HeaRT FaiLuRe

OK. In this entry, I want to share a bit of my medical knowledge about HEART FAILURE, one of the commonest illness in the whole world. Hopefully the information I'm going to share will give benefits to everyone.

Heart failure is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Often termed "congestive heart failure" or CHF, this is most commonly caused when cardiac output is low and the body becomes congested with fluid. Heart failure is a common, costly, disabling, and potentially deadly condition. In developed countries, around 2% of adults suffer from heart failure, but in those over the age of 65, this increases to 6–10%.

There are many different ways to categorize heart failure, including:

a) the side of the heart involved (left heart failure vs right heart failure). Left heart failure compromises aortic flow to the body and brain. Right heart failure compromises pulmonic flow to the lungs. Mixed presentations are common, especially when the cardiac septum is involved.

b) whether the abnormality is due to insufficient contraction and/or relaxation of the heart (systolic dysfunction vs diastolic dysfunction)

c) whether the problem is primarily increased venous back pressure (behind) the heart Afterload, or failure to supply adequate arterial perfusion (in front of) the heart Preload (backward vs forward failure)


Signs:

LEFT SIDED HEART FAILURE:
A) Rales or crackles, heard initially in the lung bases, and when severe, throughout the lung fields suggest the development of pulmonary edema (fluid in the alveoli)
B) laterally displaced apex beat (which occurs if the heart is enlarged)
C) gallop rhythm (additional heart sounds) may be heard as a marker of increased blood flow, or increased intra-cardiac pressure

RIGHT SIDED HEART FAILURE:
a) pitting peripheral oedema
b) ascites
c) hepatomegaly
d) raised Jugular Venous Pressure
e) parasternal heave may be present


Symptoms:

LEFT HEART FAILURE
a) shortness of breath on exertion
b) orthopnoea (breathlessness on lying flat)
c) paroxysmal nocturnal dyspnea (a sudden nighttime attack of severe breathlessness)

RIGHT HEART FAILURE
a) foot and ankle swelling


Causes:

a) Ischaemic heart disease
b) Cigarette smoking
c) Hypertension (high blood pressure)
d) Obesity
e) Diabetes
f) Valvular heart disease
g) Viral myocarditis (an infection of the heart muscle)
h) Infiltrations of the muscle such as amyloidosis
i) HIV cardiomyopathy (caused by human immunodeficiency virus)
j) Connective tissue diseases such as systemic lupus erythematosus
k) Abuse of drugs such as alcohol and cocaine
l) Pharmaceutical drugs such as chemotherapeutic agents
m) Arrhythmias


Diagnosis:
a) Echocardiography
b) Chest X-rays
c) electrocardiogram
d) Blood tests - B-type natriuretic peptide


Management:

a) Weight reduction through physical activity and dietary modification, as obesity is a risk factor for heart failure and left ventricular hypertrophy
b) Sodium restriction
c) Fluid restriction
d) Medications: ACE inhibitors, β-blockers, diuretic agents, vasodilator agents, aldosterone antagonists (e.g.spironolactone)


Hopefully the above information would be helpful. So, please take care of your heart. Once they fail to work well, there's no turning back. Good heart reflects good health.. :)