What is Heart Failure?: Causes, Symptoms, Types, Treatment

   OVERVIEW

What is Heart Failure?

Heart failure occurs when the heart is unable to properly pump blood throughout the body. It usually occurs as a result of the heart becoming too weak or stiff. It is also recognized as congestive heart failure, though this term is no longer widely used.

Heart failure does not imply that your heart has stopped functioning. It means it requires assistance to function properly. It can happen at any age, but it is most common in older people. Heart failure is a chronic condition that worsens gradually over time.

It is not usually curable, but the symptoms can often be managed for many years.

CAUSES & SYMPTOMS

Causes of Heart Failure:

Heart failure is most often related to another condition. The most common cause of heart failure is coronary artery disease (CAD), a disorder that causes narrowing of the arteries that supply blood and oxygen to the heart.

Other conditions that may increase your risk of developing heart failure include:

• cardiomyopathy, a disorder of the heart muscle that causes the heart to become weak
• congenital heart disease
• smoking
• heart attack
• heart valve disease
• certain types of arrhythmias, or irregular heart rhythms
• high blood pressure
• emphysema, a disease of the lung
• untreated sleep apnea
• diabetes
• an overactive or underactive thyroid
• HIV
• severe forms of anemia
• certain cancer treatments, such as chemotherapy
• substance misuse disorder

Symptoms of Heart Failure:

Heart failure symptoms can differ from person to person. They could begin suddenly or grow gradually over the course of weeks or months.

Heart failure’s most typical signs and symptoms are:

The most common symptoms of heart failure are:

• breathlessness – this may occur after activity or at rest; it may be worse when you’re lying down, and you may wake up at night needing to catch your breath
• fatigue – you may feel tired most of the time and find exercise exhausting
• swollen ankles and legs – this is caused by a build-up of fluid (oedema); it may be better in the morning and get worse later in the day
• feeling lightheaded and fainting

Less common symptoms:

Other symptoms of heart failure can include:

• a persistent cough, which may be worse at night
• wheezing
• a bloated tummy
• loss of appetite
• weight gain or weight loss
• confusion
• a fast heart rate
• a pounding, fluttering or irregular heartbeat (palpitations)

Some people with heart failure may also experience feelings of depression and anxiety.

 TYPES

Types of Heart Failure:

Heart failure occurs when the heart is unable to adequately pump blood throughout the body. Either the cardiac muscle is too fragile or not flexible enough. Additionally, other heart organs may be impacted. Depending on the type of heart failure a person has, they may need a different kind of medication to treat it.

Although it can affect both sides of the heart, heart failure often only affects the left or right side. Accordingly, doctors distinguish between three types of heart failure:

• Left-sided heart failure: Heart failure on the left side occurs when the left ventricle is unable to adequately pump blood throughout the body. Blood accumulates in the pulmonary veins as a result (the blood vessels that carry blood away from the lungs). Shortness of breath, breathing issues, or coughing result from this, especially when engaging in vigorous exercise. The most typical kind of heart failure is left-sided.
• Right-sided heart failure: Heart failure on the right side occurs when the right ventricle is unable to adequately pump blood to the lungs. Due to this, blood accumulates in the veins (the blood vessels that carry blood from the organs and tissue back to the heart). The veins’ elevated internal pressure may cause fluid to leak into the nearby tissue. This causes fluid to accumulate in the legs, or less frequently in the genital region, organs, or abdomen (belly).
• Biventricular heart failure: Both sides of the heart are impacted by biventricular heart failure. Shortness of breath and a fluid buildup are common signs of both left- and right-sided heart failure in this situation.

TREATMENT

Treatment of heart failure:

The severity of your disease and the type of heart failure you have will determine how you should be treated. Early intervention can quickly reduce symptoms, but you should continue to undergo routine testing and follow up visits with your doctor every three to six months. Increasing your longevity is the major objective of treatment.

One or more of the following therapies could be used to treat heart failure:

• medication
• bypass surgery
• percutaneous coronary intervention
• a pacemaker
• an implantable cardioverter defibrillator (ICD)
• transplant surgery

Let’s examine each of these procedures and what they include in more detail.

Medication:

To assist ease your symptoms and stop your condition from growing worse, early stages of heart failure may be managed with medicine. Some medicines are prescribed for:

enhance the capacity of your heart to pump blood

• decrease blood clots
• reduce your heart rate, when necessary
• remove excess sodium, and top up your potassium levels
• cut back on cholesterol levels
• lessen the negative hormones and bodily processes that can cause the heart to weaken

These medicines could be:

• blood thinners
• inhibitors of the angiotensin converting enzyme (ACE)
• blockers of the angiotensin II receptor (ARBs)
• medicines that decrease cholesterol
• calcium channel blockers
• beta-blockers
• angiotensin receptor-neprilysin inhibitors (ARNI)
• Inhibitors of sodium-glucose cotransporter-2 (SGLT2)
• hydralazine
• ivabradine
• verquvo (vericiguat), depending on the situation.

Surgery

Bypass surgery

Heart failure patients sometimes require surgery, such as coronary bypass surgery. Your surgeon will join a healthy section of an artery or vein to the occluded coronary artery during this procedure. This enables the blood to pass through the new artery instead of the clogged, damaged one.

Percutaneous coronary intervention (PCI)

Additionally, your doctor might advise a procedure called a percutaneous coronary intervention (PCI). A catheter with a little balloon attached is placed into the blocked or congested artery during this treatment. Your surgeon opens the injured artery by pumping a balloon into it after the catheter has reached it.
Your surgeon might have to insert a wire mesh tube known as a permanent stent into the blocked or congested artery. A stent keeps your artery open for good and can stop it from getting any narrower.

Pacemakers

Other heart failure patients will require pacemakers to help regulate their cardiac rhythms. These little gadgets are inserted into the chest. If your heart is pounding too quickly, they can slow it down; if it is beating too slowly, they can speed it up. In addition to medicines and bypass surgery, pacemakers are frequently used.

Cardioverter defibrillator implant (ICD)

An implantable cardioverter defibrillator (ICD) is a battery-operated device that monitors your heart rate and shocks your heart if it notices an irregular cardiac rhythm. The heart beat returns to its regular rhythm after this shock. People with an ejection fraction (the amount of blood your heart pumps out with each contraction) of less than 35% (if not due to blockages) and less than 30% (if due to blockages) are advised to get an ICD.

Organ Transplantation

When all other treatments for heart failure have failed, heart transplants are used. Your surgeon removes all or a portion of your heart during a transplant and replaces it with a donor heart. Heart failure patients sometimes require surgery, such as coronary bypass surgery. Your surgeon will join a healthy section of an artery or vein to the occluded coronary artery during this procedure. This enables the blood to pass through the new artery instead of the clogged, damaged one.