The strongest muscle in the body is the heart, beating about 70 times a minute 100, 000 times a day. The average heart beats about 2.5 billion times in a 70-year lifetime.

Your body’s functioning depends on the proper circulation of blood. The heart and blood vessels deliver oxygen and nutrients to the body’s cells. The heart’s continuous rhythmic contraction and relaxation helps circulate the blood.

The term “heart failure” is a progressive disorder where the heart is not pumping blood as it should, which results in damage to the cardiovascular system.  Sometimes, the heart cannot pump enough blood through the body, does not pump blood with enough force, or cannot fill with enough blood.

“Heart failure” does not mean your heart is about to stop working or has stopped completely, rather, that the heart is not pumping correctly to adequately nourish the body. Heart failure is a serious medical condition that requires serious treatment.

Heart Failure

Heart failure occurs when the heart no longer functions as an adequate pump. Any condition causing progressive weakening and damage to the heart may cause heart failure.

Blood pressure is the force of the blood flowing through the arteries. High blood pressure, also known as hypertension, forces the heart to work harder than it should to pump blood throughout your body. This extra work by the heart muscle may result in the heart thickening and enlarging, to compensate for this added effort. Over an extended period, the heart may stiffen or weaken, and eventually lose its ability to pump effectively. High blood pressure, along with coronary artery disease (CAD), and diabetes are the three leading contributors to heart failure.

Coronary artery disease (CAD), also known as coronary heart disease (CHD) is a condition when the coronary arteries, which carry oxygen-rich blood to the heart muscle, gradually become coated, narrowed, and clogged by a fatty substance called plaque. This combination of fat, calcium, and cholesterol deposits restricts normal, healthy blood flow. This condition is likely to create blood clots, which may severely limit or completely stop the flow of blood. Narrowed arteries result in a lack of blood supply to the heart and may produce chest pain (angina), damage to the heart muscle (cardiomyopathy), a heart attack (myocardial infarction), or death. A previous heart attack may produce scar tissue in the heart muscle, creating more obstacles, which further interfere with healthy blood flow. Infections, alcohol abuse, a bad reaction to drugs, and diseases of the body also damage the heart. Genetic birth defects, injury to the heart at delivery, and a physical accident are additional reasons for heart damage.

Additional contributing factors to heart failure include congenital heart defects, structural defects in the heart, valves, and chambers, and arrhythmias – abnormal heart rhythms that may result in the heart beating too fast. Conversely, a slower heartbeat may not allow the heart to pump an adequate supply of blood to reach the body. Compensating for these insufficiencies, the heart may weaken over time, which may also lead to heart failure. Myocarditis, a viral infection that causes an inflammation of the heart muscle, may result in left-sided heart failure.

The key to preventing heart failure is to recognize and reduce the risk factors associated with heart disease and take all steps necessary to delay its progression. Control your symptoms. Take preventive steps like not smoking, being physically active, eating a heart healthy diet, maintaining perfect weight, and controlling factors such as blood pressure, cholesterol, and blood glucose levels. You should also take all prescribed medications with regularity, and follow ways to manage and reduce stress.

Symptoms of Heart Failure

Heart failure can be progressive (chronic) or can be sudden (acute). Signs and symptoms of heart failure include:

• Swelling of legs, ankles, feet, and abdomen

• Discomfort in arms or chest (angina) due to blockage of coronary artery

• Weight gain or weight loss

• Shortness of breath  (with exertion or lying down)

• Fatigue (over an extended period of time)

• Loss of appetite

• Rapid or irregular heartbeat

• Inability to do daily activities

• Persistent cough or wheezing with blooded phlegm

• Decreased alertness/difficulty concentrating

These symptoms may get worse as the heart becomes weaker. You may feel tired and experience shortness of breath quite often, even when doing a simple activity like walking across a room.

Contact your doctor if you experience chest pain, fast or irregular heartbeat, shortness of breath, fatigue, difficulty doing simple tasks, coughing with blood, decreased concentration, and swelling of the abdomen, legs, feet, or ankles. Seek prompt medical attention before the symptoms worsen.

Your doctor may be able to diagnose heart failure through your physical examination, medical history, symptoms, and diagnostic tests. Your physician will check your heartbeat to listen to how clear your lungs sound. And your legs, ankles, feet, and abdomen, along with the veins in your neck, will be checked for swelling. Blood pressure will be measured to determine your high and low parameters, and your weight will be recorded, as another indicator of your overall health status.

The physician may ask you to undergo various tests. Chest X-rays allow a detailed picture of the heart, lungs, and blood vessels. Your physician will determine whether your heart is enlarged, and if there is any fluid accumulation in your lungs. An echocardiogram may be prescribed to examine the heart’s structure and motion, to more accurately determine the pumping action of heart, as well as measure the blood flow in and out of the heart. An ECG, or electrocardiogram, measures the electrical activity of your heart. It checks the rhythmic activity and enlargement of the heart, and can also show the prior heart attack history as well as a current heart attack. An ECG also records your heart’s activity as you walk on a treadmill for a given period of time. Your physician will check whether your symptoms are elevated while doing physical activity.

A test with radioactive tracers may be performed. The tracers are injected intravenously, and their movement is tracked through the heart. This helps outline the size of the heart’s chambers, accurately measures the amount of blood ejected from the heart, and determines the blood flow to regions of the heart muscle. In addition, a catheter can be inserted into the femoral artery of your leg and directed to a region of the heart via X-ray guidance. This enables your doctor to see the chambers of the heart and to measure the pressure inside the heart. This visualization technique is called angiography.

Various blood tests may also be conducted to check the function of your kidneys and thyroid, and to search for the presence of any risk factors that can cause heart disease.

Heart failure is a serious medical condition that requires urgent, continuous treatment, constant monitoring, education to understand its detrimental effects on the interrelated systems of the human body, and a trusted relationship with a medical professional. It is treatable, and manageable. You can prevent or eliminate heart failure by controlling and eliminating risk factors for heart disease, making lifestyle changes, treating coronary artery disease, controlling high blood pressure, staying physically active, managing diabetes, maintaining a heart healthy diet, and helping your own situation with needed medications. Heart failure is treatable. Its severity, damage, and lethality may be lessened with awareness of the specific condition, and then proper, prudent action can be taken to address the disease. Treatment for heart failure is determined by the severity of your condition. There are three types of treatments for heart failure – by your doctor, through medication, and with surgical applications.

 Your doctor will examine you regularly to check your daily improvement. These doctor visits will help to determine how well you are responding to the treatments and the proper course of action to manage your condition. The course of action may include immediate lifestyle changes: regular exercise, adopting a heart healthy diet, reducing stress, controlling diabetes, quitting smoking habits, and taking all of your medications as they are prescribed.

Your individual situation, symptoms, and diagnosis will determine which combinations of medicines will be prescribed, and could include:

• ACE-inhibitors, which are used to dilate or widen blood vessels and thus, improve blood flow, decreasing the strain on the heart’s workload

• Angiotensin II receptor blockage, which works similarly to ACE-inhibitors and is prescribed as an alternative for people whose system cannot tolerate ACE-inhibitors

• Digoxin, which increases the strength of the heart muscle contractions by slowing the heartbeat, reduces symptoms of heart failure, and helps your system adjust to the condition

• Beta blockers, which improve heart function and may reduce signs and symptoms of heart failure

• Diuretics, which make you urinate frequently and prevent fluids from collecting in your body. Fluid retention puts more strain on the heart. Diuretics help rid the body of this excess fluid, reducing the strain on the heart

• Aldosterone, which is a potassium-sparing diuretic that helps the heart to work better and may also reverse heart scarring. Physicians also believe it may help those with severe heart failure to live longer

In more severe cases, where medications alone do not achieve success, surgical procedures are employed, including:

• Coronary angioplasty, to remove blockages in arteries with balloons and stents

• Coronary artery bypass surgery that goes around the blockage problem, redirecting blood flow

• An implantable cardioverter-defibrillator (ICD), a small electrical impulse generator for patients at risk of sudden cardiac death. This device maintains proper heartbeat rhythm to help ensure adequate blood flow.

• Biventricular pacemaker, another electrical device to monitor and consistently regulate and shock a weakened, inconsistently-beating heart, so that it beats normally, without interruption

• Left ventricular assist devices or LVADs, to correct specific conditions in patients who do not warrant complete heart replacement

• Heart valve replacement surgery using either tissue valves from pigs or mechanical valves that tend to last longer

• Complete heart transplantation

Your doctor will examine you regularly to check your improvement and discuss your symptoms. Be prepared to ask any questions about your condition. Your frequent visits will help to determine how well you are responding to the treatment and will help your physician decide on whether to continue the present treatment or to make some changes. Your condition may mean following up and working with a specialist, a cardiologist.

Heart failure is a very serious disease which can be effectively managed by following your treatment plan carefully. Consult your doctor, and keep track of your heart function. Be frank and honest, communicating with your doctor, and understand what you can do that will help you manage your symptoms.