One of the most common reasons for hospitalization is heart failure. Although heart failure cannot be reversed but with necessary care one can efficiently manage the symptoms.  But before we understand the management of symptoms of heart failure let us understand about heart failure.

    What is Heart Failure?

    Heart failure typically indicates a heart condition that is marked by the inability of the heart to pump enough blood. Generally, the heart fails when it fails  to meet body needs due to muscle weakness or muscle stiffness. However one must understand that heart failure is NOT a heart attack.

    What are the types of heart failure?

    The different types of heart attack are:

    Systolic HF (Muscle weakness)

    Weak heart muscle makes it difficult for the muscles of the heart to be able to pump enough blood

    Diastolic HF (Muscle thickening and stiffness)

    Thickened muscles of the heart muscle makes it difficult for the heart to pump blood in a normal way

    Right-Sided Heart failure was seen in patients with lung disease.

    What are the signs and symptoms of heart failure?

    Typically, the signs and symptoms of heart failure are:

    • Shortness of breath
    • Difficulty in breathing 
    • Swelling of the lower extremity

    Some other uncommon symptoms of heart failure are:

    • Cough, 
    • Weight gain, 
    • Fatigue, 
    • Inability to lie flat due to breathing difficulty.

    What are the causes or risk factors for heart failure?

    The people who are at a higher risk of developing heart failure include people who have:

    • A history of heart attack
    • High blood pressure
    • Obesity
    • Damaged heart valve
    • A family history of heart disease 
    • Older adults.

    Is Heart Failure very common?

    Heart failure is one of the most common heart ailments. According to the Heart Failure Society of America, around 6.5 million Americans over 20 years have heart failure. The high numbers are scary but these numbers may reach more than 8 million by the next decade.

    What tests are performed to diagnose heart failure?

    Generally, doctors advise the following diagnostic test for diagnosing heart failure:

    • ECG, 
    • Echocardiogram, 
    • Chest X-ray, and 
    • Blood test

    In addition to the tests mentioned above, an echocardiogram (echo) provides data on the heart muscle’s strength and Ejection Fraction (EF). Most echo labs consider EF greater than 55% to be normal. A cardiac catheterization or stress test may be necessary for some patients.

    What are the treatment options for heart failure?

    To manage heart failure your doctor may advise you for some lifestyle and dietary modifications which may include:

    • Salt restriction, 
    • Fluid restriction, 
    • Quitting smoking/alcohol. 

    Apart from making the above mentioned changes the doctor may also prescribe some medication to get rid of extra fluid, Beta-blocker, and Ace inhibitor or ARBs (commonly used medication for blood pressure) to strengthen the heart muscle. 

    Sometimes the doctor may suggest ICD or implanted defibrillators for some people for advanced heart failure for surgical options.

    What are the stages of heart failure?

    There are two different heart failure staging schemes.

    One is determined by the degree of the patient’s symptoms –

    Functional Class of the New York Heart Association (NYHA)

    No restrictions for physical exercise, under NYHA I

    NYHA II: Moderate physical activity restriction

    NYHA III: Significant restriction in physical activity as a result of breathing problems.

    NYHA IV: Breathing difficulty when at rest

    The ACC/AHA introduced a new staging system based on cardiac injury in 2001.

    Stage A: No structural heart disease, but high risk of developing congestive heart failure

    Stage B: Has structural cardiac disease but no symptoms or indicators of it.

    Stage C: Structural heart disease accompanied by previous or present CHF symptoms

    Stage D: Advanced heart failure that needs specialized care

    What is the prognosis of heart failure?

    Unlike common perception heart failure is not the end of life. Many people with heart failure improve or stabilize with appropriate medications and care. With the advancement in healthcare facilities the prognosis for heart failure has improved over the last decade . Also, the introduction of modern medicines and advanced surgical options like LVAD (Heart pump), a heart transplant has improved the prognosis of heart failure.