Heart failure, also known as congestive cardiac failure, is a condition in which the heart is not able to pump the blood the way it should. In some cases the heart can't fill with enough blood. In other cases the heart can't send blood to the rest of the body with the enough force. Some people have both problems.
Heart failure does not mean the heart has stopped working rather it means the hearts pumping power is weaker than normal.
It can affect the right side of the heart only or both the left and right sides of the heart.
Right side heart failure occurs when the heart can't pump blood to the lungs where it picks up oxygen. Left side heart failure occurs when the heart can't pump enough oxygen rich blood supply to the rest of the body.
Causes of Heart Failure
The leading causes of heart failure are : -
Coronary artery disease: A disease of the arteries that supply blood and oxygen to the heart causes increased blood flow to the heart muscles. If the arteries become blocked or severely narrowed the heart becomes starved for oxygen and nutrients.
High blood pressure
Diabetes
Cardiac valve disease-caused by past rheumatic fever or other infections.
Infections of cardiac valves and cardiac muscles(i.e. endocarditis)
Cardiac arrhythmias
Congenital heart defects/disease (present at birth)
Chronic lung disease and pulmonary embolism
Previous heart attack(s) (myocardial infarction)
Hemorrhage and anemia
Drug induced heart failure
Symptoms of Heart Failure
The following are the most common symptoms of heart failure. However each individual may experience symptoms differently.
Symptoms can include : -
Shortness of breath during rest, exercise or lying flat.
Fatigue(tiredness) and weakness
Swelling in the ankles, feet, legs, abdomen and rarely the veins in neck.
Persistent cough often produces mucus or blood tinged sputum
Weight gain
Reduced urination
Rapid or irregular heart beats
The severity of symptoms depends on how much of the hearts pumping capacity has been lost.
Diagnosis Of Heart Failure
To diagnose a heart failure doctor will take a careful medical history and perform a physical examination
Chest X-Ray for the size of heart and whether there is fluid build up around heart and lungs.
Echocardiogram-A non invasive test that uses sound waves to produce a study of the motion of the hearts chamber and valve. The echo sound waves create an image on the monitor as a ultrasound transducer is passed over the heart This shows the heart movement
ECG (electrocardiogram): Records the electrical impulses traveling throughout the heart.
Blood test: To check cholesterol (LDH, HDL) and triglycerides are measured to determine the risk for coronary artery disease, cardiac disease and congestive cardiac failure.
BNP Blood test (B-type Natriureteric Peptide) This new test checks level of hormone called BNP which rises during heart failure is a common marker test which indicates left heart failure.
Thyroid function tests: These determine if the thyroid gland is working effectively. Both an overactive and under active thyroid gland can make an already weakened heart work harder tipping it over the edge into failure.
Coronary Cauterization (Angiogram): In this test a thin tube (catheter) is inserted into a blood vessel at your groin or arm and guided through the aorta into your coronary arteries. A dye injected through the catheter makes the arteries supplying your heart visible on X-ray. This test helps doctors identify narrowed arteries to your heart (Coronary artery disease) that can be a cause of heart failure.
Positron emission tomography (PET): PET scanning shows the level of chemical activity in areas of your heart. This scan can help your doctor see whether enough blood is flowing to these areas. It can show blood flow problems that other types of scans may not pick up.
Stress Test.
Treatment of Heart Failure
Medicinal Treatment : -
Diuretic : - Diuretics help the body excrete excessive fluid and salts, reducing the strain on the heart and blood vessels. If you take diuretics, you may need to take a potassium supplement because some diuretics cause a loss of potassium.
ACE inhibitors : - ACE inhibitors prevent the formation of a hormone that makes the blood vessels contract. This means that less effort is needed by the heart to pump blood.
Aldosterone antagonists trigger the body to get rid of salt and water through urine, which lowers the volume of blood that the heart must pump.
Angiotensin receptor blockers relax your blood vessels and lower blood pressure, so the heart doesn't have to work as hard.
Beta blockers slow your heart rate and lower your blood pressure to decrease the workload on your heart.
Agents for increasing cardiac function Digoxin (e.g. Lanoxin) helps the heart contract more vigorously.
Nitroglycerin and other nitrates : - Nitrates such as glyceryl trinitrate or isosorbide mononitrate (eg Imdur) make the veins and arteries relax and widen (dilate). When the blood vessels dilate in this way there is more space inside them and so less resistance. This makes it easier for the heart to pump blood around the body.
The list of of world class heart hospitals in India is as follows : -
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Patient Storys
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