Heart failure is a complex clinical syndrome characterized by the heart’s inability to pump sufficient blood. This is to meet the body’s metabolic demands, leading to inadequate circulation and fluid accumulation in various tissues. This condition can arise from various underlying causes, including coronary artery disease, hypertension, diabetes, and valvular heart disease.
Types of Heart Failure:
- Heart Failure with Reduced Ejection Fraction (HFrEF) – The heart muscle is weakened and cannot contract properly, leading to poor blood circulation.
- Heart Failure with Preserved Ejection Fraction (HFpEF) – The heart contracts normally but has difficulty relaxing and filling with blood.
- Right-Sided Heart Failure – The right side of the heart cannot effectively pump blood to the lungs, leading to fluid buildup in the body.
- Left-Sided Heart Failure – The left side of the heart fails to pump blood efficiently, causing fluid accumulation in the lungs.
Symptoms:
Common symptoms include:
- Shortness of breath during exertion or while lying down.
- Fatigue and weakness.
- Swelling in the legs, ankles, or abdomen due to fluid retention.
- Rapid or irregular heartbeat.
These symptoms result from inadequate blood flow and fluid accumulation, which can lead to pulmonary congestion
Causes:
- Coronary artery disease (blocked arteries)
- High blood pressure (hypertension)
- Diabetes
- Heart valve disease
- Cardiomyopathy (diseased heart muscle)
- Arrhythmias (abnormal heart rhythms)
- Previous heart attack (myocardial infarction)
Diagnosis
Diagnosis typically involves:
- Clinical evaluation: Assessing symptoms and medical history.
- Physical examination: Checking for signs of fluid retention and heart rhythm abnormalities.
- Diagnostic tests: Including echocardiography, electrocardiograms (ECG), blood tests (e.g., BNP levels), and imaging studies to evaluate heart function and structure
Treatment:
- Medications:
- ACE inhibitors, ARBs, or ARNI (reduce strain on the heart)
- Beta-blockers (slow heart rate and improve function)
- Diuretics (reduce fluid buildup)
- Aldosterone antagonists (prevent fluid retention)
- SGLT2 inhibitors (beneficial in some patients)
- Lifestyle Changes:
- Low-sodium diet
- Fluid restriction if needed
- Regular physical activity (as tolerated)
- Smoking and alcohol cessation
- Weight monitoring
- Medical Devices & Procedures:
- Implantable cardioverter defibrillator (ICD) or pacemaker
- Heart transplant in severe cases
The prognosis for individuals affected varies significantly based on factors such as the underlying cause, severity of symptoms, and response to treatment. The overall five-year survival rate is approximately 35% for patients after hospitalization. ATP