What Is Heart Failure?
Heart failure does not mean the heart has stopped working. Rather, it means that the heart’s pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result the heart cannot pump enough oxygen and nutrients to meet the body’s needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving for a short while but, in time, the heart muscle walls weaken and are unable to pump as strongly. As a result the kidneys often respond by causing the body to retain fluid (water) and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.
Basically, heart failure, also known as congestive heart failure (CHF), means your heart cannot pump enough blood to meet your body’s needs.What Causes Heart Failure?
Heart failure is caused by many conditions that damage the heart muscle. These include the following:
• Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle.
• Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle and damaging it. All or part of the heart muscle becomes cut off from its supply of oxygen. A heart attack damages the heart muscle resulting in a scarred area that does not function properly.
• Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as 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. In addition, heart failure can occur when several diseases or conditions are present at once. What Are the 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 lung – Fluid back up 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 oedema), 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 fast or irregular heartbeat.
You should see your doctor if you experience any of the signs or symptoms associated with heart failure. These include:
• Chest pain
• Fatigue and weakness
• Rapid or irregular heartbeat
• Shortness of breath (dyspnoea) when you exert yourself or when you lie down
• Reduced ability to exercise
• Persistent cough or wheezing with white or pink blood-tinged phlegm
• Swelling in your abdomen, legs, ankles and feet
• Difficulty concentrating or decreased alertness Diagnosis
A detailed history and physical examination is required for the diagnosis of congestive heart failure. Often your doctor will ask you to do a number of tests and investigations to confirm the diagnosis. Treatment
You cannot reverse many conditions that lead to heart failure, but heart failure can often be treated with good results. Medications can improve the signs and symptoms of heart failure. Doctors usually treat heart failure with a combination of medications.
Lifestyle changes, such as exercising, reducing the salt in your diet, managing stress, treating depression, and especially losing excess weight, can improve your quality of life.
The best way to prevent heart failure is to control risk factors and conditions that cause heart failure, such as coronary artery disease, high blood pressure, high cholesterol, diabetes or obesity. Complications
If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age. Complications can include:
• Kidney damage or failure. Kidney damage from heart failure can require dialysis for treatment.
• Heart valve problems.
• Liver damage.
• Heart attack and stroke. Because blood flow through the heart is slower in heart failure than in a normal heart, it is more likely you will develop blood clots which can increase your risk of having a heart attack or stroke.
Some heart functions will improve with proper treatment. However, heart failure can be life-threatening. It can lead to sudden death. Conclusion
Heart failure is a chronic disease needing lifelong management. However, with treatment, signs and symptoms of heart failure can improve and the heart sometimes becomes stronger. Doctors, sometimes, can correct heart failure by treating the underlying cause, but for most people, the treatment of heart failure involves a balance of the right medications. In some cases, devices that help the heart beat and contract properly might be needed. If you have symptoms suggestive of heart failure you should be evaluated by your doctor and the correct management measures taken to improve the quality of life. Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty five years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley. |
