Heart Failure – Types, Symptoms, Causes, Treatment
When we hear the term ‘heart failure’ it sounds like a permanent ailment with no solution. However, it actually means that it isn’t functioning properly and timely intervention and medical attention can change the game.
Our body depends on the heart as it pumps to deliver oxygen- and nutrient-rich blood to the body’s cells. When the cells receive proper nourishment, the body can function normally. When the heart weakens and is unable to supply enough oxygen to the cells, it results in fatigue, shortness of breath and even coughing. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.
While in heart failure there’s usually no cure, many people lead a full, enjoyable life when the condition is managed with medications and healthy lifestyle changes. Support from the family and friends who know your condition turns out to be really helpful.
How the normal heart works
The heart has four chambers, two on the right and two on the left:
- Two upper chambers called atria (one is an atrium)
- Two lower chambers called ventricles
The right atria takes in deoxygenated blood from the rest of the body and sends it back out to the lungs through the right ventricle to get oxygenated. Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body.
The heart pumps blood to the lungs and to all the body’s tissues by a sequence of highly organized contractions of the four chambers. For the heart to function properly, the four chambers must beat in an organized way.
What is heart failure?
Heart failure is a condition where the heart fails to function the way it should and is unable to pump oxygenated blood to the body. At first the heart tries to make up for this by:
- Enlarging. The heart stretches to contract more strongly and keep up with the demand to pump more blood.
- Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
- Pumping faster. This helps to increase the heart’s output.
The body also tries to compensate in other ways:
- The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power.
- The body diverts blood away from less important tissues and organs (like the kidneys), the heart and brain.
These are temporary measures taken by the heart, but they do not offer a permanent solution. Eventually, the heart and body just can’t keep up and it leads to all the symptoms of a heart failure.
Types of Heart Failure
Heart failure can involve the heart’s left side, right side or both sides. However, it usually affects the left side first.
Left-sided heart failure
In left-sided or left ventricular (LV) heart failure, the left side of the heart must work harder to pump the same amount of blood.
There are two types of left-sided heart failure. Drug treatments are different for the two types.
- Systolic failure: The left ventricle loses its ability to contract normally. The heart can’t pump with enough force to push enough blood into circulation.
- Diastolic failure (or diastolic dysfunction): The left ventricle loses its ability to relax normally (because the muscle has become stiff). The heart can’t properly fill with blood during the resting period between each beat.
Right-sided heart failure
When the right side loses pumping power, blood backs up in the body’s veins. This usually causes swelling or congestion in the legs, ankles and swelling within the abdomen such as the GI tract and liver (causing ascites).
Congestive heart failure
In congestive heart failure, as the blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the body’s tissues.
What Causes Heart Failure?
Heart failure is caused by many conditions that damage the heart muscle, including:
- Coronary artery disease. The arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
- Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle.
- Cardiomyopathy. Damage to the heart muscle from infections or alcohol or drug abuse.
- Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure.
Symptoms of Heart Failure?
You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:
- Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
- Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen (called edema), and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.
- Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
- Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.
If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart.
How Is Heart Failure Diagnosed?
Your doctor will ask you many questions about your symptoms and medical history. You will also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.
Your doctor may also order other tests to determine the cause and severity of your heart failure including:
- Blood tests.
- B-type Natriuretic Peptide (BNP) blood test.
- Chest X-ray. A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.
- Echocardiogram. This test is an ultrasound which shows the heart’s movement, structure, and function.
- The Ejection Fraction (EF) is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present.
- Electrocardiogram (EKG or ECG) . An EKG records the electrical impulses traveling through the heart.
- Cardiac catheterization. This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.
- Stress Test. Noninvasive stress tests provide information about the likelihood of coronary artery disease.
How Can I Prevent Heart Failure From Worsening?
- Keep your blood pressure low.
- Monitor your own symptoms.
- Maintain fluid balance.
- Limit how much salt (sodium) you eat.
- Monitor your weight and lose weight if needed.
- Monitor your symptoms.
- Take your medications as prescribed.
- Schedule regular doctor appointments.
How Can I Prevent Further Heart Damage?
In an effort to prevent further heart damage:
- Stop smoking or chewing tobacco.
- Reach and maintain your healthy weight.
- Control high blood pressure, cholesterol levels, and diabetes.
- Exercise regularly.
- Do not drink alcohol.
- Have surgery or other procedures to treat your heart failure as recommended.
How Can I Improve My Quality of Life With Heart Failure?
There are several things you can do to improve your quality of life if you have heart failure. Among them:
- Eat a healthy diet.
- Exercise regularly.
- Prevent respiratory infections.
- Take your medications as prescribed. Do not stop taking them without first contacting your doctor.
- Get emotional or psychological support if needed.
Can Surgery Be Used to Treat Heart Failure?
In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:
- Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is bypass surgery.
- Heart valve surgery. Diseased heart valves can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuloplasty).
- Implantable left ventricular assist device (LVAD).
- Heart transplant. A heart transplant is considered when heart failure is so severe that it does not respond to all other therapies, but the person’s health is otherwise good.
With the right care, heart failure may not stop you from doing your daily things. Your future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.
In case you have any query related to the heart problem, feel free to get in touch with us at our helpline number or reach to our reception desk to schedule an appointment.