Understanding the concept of Heart Failure
Heart failure (HF) can be defined as a condition wherein the heart fails to pump sufficient blood to the body at the appropriate pressure. In other heart failure cases, the heart is unable to fill enough blood or the heart is unable to pump sufficient blood to other parts of the body with the desired force. Most heart failure patients suffer from both problems. Heart failure is misunderstood as the heart stops working or is about to stop working. However, it is not true but a serious condition that require immediate care (Grossman, S.C & Porth, CM 2014).
Overview
The process of heart failure gradually increases wherein the heart’s mechanism to pump blood decreases. HF can affect both right and left sides of the heart while in most cases patients suffer from both. Right side HF is associated with the inability of the heart to pump blood to the lungs for oxygen. Left side HF is associated with the inability of the heat to pump oxygenated blood to other parts of the body. Right side HF is also linked with other health complication such as fluid accumulation on the legs, feet, ankles, abdomen, liver, and veins in the neck. Both types of HF are associated with shortness of breath and fatigue. Some of the major causes of HF include diseases that damage the heart such as high blood pressure, coronary heart disease, and diabetes (Ziaeian B & Fonarow GC. 2016).
Risk for heart failure
More than 5 million people are affected with HF in the United States. HF is a common chronic health condition in the US and other parts of the world. Some of the risk factors for HF include:
Elderly people, especially above the age of 65. Ageing is linked with weakening of the heart muscles. Other chronic diseases among the elderly along with prolonged medication and hospital stay may also contribute to the development of HF.
African-Americans (blacks) are more likely to suffer from HF compared to whites and other races. The symptoms of HF are predominantly observed at a young age among blacks along with high hospitalization and deaths due to HF.
Overweight is one of key risk factors that could lead to HF. Excess weight is associated with diabetes and hypertension which could lead to HF at later stages.
A history of heart problems including heart attack can cause severe damage to the heart muscles. Weakened heart muscles are a risk factor for HF.
Heart failure comprises of the following signs and symptoms which should not be ignored: Breathing trouble accompanied with shortness of breath
Tiredness or fatigue
Swelling in many parts of the body such as abdomen, feet, legs, ankles, and veins in the neck (Bui, A. L., Horwich, T. B., & Fonarow, G. C. 2011).
The signs and symptoms are a result of fluid accumulation in the body. Most people with HF may also suffer from shortness of breath or fatigue even after routine activities such as climbing stairs, walking etc. The symptoms of HF should not be ignored and immediate treatment interventions followed by lifestyle changes are recommended.
The symptoms of HF get worse once the heart gets old (with age). Most elderly people would suffer from common symptoms such as fatigue and shortness of breath after walking, dressing or other routine activities. In severe cases, individuals would suffer from shortness of breath even while lying down on bed. HF symptoms also lead to fluid accumulation that leads to cough, weight gain, frequent urination, and anxiety while asleep. Late night coughs are associated with acute pulmonary edema (accumulation of fluid in the lungs). In such severe conditions, immediate medical treatment is recommended.
Complications
HF can cause severe health complications which may be associated with age, gender, race, overall health and socioeconomic status. Some of the complications include: (a) Kidney damage or failure: HF is known to reduce blood flow to the kidneys which may lead to kidney failure if left untreated. Dialysis maybe required for treatment (b) Heart valve problems: HF is associated with inconsistent blood flow within the heart or enlarged heart which may lead to severe complications of blood flow within the heart. This may lead to heart valve problems which is a serious health condition (c) Heart rhythm problems: Improper heart rhythm (arrhythmias) is a chronic complication (d) Liver damage: Fluid accumulation in the liver due to HF can put pressure on the liver which can also lead to scarring of the liver which leads to improper functioning of the liver (Roger, V. L. 2010).
Treatment: The best method to prevent the complications of HF include early diagnosis and treatment. Diagnosis and treatment would ensure improved quality of life. The treatment and management of HF is based on the severity and lifestyle of the patient. Doctors recommend the following (a) Assessing the cause of HF such as diabetes or hypertension (b) Symptom reduction with help of treatment interventions (c) Preventing complications of HF by early prevention (d) Improving lifestyle and treatment as suggested by doctor. The best healthcare intervention for HF include medication, ongoing care coupled with lifestyle modifications. In severe HF cases, immediate medical care such as surgery would be required (Yancy CW, et al. 2013 and Ramani, G. V et al. 2010).
Heart-Healthy Lifestyle Changes
One of the best and conventional recommendations by doctors is a healthy lifestyle. Some of the recommendations include (a) Diet and exercise (b) weight management (c) physical activity (d) smoking cessation and (d) psychological intervention (Yancy CW, et al. 2013).
Medicines
In severe HF with complications, doctors would recommend lifestyle modifications along with medications. Some of the most common medications include: (a) ACE inhibitors: These medications are known to reduce the risk of future HF by lowering blood pressure and strain on the heart (b) Aldosterone antagonists: These medications are responsible to remove excess sodium from the body through urine and thus lowers the activity of heart muscles (c) Angiotensin receptor blockers: One of the best medications that are known to relax the blood vessels and also decrease the stress on the heart (d) Beta blockers: They help in lowering heart rate and workload of the heart (e) Digoxin: Used to pump more blood and also makes the heart stronger (f) Diuretics: They are also known as fluid pills that prevent fluid accumulation in the body which helps prevent symptoms and pulmonary edema (g) Hydralazine hydrochloride: One of the most widely prescribed medication in order to relax blood vessels and also known to reduce mortality among blacks. All medications should be taken upon doctor’s prescription only (Ahmed, A. 2009).
Support activities
It is best that patients with HF follow a routine healthy lifestyle and adopt the following support activities: (a) Keep track of the medications: It is recommended to keep track of medications by maintaining a list and also sharing the same with a new doctor. Patients are advised not to stop or take new medications without a doctor’s discretion (b) Keep track of weight and bring the record to visits with doctor: Fluid accumulation in the body can lead to weight increase. Hence, it is ideal to record weight routinely and show the same to doctor on every visit (c) Keep track of blood pressure: Home blood pressure monitoring is ideal for elderly patients. It is important to track all recordings and bring the same for every doctor visit. Thus, it is important to visit the doctor routinely and follow support activities.
References
Ahmed, A. (2009). DEFEAT – Heart Failure: A Guide to Management of Geriatric Heart
Failure by Generalist Physicians. Minerva Medica, 100(1), 39–50.
Bui, A. L., Horwich, T. B., & Fonarow, G. C. (2011). Epidemiology and risk profile of heart
failure. Nature Reviews. Cardiology, 8(1), 30–41.
Grossman, S., C and Porth, C., M (2014). Porth’s pathophysiology: Concepts of altered
health states, 9th edition. Philadelphia, PA. Lippincott William & Wilkin
Ramani, G. V., Uber, P. A., & Mehra, M. R. (2010). Chronic Heart Failure: Contemporary
Diagnosis and Management. Mayo Clinic Proceedings, 85(2), 180–195.
Roger, V. L. (2010). The Heart Failure Epidemic. International Journal of Environmental
Research and Public Health, 7(4), 1807–1830.
Yancy CW, et al. (2013). 2013 ACCF/AHA guideline for the management of heart failure: a
report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013 Oct 15;128(16):e240-327.
Ziaeian B and Fonarow GC. Epidemiology and aetiology of heart failure. Nat Rev Cardiol.
2016 Jun;13(6):368-78.
