Heart Failure

What is heart failure?

Heart failure, also known as congestive heart failure, is a long-term condition that worsens over time. It occurs when the heart is unable to pump blood as well as it should, usually because it has become too weak or too stiff. This causes blood to back up and fluid can build up in the lungs, leading to shortness of breath and lower extremities (feet / legs).

What are the different types of heart failure?

• Left-sided heart failure: Shortness of breath due to back up of fluids in the lungs
• Right-sided heart failure: Swelling due to back up of fluids in the abdomen, legs, and feet
• Systolic heart failure: Pumping problem indicated by the left ventricle not contracting vigorously
• Heart failure with preserved ejection fraction: Filling problem indicated by the left ventricle not relaxing or filling fully

What are the causes of heart failure?

Heart failure may develop following other conditions including:

• Coronary artery disease
• High blood pressure
• Cardiomyopathy (conditions affecting the heart muscle)
• Heart rhythm problems (arrhythmias)
• Damage or other problems with the heart valves
• Congenital heart disease (birth defects)
• Anaemia
• Overconsumption of alcohol
• Overactive thyroid
• High pressure in the lungs (pulmonary hypertension)

What are the symptoms of heart failure?

• Shortness of breath after activity or at rest
• Congested lungs
• Fatigue and weakness
• Swollen ankles and legs due to water retention
• Persistent cough
• Fast or irregular heart rate
• Dizziness

What are the risk factors of heart failure?

• Conditions such as coronary artery disease, heart attack, heart valve disease, congenital heart disease, high blood pressure, irregular heartbeats, diabetes, and viral infection that cause damage or weaken the heart
• Certain medications including diabetes drugs, nonsteroidal anti-inflammatory drugs (NSAIDs); certain anaesthesia medications; and certain medications used to treat high blood pressure, cancer, blood conditions, irregular or abnormal heartbeats, nervous system diseases, mental health conditions, lung and urinary problems, inflammatory diseases, and infections
• Drinking too much alcohol
• Sleep apnoea (unable to breathe properly while sleeping)
• Smoking
• Obesity

How is heart failure diagnosed?

• Medical history
• Symptoms and risk factors evaluation
• Blood tests
• Chest X-ray
• Electrocardiogram (ECG)
• Echocardiogram
• Stress test
• Cardiac computerized tomography (CT) scan
• Cardiac magnetic resonance imaging (MRI)
• Coronary angiogram
• Myocardial biopsy

What are the treatment options for heart failure?

• Healthy lifestyle changes
• Medication
• Devices implanted in the chest to control your heart rhythm
• Surgery e.g., bypass operation or heart transplant

What are the prevention tips for heart failure?

Reduce your risk factors for heart disease by making healthy lifestyle changes such as:

• Quitting smoking
• Keeping your high blood pressure and diabetes (if any) in control
• Staying physically active
• Eating healthy foods
• Maintaining a healthy weight
• Managing stress

References

1. Heart failure. Available at https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142?p=1 [Accessed on 29 April 2022]
2. Heart failure. Available at https://www.nhs.uk/conditions/heart-failure/ [Accessed on 29 April 2022]
3. Heart failure - Diagnosis. Available at https://www.mayoclinic.org/diseases-conditions/heart-failure/diagnosis-treatment/drc-20373148?p=1 [Accessed on 11 May 2022]