Expert Article: Does Winter Worsen Heart Failure?

A healthy heart pumps blood to all parts of the body. If the heart fails to pump blood at the desired level, fluid tends to accumulate in the lungs and other parts of the body with decreased blood supply to vital organs like the kidney and brain - this is known as heart failure. The burden of heart failure is estimated to be 23 million worldwide. In India, 1 in every 1,000 people is estimated to suffer from heart failure.

Diminished heart function can be due to heart attack (blockage of oxygen-rich blood flow to a part of the heart), infections of the heart, muscular heart disease, valvular problems, arrhythmias (too fast / too slow/irregular beating of the heart), alcohol intake, high blood pressure and associated lung problems.

Studies show that hospitalisation rates of heart failure patients are higher during the winter season. Extreme cold weather causes peripheral vasoconstriction, which leads to increased load on the heart, worsening heart failure. Other risk factors for heart failure, especially in winters, include air pollution and lack of perspiration.

Heart failure can present as shortness of breath, sudden weight gain, swollen ankles, inability to sleep flat at night, feeling one's own heartbeat, and feeling very tired. Baseline investigations include ECG, 2D Echo, chest X-ray, blood tests for kidney and liver function like serum creatinine, blood urea, LFT and thyroid function tests.

Measures to prevent acute exacerbation of heart failure in general and in winter include:

• Taking prescribed medicines regularly, even if you are feeling fine
• Keeping blood pressure under check
• Monitoring weight
• Limiting salt intake
• It's ideal for taking 2,300 mg of sodium per day which is equivalent to 1 tsp of salt.
• Avoiding pickles and junk food will help cut down salt intake as they have high NA+ content.
• Consuming fresh fruits and vegetables with a regular balanced diet is vital
• Reducing fluid intake to 1.5- 2 litres per day
• Avoiding smoking, tobacco chewing
• Limiting alcohol, caffeine intake
• Exercising regularly as advised by a doctor and not to over-exercise as it leads to pressure on the heart
• Exposure to early morning sunlight
• Managing stress by yoga and meditation
• Avoiding pain killers like NSAIDs which worsen heart failure
• Protecting self from winter ailments like common cold, cough, flu, influenza and pneumococcal vaccination to prevent pneumonia.

Paying close attention to symptoms of heart failure, reporting to the doctor immediately in case of significant symptoms, and keeping a list of all medicines and taking the doctor's advice on dosage adjustment is very important.