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Heart Failure

I’ve been told that I have heart failure. What is it exactly?  

Heart failure means that your heart is not functioning effectively.  It occurs when the left ventricle is not contracting with enough force to pump blood throughout the body to provide it with oxygen and other nutrients. The ventricles become stiff and damaged and are unable to pump or fill normally. The heart tries to compensate by stretching to hold more blood to pump through the body, which damages the walls of the heart. 

 

There are two types of heart failure: 

  • Systolic heart failure:  exists when the left ventricle fails to contract with enough force to adequately supply oxygenated blood around the body. 
  • Diastolic heart failure: exists when the heart contracts normally but the ventricles fail to relax adequately to allow the ventricle fill with blood. 

What are the symptoms of heart failure? 

The symptoms of heart failure may be mild or severe depending on the extent of damage to your heart. Symptoms may not always be present but can include:

  • Shortness of breath, causing patients to wake up suddenly at night
  • Swollen ankles, legs and abdomen, due to fluid retention
  • Waking up through the night to urinate
  • Tiredness due to lack of oxygen to the brain
  • Unable to carry out normal activities
  • Poor concentration or confusion
  • Palpitations
  • Feeling bloated
  • Poor appetite or nausea

What causes heart failure? 

Many factors can lead to heart failure including: 

  • Coronary artery disease: the coronary arteries fail to supply enough oxygenated blood to the muscle of the heart, putting extra strain on it. 
  • Heart attack: following this event an area of the heart muscle is left permanently damaged. 
  • Cardiomyopathy: results in damage to the heart muscle. This is caused by several factors including viral, genetics, and drug and alcohol abuse. 
  • Congenital heart disease:  where a patient is born with a heart defect. 
  • Diabetes
  • High blood pressure: also know as hypertension. 
  • Obesity. 
  • Arrhythmia: a problem with the rhythm of your heart. 
  • Chronic kidney disease. 

How can heart failure be treated? 

Treatment is primarily aimed at controlling and treating the symptoms of heart failure. As your symptoms change, medications will be adjusted to improve control and relief. 

Your treatment plan will be discussed with the heart team including your nurse, dietician, physiotherapists and technicians, who may recommend making various lifestyle and diet changes. These changes will help relieve the signs and symptoms of heart failure and prevent the disease from worsening. 

Patients with systolic heart failure who have advanced symptoms despite receiving optimum medical care, may require further interventional treatments to improve their quality of life. This could include any of the following: 

  • Cardioversion to resynchronise the heart 
  • Insertion of a permanent pacemaker 
  • Implantation of a cardiac defibrillator (ICD) 
  • Surgical options for coronary artery disease such as valve repair/replacements 
  • CardioMEMS™