By Sola Ogundipe
The heart is a pump and heart failure occurs when the heart muscle doesn’t pump blood as it should. It can be ongoing (chronic) or may start suddenly (acute).
Between 20 to 30 per cent of all admissions in Nigerian hospitals today are related to heart diseases, notably heart failure.
Currently, heart failure has no cure. The patient will need to take medicines and follow a treatment plan for the rest of his life. Despite treatment, symptoms may get worse over time.
You may not be able to do many of the things that you did before you had heart failure. However, if you take all the steps your doctor recommends, you can stay healthy.
Why it occurs
Certain conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump efficiently.
Heart failure often develops after other conditions have damaged or weakened the heart. However, the heart doesn’t need to be weakened to cause heart failure.
How it occurs
In heart failure, the main pumping chambers of the heart (the ventricles) may become stiff and not fill properly between beats. In some cases of heart failure, the heart muscle may become damaged and weakened, and the ventricles stretch (dilate) to the point that the heart can’t pump blood efficiently. Heart failure can involve the left side (left ventricle), right side (right ventricle) or both sides of the heart.
Generally, heart failure begins with the left side, specifically the left ventricle — the heart’s main pumping chamber. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of the body.
Common signs and symptoms
There might be shortness of breath (dyspnea) on exertion or when lying down, or weakness due to heart failure and not have any fluid building up. Others are: Fatigue and weakness; swelling (edema) in legs, ankles and feet; rapid or irregular heartbeat; reduced ability to exercise; persistent cough or wheezing with white or pink blood-tinged phlegm; increased need to urinate at night; swelling of abdomen (ascites); sudden weight gain from fluid retention; lack of appetite and nausea; difficulty concentrating or decreased alertness; sudden, severe shortness of breath and coughing up pink, foamy mucus and chest pain if heart failure is caused by a heart attack.
The number one risk factor for heart failure is high blood pressure- The heart works harder than it has to if the blood pressure is high. Normal blood pressure is rises with each heartbeat and falls when the heart relaxes between beats.
While blood pressure can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be around 120/80 mm Hg (systoli/diastolic) for an adult age 20 or over.
Coronary artery disease- Narrowed arteries may limit the heart’s supply of oxygen-rich blood, resulting in weakened heart muscle.
Heart attack – Damage to heart muscle from a heart attack may mean the heart can no longer pump as well as it should.
Diabetes – Having diabetes increases risk of high blood pressure and coronary artery disease.
Certain medications. Medications that may increase the risk of heart problems are many and include nonsteroidal anti-inflammatory drugs (NSAIDs); certain anesthesia medications; some antiarrhythmic medications; antihypertensives and other prescription and over-the-counter medications.
Sleep apnea – The inability to breathe properly while you sleep at night results in low blood oxygen levels and increased risk of abnormal heart rhythms. Both of these problems can weaken the heart.
Congenital heart defects – Some people who develop heart failure were born with
structural heart defects.
Valvular heart disease – People with valvular heart disease have a higher risk of heart failure.
Viruses – A viral infection may have damaged your heart muscle.
Alcohol use – Drinking too much alcohol can weaken heart muscle and lead to heart failure.
Tobacco use – Using tobacco can increase your risk of heart failure.
Obesity – People who are obese have a higher risk of developing heart failure.
Irregular heartbeats – These abnormal rhythms, especially if they are very frequent and fast, can weaken the heart muscle and cause heart failure.
When to see the doctor
Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help the patient live longer. Lifestyle changes — such as exercising, reducing salt in diet, managing stress and losing weight — can improve quality of life.
One way to prevent heart failure is to control conditions that cause heart failure, such as coronary artery disease, high blood pressure, diabetes or obesity.
See your doctor if you think you might be experiencing signs or symptoms of heart failure. Emergency treatment is necessary for chest pain, fainting or severe weakness, rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting, sudden, severe shortness of breath and coughing up pink, foamy mucus.
Although these signs and symptoms may be due to heart failure, there are many other possible causes, including other life-threatening heart and lung conditions. Don’t try to diagnose yourself. If you have a diagnosis of heart failure and if any of the symptoms suddenly become worse or you develop a new sign or symptom, it may mean that existing heart failure is getting worse or not responding to treatment. Contact your doctor promptly.
Follow a treatment plan
Treatment can relieve symptoms and make daily activities easier. It also can reduce the chance that you’ll have to go to the hospital. Thus, it’s important to follow your treatment plan. Take your medicines as your doctor prescribes. Get advice from your doctor about how active you can and should be. This includes advice on daily activities, work, leisure time, sex, and exercise. Your level of activity will depend on the stage of your heart failure (how severe it is.
Certain actions can worsen your heart failure, such as forgetting to take your medicines, not following your diet (for example, eating salty foods) and drinking alcohol. These actions can lead to a hospital stay. If you have trouble following your diet, talk with your doctor. He or she can help arrange for a dietitian to work with you.
Avoid drinking alcohol. People who have heart failure often have other serious conditions that require ongoing treatment. If you have other serious conditions, you’re likely taking medicines for them as well as for heart failure. Try to avoid respiratory infections like the flu and pneumonia. Ask your doctor or nurse about getting flu and pneumonia vaccines.
If you have heart failure, it’s important to know when to seek help. Know when to get emergency care. Keep handy the phone numbers for your doctor and hospital and a list of medicines you’re taking.
Emotional issues and support
Living with heart failure may cause fear, anxiety, depression, and stress. Support from family and friends also can help relieve stress and anxiety. If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age. Some people’s symptoms and heart function will improve with proper treatment.
However, heart failure can be life-threatening. People with heart failure may have severe symptoms, and some may require heart transplantation or support with a ventricular assist device.