Heart Failure

The heart is the strongest muscle in the body. In a day it beats about 100, 000 times, and in a lifetime of about 70 years, the heart beats about 2.5 billion times! Quite a hard work!

The heart and the network of blood vessels do a magnificent job of supplying blood to all the organs of the body. The continuous rhythmic contraction and relaxation of heart helps in circulation of blood, thereby delivering oxygen, and nutrients to various tissues. Sometimes, a progressive damage to the heart may result in declined function of the heart. As a result, the amount of blood circulated to various organs is reduced. This condition is termed as heart failure.

The word heart failure sounds scary conveying us that the heart has failed completely and is no longer in work. It is not so; it actually means that the heart is not pumping enough blood as it normally should. Your entire body function depends on circulation of blood that delivers oxygen and nutrients to various tissues.

Cause of the failing heart

There could be many reasons for heart failure. Any reason that causes progressive weakening and damage to the heart may cause heart failure.

Coronary heart disease, a condition where the arteries carrying blood to heart narrows by fat deposition, may be a reason for heart failure. Due to the fat deposition in the arteries, the blood supply to heart is reduced considerably, which is enough only to keep the heart muscle alive, but not enough to carry out normal function. A previous heart attack that has left behind damaged heart muscle may also result in poor heart function.

If you have a high blood pressure, the heart has to work extremely hard to pump blood throughout your body. Over time, this result in thickening and weakening of heart muscle, eventually, the heart loses its ability to pump effectively.

A defective heart valve due to coronary heart disease, heart defect or heart infection forces heart to work hard to pump blood. These may result in weakening of heart muscles.

Other causes that may result in heart failure myocarditis, a viral infection resulting in inflammation of heart , structural heart defects from birth and abnormal rhythm of heart beat resulting in too fast heart beat that increases the work of heart.

Heart failure can be progressive (chronic) or can be sudden (acute). Few signs and symptoms of heart attack are:

  • Swelling of legs and ankles
  • Discomfort in arms or chest (Angina) due to blockage of coronary artery
  • Either weight gain or weight loss
  • Shortness of breath
  • Fatigue
  • Loss of appetite
  • Fast and irregular heart beat
  • Unable to do daily activities
  • Persistent cough or wheezing with blooded phlegm
  • Abdomen swelling

These symptoms and signs of a heart attack may get worsen as the heart becomes weaker, you may feel tired and experience shortness of breath quite often or even when you walk across the rooms.

Contact your doctor if you experience chest pain, fast and irregular heartbeat, shortness of breath, fatigue, difficulty doing simple task, cough or wheezing with blood, swelling of abdomen, legs or ankle; decreased concentration. Contact your doctor before the symptoms worsens.

Your doctor may be able to diagnose heart failure through your physical examinations and diagnostic tests. Your physician will check your heart beat, lungs sound and will look for swollen legs, ankle, feet and abdomen. Your blood pressure will be measured and your weight will be note down.

The physician may ask you to get various tests. X-ray study of chest gives a detailed picture of heart, lungs, and blood vessels. Your physician will look whether your heart is enlarged or there is fluid accumulation around your lungs.

An echocardiogram may be prescribed to know the pumping action of heart. An ECG or electrocardiogram would be done to measure the electrical activity of your heart; this checks the rhythmic activity and enlargement of heart or prior history of heart attack. ECG is also recorded while you are working on a treadmill for a given period of time. Your physician will check whether symptoms are elevated while doing activity.

A test with radioactive tracers can be done. Radioactive tracers are injected intravenously into your blood and its movement in heart is tracked. This helps in knowing the size of chamber of heart, amount of blood ejected from heart and to know blood flow to regions of heart muscles.

In addition, a catheter can be inserted into the artery of your leg and direct it to region of heart via X-ray guidance. This help to see the chambers of heart and to measure the pressure inside heart. This visualization is called angiography

Various blood tests may also be done to check the function of your kidney and thyroid and to detect the presence of risk factors that can cause heart disease

Heart failure needs lifelong management. Treatment for heart failure depends on the severity of your condition. Three types of treatment are done for heart failure – Treatment by doctor, treatment by medication and surgical treatment.

Combinations of medicine will be given depending on your heart attack symptoms. Few medications that your physician might prescribe are

  • ACE-inhibitors, which are used to dilate blood vessels and improve the flow of blood.
  • Angiotensin II receptor blockage, works similar to ACE-inhibitors and are prescribed in people who can’t tolerate ACE-inhibitors.
  • Digoxin, this increases the heart muscle strength.
  • Beta blockers slows your heartbeat and reduces blood pressure.
  • Diuretics make you urinate frequently and prevents fluid accumulation.
  • Aldosterone antagonists help in removing of scarring heart tissues makes heart work better & increases your life span.

In some severe cases, where medications do not prove effective, doctors may proceed for surgical treatments like:

  • Coronary angioplasty and coronary artery bypass surgery to remove blockage in arteries implantable cardioverter defibrillators (ICDs) may be placed under skin to check heart rhythm.
  • Biventricular pacing for effective pumping
  • Left ventricular assist devices or LVADs for proper heart pump
  • Heart valve replacement surgery
  • Complete heart transplantation

Your doctor will examine you regularly to check your every day improvement. Your frequent visits will help to determine how well you are responding to the treatment and will decide on whether to continue the present treatment or to make some changes in your treatment.

Though various options of treatment are available for heart failure treatment, all of it proves effective only in controlling your symptoms. Therefore, it is better that you take few preventive steps like - no smoking, being physically active, eating a healthy diet, maintaining perfect weight, controlling blood pressure, cholesterol and blood glucose levels; and following ways to manage and reduce stress.


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