Q1) What is heart failure?
Heart failure is a serious medical condition in which the heart does not pump blood around the body as effectively as it should. It is due to the weakening of the heart muscles and valves. The risk of heart failure increases with age.
Q2) What is the function of the heart that stops?
The heart acts as a pump to force the blood around the body and in heart failure, the heart is unable to pump the blood effectively which means that blood can’t deliver enough oxygen and nourishment to your body to allow it to work normally. This may cause you to feel tired or fatigued.
Q3) Does heart failure mean immediate death?
Even though it is called a heart ‘failure’, it doesn’t mean that your heart has stopped working. It means that your heart is still working but is having difficulty in meeting the needs of your body, especially during physical activities.
Q4) Are heart attacks, heart failure, and cardiac arrest the same?
- Heart Attack: Blockage of the blood vessels supplying blood to the heart.
- Heart Failure: The inability of the heart to pump blood around the body.
- Cardiac Arrest: Heart stops. No blood circulation in the body. No pulse is felt.
Q5) Can heart failure occur without knowing it?
Heart failure can occur without any symptoms being felt by the patient. Or a person may just feel a chronic cough, decreased appetite, shortness of breath on lying down, or generalized weakness.
It is a chronic condition and progress is unpredictable and is different for each person. In many cases, the symptoms remain at a stable level for quite some time (months or years) before becoming worse. In some cases, the severity and symptoms may progress rapidly.
Q6) What are the pre-existing conditions that may increase the risk of heart failure?
- Coronary artery disease
- Previous heart attacks
- Chronic kidney disease
- Valvular heart disease
- Recent Viral Respiratory Infection
- Chronic lung disease
- Diabetes (high blood sugar)
- Hyper/hypothyroidism
- HIV/AIDS
- High blood pressure
- Congenital heart defects (by birth)
Q7) What are the risk factors for Heart Failure?
- Obesity
- Diabetes
- High Blood Pressure
- Atherosclerosis
- Drug intoxication
- Alcohol abuse
- Increasing age
- Family history of heart diseases
- Sedentary lifestyle
- Fatty food consumption
Q8) Is a Heart failure a normal consequence of getting old?
Heart Failure can affect all age groups. Most people with heart failure are elderly; however, heart failure isn’t necessarily a consequence of age. It’s a serious cardiovascular condition that can often be prevented and managed well with available treatment options.
Q9) Are Indians at a greater risk of heart failure?
Indians develop heart disease 5-10 years earlier compared to other ethnic populations. Nearly 52% of Indians die as a result of heart diseases.
It also found that Indians who consumed more red meat, in particular mutton, were 20 times more likely to die of heart disease than the Chinese. Hence the young should start monitoring their health when they are in their 30s and not wait till they are in the 40s.
Q10) What are the sign and symptoms of Heart Failure?
- Breathlessness on lying flat, bending down or leaning forward
- Weight gain
- Swollen ankles
- Excessive fatigue
- Nocturia (frequent urination at night)
- Nocturnal cough
- Chest pain or pain in the abdomen
- Needing more pillows to sleep comfortably
- Rapid heart rate
- Puffy face after getting up from the bed.
- Sweating with cold extremities
Many people tend to ignore these early warning signs and wait until symptoms worsen to visit the doctors.
Q11) Is my increasing age risk for heart failure?
Heart failure can develop at any age but becomes more common with increasing age. Around 1% of people under 65 years of age have heart failure, but 7% of 75-84-year-olds have heart failure and this increases to 15% in people older than 85. It is the most common cause of hospitalization in patients above 65 years of age.
Q12) Can heart failure occur in young people?
Although the risk increases with increasing age, young people can also suffer from heart failure. You may be at a higher risk if there is preexisting congenital heart disease.
Q13) What is the consequence of not availing timely treatment?
Heart failure is a serious, chronic condition that gradually worsens over time. Eventually, it can shorten your life. Starting the medical treatment on noticing symptoms can help manage the same.
Q14) How can it be prevented?
Generally, speaking men are at higher risk to develop heart disease earlier than women. However, women-run an equal risk like that in men after the menopause. The risk increases with advancing age.
- Avoid sedentary inactive lifestyle
- Engage in physical activity like swimming, bicycling, or jogging
- Diet control avoiding excess salt and sugar
- Stress management: yoga meditation counseling
- Refrain from the consumption of fatty and fast foods
- Avoid alcohol and illegal drug use
- Maintain a healthy weight
- Monitor blood pressure regularly
Q15) How is heart failure diagnosed?
- Clinical history of the person
- Basic blood tests
- Echocardiography
- Chest X-rays
- Blood biomarker test
Q16) What can be done if a person is diagnosed with heart failure?
A combination of medical treatments, lifestyle adjustments, and self-management are the keys to effectively managing heart failure.
- Stage A: Blood pressure management, stop tobacco and alcohol consumption, refrain from illegal drug use, control obesity, exercise daily
- Stage B: Medications with Blood pressure management, stop tobacco and alcohol consumption, refrain from illegal drug use, control obesity, exercise daily
- Stage C: Medical and surgical management with Dietary salt restriction along with management like stage A and B
- Stage D: Hospitalization is required and specialized medical care is given
Q17) Can heart failure be cured? For how many years a person survives after the CHF?
CHF is not curable, but early detection and treatment are very effective at reducing symptoms and delaying the progression of the condition. The prognosis depends on the stage of CHF and the presence of other diseases. People receiving early diagnosis and treatment do much better.
Q18) What types of medicines are given for Heart Failure patients?
- Blood thinners in order to reduce the risk of blood clots, which might break loose and travel to the heart, lungs, or brain.
- Angiotensin-Converting Enzyme (ACE) inhibitors to widen blood vessels, making it easier for the heart to pump blood around the body.
- Anti-platelet drugs used to stop blood clots by preventing platelets in the blood from clumping together.
- Beta-blockers reduce blood pressure.
- Diuretics help the body excrete more fluid in the urine and prevent it from retaining in body tissues.
Q19) What are the dietary restrictions?
- Limiting sugary, fatty and salty meals and snacks
- Consume green leafy vegetables, wholegrain, fruit, nuts, and seeds every day
- Choosing healthier fats and cooking oils such as olive oil
- Using herbs and spices to flavor food instead of salt
People with CHF tend to retain fluid in the body, so doctors often recommend restricting their fluid intake to the minimum each day. Consuming too much liquid may interfere with the effects of diuretic medicines.
Q20) What type of exercises is to be done/not to be done?
- Moderate-intensity physical activity, like walking, slow jogging is great for your health.
- You can them in smaller bouts, such as three 10-minute walks, if it is easier.
- The strenuous physical exercises are to be avoided.
- Avoid exercising after consumption of a heavy meal or if you have not eaten for a long while.
- Activities that call for holding your breath with sudden bursts of energy are to be avoided.
- Always do a warm-up and cool down before you start exercising.
- If you are considering doing more intensive sports, you should consult your cardiologist first.
Q21) Is driving safe for a person with heart failure?
Most people can safely drive however if there is a history of fainting due to abnormal heart rhythm then consultation with the doctor is necessary. Refrain from driving a heavy goods vehicle or public transport.
Q22) Is fertility affected by heart failure?
If you plan on having a baby, you should discuss this carefully with your doctor. You shouldn’t think that having heart failure means that you can’t get pregnant or carry a pregnancy to term; this is often possible, but your pregnancy will have to be carefully managed and monitored.
Most of the people have a rewarding sex life even when on therapy. It is normal to have a stress free life after being diagnosed with CHF.
Q23) What surgical options are there for a heart failure patient?
Device therapy helps in improving quality of life and life expectancy. CRT device helps in improving Ejection Fraction and decreases mortality. AICD device prevents sudden cardiac death. Both these devices can be implanted without anesthesia and require hospitalization for a couple of days.
LVAD are devices that act as an artificial heart and are used in critically ill patients. Cardiac transplantation is another option that helps in removing the diseased heart and giving a healthy heart to the patient.
Dr. Nikhil Choudhary, Consultant – Cardiology – Adult, Narayana Multispecialty Hospital, Jaipur