Heart failure

The Heart Failure is the inability of the myocardium to meet the demands of a cardiac or debit cardiac output according to physical and metabolic needs of the individual.

Summary

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  • 1 Risk factors
  • 2 Symptoms of the disease
  • 3 Diagnosis of heart failure
  • 4 Recommendations to improve heart failure
  • 5 Medications
  • 6 Percutaneous coronary interventions
  • 7 Surgical procedures
  • 8 Prevention
  • 9 See also
  • 10 Sources

Risk factor’s

  • Previous heart attacks
  • Coronary artery disease
  • High blood pressure (hypertension)
  • Irregular heartbeat (arrhythmia)
  • Heart valve disease (especially in the aortic and mitral valves)
  • Congenital heart defects (birth defects)
  • Abuse of Alcoholand Drugs
  • Hemochromatosis(dangerous accumulation of iron in the body)
  • Obesity

Symptoms of the disease

Symptoms help determine which side of the heart is not working properly. If the left side of the heart doesn’t work well (left heart failure), blood and mucus build up in the lungs. The patient easily loses his breath, feels very tired and has a cough (especially at night). In some cases, patients expel bloody sputum when coughing.

If the right side of the heart doesn’t work well (right heart failure), fluid builds up in the veins because the blood circulates more slowly. The feet, legs, and ankles begin to swell. This swelling is called edema . Sometimes the edema can spread to the lungs , liver, and stomach .

Due to fluid accumulation, the patient has to urinate more frequently, especially at night. Fluid buildup also affects the kidneys , reducing their ability to remove salt , sodium, and water , which can lead to kidney failure. When heart failure is treated, the kidneys generally return to normal function.

As heart failure worsens, the heart weakens and symptoms begin to manifest. In addition to those mentioned above, heart failure can cause the following symptoms:

  • Difficulty breathing or lying down, because you easily lose your breath.
  • Tiredness, weakness and inability to exercise or perform physical activities.
  • Weight gain due to excess fluid.
  • Chest pain.
  • Lack of appetite or indigestion.
  • Swollen veins in the neck.
  • Cold and clammy skin.
  • Fast or irregular pulse.
  • Agitation, confusion, lack of concentration, and memory problems.

Diagnosis of heart failure

Most doctors can make a provisional diagnosis of heart failure based on the presence of edema and shortness of breath.

  • With a stethoscope, the doctor can listen to the chest to try to detect crackles that indicate the presence of fluid in the lungs, the characteristic sound of defective valves (heart murmur), or the presence of very fast heartbeats. By tapping the chest lightly with the fingers (percussion), the doctor can determine if there is accumulated fluid.
  • A chest x-ray can show if the heart is enlarged and if there is fluid in or around the lungs.
  • An electrocardiogram(ECG) may be performed to detect irregular heartbeats, arrhythmia, and cardiac effort. Electrocardiography can also indicate if the patient has had a heart attack.
  • Echocardiographycan be performedto assess valve function, heart wall movement, and heart size. One measurement that is typically taken during echocardiography is the left ventricular ejection fraction, or LVEF of the heart. During a heartbeat, which is a two-phase pumping action, the heart contracts and relaxes. When the heart contracts, it expels (or ejects) blood from the ventricles. When the heart relaxes, the ventricles fill with blood. As strong as the contraction is, the heart never ejects all the blood from the ventricles. LVEF is the percentage of blood expelled from the left ventricle with each beat. LVEF in a healthy heart is between 55 and 70 percent. LVEF may be less if the heart has been damaged.

Other imaging techniques, such as nuclear ventriculography and angiography, confirm the diagnosis and determine the severity of heart disease.

Recommendations to improve heart failure

There are several treatments that help reduce strain on the heart, including lifestyle changes, medications, transcatheter interventions, and surgery. Changes in lifestyle

  • If you smoke, stop it.
  • Learn how to control blood pressure, cholesterol levels, and diabetes.
  • Follow a moderate, low-calorie, saturated fat, and salt diet.
  • Limit your alcohol intake.
  • Limit your fluid intake.
  • Weigh yourself every day to detect a build-up of fluid.
  • Begin a doctor-approved aerobic exercise program.

Get screened for obstructive sleep apnea (OSA) if you suspect you have it. In patients with heart failure, OSA can aggravate the disease due to the exertion to which the heart is exposed during sleep.

Medicines

Studies show that medications also help improve heart function, allowing the patient to exercise and enjoy other physical activities more easily. The following medications are commonly administered to patients with heart failure:

  • Diuretics, which help remove excess fluid from the body.
  • Inotropics, such as digital, that increase the heart’s pumping capacity.
  • Vasodilators, such as nitroglycerin, that open narrowed blood vessels.
  • Calcium blockers, which keep blood vessels open and lower blood pressure.
  • Beta-blockersthat have been shown to be effective in increasing exercise capacity and improving symptoms over time.
  • ACE inhibitors, which keep blood vessels dilated and lower blood pressure.
  • Angiotensin II receptor blockers, which keep blood vessels dilated and lower blood pressure.

Percutaneous coronary interventions

  • Angioplasty: A procedure used to open arteries narrowed by accumulations of fatty plaque. It is performed in a cardiac catheterization laboratory. Doctors use a long, thin tube called a catheter that has a small balloon (or balloon) at the tip, which is inflated at the site of the artery blockage to compress the fatty plaque against the arterial wall.
  • Stent implantation: It is performed together with balloon angioplasty. The stent is a tubular metal mesh that is implanted in the area of ​​the artery obstructed by plaque. * The stent, mounted on a catheter with a balloon at the tip, is inserted through the artery and located at the site of the obstruction. The balloon is then inflated, opening the stent. The catheter is then removed with the balloon deflated, leaving the stent in place. The open stent keeps the artery open and prevents it from contracting.
  • Treatment with inotropic drugs: Increases the pumping capacity of the heart. The medicine is administered through a small catheter that is placed directly into an artery.

Surgical procedures

  • Heart valve repair or replacement
  • Pacemaker implantation
  • Correction of congenital heart defects
  • Coronary bypass
  • Mechanical assist devices
  • Heart transplant

Prevention

The best way to prevent heart failure is to practice healthy lifestyle habits that reduce your chances of heart disease. It is also important to find out if one has a risk factor that contributes to heart failure, such as high blood pressure or coronary artery disease. Many patients with heart failure can be successfully treated, usually with percutaneous coronary intervention.

 

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