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Heart Failure, Symptoms, Causes, Types

by | Mar 4, 2022 | Info | 0 comments

Heart Failure Overview

Heart failure also known as congestive hear failure is a chronic, progressive condition, which is characterized by the heart’s inability to pump an adequate supply of blood to the body. Without sufficient blood flow, all major body functions are disrupted. Heart failure is a condition or a collection of symptoms that weaken or stiffen the heart.

The body relies on the pumping action of the heart to deliver nutrient’s and oxygen-rich blood to each of its cells. When the cells do not receive adequate nourishment, the body cannot function properly.

If the heart becomes weakened and cannot supply the cells with sufficient blood, it can lead to fatigue and shortness of breath. Everyday activities that used to be easy may become difficult and challenging.

Heart failure is a serious condition, in which the heart does not pump blood around the body efficiently.

Certain heart conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually makes the heart too weak or stiff to fill and pump blood properly.

According to the Centers for Disease Control (CDC) more than 6 million adults in the United States have heart failure, according to the Centers for Disease Control and Prevention. Children can also have heart failure, but this health topic focuses on heart failure in adults.

Most cases are diagnosed in men. However, women are more likely to die from heart failure when the condition goes untreated.

The condition can develop suddenly which is known as the acute kind or over time as your heart gets weaker, this is called the chronic kind. It can affect one or both sides of your heart.

Heart failure can damage the liver or kidneys. Other complications may include pulmonary hypertension or other heart conditions, such as an irregular heartbeat (arrhythmia), heart valve disease and sudden cardiac arrest.

Usually there is no cure for heart failure, but with the right treatment, people can often lead enjoyable and productive lives.


How the Normal Heart Works

The normal healthy heart is a strong, muscular pump a little larger than a fist. It pumps blood continuously through the circulatory system.

Human heart has four chambers, two on the right and two on the left:

  • Two upper chambers called atria (one is called an atrium)
  • And the two lower chambers called ventricles

The right atrium takes in oxygen-depleted blood from the rest of the body and sends it through the right ventricle where the blood becomes oxygenated in the lungs.

Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body.

The heart pumps blood to the lungs and to all the body’s tissues through a sequence of highly organized contractions of the four chambers. For the heart to function properly, the four chambers must beat in an organized way.


Different Types of Heart Failure

Heart failure can occur in either the left or right side of your heart. It’s also possible for both sides of your heart to fail at the same time.

Heart failure is also classified as either diastolic or systolic.

Left-Sided Heart Failure

Left-sided heart failure is the most common type of heart failure.

The left ventricle is located in the bottom left side of your heart. This area pumps oxygen-rich blood to the rest of your body.

Left-sided heart failure occurs when the left ventricle doesn’t pump efficiently. This prevents your body from getting enough oxygen-rich blood. The blood backs up into your lungs instead, which causes shortness of breath of breath and a buildup of fluid.

Right-Sided Heart Failure

The right heart ventricle is responsible for pumping blood to the lungs to collect oxygen. Right-sided heart failure occurs when the right side of your heart is not able perform its job effectively.

It’s usually triggered by left-sided heart failure. The accumulation of blood in the lungs caused by left-sided heart failure makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail.

Right-sided heart failure can also occur because of other conditions, such as lung disease or valve disease. Right-sided heart failure is marked by swelling of the lower extremities or abdomen. This swelling is caused by fluid backup in the legs, feet, and abdomen.

Diastolic Heart Failure

Diastolic heart failure occurs when the heart muscle becomes stiffer than normal. The stiffness, which is usually due to heart disease, means that your heart doesn’t fill with blood easily. This is known as diastolic dysfunction. It leads to a lack of blood flow to the rest of the organs in your body.

Diastolic heart failure is more common in women than men patients.

Systolic Heart Failure

Systolic heart failure occurs when the heart muscle loses its ability to contract. The contractions of the heart are necessary to pump oxygen-rich blood out to the body. This problem is known as systolic dysfunction, and it usually develops when your heart is weak and may be enlarged.

Systolic heart failure is more common in males than in female patients.

Both diastolic and systolic heart failure can occur on the left or right sides of the heart. You may have either condition on both sides of the heart.


Stages of Heart Failure

Following are the stages of heart failure:

  • Stage A: A person has not yet developed heart failure but has a high risk due to one or more pre-existing conditions, such as high blood pressure, coronary artery disease or diabetes.
  • Stage B: A person has not developed heart failure or its symptoms but has received a diagnosis of systolic left ventricular dysfunction.
  • Stage C: A person has ongoing or past symptoms of heart failure and currently has structural heart disease.
  • Stage D: A person has advanced heart failure that is difficult to manage with standard treatment.


Signs and Symptoms of Heart Failure

Following are the common signs and symptoms of heart failure:


Causes of Heart Failure

Chronic (long-term) heart failure is often caused by other medical conditions that damage or overwork your heart. Acute (sudden) heart failure can be caused by an injury or infection that damages your heart, a heart attack, or a blood clot in the lung. 

Any condition that damages the heart muscle can cause systolic heart failure. These conditions include the following:

  • Coronary Artery Disease: The coronary arteries supply the heart muscle with blood. If these become blocked or narrowed, the flow of blood diminishes, and the heart does not receive the blood supply that it needs.
  • Heart attack: This involves damage to the heart muscle. It can result from a sudden blockage of the coronary arteries that causes scarring and reduces how effectively the heart can pump. The damage may also result from an increased demand for blood flow due to a fixed blockage.
  • Nonischemic cardiomyopathy: This disease involves weakness of the heart muscle caused by something other than a blockage in the coronary arteries. Possible causes include genetic conditions, drug side effects, and infections.
  • Conditions that overwork the heart: Examples include valve disease, high blood pressure (hypertension), diabetes, kidney disease, sleep apnea, and heart irregularities present at birth.

Risk Factors of Heart Failure

Heart failure can happen to anyone. However, certain factors may increase your risk of developing this condition.

There is a higher incidence of heart failure in men compared with women, though the prevalence is about the same for all sexes.

Patients with diseases that damage the heart are also at an increased risk of heart failure.

These conditions include the following:

Certain behaviors can also increase a persons risk of developing heart failure, which includes the following:

  • Being overweight and obesity
  • Eating foods that are high in fat or cholesterol
  • Not getting enough exercise
  • Smoking

Diagnosis of Heart Failure

Your doctor may perform a physical exam to check for signs of heart failure. For instance, leg swelling, irregular heart rate, and bulging neck veins may lead your doctor to diagnose heart failure.

If a doctor suspects heart failure, they will recommend further tests, which may include the following:

  • Blood and urine tests: The aim is to check the person’s blood count, as well as their liver, thyroid, and kidney function and any indications of “stretch” in the heart. The doctor may also want to check the blood for specific chemical markers of heart failure.
  • Chest X-ray: The aim is to show whether the heart has become enlarged. It will also show whether there is fluid in the lungs.
  • An electrocardiogram: The aim is to record the electrical activity and rhythms of the heart. It may also reveal any damage from a heart attack.
  • An echocardiogram: This is an ultrasound scan that shows the pumping action of the heart. The doctor measures the amount of blood that leaves the left ventricle, the main pumping chamber, with each heartbeat. This measurement is called the ejection fraction.

The doctor may also do the following additional tests:

  • A stress test: The aim is to see how the heart responds to stress and determine whether there is a lack of oxygen due to blockages in the coronary arteries. A person may have to use an exercise machine, such as a treadmill, or take a medication that stresses the heart.
  • A cardiac MRI or CT scan: The aim is to measure the ejection fraction and examine the heart’s arteries and valves. The results can help the doctor determine whether the person has had a heart attack.
  • A PET scan: A doctor can examine the heart muscle and look for signs of rare causes of heart problems, such as sarcoidosis.
  • A B-type natriuretic peptide (BNP) blood test: The release of BNP into the blood occurs if the heart becomes overfilled and is struggling to function properly.
  • An angiogram: An angiogram is an X-ray of the blood vessels around the heart. A doctor injects dye into the coronary arteries to help detect coronary artery disease or narrowed arteries, which can cause heart failure.

Treatment of Heart Failure

Treatment of heart failure depends on the severity of the individuals condition and the type of heart failure they have.

Damage that affects the heart’s pumping action is not always reversible. Nevertheless, treatments can significantly improve the quality of life by keeping heart failure under control and helping to relieve many of the symptoms.

Doctors also focus on treating the cause of heart failure. This will reduce the burden on the heart.

Medications

Many medications can treat the symptoms of congestive heart failure. They include:

  • ACE inhibitors: These medicines reduce the heart’s workload by helping the arteries relax and lowering blood pressure.
  • ARBs: These reduce symptoms of heart failure and prevent blood pressure from rising. They include candesartan, losartan, and valsartan.
  • ARNIs: These reduce strain on the heart. 
  • Anticoagulants: These thin the blood, making it harder for the blood to clot and helping to prevent a stroke. Doctors closely monitor people who are taking these medications.
  • Antiplatelet drugs: These stop blood platelets from forming. Aspirin is an example, and it might be suitable for people with a very high risk of a heart attack or stroke and a low risk of bleeding — or for people who have had a heart attack or stroke.
  • Beta-blockers: Anyone with heart failure may benefit from taking beta-blockers. 
  • Diuretics: These help relieve ankle swelling, fluid retention, and breathlessness resulting from heart failure. Diuretics help the body remove water and salt. The two main types are loop and thiazide diuretics.
  • Digoxin: This drug slows the heartbeat and improves the strength of heart contractions.
  • MRAs: These block hormones produced by the adrenal glands that could damage the heart.
  • SGLT2 inhibitors: According to a recent study SGLT2 inhibitors which are lso called gliflozins, may help prevent and treat heart failure,

Surgery

Every patient with heart failure may not respond to drug treatments. In these cases, there are some surgical options:

Coronary artery bypass graft: Doctors commonly recommend this procedure when coronary artery disease is the cause of congestive heart failure.

Percutaneous coronary intervention: Sometimes called PCI, this is a nonsurgical procedure to place a stent in the heart to open up the blood vessels.

Pacemaker: This is a small device placed under the skin in the chest to help correct an irregular heartbeat.

Cardiac ablation: This procedure can help correct a heart rhythm problem. A catheter is inserted into the arteries or veins.

Heart valve surgery: This procedure repairs a defective valve that makes the heart pump inefficiently.

Implantable left ventricular assist device: For hospital inpatients who have not responded to other treatments, this can help the heart pump blood. Doctors may recommend them for patients who are waiting for a transplant.

Heart transplant: If no other treatments or surgeries help, a transplant is an option. Doctors only consider a transplant for a patient who is healthy beyond the problem affecting their heart.

 

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