What is heart failure?
Heart failure is a chronic, progressive heart disease that reduces the heart’s pumping power, because the cardiac muscle is weaker than normal. Heart failure doesn’t mean that the heart has stopped beating, but rather that the level of function has dropped. The body’s cells need oxygen and nutrients to function, and for this to happen, it is essential that the heart is able to pump blood forward to the rest of the body, so the ‘old’ blood, low in oxygen and nutrients, can be replaced by ‘new’ blood, rich in oxygen and nutrients. Heart failure will therefore reduce the supply of fresh blood to the body’s cells. This will cause a number of symptoms from different organs as a shortage of oxygen and nutrients will result in dysfunctional cells.
The average age of heart failure patients in the UK is 76 years, and the number of people who are diagnosed with heart failure each year is on the rise. Around 900,000 people suffer from heart failure in the UK.
What are the symptoms of heart failure?
- Breathlessness or difficulty breathing
- A persistent cough and wheezing
- Swollen ankles and legs/oedema
- Nausea and loss of appetite
- Confusion and reduced cognition
- A fast heart rate
Unfortunately, many of these symptoms are associated with poor physical fitness, obesity and old age as well, and therefore they are often neglected. Heart failure is a serious condition, and early diagnosis and treatment will improve the prognosis.
Why do these symptoms occur?
Because the heart’s ability to pump is weakened, the blood supply to the rest of the body is insufficient. This causes blood to back up, or ‘congest’, into the veins that carry blood through the lungs. The increased amount of blood in the lungs increases the blood pressure in the small veins, and fluid is pushed into the alveoli in the lungs. This causes shortness of breath and wheezing. Because the heart pumps less blood to the body, the amount of blood returning to the heart will be reduced as well. Thus, the blood will accumulate in the veins, causing fluid to build up in the tissues. This causes swollen legs and feet.
When the levels of oxygen are insufficient, the body will prioritise the most important organs, such as the brain, and supply them with oxygen at the expense of e.g. muscles and intestines. Because of this, patients suffering from heart failure often feel exhausted, and they often experience indigestion. When the levels of important nutrients in the blood are reduced, the brain can’t function properly, and thus some people experience reduced mental activity. The heart will attempt to compensate for the reduced amount of blood pumped per heartbeat by increasing the heart rate.
What causes heart failure?
People, who develop heart failure, often have other diagnoses as well, or they have experienced symptoms from the heart prior to the diagnosis. Several diseases can lead to heart failure. The most common conditions that can lead to heart failure include coronary heart disease, hypertension, and heart attacks. In addition, congenital heart defects, faulty heart valves or cardiomyopathy, severe lung conditions, diabetes, obesity, sleep apnoea, alcohol and certain types of medication might lead to heart failure.
To compensate for the weakening, the heart will grow bigger and pump faster in an attempt to increase the amount of blood pumped into the aorta per minute. In addition, the blood vessels will contract and narrow to compensate for the blood pressure drop, caused by the reduced amount of blood per heartbeat. At the same time, the blood will be lead to the most essential organs. These mechanisms will conceal the condition for a while, but at some point, they will no longer be sufficient, and the patient will experience shortness of breath and exhaustion, especially during physical activity.
How is heart failure treated?
To diagnose heart failure, the doctor will make an electrocardiogram and conduct an ultrasound examination of the heart. After this, the doctor will make a treatment plan based on age, severity, cause and general state of health.
Frequently, the doctor will recommend that the patient quits smoking, loses weight, increases the amount of physical activity and reduces the intake of salt and alcohol if these factors are thought to be beneficial in the treatment of the disease. In addition, a variety of medication with different effects can help alleviate the symptoms. The most commonly used medication include beta blockers, ACE-inhibitors, digoxin and diuretics.