 79 

Photo credit: Getty

5. Dental assistant

Dental assistants help dentists, set up equipment, prepare patients for treatment, and keep records.

Median annual salary: $36,940

Overall unhealthiness score: 65.5

Top three health risks:

1. Exposure to disease and infections: 96
2. Exposure to radiations: 85
3. Exposure to contaminants: 78 

Photo credit: Getty

4. Dental laboratory technician

Dental laboratory technicians construct and repair full or partial dentures or dental appliances.

Median annual salary: $37,680

Overall unhealthiness score: 65.7

Top three health risks:

1. Exposure to contaminants: 99
2. Time spent sitting: 85
3. Exposure to disease and infections: 72 

Photo credit: Getty

3. Veterinary assistant and laboratory animal caretaker

Veterinary assistants and laboratory animal caretakers feed, water, and examine pets and other nonfarm animals for signs of illness, disease, or injury in laboratories and animal hospitals and clinics.

Median annual salary: $25,250

Overall unhealthiness score: 66.5

Top three health risks:

1. Exposure to disease and infections: 87
2. Exposure to contaminants: 82
3. Exposure to minor burns, cuts, bites, or stings: 77 

Photo credit: Getty

2. General dentist

General dentists examine, diagnose, and treat diseases, injuries, and malformations of teeth and gums. They may treat diseases of nerve, pulp, and other dental tissues affecting oral hygiene and retention of teeth and fit dental appliances or provide preventive care.

Median annual salary: $153,900

Overall unhealthiness score: 69.5

Top three health risks:

1. Exposure to disease and infections: 95
2. Exposure to radiation: 85
3. Time spent sitting: 82 

Photo credit: Getty

1. Dental hygienist

Dental hygienists clean teeth and examine oral areas, head, and neck for signs of oral disease. They may educate patients on oral hygiene, take and develop x rays, or apply fluoride or sealants.

Median annual salary: $72,910

Overall unhealthiness score: 72.8

Top three health risks:

1. Exposure to disease and infections: 100
2. Exposure to radiation: 91
3. Time spent sitting: 85 

Photo credit: Getty

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By early 2015, Alberto was wholly debilitated and terribly depressed. As they struggled to identify the source of his heart trouble, cardiologists treated him with a host of medications to treat cardiac failure, but his blood pressure dropped so low that his body couldn’t tolerate the treatment. It was then that Alberto was referred to Dr. Nir Uriel.

“The patient’s parents had to wheel him into the clinic because he didn’t have the strength to make his way from the parking garage,” Uriel says. “He had end-stage heart failure.”

Uriel began evaluating Alberto for a combined heart and liver transplant, while trying to determine the cause of his cardiac issues. “Because a lot of tests had already been done, we tried to think outside the box, to find something that hadn’t been done.”

Uriel wondered whether the Crohn’s, which made it difficult for the patient’s body to absorb nutrients, might be at fault. He analyzed Alberto’s blood for minerals crucial to heart health and found a selenium deficiency, something no one at the hospital had encountered before.

“Selenium is responsible for the electrical activity between the cells in the heart. When a patient is deficient, it can cause cardiomyopathy,” Uriel says, adding that it had taken a few months to identify the source of Alberto’s heart troubles because he was in such bad shape. “We really thought, ‘This heart is done.’” Learn about the most miraculous medical recoveries of 2017.

 After consulting a nutritionist to determine how best to reverse the patient’s deficiency, they put him on a selenium drip. Within days, Alberto’s condition had improved. “Six months later, his heart had completely recovered,” Uriel says, “with no need for a transplant.”

While Uriel acknowledges that this was a rare twist in a cardiac-failure diagnosis, he says the case shows how important it is to think about what might be missing in the blood, especially in a patient with nutrient-absorption issues. After leaving the hospital, Alberto changed medications and follows a specialized diet that includes selenium supplements.

Now, two years after his ordeal began, he’s back at work and playing golf again—with a healthy heart. Learn the things cardiologists do every day to keep their hearts healthy.

*Name changed to protect patient privacy

The post A Surprising Deficiency Caused This Man’s Heart to Fail appeared first on Reader's Digest.

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