Keshan disease is a congestive cardiomyopathy

Cardiomyopathy

Cardiomyopathy, which literally means "heart muscle disease," is the deterioration of the function of the myocardium for any reason. People with cardiomyopathy are often at risk of arrhythmia or sudden cardiac death or both. Cardiomyopathy can often go undetected, making it especially dangerous to...

 caused by a combination of dietary deficiency

Selenium deficiency

Selenium deficiency is relatively rare in healthy well-nourished individuals. Few cases have been reported.-Causes:It can occur in patients with severely compromised intestinal function, those undergoing total parenteral nutrition, those who have had gastrointestinal bypass surgery, and also on...

 of selenium

Selenium

Selenium is a chemical element with atomic number 34, chemical symbol Se, and an atomic mass of 78.96. It is a nonmetal, whose properties are intermediate between those of adjacent chalcogen elements sulfur and tellurium...

 and the presence of a mutated strain of Coxsackievirus

Coxsackievirus

Coxsackievirus is a virus that belongs to a family of non enveloped linear positive-sense ssRNA viruses, Picornaviridae and the genus Enterovirus, which also includes poliovirus and echovirus. Enteroviruses are among the most common and important human pathogens and ordinarily its members are...

, named after Keshan County of Heilongjiang

Heilongjiang

For the river known in Mandarin as Heilong Jiang, see Amur River' is a province of the People's Republic of China located in the northeastern part of the country. "Heilongjiang" literally means Black Dragon River, which is the Chinese name for the Amur. The one-character abbreviation is 黑...

 province, Northeast China, where symptoms were first noted. These symptoms were later found prevalent in a wide belt extending from northeast to southwest China, all due to selenium-deficient soil. The disease peaked in 1960-1970, claiming thousands of lives.

Often fatal, the disease afflicts children and women of child bearing age, characterized by Heart failure and Pulmonary edema

Pulmonary edema

Pulmonary edema , or oedema , is fluid accumulation in the air spaces and parenchyma of the lungs. It leads to impaired gas exchange and may cause respiratory failure...

. Over decades, Supplementation with selenium reduced this affliction.

It has previously been linked to the coxsackie B

Coxsackie B

Coxsackie B is the name of a group of six serotypes of pathogenic enteroviruses that trigger illness ranging from mild gastrointestinal distress to full-fledged pericarditis and myocarditis.-Geographic distribution:...

 virus. Current research suggests that the lack of selenium results in a more virulent strain of the coxsackievirus becoming the dominant viral species present in the population of virus, but the mechanism of this selection event is presently unclear.

The disease got its name from the province it was originally discovered in, Keshan, China. Since its discovery, it can also be found in New Zealand and Finland. Keshan disease results from a selenium deficiency which is a nutrient we receive in our diet from eating foods that were grown in selenium enriched soils. Because of that factor, Keshan deficiency can be found anywhere that the level of selenium present in the soil is low. An individual with Keshan disease will have an abnormally large heart. Keshan disease can also lead to higher rates of Cancer, Cardiovascular Disease, hypertension, and strokes. In addition, an individual can experience eczema, psoriasis, arthritis, cataracts, alcoholism, and infections.

Prevention

It is hard to consider Keshan disease extremely preventable because they only way to ensure that the individual is getting enough selenium would be to test the soil around where they live. However one way that your selenium intake can be controlled would be to try and intake foods that have been enriched with selenium such as onions, canned tuna, beef, spaghetti w/ meat sauce, cod, turkey, beef chuck roast, chicken breast, enriched pasta, egg, cottage cheese, oatmeal, white or brown rice, garlic. If the individual lives in an area that does not have selenium enriched soil they should consider taking a Dietary supplement

Dietary supplement

A dietary supplement, also known as food supplement or nutritional supplement, is a preparation intended to supplement the diet and provide nutrients, such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may not be consumed in sufficient quantities in a person's diet...

 . To determine whether or not an individual is selenium deficient, they should consider asking their doctor for a blood test. If the individual is exhibiting the symptoms of Keshan disease see your doctor immediately for advice.

Treatments

The treatment for Keshan disease is selenium supplementation. The recommended amounts are fifty-five micrograms of selenium per day for adult men and women, sixty micrograms a day for women during pregnancy and seventy micrograms per day for women during after pregnancy. A doctor may insist that if a man is sexual active, he may have to take up to seventy micrograms of selenium per day. A doctor may also recommend that the individual take Vitamin E also, Selenium and Vitamin E are medically linked and seem to work to together. An individual will also be advised to have a diet that includes seafood, meats such as kidney, and liver, and some grains and seeds; all of these are high in selenium. Brewer’s yeast and wheat germ both contain high levels of selenium. Garlic, onions, mushroom, broccoli, tomatoes, radishes, and Swiss chard may be good sources of selenium if the soil in which they are grown contains it. An individual will have to be monitored once they begin to take the selenium supplements, due to the fact that too much of it can cause balding, intestinal distress, weakness, and slow mental functioning. Individuals in China with the disease, treat it with a herb called Astragalus, which accumulates selenium from the soil.

Living with Keshan disease

The individual should talk to their doctor if their symptoms worsen- it is extremely important to visit a doctor, to prevent any major complications of this condition
Avoid alcohol - avoid all alcohol during the duration of the illness, because alcohol puts pressure on an individuals heart, which is already having enough difficulty, (and body) and can make the symptoms worse
Foods rich in selenium - eat foods rich in selenium to help the individuals heart heal more quickly (in addition to any supplements they may also be taking).
Healthier diet -eat healthy fresh, unprocessed foods, with lots of vegetables, fruits, legumes, nuts, seeds and some fish and lean meat to provide more vitamins, minerals, amino acids and antioxidants which can all help your heart. A diet lower in saturated fats and processed (junk) foods is also an excellent idea to give yourself a more healthy heart.
Monitor side effects to medications - if the individual is prescribed any type of medication(s), it may be helpful if the individual can monitor any side effects they have (if they are present) and see their doctor if the side effects are more than just the mildly common ones
Rest - sleep as much as possible, because the individuals heart is not functioning as well as normal and your body needs all its energy to get healthy. In the case of mild Keshan's disease caused by a viral agent, the individuals doctor will advise them to have complete rest (and adequate fluids) for a specific period to help their body's immune system fight the viral infection and heal
Supplements - an indivudual will most likely be prescribed selenium supplements (in the form of selenomethionine) or have injections of this mineral, so it would be helpful if they could take their supplements at the same time each day, to prevent forgetting a dose
Surgery - if surgery has been advised (implants, stents or full heart transplant) the individual cardiac specialist will advise you about the pre- and post-operative care that they will need to undergo and how to best take care of themselves during this time, to avoid complications or worsening of any symptoms or health.