MBBS, MD’Clinical Ordinatura (Cardiology)
FACC, FICC, Fellowship in Intervention Cardiology
Adult and Paediatric Intervention Cardiologist

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HEART FAILURE

Heart Failure

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload. In acute heart failure, the symptoms appear suddenly but go away fairly quickly. This condition often occurs after a heart attack. It may also be a result of a problem with the heart valves that control the flow of blood in the heart.

In chronic heart failure, however, symptoms are continuous and don’t improve over time. The vast majority of heart failure cases are chronic

heart-failure

What are the Symptoms of Heart Failure?

The symptoms of heart failure may include:

  • Excessive fatigue
  • Sudden weight gain
  • A loss of appetite
  • Persistent coughing
  • Irregular pulse
  • Heart palpitations
  • Abdominal swelling
  • Shortness of breath
  • Leg and ankle swelling
  • Protruding neck veins

How is Heart Failure Diagnosed?

To diagnose heart failure, your doctor will ask you questions about your medical history, talk about your symptom(s) and do a physical examination. This will include checking your heart rate and rhythm, taking your blood pressure, and checking if you have fluid in your lungs, legs and other parts of your body. In most cases you will also have further tests to confirm the diagnosis and guide how your symptoms are controlled.

You may hear your doctor talk about the ‘ejection fraction’ of your heart. This refers to the amount of blood that is pushed out of your left ventricle every time your heart beats. It’s usually expressed as a percentage – over 50% is considered normal.

Some people with heart failure have a normal ejection fraction, so ejection fraction is used alongside other tests to help diagnose heart failure.

Risk Factors

A single risk factor may be enough to cause heart failure, but a combination of factors also increases your risk.

Risk factors include:

  • High blood pressure. Your heart works harder than it has to if your blood pressure is high.
  • Coronary artery disease. Narrowed arteries may limit your heart’s supply of oxygen-rich blood, resulting in weakened heart muscle.
  • Heart attack. A heart attack is a form of coronary disease that occurs suddenly. Damage to your heart muscle from a heart attack may mean your heart can no longer pump as well as it should.
  • Diabetes. Having diabetes increases your risk of high blood pressure and coronary artery disease.
  • Some diabetes medications. The diabetes drugs rosiglitazone (Avandia) and pioglitazone (Actos) have been found to increase the risk of heart failure in some people. Don’t stop taking these medications on your own, though. If you’re taking them, discuss with your doctor whether you need to make any changes.
  • Sleep apnea. The inability to breathe properly while you sleep at night results in low blood oxygen levels and increased risk of abnormal heart rhythms. Both of these problems can weaken the heart.
  • Congenital heart defects. Some people who develop heart failure were born with structural heart defects.
  • Valvular heart disease. People with valvular heart disease have a higher risk of heart failure.
  • Viruses. A viral infection may have damaged your heart muscle.
  • Alcohol use. Drinking too much alcohol can weaken heart muscle and lead to heart failure.
  • Tobacco use. Using tobacco can increase your risk of heart failure.
  • Obesity. People who are obese have a higher risk of developing heart failure.
  • Irregular heartbeats. These abnormal rhythms, especially if they are very frequent and fast, can weaken the heart muscle and cause heart failure.

Treatments for Heart Failure

Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.

Common treatments include:

  • lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
  • Medicine – a range of medicines can help; many people need to take 2 or 3 different types
  • Devices implanted in your chest – these can help control your heart rhythm
  • Surgery – such as a bypass operation or a heart transplant

Treatment will usually be needed for life.

A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.