Heart Failure

1. What is Heart Failure?

Heart failure is a condition in which heart does not pump enough blood to meet the body's demand for blood and oxygen. Most commonly there is a decrease in pumping function of the heart leading to a build-up of fluid in lungs and other parts of body, such as legs and abdomen.

It is important to note that the term "heart failure" does not mean that heart has stopped working.

2. ​What are the symptoms of heart failure?

The symptoms of heart failure are caused by fluid accumulation and poor blood flow to the body. The common symptoms of heart failure are:

· Shortness of breath on exertion, at rest or on lying down

· Swelling of legs, ankles or feet

· Distension of abdomen

· Reduced urine output

· Weight gain due to fluid retention

· Fatigue and weakness

· Reduced ability to exercise

· Wheezing or Cough (cough may be dry or associated with pink coloured sputum)

· Lack of appetite and nausea

3. What are the causes of heart failure?

The common causes of heart failure are coronary artery disease, high blood pressure, disease of heart muscle, irregular rhythms, etc.

· Coronary artery disease which leads to luminal narrowing of heart blood vessels thereby reducing blood flow, damaging and weakening heart muscles.

· If blood pressure is persistently high for a long time, it may lead to heart failure.

· Disease of heart muscle called Cardiomyopathy is a condition in which heart becomes enlarged or stiff due to thickening of muscles leading to impairment of heart function

· Irregular rhythms especially those associated with very high heart rates

· Inadequate opening or closure of valves of heart

· Infections can also precipitate heart failure; this is called myocarditis.

4. What are the tests suggested for a heart failure patient?

Besides clinical examination, the tests commonly performed for a heart failure patient are:

· Electrocardiogram (ECG)

· Echocardiography

· Chest x-ray

· Blood tests including blood counts, Kidney and liver function test, electrolytes, thyroid function test and more importantly NT Pro BNP level which quantifies the degree of heart failure and also prognosticates it.

· Coronary angiography is usually performed in patients with heart failure to rule out coronary artery disease.

5. What is the treatment for heart failure?

The treatment for Heart failure includes Lifestyle modifications, Medications, Device therapy and Heart Transplantation.

Lifestyle modifications include

· Restricting fluid intake

· Reducing salt intake and

· Monitoring symptoms, blood pressure, pulse rate, body weight etc.

Medications are very essential for treating heart failure as they improve symptoms, quality of life, reduce mortality and repeated hospitalisation.

Device therapy includes ICD device implanted to treat arrhythmias and also devices such as CRT, Impella and LVAD to improve pumping function of heart

Finally Heart Transplantation is a surgical procedure that involves replacing a failing heart with a healthy heart from a donor.