How is Heart Failure defined ?

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Heart failure is a condition in which the heart has lost the ability to pump enough blood to the body's tissues. With too little blood being delivered, the organs and other tissues do not receive enough oxygen and nutrients to function properly. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems. Heart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly. The condition may affect the right side, the left side, or both sides of the heart. Right-sided heart failure means the right ventricle of the heart loses its pumping function. Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body. Heart failure is often classified as either systolic or diastolic. Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well. Diastolic heart failure means that your heart's pumping chamber does not fill up with blood. The most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. Other heart problems that may cause heart failure are : Congenital heart disease Heart valve disease Some types of abnormal heart rhythms (arrhythmias) Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failure

What are the symptoms ?

Heart failure can be chronic — meaning your condition is ongoing — or acute, meaning your condition has started suddenly. Chronic heart failure symptoms Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness

Acute heart failure symptoms Symptoms similar to those of chronic heart failure, but more severe and start or worsen suddenly Sudden fluid buildup Rapid or irregular heartbeat (palpitations) Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain, if your heart failure is caused by a heart attack

Surgery and medical devices

In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Some treatments being studied and used in certain people include

Coronary bypass surgery

If severely blocked arteries are contributing to your heart failure, your doctor may recommend coronary artery bypass surgery. In this procedure, a vein from your leg, arm or chest replaces a blocked vein in your heart to allow blood to flow through your heart more freely.

Heart valve repair or replacement

If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing the valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons also can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty). Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged valve is replaced by an artificial (prosthetic) valve.

Implantable cardioverter-defibrillators (ICDs)

An ICD is a device implanted under the skin and attached through the veins in your chest to your heart with small wires. The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to shock it back into normal rhythm.

Cardiac resynchronization therapy (CRT) or biventricular pacing

A biventricular pacemaker sends timed electrical impulses to both of the heart's lower chambers (the left and right ventricles), so that they pump in a more efficient, coordinated manner. As many as half the people with heart failure have problems with their heart's electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.

Heart pumps (left ventricular assist devices, or LVADs)

These mechanical devices are implanted into the abdomen or chest and attached to a weakened heart to help it pump. Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. LVADs are now sometimes used as an alternative to transplantation. Implanted heart pumps can significantly extend and improve the lives of some people with severe heart failure who aren't eligible for or able to undergo heart transplantation or are waiting for a new heart

Heart transplant

Some people have such severe heart failure that surgery or medications don't help. They may need to have their diseased heart replaced with a healthy donor heart. Heart transplants can dramatically improve the survival and quality of life of some people with severe heart failure. However, candidates for transplantation often have to wait months or years before a suitable donor heart is found. Some transplant candidates improve during this waiting period through drug treatment or device therapy and can be removed from the transplant waiting list.

Prevention

The best way to prevent heart failure is to : Lower your risk of getting heart disease by making lifestyle changes; Control certain health problems, such as high blood pressure and diabetes; To reduce your risk : Don't smoke. If you smoke, quit. Smoking greatly increases your risk for heart disease. Avoid secondhand smoke too; Lower your cholesterol. If you have high cholesterol, follow your doctor's advice for lowering it. Eating a heart-healthy diet-such as the TLC diet -exercising, and quitting smoking will help keep your cholesterol low; Control your blood pressure. High blood pressure raises your risk of getting heart disease. Studies show that lowering blood pressure to normal levels in people who have high blood pressure could reduce the cases of heart failure by half. Exercising, limiting alcohol, and controlling stress will help keep your blood pressure in a healthy range; Get regular exercise. Exercise will help control your weight, blood pressure, and stress. Controlling these things will help keep your heart healthy. Try to do activities that raise your heart rate. Aim for at least 2½ hours of moderate exercise a week.3 One way to do this is to be active at least 10 minutes 3 times a day, 5 days a week. Talk to your doctor before starting an exercise program; Control diabetes. Take your medicines as directed, and work with your doctor to make a diet and exercise plan to control diabetes; Limit alcohol. If you drink alcohol, drink moderately. This means no more than 2 drinks a day for men and 1 drink a day for women. Heavy consumption of alcohol can lead to heart failure.

Complications Irregular heart rhythms (can be deadly) Pulmonary edema Total heart failure (circulatory collapse)