Apollo Heart Institutes
Let’s know about heart failure symptoms and causes from the centres of cardiology and cardiothoracic surgery at Apollo Hospitals are among the largest Cardiac Centres in the world.
The Apollo Heart Institutes are regarded as one of the top centres in the world, performing a multitude of treatments and procedures in cardiology and cardiothoracic surgery. Our team of cardiologists and cardiothoracic surgeons are trained at the top institutes in India and abroad. They are dedicated to the prevention and treatment of cardiac disease.
Our pioneering work for the prevention and treatment of cardiac diseases has led to the achievement of better outcomes and improved quality of life. Several of the doctors have been recognized for their contributions to the speciality through national and international awards. The scorecard shows an unmatched record of over 1,65,000 heart surgeries, which include complicated coronary artery bypass operations, surgery for all types of valvular heart disease, infant and neonatal heart surgery with success rates comparable to international standards.
Our advanced infrastructure and cardiac emergency care with third generation Cath Labs, Cardiac Critical Care, Intensive Care Units, experienced Cardiologists and post operative care teams, make us one of the best heart hospitals in the world. chronic myeloid leukemia.
What is Heart Failure?
Heart failure is a progressive disorder in which damage to the heart results in the weakening of the patient’s cardiovascular efficiency. It is generally a chronic, long-term condition though it can sometimes develop suddenly. While the most common cause of heart failure is coronary artery disease, this condition can also occur when an infection weakens the heart muscle or due to certain diseases like diabetes or thyroid problems, due to uncontrolled hypertension, renal failure, persistent fast heart rhythms, and also due to certain drugs used in cancer treatment.
Heart failure is on the rise as the ageing population is increasing. But today there is increased awareness and better diagnostic facilities available. More cardiac patients are therefore able to survive now & live longer.
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What is heart failure? Is it the same as heart attack?
No. Heart failure is quite different from a heart attack. Heart failure is not a disease by itself but a constellation of various signs and symptoms caused by a wide variety of disorders that include valvular heart muscles, pericardial (covering layer of heart) and other non-cardiac (unrelated to heart) diseases. The onset and severity of the symptoms of heart failure depend on the nature of the underlying cardiac disease and the rate at which this develops.
How severe and life threatening is heart failure?
The presentation of heart failure may be sudden (acute) or over a period of time (chronic). Heart failure can occur with normal pumping capacity of heart when there is a failure to relax normally (diastolic) heart failure where ejection fraction or pumping capacity is near normal. It can also occur due to poor pumping capacity of the heart (systolic heart failure).
It becomes an emergency when the patient presents with acute heart failure and has a family history of angina/heart attacks or with severe high blood pressure.
What are the symptoms of heart failure?
Most of the symptoms and signs of heart failure are due to congestion and fluid collection in the lungs, legs, abdomen etc, and the inability of the heart to pump efficiently to meet the demands of the organs and the tissues in the body.
Some of the symptoms of heart failure are breathlessness, which could be an exaggarated, uncomfortable awareness of breathing. The breath does not go all the way down the lungs Others include:
- Shortness of breath
- Heavy breathing
- Tightness in chest
Breathlessness may arise during exertion in the early stage of the disease, but may also occur at rest when the disease is advanced. There could be breathlessness occurring in a lying posture but relieved on sitting up.
Patients state that they have to sleep on three or more pillows to feel comfortable at night. This leads to Paroxymal Noctumal Dyspnoea (PND), which usually starts 2-4 hours after onset of sleep. Patients develop cough and sweating with breathlessness, which is relieved by getting out of bed.
Fatigue and impaired effort capacity are other prominent symptoms of heart failure. Patients may also report abdominal fullness swelling of legs, nausea and loss of appetite.
How is heart failure diagnosed?
The physician diagnoses heart failure based on the symptoms the patients present with and the signs he observes while examining the patient.
The patient may have prominent neck veins, swelling of legs, may appear breathless, have increased heart and feet, enlargement of liver, wheezing etc.
Once the clinical suspicion of heart failure is ascertained, certain tests are carried out to ascertain the presence and the cause of heart failure. In a new patient with suspected heart failure, a blood test is done to assess BNP [Brasin Natriuretic Peptide); If it is raised more than 100 Pg/ ml, the possibility of heart failure is stronger, ECG and chest X ray are routinely done and an echocardiogram reveals the function of the heart. An evaluation of precipitating factors is also done with specific tests to rule out reversible causes such as metabolic or hormonal disturbances and infection.
Heart failure doesn’t mean that the heart has stopped functioning. It simply means that the heart is functioning at a low capacity or lesser efficiency. Medical, surgical and advanced techniques can be used to treat heart failure. General measures advised to patients to control heart failure include – Rest, reduce salt intake and fluid restriction.
The mainstay of the drug treatment for heart failure:
- Decrease the fluid overload (Diuretics)
- Decrease the filling pressures within the heart (Nitroglycerine)
- Decrease the stress on the heart (Vasodilators)
- Improve or strengthen heart muscle performance (Digoxin and inotropes)
- Improve or prevent adverse changes in the heart (ACE inhibitors and AT IL blockers]
- Improve survival, decrease need for hospitalization and prevent sudden death (Beta Blockers] Prevent dysrhythmia (Antiarrhythmic agents)
- Prevent blood clotting (Antiplatelets, Anticoagulants)
Drugs to treat Hypertension, Diabetes and Coronary Artery Disease are also given, if required.
Surgical treatment includes coronary artery bypass graft surgery, valve surgery, surgery to restore heart size and geometry, and surgery for implantable ventricular assist devices. Heart transplantation is the last option.
Can Pacemakers help in this condition?
The loss of synchronized contraction of the left and right ventricle of the heart in a patient with heart failure can be rectified by implanting a pacemaker (Triple Chamber pacemaker), which improves the overall pumping efficacy of the heart. This cardiac resynchronization therapy (CRT) provides symptom relief, improves survival, and decreases the frequency of hospitalization.
What happens in case of advanced heart failure?
While the initial treatment for heart failure is with medicines, the overall prognosis for those who have moderate to severe heart failure with medicines alone is quite poor Surgical options benefit many of these patients both in terms of prognosis and quality of life. There are several surgical and interventional options that may be considered.
HEART FAILURE MANAGEMENT IS COMPLEX. IT NEEDS A MULTIDISCIPLINARY APPROACH, WHICH INCLUDES PATIENT EDUCATION, DIETARY ADVICE, AND PERIODIC REVIEW BY CARDIOLOGIST TO ULTIMATELY DELIVER COST-EFFECTIVE TREATMENT TO REDUCE MORBIDITY AND RECURRENT HOSPITALIZATION
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