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Heart Failure: Causes, Types, Symptoms, Diagnosis And Treatment

Heart failure is a condition that weakens your heart's ability to pump adequate blood to the body. In India, the prevalence of heart failure is due to coronary heart disease, obesity, diabetes, hypertension and rheumatic heart disease [1] . According to the Centers for Disease Control and Prevention, about 5.7 million adults in the US have heart failure.

What Causes Heart Failure

The heart might not pump blood properly due to certain conditions such as coronary artery disease, high blood pressure, heart attack, heart valve disease, diabetes, arrhythmia, etc. and it can damage or weaken the heart, leading to heart failure.

The main pumping chambers of the heart (ventricles) may become stiff and dilate to an extent that the heart can't pump blood throughout the body. Heart failure can affect both the left or right side of your heart and it can be either acute or chronic [2] .

In acute heart failure, the symptoms suddenly appear and disappear very quickly, and in chronic heart failure, the symptoms are continuous and don't surpass time.

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Types Of Heart Failure [3]

  • Left-sided heart failure - It is the most common type of heart failure. It occurs when the left heart ventricle, which is located in the bottom left side of the heart doesn't pump efficiently.
  • Right-sided heart failure - It occurs when the right heart ventricle can't pump enough blood to your lungs to collect oxygen.
  • Systolic heart failure - It happens when the heart muscles are unable to pump oxygen-rich blood out of the body and it usually develops when the heart is weak and enlarged. Men are more likely to suffer from systolic heart failure than women.
  • Diastolic heart failure - Diastolic heart failure happens when the heart muscles become stiff, usually due to heart disease. This, in turn, causes a lack of blood flow to the rest of the body's organs.

Symptoms Of Heart Failure [4]

  • Excessive fatigue
  • Rapid weight gain
  • Loss of appetite
  • Irregular heartbeat
  • Heart palpitations
  • Persistent coughing
  • Shortness of breath
  • Swelling of the legs and ankles
  • Abdominal swelling
  • Increased urination at night
  • Difficulty in concentrating

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Risk Factors Of Heart Failure

The African people have an increased risk of heart failure [5] and men are at a higher risk of having heart failure than women [6] . In addition, people with the following diseases are at a higher risk of heart failure.

  • Anaemia
  • Obesity
  • Hyperthyroidism
  • Hypothyroidism
  • High blood pressure
  • Coronary artery disease
  • Diabetes
  • Heart attack
  • Sleep apnoea
  • Congenital heart defects
  • Valvular heart disease
  • Excessive use of tobacco and alcohol

Complications Of Heart Failure [7]

  • Kidney damage - Heart failure reduces the flow of blood to the kidneys, which can eventually cause kidney failure or kidney damage.
  • Arrhythmia - It occurs when the heart either beats too quickly, too slowly or in an irregular pattern. It is a common complication of heart failure.
  • Heart valve problems - The valves of the heart don't function properly if your heart is enlarged due to heart failure.
  • Liver damage - Liver damage, a complication of heart failure can occur when there is a build-up of fluid that puts excess pressure on the liver, making it difficult for your liver to function properly.

If heart failure is left untreated, it can lead to congestive heart failure, a condition in which blood accumulates in other areas of the body.

When To See A Doctor

Consult a doctor if you start experiencing chest pain, fainting or severe weakness, shortness of breath, and rapid or irregular heartbeat.

Diagnosis Of Heart Failure [8]

Your doctor will first ask about your medical history, have a look at your symptoms and perform a physical examination. Following the physical exam, your doctor will perform some tests, these include the following.

  • Blood tests - The doctor will take a blood sample to look for signs of diseases that are affecting the heart.
  • X-ray - An X-ray of the chest will help see in what condition the lungs and heart are in.
  • ECG - ECG test is performed to record the electrical activity of the heart through electrodes attached to the skin.
  • CT scan - This test is done to collect images of your heart and chest.
  • MRI - This test creates images of the heart to check and see its functionality.
  • Echocardiogram - This test helps the doctors see the shape and size of the heart along with any other abnormalities.
  • Myocardial biopsy - The doctor inserts a small catheter into a vein in your arm, neck or groin and takes out small pieces of the heart muscle.

Treatment Of Heart Failure

Treatment depends on the severity of the condition and treating it on time may help you live longer.

Medications

Doctors treat heart failure with a combination of medications to help relieve your symptoms and also to help in improving the heart's ability to pump blood, reduce blood clots, eliminate excess sodium and lower the heart rate and cholesterol levels.

Surgery

Some people may need surgery like the coronary bypass surgery which is done by taking a healthy piece of the artery and attaching it to the blocked coronary artery. This allows the blood to pass through the new artery [9] .

Angioplasty is another treatment procedure, wherein a small catheter with a balloon is inserted into the blocked or narrowed artery. The surgeon inflates the balloon to open up the blocked artery [10] .

Pacemakers are small devices which are placed into the chest to help control the heart rhythms. They can help in slowing down the heart rate when it is beating too quickly or increase the heart rate when it is beating too slowly [11] .

When all other treatments have failed, heart transplants are used in the final stage. The surgeon removes your heart and replaces it with a healthy heart taken from a donor [12] .

Prevention Of Heart Failure

  • Quit smoking
  • Limit alcohol intake
  • Get enough sleep
  • Avoid foods high in fat
  • Maintain a healthy weight
  • Control your blood pressure and diabetes
  • Stay physically active
  • Reduce and manage stress
View Article References
  1. [1] Huffman, M. D., & Prabhakaran, D. (2010). Heart failure: epidemiology and prevention in India.The National medical journal of India,23(5), 283-288.
  2. [2] Tavazzi, L., Senni, M., Metra, M., Gorini, M., Cacciatore, G., Chinaglia, A., ... & IN-HF (Italian Network on Heart Failure) Outcome Investigators. (2013). Multicenter prospective observational study on acute and chronic heart failure: one-year follow-up results of IN-HF (Italian Network on Heart Failure) outcome registry.Circulation: Heart Failure,6(3), 473-481.
  3. [3] Salisbury, P. F., Cross, C. E., Rieben, P. A., & Lewin, R. J. (1960). Comparison of two types of mechanical assistance in experimental heart failure.Circulation research,8(2), 431-439.
  4. [4] Colucci, W. S., Packer, M., Bristow, M. R., Gilbert, E. M., Cohn, J. N., Fowler, M. B., ... & Sackner-Bernstein, J. D. (1996). Carvedilol inhibits clinical progression in patients with mild symptoms of heart failure.Circulation,94(11), 2800-2806.
  5. [5] Der Ananian, C., Winham, D. M., Thompson, S. V., & Tisue, M. E. (2018). Perceptions of Heart-Healthy Behaviors among African American Adults: A Mixed Methods Study.International journal of environmental research and public health,15(11), 2433.
  6. [6] Strömberg, A., & Mårtensson, J. (2003). Gender differences in patients with heart failure.European Journal of Cardiovascular Nursing,2(1), 7-18.
  7. [7] Watson, R. D., Gibbs, C. R., & Lip, G. Y. (2000). ABC of heart failure. Clinical features and complications.BMJ (Clinical research ed.),320(7229), 236-239.
  8. [8] Inamdar, A. A., & Inamdar, A. C. (2016). Heart Failure: Diagnosis, Management and Utilization.Journal of clinical medicine,5(7), 62.
  9. [9] Dalén, M., Lund, L. H., Ivert, T., Holzmann, M. J., & Sartipy, U. (2016). Survival after coronary artery bypass grafting in patients with preoperative heart failure and preserved vs reduced ejection fraction.JAMA cardiology,1(5), 530-538.
  10. [10] Peterson, J. C., Allegrante, J. P., Pirraglia, P. A., Robbins, L., Lane, K. P., Boschert, K. A., & Charlson, M. E. (2010). Living with heart disease after angioplasty: A qualitative study of patients who have been successful or unsuccessful in multiple behavior change.Heart & lung : the journal of critical care,39(2), 105-115.
  11. [11] Patel, H. C., & Mariani, J. A. (2017). An overlooked case of pacemaker-related heart failure.Echo research and practice,4(4), K57-K60.
  12. [12] Alraies, M. C., & Eckman, P. (2014). Adult heart transplant: indications and outcomes.Journal of thoracic disease,6(8), 1120-1128.

Story first published: Monday, November 18, 2019, 10:00 [IST]
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