People often get confused with the term, heart failure. It doesn’t mean that the heart has stopped working altogether. It means that, unlike a healthy heart, it is now unable to pump blood like before. There is slight...
People often get confused with the term, heart failure. It doesn’t mean that the heart has stopped working altogether. It means that, unlike a healthy heart, it is now unable to pump blood like before. There is slight wear and tear of the heart you can say, in a way.
The chambers of the heart might become thicker and harder in this condition and they might stretch to carry more blood to pump through the body. Over time, the heart muscles might also get weaker. The kidney also begins to react to this, holding on to water and salt. Subsequently, fluid may build up in different parts of the body like the arms, legs, ankles, feet, lungs, etc.
To make it easier for people to understand, the American Heart Association and American College of Cardiology have broken down the term heart failure into four stages about how it deteriorates over time, the different types of remedies and treatment required among others.
Causes of heart failure
It can be brought about by a slew of reasons that go on to damage the heart over time, if not intervened. Some of the main causes of heart failure are:
Coronary artery disease : In this problem, the arteries supplying blood and oxygen to the heart get debilitated, which means a lesser amount of blood flows into the heart than usual. When the arteries get blocked or become narrow there is an inadequate supply of oxygen and nutrients to the heart and it becomes incapable to pump as well.
Heart attack : It may happen with a sudden blockage of a coronary artery, stopping the flow of blood to the heart muscle.
Cardiomyopathy : It is referred to the damage to the heart muscles. It can be induced and precipitated by an artery or blood flow issues, infections, and substance abuse like alcohol and drugs. Cardiomyopathy is also said to be genetic. If it is in the genes, one might suffer from it. So, your doctor should know all about the family’s heart ailment history to make the correct diagnosis.
Other conditions : There are other causes also that may trigger heart failure. They include high blood pressure, diabetes, heart valve disease, thyroid problems, and heart defects people are born with.
All these conditions lead to overwork of the heart and with time lead to heart failure. These causes can be reversed to a great extent with effort and by leading a healthy life.
Different types of heart failure
It is important to understand its different types to prevent them or recognize the symptoms for treatment and faster recovery. Awareness and prompt action can save many lives from any heart problem.
Systolic heart failure : This condition happens when the heart muscle becomes weak and couldn’t squeeze with enough force. So, as a result, the heart pumps less oxygen-rich blood through the body.
Diastolic heart failure : In this case, the heart squeezes normally, but the ventricle, which is called the main pumping chamber, ceases to work normally, i.e. doesn't relax properly. Hence, an inadequate amount of blood enters the heart, and the blood pressure in the lungs shoots up. When that happens, fluid gets accumulated in the lungs, legs, and stomach.
Stage A heart failure
Heart failure, in this period, happens when people mostly suffer from high blood pressure, diabetes, coronary artery disease, metabolic syndrome, etc. Moreover, the changes in a heart go up significantly with a history of cardio-toxic drug therapy, alcohol or drug abuse, rheumatic fever, and a family history of cardiomyopathy.
Treatment
The doctor usually advises such patients to do some regular exercise and to quit drinking alcohol, smoking, and using illegal drugs. Different steps are also recommended to control and lower high blood pressure or high cholesterol.
In case a patient has high blood pressure or had a heart attack, doctors may prescribe beta-blockers as a treatment. When a person has diabetes, high blood pressure, or any other heart vessel conditions including coronary artery disease, physicians prescribe an ACE inhibitor or an angiotensin II receptor blocker (ARB).
Stage B heart failure
In this phase, a patient may have never had any symptoms of heart failure but was diagnosed with a systolic left ventricular dysfunction or issue. In this case, the heart’s left chamber becomes incapable to pump well. One is more susceptible to falling into this category in case of a heart attack, valve disease, and cardiomyopathy.
Treatment
Depending on the severity or the state of the condition the doctor will decide on the treatment. The physician may prescribe an ACE inhibitor or angiotensin II receptor blocker (ARB), or beta-blockers after a heart attack.
Chances are that doctors may also additionally recommend an aldosterone inhibitor if the symptoms persist while continuing with beta-blockers and ACE/ARB medications.
At times, surgeries are also conducted on patients to repair arteries and valves. Certain valves are also replaced with surgery by doctors. An implantable cardiac defibrillator (ICD) is another option doctors may opt for, depending on the condition of the patient.
Stage C heart failure
A patient is said to be in this phase when there is systolic heart failure along with other symptoms such as shortness of breath, incapable to do exercise, fatigue, etc.
Treatment
For patients in this phase, doctors may prescribe ACE inhibitors and beta-blockers, neprilysin inhibitors, and Angiotensin receptor blockers.
In case, the symptoms persist, the patients may need to take the following:
- Hydralazine/nitrate combination
- Diuretics (water pills) and digoxin
- Aldosterone inhibitor (when symptoms remain severe along with other treatments)
- Soluble Guanylate Cyclase (sGC) stimulators
In certain cases, doctors also go for a biventricular pacemaker or implantable cardiac defibrillator (ICD).
Patients are also advised on some lifestyle changes along with medications and other therapies. Doctors ask their patients to consume less salt, lose weight (if one is overweight), drink lesser amounts of fluids, stopping drugs that aggravate the condition.
Stage D heart failure
When a patient has systolic heart failure and exhibits advanced symptoms even after getting medical care, it is called Stage D in heart failure.
Treatment
Many of the treatments from stages A, B, and C will help in stage D, too. In this phase, doctors may also discuss and contemplate the following:
- Heart transplant
- Surgery options
- Ventricular assist devices
- Continuous infusion of intravenous inotropic drugs, etc.
Conclusion
Discussing all types of heart failure is beyond the scope of a single article. However, there will be separate articles on each type of heart failure, which include High-output heart failure (it is rare), right-side heart failure, and congestive heart failure.
All these types of heart failure require a detailed explanation of signs, causes, risk factors, and treatments available. It is imperative to have healthy habits to keep our heart healthy and strong.
