Heart Failure



HEART AND FUNCTIONS

Heart is a muscular organ located just to the left of the breastbone and within the chest cavity. It has four chambers:

Valves help direct blood flow. As they open and close, the valves produce sounds that can be heard with a stethoscope. There are four valves in the heart. Every cell in the body needs oxygen to live and function. The role of the heart is to deliver the oxygen-rich blood to every cell in the body. The arteries are the pathways through which blood is delivered. The largest artery is the aorta, which branches off the heart and then divides into many smaller arteries. The veins carry the deoxygenated blood back to the lungs to pick up more oxygen, and return an oxygen-rich blood to the heart. The blood flows continuously through the circulatory system, and the heart muscle is the pump that makes it possible.


WHAT IS HEART FAILURE

Heart failure is the inability of heart muscles to adequately pump blood in the body. There may be many causes for such weakness of the heart muscles, e.g. high blood pressure, coronary artery disease, heart attack, diabetes, congenital heart disease or severe lung disease. As a result, the ability of the heart to pump blood is reduced and blood begins to back up in the chambers of the heart, which in return backs up in the lungs and body tissues. This results in fluid accumulating in the lungs (shortness of breath) and tissues (swelling). In addition, the vital organs receive less blood. The kidney reacts by retaining water and salt. Extra salt in the body causes further fluid retention.


DIAGNOSIS OF HEART FAILURE

The diagnosis of heart failure can often be made on the basis of medical history and physical examination. Laboratory investigation and cardiac tests like ECG and echocardiography not only help in the confirmation of diagnosis but also assist doctors in assessing the severity of the disease as well as in identifying the cause of heart failure. Heart failure may develop slowly over the period of several days or weeks (chronic) or suddenly that is the acute heart failure, which is also called pulmonary edema. Chronic heart failure may or may not require hospital admission, depending on how severe it is.


SIGNS AND SYMPTOMS OF HEART FAILURE

The warning signs of heart failure are:


TREATMENT OF HEART FAILURE

Heart failure is a serious condition, and there is usually no cure for it. But in most cases, heart failure can be controlled by taking medications and making healthy changes in lifestyle, such as eating a healthy diet and doing moderate exercise. Treatment of heart failure is directed towards bringing the demand and supply of blood in the body into proper balance. There are three goals of treating heart failure:

We can achieve the above-mentioned goals through:


MEDICATIONS

Dioxin (Lanoxin)

This is one of the oldest medicines used in heart failure. It strengthens the heart muscles and enables the blood and oxygen to be pumped more forcefully and effectively to the body.


Caution

It is very important to take the exact amount of medication even if you are feeling better.
Inform your doctor if you have:

Diuretics

These medications are often called "water pills". They assist your body in removing water and salt, which help to decrease the workload of your heart, lower the blood pressure and maintain weight.


Potassium (K+)

This is a mineral needed by heart muscles to contract and relax properly. Since some diuretics cause loss of K+, you may need to take food rich in potassium like citrus fruit and bananas. You may need to take potassium supplements as well. Check with your doctor if you need to take any special diet for this purpose. Call your doctor if you feel any weakness or muscle cramps.


Vasodilators (ACE Inhibitor and Angiotensin Receptor Blockers)

These medications relax your blood vessels and lower the blood pressure so that your heart does not need to work as hard. Caution: Lie down straight on the bed for five minutes after taking these medicines, to avoid dizziness. These drugs have been proven to increase survival in heart failure, therefore, you must continue to take these medicines regularly. Contact your doctor for symptoms of dizziness or cough.


DIET

You can help your heart work better by reducing salt intake. Generally you do not need to completely eliminate the use of salt in your food but by taking a low-salt diet, you can significantly reduce fluid retention or edema. You may also need to limit intake of liquids including water. Ask your doctor for any special instructions.


CONTROLLED PHYSICAL ACTIVITY

Controlled and monitored physical training certainly improves the ability of heart failure patients to lead more active and productive life. A well-structured cardiac rehabilitation programme can help you in this regard. Suggestion: Daily schedule of a patient recovering from a heart failure:


PATIENT EDUCATION AND COUNSELLING

Proper knowledge and counselling of the patient provides the basis for compliance with the treatment and improved long-term healthy outcome.


SPECIAL INSTRUCTIONS


VISIT YOUR DOCTOR IF YOU HAVE