Heart Failure | How Heart Failure is diagnosed |
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What is Heart Failure?

Heart failure, sometimes also known as Congestive Heart Failure, is a long-term condition that occurs when the heart is unable to pump blood as well as it should. It does not mean that the heart has stopped functioning altogether; instead, it is working less efficiently than normal. Due to many reasons, blood moves through the body at a slower rate, increasing pressure on the heart. When this happens, blood flows back, and fluid can build up in the lungs, causing shortness of breath. The inability of the heart to pump blood effectively results in a malfunction of other organs as well. Try Second Opinion provides the second medical opinion for all types of heart disease.

Congestive heart failure may affect the right or left side of the heart or both at the same time. It can be an acute (short-term) or chronic (ongoing) condition. With acute heart failure, symptoms may go away relatively faster, but symptoms are continuous and do not improve over time with chronic heart failure. Heart failure cases are mostly chronic. Heart failure is a serious medical condition that requires treatment. Early treatment improves the chances of recovery and leads to fewer complications. 

The condition is generally broken down into the following types:

Left-sided heart failure 

HF with reduced left ventricular function (HF-rEF): The lower left chamber of the heart, called the left ventricle, gets bigger and cannot contract hard enough to pump the right amount of oxygen-rich blood to the rest of the body. 

Heart failure with preserved left ventricular function (HF-pEF): The heart contracts and pumps normally, but the bottom chambers of the heart or ventricles become thicker and stiffer than usual. Because of this, they cannot relax properly and fill up all the way. Therefore, the heart ends up pumping out less blood to the rest of the body when it contracts. 

Right-sided HF

The right side of the heart can also be affected by heart failure. Common causes include lung disease and certain diseases in other organs. Left-sided heart failure is also a cause.

Causes of HF

Many medical conditions can weaken the heart, leading to heart failure. Common causes include:

–       Coronary artery disease and heart attack. Coronary artery disease is the most common type of heart disease and a major cause of heart failure. It results from a buildup of fatty deposits in the arteries, limiting blood flow and leading to a heart attack. A heart attack occurs when a coronary artery becomes completely blocked. Damage to the heart means that the function of pumping blood has weakened. 

–       Cardiomyopathy. This implies damage to the heart muscles for reasons other than artery blockage or blood-flow-related problems. These include infections, alcohol or drug abuse, and chemotherapy, to name a few. 

–       Congenital Heart Disease. Heart ailments present at birth may result in damage to the heart over a period of time. Sometimes, chambers and valves of the heart may not have formed correctly since birth, making it difficult for the heart to pump blood.

–       Hypertension (High blood pressure). If the blood pressure is high, the heart has to work harder to circulate it throughout the body. Over a period of time, this added strain on the heart can make the heart muscles too stiff and weak to pump blood. 

–       Arrhythmia (abnormal heart rhythms). Arrhythmia may cause the heart to beat too fast, too slow, or out of rhythm. This adds pressure on the heart and can lead to cardiac failure. 

–       Myocarditis (inflammation of the heart muscle). This is most commonly caused by a virus, including the Covid-19 virus, leading to left-sided cardiac failure. 

–       Faulty heart valves. The heart valves are used to keep the blood flowing in the proper direction. A damaged valve due to coronary heart disease or any other infection forces the heart to work harder and can lead to cardiac collapse over a period of time. 

–       Long-term chronic diseases. Conditions such as diabetes, HIV, hyperthyroidism, hypothyroidism, kidney disease, or protein buildup may also contribute to heart failure. 

In addition, acute or sudden heart failure may be caused by-

– Allergic reactions

– Severe infections

– Blood clots in the lungs

– Any autoimmune disease affecting the whole body 

Symptoms of Heart Failure

Symptoms of cardiac failure may be mild or severe and may come and go. Heart failure may be chronic or ongoing. Common symptoms include:

– Lung congestion and shortness of breath

– Fatigue, dizziness, weakness

– Palpitations or arrhythmia

– Bloated stomach, nausea or loss of appetite

– Persistent coughing

– Intolerance to exercise 

– Swelling in legs or ankles or abdomen

– Weight gain

– Chest pain when heart failure is caused by a heart attack

What are the risk factors for cardiac failure?

Certain risk factors may increase the risk of developing heart failure. These include:

– Heart attack: A heart attack is a form of coronary artery disease that occurs suddenly

– Coronary artery disease: Narrowed arteries may limit the supply of oxygen-rich blood to the heart, causing a weakening in the heart muscles.

– High blood pressure

– Heart valve disease

– Alcohol usage

– Sleep apnea: This is a condition causing an inability to breathe while sleeping. Arrhythmia caused as a result can weaken the heart

– Diabetes: The presence of sugar in the blood increases the risk of high blood pressure and, therefore, coronary heart disease. 

– Obesity: increased weight poses added pressure on the heart and increases the risk of cardiac failure. 

– Smoking or tobacco intake

How is heart failure treated?

Proper treatment of underlying heart conditions can resolve the symptoms of heart failure. Lifestyle changes such as weight loss, stress management, exercise, and reduced salt intake- can improve quality of life. 

Medical treatment of heart failure depends on the severity of the condition, patient’s age, type of heart failure and immunity. It may include one or more of the following:

– Medication, in cases where it is relatively mild- to reduce blood clots, heart rate, reduce sodium or cholesterol levels

– Bypass surgery- Using a piece of healthy veins or arteries from another part of the body and attaching it to the blocked coronary artery- creating a ‘bypass’

– Installation of a pacemaker- to resolve arrhythmia

– Percutaneous Coronary intervention- insertion of a catheter or balloon into the blocked artery

– Transplant surgery- in the final stages of heart failure when all other treatments have failed

– An implantable cardioverter defibrillator (ICD)- to keep track of the heart rate and shock the heart if it detects an abnormally low heart rate 

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