Categories: Cardiology

Management of Heart Failure

Q1) What is Heart Failure?

Heart failure occurs when the heart muscle has weakened and unable to pump enough blood to meet the body’s needs. This may cause you to feel tired or experience shortness of breath. 

  • Avg. age of heart failure in Indians is 59 years: Indians experience heart failure nearly 10 years earlier than their counterparts in countries like South America & China.
  • Progressive condition: Heart failure symptoms are absent initially but can progress rapidly if neglected.
  • Heart Transplant is the LAST OPTION: Medicines and lifestyle modification is the first line of treatment in heart failure.
  • Not always related to ageing: Heart failure also happens due to other conditions that damage or weaken the heart.

Q2) What are the possible symptoms of Heart Failure?

  • Shortness of breath
  • Swelling in legs and weight gain
  • Lack of appetite / Nausea
  • Fatigue
  • Persistent coughing (especially at night)
  • Rapid or irregular heartbeat
  • Dizziness or loss of consciousness
  • Difficulty in Lying down

Q3) What are the causes of Heart Failure?

Most people with heart failure are elderly; however, it often occurs because other conditions have weakened the heart muscle or made it too stiff. 

  • High blood pressure
  • Coronary Artery Diseases
  • Heart attack
  • Diabetes
  • Congenital Heart Defects
  • Faulty Heart Valves
  • Damage to the heart muscle caused by infections, alcohol abuse & toxic effect of certain drugs
  • Abnormal heart rhythm

Q4) Who should get regularly evaluated?

  • Heart attack patients even if undergone angioplasty or bypass surgery
  • History of cardiac disease
  • Prolonged High BP or diabetic
  • Experiencing one or more symptoms
  • EF <40%

Q5) What is the progression of Heart Failure?

The New York Heart Association (NYHA) classification scale is useful in assessing the stage of this condition based on how much the patient is limited during physical activity.

Stage – 1: Can perform all physical activities without getting tired or short of breath.

Stage – 2: Gets short of breath or tired when performing more strenuous activities like walking up several flights of steps.

Stage – 3: Gets short of breath or tired when performing day-to-day activities like walking along a flat path.

Stage – 4: Feels breathless at rest and mostly housebound. Unable to carry out any physical activity without getting short of breath or tired. 

Depending on your stage, you shall have to consult a heart failure specialist about the changes that you need to make in everyday life to accommodate activities like: work, social activities, driving, sex life.

Q6) Positive outlook in Heart Failure:

  • Medical history review, physical examination & few tests can help diagnose the condition quickly
  • Having a heart failure specialist ensures that patients get the best-in-class treatment
  • Timely treatment very effective in reducing symptoms, delaying progression & can help the patient live longer
  • Lifestyle changes help manage the condition better

Q7) Managing Heart Failure via Lifestyle Changes:

1. Restricted fluid intake as per doctor advice

2. Reduce salt intake – replace it with herbs and spices

3. Eat a healthy diet – small but frequent meals

4. Quit tobacco use in all forms (cigarette, gutkha, pan masala) 

5. Limit alcohol intake

6. Manage your weight or lose weight if needed

7. Be physically active – moderate-intensity exercise under doctor guidance

8. Manage stress via yoga, meditation and being around people you love

Q8) What are the treatment options for Heart Failure?

In the early stages of heart failure, symptoms are often minimal and people may not notice a significant effect on how they’re feeling. However, symptoms do progress, so it is important to proactively manage the condition via: 

  • Lifestyle changes
  • Medications
  • Implanted devices (AICD / CRT-D)
  • Heart Transplant

Q9) What is the Narayana advantage in managing Heart Failure?

• Experienced Heart failure team – Interventional Cardiologists, Cardiac Surgeons, LVAD specialists & Trained Counsellors

• New age drug therapy and interventions 

• Expertise in implantation of specialized devices like AICD, CRT-D, etc.

• Expertise in management of electro-physiological or heart rhythm problems 

• Fully equipped for Heart Transplant 

• Education for heart failure patients and family members through one-to-one consultation

• Healthy Heart card offering discounts on diagnostics, consultation, medications, admission, etc.

Dr. Devendra Shrimal, Senior Consultant – Cardiology – AdultNarayana Multispeciality Hospital, Jaipur

Narayana Health

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