Heart Failure

Overview

Congestive heart failure is a chronic condition where the heart does not pump blood sufficiently to satisfy the body's needs. It means the blood and fluids start to collect in the lungs, legs, and other parts of the body over time. Though the condition is serious and potentially life-limiting, medications and other treatments can be effective in managing the swelling and improving the quality of life.

What is Heart Failure?

Heart failure is a condition in which the heart cannot pump enough blood to meet the body's demand for oxygen and nutrients. It is called a failure because the name suggests the heart has stopped working. In fact, it is only working less efficiently than usual. Blood flow through the heart and body begins to slow down and congestion builds inside the heart. This condition affects nearly millions of people, with about 1 in 4 people diagnosed with this condition at some point in their lifetime. Heart failure is also the most common cause of hospital visits in individuals over the age of 65.

Types of Heart Failure

Heart failure can take on various forms, each with different causes and impact:

Left-Sided Heart Failure

Left-sided heart failure ensues when the left side of the heart cannot function properly to pump blood to other parts of the body. Consequently, this constricts the flow of oxygen to necessary organs and potentially leads to right-sided heart failure or organ damage.

Right-Sided Heart Failure

Right-sided heart failure is when the right ventricle of the heart is too weak to pump blood properly into the lungs. The veins become distended, and fluid leaks into the tissues, producing symptoms such as swelling, often in the legs or abdominal cavity, and shortness of breath. The approach to treatment focuses on slowing the disease progression and managing symptoms to improve quality of life.

High Output Heart Failure

High-output heart failure is a rare form of heart failure where the heart pumps a normal or elevated volume of blood, but in this case, is still unable to meet the body's needs. While it does not involve low blood output and, instead, creates more complexity due to increased heart rate, serious complications may occur. Thus, the earlier the root cause is identified, the better the treatment and prognosis because treatment and outcomes depend on the resolution of the disorder causing failure.

Heart Failure Symptoms

The heart becomes unable to pump enough blood for its needs in heart failure. Symptoms may develop gradually, or they can arise suddenly, depending on how severe and fast the condition develops. Possible signs and symptoms include swelling of legs, decreased exercise capacity, a persistent cough, exhaustion and weakness, swelling or discomfort in the abdomen, shortness of breath, rapid or irregular heart, decreased oxygen delivery, wheezing or persistent shortness of breath, nausea or anorexia, chest pain, and sudden weight gain.

Causes of Heart Failure

Heart failure can stem from a variety of conditions that either weaken the heart or place excessive demands on it, such as:

Heart Attack: It is a sudden blockage in an artery that can damage the heart muscle and hinder its function.

Coronary Artery Disease (CAD): The build-up of plaque in the arteries limits blood flow, depriving the heart of necessary oxygen.

Overworked Heart: Factors like high blood pressure, heart valve disease, thyroid issues, kidney disease, diabetes, or congenital defects can place additional stress on the heart.

Cardiomyopathy: This condition involves a weakened or damaged heart muscle, which can be due to genetic factors, infections, or substance abuse.

How is Congestive Heart Failure Diagnosed?

To diagnose heart failure, healthcare professionals assess the symptoms, medical history, and risk factors such as high blood pressure, coronary artery disease, or diabetes. Common diagnostic tests include:

Chest X-ray: This imaging test shows the size and condition of the heart and lungs.

Blood Tests: These tests can identify diseases affecting the heart and measure proteins that increase during heart failure.

Echocardiogram: It uses sound waves to produce images of the heart’s size, structure, and blood flow, including the ejection fraction (the percentage of blood pumped out with each heartbeat).

Electrocardiogram (ECG/EKG): This test records the heart's electrical activity to evaluate heart rate and rhythm.

Myocardial Biopsy: This test involves examining small samples of heart muscle to diagnose specific heart conditions.

Exercise or Stress Tests: These tests monitor heart function during physical activity or with medication if exercise is not feasible.

Coronary Angiogram: This procedure identifies blockages in the heart's arteries using a catheter and contrast dye.

Cardiac CT or MRI: These imaging techniques provide detailed views of the heart's structure and functioning.

How is Heart Failure Treated?

Treating heart failure involves managing symptoms, slowing the progression of the disease, and addressing its underlying causes. The treatment plan varies based on the specific factors contributing to the condition. Common approaches include:

Implantable Devices: Devices such as pacemakers or implantable cardioverter defibrillators (ICDs) can assist in regulating heart rhythm and improving overall function.

Medications: Most individuals will need a combination of 2-3 medications to alleviate symptoms, enhance heart function, and minimise complications of heart failure.

Lifestyle Changes: Embracing a heart-healthy lifestyle by following a balanced diet, engaging in regular exercise, cutting down on salt, and quitting smoking.

Surgery: In severe cases or when a treatable cause is identified, procedures like coronary artery bypass surgery, valve repair or replacement, or heart transplantation may be necessary.

Heart Failure Prevention

Preventing heart failure starts with managing conditions that can lead to it, including coronary artery disease, high blood pressure, diabetes, and obesity. Adopting a heart-healthy lifestyle is crucial. Here are some effective prevention strategies:

• Stay Active: Engage in regular physical activity to strengthen the heart and enhance overall health.
• Quit Smoking: Completely avoid tobacco use, as it harms the heart and blood vessels.
• Maintain a Healthy Weight: Achieve and maintain a healthy weight to lessen the strain on the heart.
• Eat a Heart-Healthy Diet: Prioritise fruits, vegetables, whole grains, lean proteins, and low-sodium options.
• Follow Medical Advice: Adhere to prescribed medications and closely monitor health conditions.
• Manage Stress: Utilise relaxation techniques such as meditation, deep breathing, or yoga to reduce stress levels.

Myths and Facts Related to Heart Failure

Following are the myths and facts individuals must keep in mind regarding heart failure:

Myth 1: Heart failure happens when people grow old
Fact: Heart failure is not an inevitable result of the ageing process. Although it is common with increasing age, it can happen to anyone at any stage. Heart failure is a serious condition, but it can be prevented, perhaps, and surely controlled through proper treatment and improvement of lifestyle.

Myth 2: Heart failure leads to death
Fact: Advances in early diagnosis, treatment, and public awareness have dramatically improved outcomes for persons with heart failure. Many patients can enjoy full, active lives by following their treatment plans and managing their condition effectively.

Myth 3: Cholesterol only needs to be checked in middle age
Fact: Monitoring of cholesterol levels should be initiated early in adulthood. Even in the 20s, high levels of LDL, or bad cholesterol, increase the lifetime risk of cardiovascular disease. Regular screenings every four to six years after age 20, together with a healthy diet and regular exercise, will keep the heart healthy.