Heart Failure

Heart failure

Heart failure can be defined as a chronic and progressive condition in which the heart fails to pump an adequate amount of blood into the body. Due to various medical conditions, the flow of blood in the body is decreased, and the pressure on the heart is increased. As a result, there would be nutritional deficiency in all the organs, especially vital organs, and the patient may experience symptoms. 

The types of heart failure include left-side heart failure (left side of the heart cannot perform its function), right-side heart failure (right side of the heart cannot perform its function), and congestive heart failure (resulting in swelling due to backflow of blood in veins).  Congestive heart failure is an advanced stage of heart failure, as in this stage there is a fluid accumulation in arms, feet, lungs and other organs.

Signs and symptoms of heart failure may include the following:-

1. Shortness of the breath
2. Weakness and fatigue
3. Swelling in ankle, legs, and feet
4. Irregular or rapid heartbeat
5. Reduced exercising ability
6. Cough which is persistent
7. Abdominal swelling
8. Rapid weight gain due to fluid accumulation
9. Lack of appetite and nausea
10. Reduced alertness
11. Fluid or water retention
12. Chest pain if the heart attack is the cause of heart failure

The most common cause of heart failure is coronary artery disease. Some other conditions that, if not treated, can lead to heart failure are:-

1. Heart valve disease
2. Hypertension
3. Heart attack
4. HIV
5. Untreated sleep apnea
6. A severe form of anaemia
7. Congenital heart disease
8. Hyperthyroidism
9. Chemotherapy 

Anybody can be affected by the condition of heart failure. But, some factors increase the chances of the development of heart failure. They are:-

1. Cardiovascular diseases: Several cardiovascular conditions, such as increased blood pressure, anaemia heart valve disease, coronary artery disease, congenital heart disease and irregular heartbeat. These conditions make the heart work harder. Persistent exertion on the heart results in heart failure.
2. Underlying medical condition: Underlying medical conditions such as diabetes, thyroid dysfunction, obesity, viral infection, kidney disease, and sleep apnea also increases the risk of heart failure.  Viral infection of the heart results in heart muscle inflammation.
3. Lifestyle factors: People who smoke and consume alcohol excessively are at increased risk of heart failure. Smoking accelerates the deposition and blockage of coronary artery disease. The heart muscles of the people with alcohol abuse become thin and weak resulting in the reduced pumping function of the heart. 
4. Medications: Certain medications, such as those used for managing cancer, increase the risk of heart failure.

If heart failure is not treated on time, it may lead to a condition known as congestive heart failure (CHF). There may be an accumulation of fluid in the limbs and other organs in this condition. 

Other complications may include stroke, kidney dysfunction, arrhythmias, and thromboembolism. 

Disease progression

Stage A: You are more likely to develop heart failure during this stage. This stage can be indicated by the following:- Diabetes and the presence of coronary artery disease.

Stage B: If you have never experienced any symptoms of heart failure but have been diagnosed with a condition in which the left chamber of the heart does not pump normally, then you are in the second phase of the heart failure. 

Stage C: If you have been diagnosed with systolic heart failure accompanied by symptoms like less ability to exercise and shortness of breath, you are in the third phase of heart failure.

Stage D: A patient is said to be in stage D if he/she is diagnosed with systolic heart failure and has some other symptoms of heart failure.

Physical diagnosis

1. To diagnose heart failure, the doctor will first have a look over the medical history of the family and self of the patient. 
2. To confirm the heart failure condition, the doctor may also check for the presence of the risk factors in the patient.
3. The doctor may also check for lung congestion and the presence of heart murmuring.

Other diagnostic tests

1. Blood test: Blood tests are ordered by the doctor to look for the increased matrices in the blood that could sign heart failure. One such test is the BNP test. This test is performed through blood. A protein, brain natriuretic peptide, is formed by the heart and the blood vessels. In the case of heart failure, the level of this protein in the blood increases. 
2. X-ray: X-ray can help show the lungs and heart conditions.
3. CT (Cardia Computerised Tomography) scan: in this test, the patient is asked to lay inside a doughnut-shaped machine. An x-ray tube inside the machine shows a clear image of the internal organs.
4. Echocardiogram: In this test, the sound waves are used to obtain the image of the moving heart. This test helps show the shape and size of the heart and the condition of all the valves of the heart. It is also used to determine the efficiency of the working of the heart.
5. Stress test: stress test helps to determine the health of the heart when doing any physical activity.

The treatment of heart failure depends upon the severity and the condition of the heart failure. If the condition is diagnosed in the early phase and the treatment is started, the treatment can very quickly improve the symptoms of heart failure. It is achieved with the regular appointment with the doctor for 3 to 6 months. The treatment can be done by using any of the following approaches:-

Surgery

1. Coronary bypass surgery: If the blockage of several arteries causes heart failure, this surgery is used. In this procedure, healthy blood vessels from the legs, arms or the chest are taken and then connected to the heart. Hence a new pathway to the heart is created.
2. Heart valve repair or replacement: If a fault causes the heart failure in the valve of the heart, then this surgery is recommended. In this surgery, the doctor repairs the heart valve by either reconnecting or removing the excess of the flap muscles. After doing this, the valves can close tightly, preventing any leakage from the site. 

Medicines: If the heart failure condition is diagnosed at an earlier stage, then it can be relieved by using medicines only. Medicines in an early stage can help improve the symptoms of heart failure and prevent it from worsening. The medicines may help in:-

1. Improving the heart's ability to pump blood.
2. Reducing the blood clots
3. Reducing the cholesterol level.
4. Some of the medicines used in treating the condition of heart failure are beta-blockers, calcium channel blockers, nitrates, hydralazine, and medicines used to lower cholesterol. In some cases, medicines of class ivabradine are also used. 

There is a difference between heart attack and heart failure. In a heart attack, the blood supply to the heart muscles is partly or completely blocked. In heart failure, although the supply of blood may be adequate, the heart is unable to effectively pump the blood. In some patients, a heart attack may lead to heart failure by reducing the pumping ability of the heart.

You should immediately see a heart specialist if you are experiencing any of the following symptoms:-

1. Gained more than one kg in a day along with swelling.
2. The swelling in your ankle and legs are getting worse.
3. Feeling bloated and full all time.
4. Feeling out of energy.