Prof. Dr. Vijayaraghavan G
KIMSHEALTH Trivandrum
Cardiology,Cardiac Sciences
Heart Failure
Prof. Dr. Vijayaraghavan G
KIMSHEALTH Trivandrum
Cardiology,Cardiac Sciences
Heart Failure
In medical terms, heart failure is often described as congestive heart failure or CHF. It can be defined as a chronic condition where the heart is not capable of pumping blood properly. The upshot is a long-term inadequate function of the blood flow to provide enough oxygen and nutrients to the body. The term heart failure does not mean the heart has quit working but instead implies that the heart is not working properly.
Heart failure can affect the left, right side, or even both sides. In the majority of cases, the left side is affected, which supplies blood to all the body parts. Right-sided heart failure brings fluid buildup into the lungs, abdomen, and even into the legs.
The condition is progressive, meaning it will worsen if not treated properly over time leading to a decreased quality of life and a great risk for complications.
Causes of heart failure
Heart failure commonly follows other medical conditions that occur over time to weaken or damage the heart. Some common causes include:
- Coronary artery disease
- High blood pressure (hypertension)
- Cardiomyopathy
- Heart attack
- Valvular heart disease
- Diabetes
Other causes include arrhythmias or rhythmic irregularities of the heart, congenital heart defects, chronic alcoholism, and viral infections.
Symptoms of heart failure
Symptoms of heart failure include:
- Dyspnea: This is the shortness of breath which may occur with physical activity or even rest. Fluid accumulation within the lungs is the most common cause.
- Fatigue and weakness: Since the heart becomes inefficient at pumping its blood, less oxygen is delivered to the body and people might feel very tired, especially after mild exercise.
- Oedema: Fluid retention is common in the legs, ankles, feet and abdomen because of an inefficient passage of blood through the heart where it builds.
- Palpitations: The heart compensates for its weakness by pounding faster or with less rhythm, which can cause palpitations.
- Persistent cough or wheezing: Fluid can collect in the lungs, which leads to chronic coughing, wheezing, or even coughing up pink-tinged mucus.
- Increased nocturia: Fluid overload over the day may result in increased urination during the night since the body tries to get rid of excess fluid.
- Rapid weight gain: This is a sign of fluid accumulation hence an ominous sign of worsening heart failure.
Diagnosis of heart failure
A diagnosis by a cardiologist often starts with a history and physical examination, but to confirm heart failure, the doctor will perform tests that check on heart performance as follows:
- Electrocardiogram (ECG): This test measures electrical activity in the heart, to diagnose abnormal heart rhythm or scarring from a heart attack or other cardiac problem.
- Echocardiogram: Heart ultrasound. The structure and function of the heart are inspected to evaluate the severity of heart failure in this test.
- Chest X-ray: An imaging test used to show fluid buildup in the lungs and check for heart enlargement.
- Blood tests: Blood tests include BNP levels.
- Stress tests: These tests test how the heart performs when subjected to physical exercise and thus help diagnose coronary artery disease and heart functioning problems.
Management of heart failure
Heart failure is a chronic condition, but proper management may improve a patient's quality of life and slow the progression of the condition.
Lifestyle interventions
A healthy diet consists of lowering the intake of salt to reduce fluid accumulation and then a balanced diet. Physical activity should be regularized as well to build up the heart and flow but under an advisory exercise intensity level by a doctor. It is advisable to quit smoking and cut back on alcohol.
Medications
Several drugs are given to control heart failure; some of them include ACE Inhibitors and ARBs, beta-blockers, and diuretics to manage heart failure. Surgical intervention may be necessary in certain cases to correct congenital defects, such as coronary artery bypass grafting surgery or valve repair/replacement. A pacemaker or a defibrillator may be required to normalize heart rhythm or prevent a potentially fatal arrhythmia.
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