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What is Heart Failure?

Heart failure is a common condition where the pumping function of the heart reduces drastically such that it cannot supply enough blood to the rest of the body. This is often seen in the elderly or persons suffering from heart disease for many years. It is a medical emergency and must be immediately treated in a hospital.

What are its main signs and symptoms?

The common signs and symptoms are:

What are its causes?

The chief causes of heart failure are as follows:

  • Cardiac causes such as
    1. High blood pressure
    2. Stenosis (Aortic or Pulmonary i.e. narrowing of blood vessels)
    3. Structural defects like interatrial or interventricular septal defect (hole in the walls of the heart)
    4. Myocardial Infarction (damage of heart muscle)
    5. Infective Endocarditis
  • Other causes include
    1. Infections
    2. Pulmonary embolism (blood clot in the lungs)
    3. Overdosage of Drugs like beta-blockers, non-steroidal anti-inflammatory drugs, etc
    4. Physical and emotional stress

How is it diagnosed and treated?

The doctor will take a detailed history of the patient to understand the symptoms, take blood pressure readings and also check for heart sounds.

Diagnosis is made by both laboratory tests as well as physical examination by a doctor. Laboratory testing is done to asses  

  • Urea
  • Electrolytes
  • Complete blood count
  • BNP (Brain natriuretic peptide)
  • Liver function
  • Kidney function

Imaging studies like Electrocardiogram (ECG),  chest X-ray and Echocardiography will also be performed.

Management of a patient with cardiac failure is as follows:

  • Physical and emotional rest
  • Weight loss
  • Treating breathlessness by providing oxygen therapy
  • Diet counselling
  • Stoppage of alcohol and smoking
  • Regular physical exercise

Drug therapy involves the following drugs:

  • Diuretics
  • Vasodilators
  • ACE inhibitors
  • ARBs
  • β-blockers
  • Statins
  1. Medicines for Heart Failure

References

  1. Stuart Ralston, Ian Penman, Mark Strachan, Richard Hobson. Davidson’s Principle and Practise of Medicine. 23rd Edition: Elsevier; 23rd April 2018. Page Count: 1440
  2. Aggarwal Praveen et al. Textbook of Medicine by K. George Mathew. Elsevier India, 2011; 878 pages
  3. American Heart Association. What is Heart Failure?. [Internet]
  4. Arati A. Inamdar et al. Heart Failure: Diagnosis, Management and Utilization. J Clin Med. 2016 Jul; 5(7): 62. PMID: 27367736
  5. Nahid Azad et al. Management of chronic heart failure in the older population. J Geriatr Cardiol. 2014 Dec; 11(4): 329–337. PMID: 25593582

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