Heart Failure: Key points on the silent killer everyone must be aware of

Heart failure (HF) occurs when the heart is unable to pump blood efficiently to meet the body's needs. It is a chronic condition that can develop gradually. There are several types of heart failure:

Left-Sided Heart Failure: The left side of the heart is impaired, leading to fluid accumulation in the lungs (pulmonary congestion).

Right-Sided Heart Failure: The right side of the heart struggles, causing fluid buildup in the body’s tissues and organs (peripheral edema).

Congestive Heart Failure (CHF): This term often refers to both left- and right-sided heart failure combined, with symptoms of fluid retention.

What causes heart failure
Heart failure can result from various underlying conditions, including:

• Coronary Artery Disease (CAD): Narrowing of the arteries that supply blood to the heart muscle.
• Hypertension: High blood pressure that forces the heart to work harder.
• Myocardial Infarction: A heart attack that damages the heart muscle.
• Cardiomyopathy: Diseases of the heart muscle that can affect its ability to pump blood.
• Heart Valve Disease: Malfunction of heart valves that affects blood flow.

What are the symptoms of heart failure?
Common symptoms of heart failure include:

• Shortness of breath: Particularly during physical activity or when lying flat.
• Fatigue: Feeling unusually tired or weak.
• Swelling: In the legs, ankles, or abdomen due to fluid retention.
• Persistent cough: Often with a frothy or pink-tinged sputum.
• Rapid or irregular heartbeat: Palpitations or a racing heart.

DiagnosisDiagnosing heart failure typically involves:

• Medical history and physical examination: Assessing symptoms and listening for abnormal heart sounds or fluid in the lungs.
• Blood tests: Checking for markers such as B-type natriuretic peptide (BNP) that indicate heart strain.
• Imaging tests: Including chest X-rays and echocardiograms to evaluate heart structure and function.
• Electrocardiogram (ECG): Monitoring electrical activity and identifying arrhythmias.

Treatment
Managing heart failure often involves a combination of lifestyle changes, medications, and possibly procedures:

Lifestyle changes: Dietary modifications (low-sodium diet), regular exercise, and weight management.

Medications: Commonly prescribed drugs include ACE inhibitors, beta-blockers, diuretics, and aldosterone antagonists.

Procedures: In severe cases, treatments like implantable devices (e.g., pacemakers, defibrillators) or heart transplantation may be considered.

Prevention
Preventing heart failure involves managing risk factors and maintaining overall heart health:

Control Blood Pressure: Regular monitoring and treatment if elevated.

Healthy Diet: Low in saturated fats, cholesterol, and sodium.

Regular Exercise: Engaging in moderate physical activity.

Avoid Smoking and Limit Alcohol: Both can exacerbate heart conditions.

Manage Chronic Conditions: Effective management of diabetes, high cholesterol, and other health issues.

Prognosis and Outlook

Heart failure is a serious condition but can be managed effectively with proper treatment and lifestyle adjustments. Prognosis varies based on the severity, underlying causes, and response to treatment. Regular follow-up with healthcare providers is crucial for optimizing management and improving quality of life.

Living with Heart Failure

Patients with heart failure should work closely with their healthcare team to monitor symptoms, adhere to treatment plans, and make necessary lifestyle changes. Support from family, friends, and heart failure support groups can also be valuable in managing the condition and maintaining emotional well-being.

Understanding heart failure is essential for managing the condition effectively. Awareness of its causes, symptoms, and treatments can empower patients to take control of their health and work towards a better quality of life.

(Author: Dr. Lakshmi Kanth P, MBBS, MD (General Medicine), DM (Cardiology), Consultant & Interventional Cardiologist, Apollo Hospitals, BG Road, Bangalore)