What is heart failure? Symptoms, causes and treatment #hearthealth

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The symptoms of heart failure develop gradually and over a period of time. And sometimes, silently, so that the person does not notice it. 

On average, the heart beats about 2.5 billion times in the course of an individual’s life. And during this time, it pushes millions of gallons of blood to various parts of the body, carrying oxygen, fuel, hormones, essential compounds and other important components to help us function healthily. The heart also ensures that it transports waste products from our metabolism. So, you can imagine what can happen if the heart stops working! Vital functions come to a standstill almost instantly!

What is heart failure?

Heart failure is a condition in which the heart fails to function properly. “Heart failure” and “Congestive Heart Failure (CHF)” don’t mean that the heart has actually “failed” or stopped; they mean that one or more chambers of the heart has failed to keep up with the volume of blood flowing through them.

Heart failure is the result of a variety of underlying diseases and health problems. One’s condition could relate to the left side, the right side or both sides of the heart. Each side has two chambers:

• An atrium or upper chamber
• A ventricle or lower chamber

When there’s heart failure, one or more of these chambers may be unable to keep up with the volume of blood flowing through it.

Types of heart failure

Heart failure can be a result of two types of heart dysfunction:

• Systolic Heart Failure – the most common cause of heart failure that occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs.
• Diastolic Failure – where the muscle becomes stiff and loses some of its ability to relax. Because of this, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.

It is important to know that the left side of the heart is crucial for normal heart function and this is usually where heart failure begins. The left atrium receives oxygen-rich blood from the lungs and pumps it into the left ventricle, the heart’s largest and strongest pump, which is responsible for supplying blood to the body.

After circulating through the body, blood returns to the right atrium and then travels to the right ventricle, which pumps it into the lungs to be replenished with oxygen. When the right side loses pumping power, blood can back up in the veins attempting to return blood to the heart.

Right heart failure may occur in isolation but is usually a result of left-sided failure. When the left ventricle fails, fluid backs up in the lungs. In turn, pressure from excess fluid can damage the heart’s right side as it works to pump blood into the lungs.

Heart failure usually is a chronic, or long-term, condition that gradually gets worse. By the time most people decide to see a doctor about their symptoms, the heart has been “failing,” little by little, for a long time.

This is why regular health checks are important. During a routine physical examination, your doctor may detect signs of heart failure long before you experience symptoms.

What are the causes of heart failure?

Considering that the heart has a non-stop workload, it is amazing that it works efficiently for so long in so many people. However, there are chances that it can fail. Heart failure is invariably connected to another health condition or disease. The most common cause of heart failure is coronary heart disease (CAD) where the arteries that supply blood and oxygen to the heart become narrow making it hard to pump blood efficiently.

Other conditions that may increase your risk for developing heart failure include:

• Cardiomyopathy, a disorder of the heart muscle that causes the heart to become weak
• A congenital heart defect
• A heart attack
• A period of seriously high blood pressure
• Heart valve disease
• Certain types of arrhythmias, or irregular heart rhythms
• Emphysema, a disease of the lung
• Diabetes
• An overactive or underactive thyroid
• HIV
• AIDS
• Severe forms of anemia
• Certain cancer treatments, such as chemotherapy
• Drug or alcohol misuse
• Poor diet
• A lack of exercise
• Smoking
• Infection
• Unlucky genes

What are the symptoms of heart failure?

Heart failure symptoms, just like heart disease, are gradual, progressive, and chronic.

• Gradual – because they can go unnoticed. Heart failure is not sudden or traumatic. And neither are the symptoms.
• Progressive – because the symptoms get worse unless something is done about them. Survival rates increase when the patient take the right medication and make lifestyle changes to improve heart health. Changes usually begin with a sensible diet and regular exercise.
• Chronic – as the symptoms last as long as one lives. The condition is not curable, but definitely treatable. The good news? You can prevent heart failure.

Symptoms usually appear as the heart gets weaker, but it’s possible to have heart failure and not know it. Symptoms may be mild or severe, depending on the degree of heart failure and the side of the heart affected.

Every symptom is caused by a specific heart failure malfunction. Here are the most commonly reported symptoms, as described by the AHA and other organizations.

1. Shortness of breath (dyspnea)

Fluid accumulates in the lungs when the blood backs up in the vessels that return blood from the lungs to the heart, causing shortness of breath. The heart simply can’t keep up with blood supply. Congestion causes “rales” (noises in the lungs that sound like crackles). Rales can be heard via a stethoscope. The symptom can develop when exercising or when lying down and becomes worse at night.

2. Shortness of breath (bendopnea)

While bending over at the waist, this action increases pressure within the chest and heart. If the shortness of breath occurs within 30 seconds of bending over, it is a symptom in nearly one-third of advanced heart failure patients.

3. Persistent wheezing or coughing

As with shortness of breath, the coughing/wheezing is a result of fluid build up in the lungs. The cough might produce white or pink mucus. A pinkish color indicates the presence of blood. These symptoms may get worse when you are lying down.

4. Swelling (edema)

This comes from excess fluid seeping through the blood vessel walls into body tissues, especially in the legs, ankles, and feet (shoes may feel tight), but also in the abdomen. The kidneys are not able to get rid of sodium and water, which also causes fluid retention in tissues.

5. Difficulty sleeping

When fluid backs up in the lungs, you may wake up with shortness of breath, coughing, or wheezing, disrupting sleep.

6. Unusual weight gain

Because of salt and water retention, as heart failure worsens, it can cause  a weight gain of two to three pounds in a day or five pounds in one week.

7. A lack of appetite

You might feel sick to your stomach or have a feeling of being full. In either case, it’s because less blood is flowing to the digestive system.

8. Pale, cool hands and feet

This results from less blood flowing to extremities because more blood is going to vital organs.

9. Decreased urination

This symptom may develop in severe heart failure when the kidneys are not receiving enough blood to produce urine.

10. Light-headedness or dizziness

Abnormal heart rhythm or low blood pressure (hypotension) can lead to these sensations.

11. Abdominal swelling/bloating

In addition to swelling or bloating due to fluid retention, symptoms such as nausea and a poor appetite are likely.

12. Irregular heartbeat (arrhythmia)

This is a change in the pattern or efficiency of electrical signals. The condition is particularly noticeable when you lie on your left side. A pounding heart may also be a symptom.

13. Increased heart rate

The heart beats faster to make up for its loss in pumping capability.

14. Poor memory, drowsiness, confusion

These symptoms may be a sign that the condition is worsening. They can occur from low cardiac output (reduced blood flow). A change in the level of sodium also can cause confusion.

15. Fatigue, activity limitations

Less blood flow to major organs and muscles can cause fatigue and shortness of breath, preventing patients from normal daily activities.

16. Frequent night-time urination

This often happens at night when the legs are elevated and kidneys recognize excess water within bloodstream.

How is heart failure diagnosed?

Usually, heart failure diagnosis is done via an echocardiogram, which uses sound waves to create detailed pictures of the heart. This helps your doctor evaluate the damage to your heart and determine the underlying causes of your condition. Your doctor may use an echocardiogram along with other tests, including a physical exam to check for physical signs of heart failure. For example, if there is leg swelling, an irregular heartbeat and bulging neck veins, heart failure could be likely.

How is heart failure treated?

Depending on the severity of the heart failure, treatment is determined. While early treatment can improve symptoms, regular testing is still recommended every three to six months. The goal of treatment is to increase lifespan.

Some treatment options are:

Medication

If the heart failure is in its early stages, prescription medication may be effective to relieve the symptoms and prevent the condition from getting worse. Medications are prescribed to help the heart pump blood, reduce blood clots, reduce heart rate as necessary, remove excess sodium and replenish potassium levels and reduce cholesterol levels. It is important to consult your doctor before taking any medication for heart failure symptoms, since certain medications can be dangerous for those with a heart condition. Examples are Naproxen )Aleve, Naprosyn), Ibuprofen (Advil, Midol), etc.

Surgery

Some people with heart failure will need surgery, such as a coronary bypass surgery, where a healthy piece of artery is taken and attach to the blocked coronary artery. This allows the blood to bypass the blocked, damaged artery and flow through the new one.

Angioplasty

An angioplasty may also be recommended. Here a catheter with a small balloon attached to it is inserted into the blocked or narrowed artery. Once the catheter reaches the damaged artery, your surgeon inflates a balloon to open the artery. A permanent stent or wire mesh tube may need to be placed into the blocked or narrowed artery. A stent permanently holds your artery open and can help prevent further narrowing of the artery.

Pacemaker

Another treatment option is a pacemaker to help control heart rhythms. These are small devices placed into the chest. They can slow the heart rate down when the heart is beating too quickly or increase heart rate if the heart is beating too slowly. Pacemakers are often used in combination with bypass surgery as well as medications.

Heart transplant

In the final stages of heart failure, a heart transplant is an option if all other treatments have failed. All or part of the heart is replaced with a healthy heart from a donor.

How to prevent heart failure?

To begin with, a healthy lifestyle can help treat heart failure and prevent the condition from developing in the first place. Losing weight and exercising regularly decrease your risk of heart failure. Going easy on the salt in your diet is also important to lower the risk.  Besides this, the following healthy habits help:

• Reducing alcohol intake
• Quitting smoking
• Avoiding high-fat foods
• Getting enough sleep

What are the complications of heart failure?

If left untreated, heart failure can eventually lead to a life-threatening condition called congestive heart failure (CHF), where blood builds up in other areas of the body. When this happens, there is fluid retention in the limbs as well as in the organs, such as the liver and lungs.

Heart failure can also result in a heart attack. Emergency services should be contacted if the following symptoms are seen:

• Unbearable chest pain
• Squeezing or tightness in the chest
• Discomfort in the upper body such as numbness or coldness
• Extreme fatigue
• Dizziness
• Rapid heart rate
• Nausea and vomiting
• Cold sweats and chills

Prognosis for people with heart failure

As mentioned earlier, left untreated, heart failure can lead to complications or fatal consequences. It is a long-term condition requiring ongoing treatment.

Heart failure can happen to anyone. Therefore, it is crucial to live a healthy lifestyle. Any unusual symptoms must immediately be attended to. Since heart failure is a chronic condition, symptoms can only get worse over time. While medication and surgery may relieve symptoms, a severe case of heart failure can be life-threatening. To avoid this, timely diagnosis and treatment are important. If you or someone you know are showing signs of heart failure, contact your doctor right away.

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