Heart Failure

Heart Failure or Heart Attack

Overview, Causes, Symptoms, and Management

What is Heart Failure?

A chronic condition known as heart failure (HF) occurs when the heart is unable to pump enough blood to meet the body's needs. It happens when the heart muscle weakens or stiffens, which prevents enough oxygen and nutrients from being circulated. Heart failure, despite its name, refers to an inefficient heart rather than a failing heart.

Types of Heart Failure

There are three types of heart failure.

1. Left-Sided Heart Failure
• Systolic HF (HF with Reduced Ejection Fraction - HFrEF): The heart's left ventricle cannot contract strongly enough, reducing blood flow.
• Diastolic HF (HF with Preserved Ejection Fraction - HFpEF): The left ventricle stiffens and cannot relax properly, impairing filling.
2. Right-Sided Heart Failure
• Often caused by left-sided failure or lung diseases (e.g., pulmonary hypertension), leading to fluid build-up in the legs and abdomen.
3. Congestive Heart Failure (CHF)
• A progressive condition where fluid accumulates in the lungs, legs, and other tissues due to poor circulation.

Causes and Risk Factors

• Coronary artery disease (CAD) and heart attacks (most common cause).
• High blood pressure (hypertension) – forces the heart to work harder.
• Cardiomyopathy (disease of the heart muscle).
• Arrhythmias (irregular heartbeats).
• Valvular heart disease (e.g., aortic stenosis, mitral regurgitation).
• Diabetes, obesity, and metabolic syndrome.
• Chronic lung diseases (e.g., COPD).
• Alcohol/drug abuse, chemotherapy drugs.
• Aging (risk increases with age).

Symptoms

• Shortness of breath (especially when lying flat or during exertion).
• Fatigue and weakness.
• Swelling (edema) in legs, ankles, and abdomen.
• Persistent cough or wheezing (due to fluid in lungs).
• Rapid or irregular heartbeat.
• Reduced exercise tolerance.
• Sudden weight gain (from fluid retention).

In severe cases, heart failure can lead to cardiac arrest or organ failure due to poor blood supply.

Diagnosis

• Medical history and physical exam (checking for fluid retention and abnormal heart sounds).
• Blood tests (BNP or NT-pro-BNP—markers of heart stress).
• Echocardiogram (assesses ejection fraction and heart structure).
• Electrocardiogram (ECG) (detects arrhythmias).
• Chest X-ray (shows heart enlargement or lung congestion).
• Cardiac MRI or CT scan (detailed heart imaging).

Treatment and Management

1. Lifestyle Modifications

• Low-sodium diet (to reduce fluid retention).
• Fluid restriction (in severe cases).
• Regular, moderate exercise (as tolerated).
• Weight management.
• Quitting smoking and limiting alcohol.

For lab testing Find A Lab Near You

2. Medications (Consult your doctor).

These are not suggestions. You should consult your doctor. It is a must. 

3. Surgical and Device Therapies

• Implantable cardioverter-defibrillator (ICD) (prevents sudden death from arrhythmias).
• Cardiac resynchronization therapy (CRT) (improves heart coordination)
• Ventricular assist devices (VADs) (mechanical pumps for severe cases).
• Heart transplant (for end-stage HF).

Prognosis

Although heart failure is a chronic, progressive condition, many people can lead active lives for years if it is properly managed. Results are improved by early diagnosis and treatment.

Complications

• Kidney damage.
• Liver congestion.
• Arrhythmias (atrial fibrillation, ventricular tachycardia).
• Sudden cardiac death.

Important

Heart failure is a serious but manageable condition. Lifestyle changes, medications, and advanced therapies can significantly improve quality of life. Regular follow-ups with a cardiologist are essential for optimal care.

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