Written By: Mihikaa Roy
Edited by: Rhysand Warner and Jessica Rubio
Introduction
Heart failure is the leading cause of the hospitalization of people above the age of 65. It occurs when the heart pumps abnormally and overtime, begins to lose its pumping function. This usually develops after the heart is damaged or weakened, leading to fatigue and shortness of breath. Congestive heart failure is rising due to more people surviving heart attacks and other heart conditions. As a result, the survivors are becoming more susceptible to heart failure in the future.
Causes
The most common cause of a heart failure is a myocardial infarction that happens as a result of coronary artery disease. This is better known as a heart attack. Heart attacks occur when a coronary artery is blocked, causing the blood to be unable to flow to all areas of the heart muscle. This may lead to the heart muscle cells dying, which could permanently damage the muscle.
Another cause is long-term undiagnosed or untreated high blood pressure, which is also known as hypertension. High blood pressure requires the heart to pump harder to move blood across the body, causing the left ventricle to become thicker or stiffer. It may also cause the coronary artery to become narrow and lead to coronary artery disease. Some uncommon causes of heart failure are heart valve disease, diabetes, obesity, and high blood cholesterol.
Symptoms
A typical symptom of heart failure is shortness of breath, particularly when lying down or exercising. This is caused by fluid backing up into the lungs or the body not receiving enough oxygen-rich blood. Sudden weight gain or swelling in the ankles, legs, or abdomen may also occur. This is because, when the kidney does not filter enough blood, the body retains the extra fluid and water. Rapid or irregular heartbeats may be a result of the heart compensating for its abnormal pumping or a large heart caused by a heart attack. Other symptoms include fatigue, dizziness, confusion, increased urination at night, dry cough, and a change in appetite.
Diagnosis and Treatments
Doctors will begin by taking the medical history of the patient, followed by an examination and tests to determine whether heart failure is present. The tests may include a blood test, brain natriuretic peptide (BNP) test, electrocardiogram (ECG), chest X-ray, echocardiogram, stress test, or a coronary angiogram.
Heart failure has no cure, but it can be improved with proper treatment. Treatments could include medication, surgery or lifestyle changes. Some common procedures and medical devices include:
Cardiac Resynchronization Therapy (CRT): A biventricular pacemaker could be implanted to make both ventricles contract at the same time.
Implantable Cardioverter Defibrillator (ICD): This device is implanted to regulate irregular heart rhythms. A small unit monitors the heart rhythm and generates an electric shock to restore the normal heart rate when necessary.
Heart Transplant: The failing heart and any pre-existing devices are removed, and are replaced by a donor’s heart.
Bypass Surgery: This surgery improves the blood flow to the heart by using a blood vessel from elsewhere in the body to create a detour or bypass around the blocked section of the coronary artery.
Percutaneous Coronary Intervention (PCI): A non-surgical procedure that uses a catheter to place a stent in the heart. This is used to open the blood vessels that have been narrowed by the plaque buildup.
If heart failure is not treated in time, it may lead to complications such as kidney failure or damage, heart valve or rhythm problems, and liver damage.
Living with Heart Failure
With early diagnosis and appropriate lifestyle changes, a patient can live a prolonged normal life and avoid visits to the hospital. Heart failure may be managed by taking medication regularly as prescribed by the healthcare provider or cardiologist. The patient should also weigh themselves regularly to ensure no sudden weight gain. Those with heart failure should regulate their fluid intake; they can drink no more than 1.5 to 2 liters of fluids per day with at least half of the fluid being water. Other management techniques include reducing salt intake, increasing physical activity, getting enough sleep, eating a healthy diet with plenty of fiber, reducing alcohol intake and caffeine consumption, and stopping smoking.
Prevention
Lifestyle changes can be introduced to reduce the risk factors of heart failure. Some examples are not smoking, controlling conditions such as high blood pressure and diabetes, staying active, eating healthy food, maintaining a good weight, and managing stress.
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Bibliography
“Heart Failure.” Heart and Stroke Foundation of Canada, www.heartandstroke.ca/heart-disease/conditions/heart-failure.
“Heart Failure.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 May 2020, www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142#:~:text=Heart%20failure%2C%20sometimes%20known%20as,to%20fill%20and%20pump%20efficiently.
“Heart Failure: Understanding Heart Failure.” Cleveland Clinic, 2020, my.clevelandclinic.org/health/diseases/17069-heart-failure-understanding-heart-failure.
Team, Heart and Vascular. “Heart Failure Before Age 65: How Does It Happen?” Health Essentials from Cleveland Clinic, 13 Feb. 2017, health.clevelandclinic.org/heart-failure-before-age-65-how-does-it-happen/.