Heart Failure

Heart failure is a syndrome that causes a reduction in the heart's ability to pump blood. Normally, the heart pumps blood to supply vital nutrients and oxygen to all parts of the body. In heart failure, the heart has difficulty pumping adequately and starts to function in an abnormal manner in order to compensate.

Types of heart failure

Heart failure may arise in the following ways:

Heart failure occurring due to failure of the left ventricle muscle to pump blood around the body. This is called left ventricular systolic dysfunction (LVSD) or left ventricular failure (LVF).

Backward failure or right ventricle failure leads to an excess accumulation of fluid in the body and edema, called anasarca. This usually causes the feet and legs to swell up. The liver may also become enlarged and blood coagulation problems may manifest.

Biventricular failure refers to when both the left and right ventricles fail to work as usual.

Heart failure where the amount of blood ejected or ejection fraction remains constant. This is termed heart failure with preserved ejection fraction (HFPEF) and occurs when the ventricle becomes stiff and fails to expand and fill up with the blood before pumping it out.

Heart failure occurring due to disease of the heart valves.

Causes of heart disease

Some of the causes and triggers of heart failure include:

• Coronary heart disease
• High blood pressure
• Weakened heart muscles or cardiomyopathy
• Heart rhythm abnormality or arrhythmia
• Heart valve disease
• Severe anemia
• Hyperthyroidism or overactive thyroid gland
• Pulmonary hypertension

Symptoms of heart failure

Symptoms of heart failure vary according to the type and severity of the heart failure but, commonly, symptoms include breathlessness and coughing, extreme weakness and fatigue and swelling in various parts of the body.

Diagnosis and treatment of heart failure

In many people, heart failure is a lifelong condition that cannot be cured. Treatment aims at maximizing heart function and improving quality of life. This may be achieved through:

Lifestyle changes including regulating water and salt intake and stopping smoking and alcohol drinking.

Taking medications (such as digoxin) may help the heart to pump more effectively and diuretics can reduce the fluid load in the body. In addition, angiotensin receptor blockers (eg, losartan, valsartan and candesartan) reduce blood pressure and also lead to modifications in the heart muscles that can help to correct heart failure to a certain extent.

Surgical correction and use of medical devices such as heart valves or pacemakers.