Heart Failure
What is Heart Failure?
Our heart is a powerful muscle that pumps blood to all parts of the body. Heart failure does not mean that the heart has suddenly stopped working or is about to stop. Heart failure is a condition where the heart muscle has become weak. As a result, the heart can no longer pump blood as effectively as it should for normal body functions. As the heart’s pumping action weakens, blood moves through the heart and the body at a slower rate, and pressure in the heart increases. Blood can then back up into the blood vessels around the lungs and causes water to leak into the lungs. This water fills up the lungs and makes it hard to breathe, causing coughing and wheezing. Many people with heart failure also have swollen feet, ankles or abdomen. That is why heart failure is sometimes called congestive heart failure.
What causes Heart Failure?
Heart failure often develops after other conditions have damaged or weakened the heart, including:
- Coronary artery disease (hardening/narrowing/clogging of heart vessels)
- Heart attack
- High blood pressure (hypertension)
- Faulty heart valves
- Cardiomyopathy (damage to the heart muscle by a virus or alcohol)
- Heart defects present at birth
- Other medical conditions such as diabetes, chronic kidney disease and thyroid disease
What happens when you have Heart Failure?
Many people with heart failure are not aware that they have it, because some of the most common symptoms of heart failure, such as feeling tired and short of breath, are often mistaken for normal signs of getting older.
Heart failure typically develops slowly and is a chronic, long-term condition, although you may experience a sudden onset of symptoms, known as acute heart failure. Signs and symptoms of heart failure are:
- Rapid and irregular heart beat
- Tiredness and decreased ability to complete daily activities
- Shortness of breath at rest or lying down
- Swelling in the feet, ankles or abdomen
- Sudden weight gain of 1 – 2 kg in 3 days from fluid retention
- Persistent cough or wheezing
- Loss of appetite and nausea
- If not treated, heart failure can progress to cause permanent damage to the heart. As the heart’s ability to pump continues to weaken, the symptoms become more and more severe.
Your ability to work or carry out normal daily activities will be affected. The damage may come to a point where medications can no longer provide relief and the only solution may be a heart transplant.
Are you at Risk?
There are a number of diseases, medical conditions and other factors that can put people at higher risk for heart failure. Not everyone with these risk factors develops heart failure, but they put extra stress on the heart that may lead to the condition. The chances of developing heart failure are especially high in people who have more than one of these risk factors:
- High blood pressure
- Coronary artery disease
- Heart attack
- Irregular heartbeats
- Diabetes
- Sleep apnea (inability to breathe properly while sleeping)
- Congenital heart defects
- Viral infection
- Alcohol use
- Kidney condition
Risk factors associated with heart disease in general may also contribute to heart failure, including:
- High cholesterol
- Smoking
- Family history of heart failure or other cardiovascular diseases
How can you tell if you have Heart Failure?
Only your doctor can tell you if you have heart failure.
To diagnose heart failure, your doctor will take a careful medical history and perform a physical examination. Your doctor will also check for the presence of risk factors such as high blood pressure. After the physical exam, your doctor often order blood tests and a chest X-ray, followed by an echocardiogram. Echocardiogram is the most important of these tests. This test tells your doctor what your ejection fraction, or “EF”, is. The ejection fraction is a measurement of how well your heart is pumping. People with a healthy heart usually have an ejection fraction of 60% or higher. Most people with heart failure have an ejection fraction of 40% or less.
How can Heart Failure be treated?
The keys to managing heart failure are to:
- Take your medications as prescribed
- Watch your fluid and salt intake
- Balance activity and rest
- Be aware of signs and symptoms of heart failure
- Monitor your weight daily
- Keep your medical appointments
Treatments may also include:
- Treatment of underlying causes, such as coronary artery disease, heart valve disease and high blood pressure.
- Surgical treatments such as coronary artery bypass surgery, valve surgery, left ventricular reconstruction surgery and heart transplant for patients with the most severe form of heart failure.
- Implanted devices that can control abnormal heart rhythms that may result from heart failure. Devices include pacemakers and implantable cardiac defibrillators.
- Cardiac Resynchronisation Therapy (CRT), which is a technique in which a special type of pacemaker is implanted to coordinate and synchronise heart muscle contractions.
How can Heart Failure be prevented?
The best way to prevent heart failure is to make changes in your lifestyle that lower your risk of developing heart disease. It is also important to control certain medical conditions, such as high blood pressure or diabetes, to lower your chances of developing heart failure.
Steps you can take to prevent heart failure are:
- Do not smoke
- Lower your cholesterol
- Control your blood pressure
- Control your diabetes
- Get regular exercise
- Limit alcohol intake