Heart failure
does not mean that the heart has stopped or that
it is about to do so. Instead it is when the heart
cannot pump blood around the body quickly enough.
This means that the tissue of the body is not
getting enough oxygen and nutrients to enable
it to function properly. The result is that fluid
builds up in the lungs and tissue.
Heart failure is
caused by various types of heart disease and is
most common in those over 65. Depending on where
the heart muscle damage is worse, heart failure
can affect mainly the right side of the heart
or mainly the left side. Doctors describe these
as right heart failure and left heart failure
respectively:
- If
blood returning from the body to the right side
of the heart cannot be pushed on to the lungs
quickly enough, this is called right heart failure.
- When the left
side of the heart is unable to clear the blood
from the lungs quickly enough, causing breathlessness
and fluid accumulation in the lungs, this is
called left heart failure.
Right heart failure
is most commonly a secondary effect of left heart
failure. It is rare for either side to fail in
complete isolation. Heart failure can also be
acute (it can come on quickly, without warning)
or chronic (a long standing problem).
Symptoms
Right heart failure
features blueness (cyanosis) and the accumulation
of fluid in the tissues (Oedema). The ankles swell
and the liver becomes enlarged. In severe cases
a considerable amount of fluid accumulates within
the abdomen (ascites).
The main symptom
of left heart failure is breathlessness, which
may occur on mild exertion or even when the affected
person is at rest. There may be attacks of sudden
breathlessness during the night. As the condition
worsens, the tendency to breathlessness increases.
Causes
Heart failure is
commonly caused by coronary artery disease, high
blood pressure and rheumatic heart disease. However,
it may result from one of many different heart
disorders. Other causes include:
- Heart-valve
leakage (incompetence) with blood regurgitation
- Heart-valve
narrowing (stenosis) with an increased load
on the muscle
- Chronic lung
disease with increased resistance to blood flow
through the lungs
- Anaemia
- Thyroid gland
overactivity (Hyperthyroidism)
- Vitamin B deficiency
(beri-beri)
- Compression
of the heart from tightening of the heart bag
(constrictive pericarditis)
- Heart rhythm
disorders
Heart failure can
be brought on in a weakened heart by additional
load factors. These include pregnancy, lung infections,
anaemia, heart rhythm disorders and infection
of the heart lining (Endocarditis)
Treatment
Heart failure can
usually be treated effectively, especially if
the underlying cause of the heart damage can be
remedied. Prolonged bed-rest should be avoided
and carefully graded exercising prescribed when
possible.
Weight problems
should be treated by sensible dieting and taking
moderate exercise. Other sensible precautions
include reducing salt intake, avoiding alcohol
and giving up smoking. Vaccination against influenza
is important.
The drug digitalis
is valuable in increasing the strength and effectiveness
of the heartbeat (contraction). Its use often
greatly improves the condition of the affected
person. Fluid in the lungs and in the tissues
can be removed by the use of diuretic drugs, which
greatly increase the frequency of passing water
(urine). After effective treatment for heart failure,
the patient may spend long periods in the toilet
disposing of excess water. Abdominal fluid may
sometimes be removed by suction through a wide-bore
needle.
Drugs that widen
arteries and those that can control heart beat
irregularities can also be helpful. |
Heart Failure
