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From symptoms to treatment, know all about heart failure

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heart failure

One way to prevent heart failure is to manage conditions like high blood pressure, diabetes or obesity, which leads to heart failure. Here, we tell you everything you need to know about heart failure and preventive measures.

What is heart failure?

Heart failure is a common medical condition wherein there is an inability of the heart to pump blood as per the body’s requirement. If you have heart failure, it means that your heart is not working as it should.

Ejection Fraction (EF) is a measurement used by physicians to determine how well your heart is functioning. Normally, we say that the heart’s pumping capacity is around 60% (ejection fraction), that means if 100 ml of blood reaches the heart, 60% is pump back into the circulation that is the normal heart. And, if the patient has heart failure then this pumping fraction would come down to 30-35%, or sometimes less than that. Thus, a heart cannot pump blood, and as a result, the body doesn’t get adequate blood supply. Moreover, there is fluid accumulation in the lungs and body.

The symptoms

Patients may exhibit symptoms like breathlessness, swelling of the body and fatigue. Furthermore, when it comes to advanced heart failure, there will be loss of appetite and weight.

Why does heart failure set in?

Heart failure strikes when the muscles of the heart fails to pump blood. If someone has developed a heart attack in the past as due to it, the blood pumping capacity of the heart drastically goes down. Other common causes of it are untreated hypertension, diabetes, a viral infection of the heart that causes muscles to become weak, over intake of alcohol, hereditary condition of heart failure, chemotherapeutic drugs, and certain nutritional deficiencies like the lack of adequate vitamins, while pregnancy is rarely associated with heart failure.

What is the difference between a heart attack and heart failure?

Heart attack means a sudden blockage that occurs in one of the blood vessels of the heart, which is also known as myocardial infarction. Here, one portion of the heart suddenly stops pumping blood. Moreover, it can give rise to chest pain, cause sudden death, and if left untreated, then it may lead to heart failure.

What is the treatment for heart failure?

Patients with heart failure are managed on medical terms. If medicines are included to push the fluid outside of the body, the doctor will check if there is any treatable cause for heart failure. Angiography is done to see if there are any treatable blockages. Thus, we treat the blockage with the hope and intent that doing so can increase the pumping in the heart, and the patient can tackle heart failure. If regular medicines and follow up fail to give symptomatic improvement, then we have advanced treatment options. In some patients, certain pacemakers called cardiac resynchronization therapy (CRT). It is a type of treatment for people with heart failure to help correct serious heart rhythm problems, and pumping of the heart, by surgically inserting it beneath the skin, and the chest.

But, in spite of medications, a close follow up, and pacemaker, one’s health continues to deteriorate and has to be hospitalized multiple times, as the symptoms recur, then the option is a cardiac transplant. It is done from a cadaver donor (that is a brain dead donor), whose family has agreed to donate the organ. Then, in a matched recipient, the heart is transplanted, and there is a considerable improvement in the patient, post-transplant. Also, after the transplantation, the patient has to take care, and medications, as there will be a risk of infection or the organ rejecting the new organ. So, focus care is required. Also, remember that the transplant option is only offered when there is advanced heart failure, which is not responding to any conventional treatment.

What are the preventive measures?

One must take care of the risk factors which cause heart failure. If you have hypertension, treat it even if you don’t notice any symptoms. Many people, who don’t have symptoms, tend to discontinue their medications. Doing so is a strict no-no. Treating underlying risk factors like hypertension, diabetes, obesity, is essential. As these patients will have severe complications which can increase their risk of heart failure. Cut down on smoking and alcohol, and exercise regularly to battle the bulge, and maintain a healthy weight. If someone has heart failure then the person needs a close follow-up with a cardiologist. Not only this, the patient is also advised to reduce salt and water intake. This is so because the extra salt can burden the heart, whereas, that extra water can put additional stress on the heart. The recommended salt intake for adults is 5 gms per day.

(Disclaimer: The writer is Dr Praveen Kulkarni, Senior Cardiologist, Global Hospital, Mumbai. Views expressed are a personal opinion.)

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