What is Heart Failure? symptoms and causes

Heart failure is a chronic condition where the heart cannot pump blood effectively to meet the body’s needs, leading to inadequate oxygen and nutrient delivery to organs. It occurs when the heart muscle weakens or stiffens, impairing its ability to fill with or eject blood properly. 

This can result from various underlying issues, such as heart disease or high blood pressure, and does not mean the heart stops functioning entirely; instead, it means the heart functions less efficiently. 

In India, heart failure affects an estimated 8-10 million people, with a significant burden due to rising rates of hypertension, diabetes, and coronary artery disease, making it an important public health concern. 

Let’s explore the details of heart failure, its causes, symptoms, and management strategies to empower readers with knowledge for better heart health.

Types of Heart Failure

• Left-Sided Heart Failure
• The left ventricle cannot pump blood effectively to the body.
• Causes fluid to buildup in the lungs, resulting in breathing difficulties.
• Subtypes:
• Systolic: Weak contraction reduces blood output.
• Diastolic: Stiff ventricle impairs blood filling.
• Right-Sided Heart Failure
• The right ventricle fails to pump blood to the lungs.
• This leads to fluid accumulation in the legs or abdomen, resulting in swelling.
• Congestive Heart Failure
• Fluid buildup in lungs or body from left- or right-sided failure.
• Causes shortness of breath and swelling.
• High-Output Heart Failure
• The heart pumps normally, but the body’s blood demand is too high.
• Rare, but over strains the heart.

Symptoms of Heart Failure

• Shortness of breath, especially when lying down
• Persistent cough or wheezing
• Swelling in legs, ankles, or abdomen
• Fatigue or weakness
• Rapid or irregular heartbeat
• Chest pain or pressure
• Reduced ability to exercise
• Sudden weight gain from fluid buildup
• Loss of appetite or nausea
• Confusion or difficulty concentrating
• Frequent urination at night

Causes of Heart Failure

• Coronary Artery Disease: Blocked or extremely narrow heart arteries, caused by plaque buildup, reduce blood flow, starving the heart muscle of oxygen & causing heavy damage that weakens its pumping ability over time.
• High Blood Pressure (Hypertension): Persistent high blood pressure in the blood vessels forces the heart to work harder, leading to muscle thickening or stiffening, which impairs efficient pumping and can cause heart failure.
• Heart Attack: A sudden blockage in a heart artery cuts off blood supply, killing part of the heart muscle and forming scar tissue that reduces the heart’s ability to pump effectively.
• Cardiomyopathy: Diseases of the heart muscle caused by genetics, infections, alcohol abuse, or toxins weaken or stiffen the heart, making it struggle to pump blood and increasing heart failure risk.
• Heart Valve Problems: Malfunctioning valves, either too narrow or leaky, disrupt blood flow, forcing the heart to work harder and eventually weakening it, which can lead to heart failure.
• Arrhythmias: Irregular heart rhythms, such as fast or erratic heartbeats, disrupt regular pumping, stressing the heart and reducing its efficiency, which can contribute to heart failure.
• Diabetes: Chronic high blood sugar damages blood vessels & the heart muscle, accelerating artery disease and impairing the heart’s pumping capacity, raising the risk of heart failure.
• Obesity: Excess body weight increases blood volume and heart workload, often combined with hypertension or diabetes, straining the heart muscle and leading to heart failure.
• Other conditions, such as thyroid disorders, anemia, or lung disease, can alter heart function, increase demand, or cause fluid imbalances, overtaxing the heart and potentially triggering or worsening heart failure.

Risk Factors for Heart Failure

• High Blood Pressure: Elevated blood pressure forces the heart to pump harder, causing muscle thickening or stiffening, which weakens its pumping ability and can lead to heart failure.
• Coronary Artery Disease: Narrowed arteries limit blood flow to the heart, causing damage or a reduced oxygen supply that impairs pumping and increases the risk of heart failure.
• Diabetes: High blood sugar damages vessels and heart muscle, promoting artery disease and weakening pumping capacity, raising heart failure risk.
• Obesity: Excess weight increases heart workload, often with hypertension, straining the heart and contributing to heart failure.
• Smoking: Tobacco chemicals damage vessels and the heart, reducing oxygen delivery and increasing strain, heightening heart failure risk.
• High Cholesterol: Elevated cholesterol levels cause plaque buildup in arteries, restricting blood flow to the heart and potentially leading to heart failure.
• Family History of Heart Disease: A genetic predisposition to heart conditions increases the likelihood of heart muscle weakening and heart failure.
• Age: Aging weakens the heart muscle and stiffens the vessels, reducing pumping efficiency and increasing the risk of heart failure, especially after the age of 65.
• Sleep Apnea: Breathing pauses during sleep reduce oxygen and strain the heart, contributing to heart failure.
• Chronic Kidney Disease: Impaired kidney function causes fluid retention and high blood pressure, overloading the heart and raising heart failure risk.
• Alcohol or Drug Abuse: Excessive alcohol or drug use damages heart muscle, leading to cardiomyopathy and heart failure.

Stages of Heart Failure

Stage A

Stage A means you’re at high risk for heart failure but don’t have heart damage or symptoms. You might have conditions like high blood pressure, diabetes, coronary artery disease, or a family history of heart problems, or you’ve used alcohol heavily or taken drugs that can harm the heart.

Stage B

Stage B means your heart has structural issues, like a weakened left ventricle or damage from a past heart attack, but you haven’t had heart failure symptoms. Treatment is needed to prevent symptoms from starting.

Stage C

Stage C is when you have a heart failure diagnosis and have had or currently have symptoms like shortness of breath, fatigue even while resting, and swelling in the legs. Management focuses on controlling these symptoms.

Stage D

Stage D is advanced heart failure, where severe symptoms like extreme tiredness or trouble breathing persist even with treatment. This stage may require options like heart pumps, transplants, or comfort care.

Diagnosis of Heart Failure

• Medical History and Physical Exam

Doctors ask about symptoms such as shortness of breath or swelling and review risk factors, including high blood pressure or heart problems. They listen to your heart and lungs, check for fluid buildup, and measure blood pressure and heart rate.

• Blood Tests

Blood tests measure proteins, such as B-type natriuretic peptide (BNP), which rise when the heart is stressed, and check kidney, liver, or blood sugar levels to identify related conditions.

• Chest X-Ray

A chest X-ray shows heart size and checks for lung fluid, indicating heart failure or other abnormalities.

• Electrocardiogram (ECG)

An ECG records the heart’s electrical activity to detect irregular rhythms or past heart attacks, using electrodes on your chest, arms, and legs.

• Echocardiogram

This ultrasound shows the heart pumping and damage to muscles or valves, measuring the ejection fraction to assess the severity of heart failure.

• Stress Test

A stress test monitors heart function during exercise or with medication, revealing blood flow issues associated with heart failure.

• Other Imaging Tests

CT scans or MRIs provide detailed heart images to identify blockages or muscle damage causing heart failure.

• Cardiac Catheterization

A tube inserted into a blood vessel checks for artery blockages or measures heart pressure, confirming artery-related heart failure.

Treatment of Heart Failure

• Stage A: High Risk, No Symptoms

Treatment prevents heart failure by addressing risk factors. Lifestyle changes include adopting a low-sodium, low-fat diet, engaging in regular exercise (such as 30 minutes of walking), quitting smoking, and limiting alcohol consumption. Doctors manage high blood pressure or diabetes with medications or monitoring. Weight control reduces heart strain.

• Stage B: Structural Heart Changes, No Symptoms

The goal is to prevent symptoms. Lifestyle changes continue, along with medications to reduce heart strain or regulate the rhythm. Tests like echocardiograms monitor heart function. Procedures like stenting or valve repair may improve heart health.

• Stage C: Symptomatic Heart Failure

Treatment controls symptoms and slows progression. A strict low-sodium diet and limited fluid intake reduce fluid buildup. Medications improve pumping or prevent irregular heartbeats. Devices like pacemakers regulate rhythm. Cardiac rehabilitation improves strength. Regular monitoring adjusts treatment.

• Stage D: Advanced Heart Failure

Advanced treatments manage severe symptoms. Medications and devices are optimized, but heart pumps or transplant evaluation may be needed. Palliative care manages pain or breathing issues. Hospice care supports end-stage patients.

• General Treatment Approaches

Surgery, like bypass or valve repair, addresses underlying issues. Flu and pneumonia vaccines prevent infections. Patients track symptoms, such as swelling, and report any changes they experience. Counseling or support groups manage stress.

Managing Heart Failure

• Follow Your Treatment Plan

Take prescribed medications to improve heart function or reduce fluid. Attend follow-ups and tests like echocardiograms. Report any new symptoms, such as shortness of breath or swelling, immediately.

• Adopt a Heart-Healthy Diet

Eat a low-sodium diet consisting of fruits, vegetables, and lean proteins while avoiding processed foods. Limit fluids if advised. A dietitian can create a heart-healthy meal plan.

• Stay Active with Guidance

Engage in recommended exercises, such as walking, or participate in cardiac rehabilitation. Avoid overexertion and rest when tired to prevent heart strain.

• Monitor Your Weight Daily

Weigh yourself every morning; a 2-3 pound gain in a day or 5 pounds in a week may signal fluid buildup. Keep a weight log for your doctor.

• Quit Smoking and Limit Alcohol

Stop smoking with quitting programs. Limit alcohol to one drink daily for women and two for men to avoid heart damage.

• Manage Stress and Mental Health

Use deep breathing or meditation to reduce stress. Join support groups or seek counseling for anxiety or depression.

• Prevent Infections

Get flu and pneumonia vaccines. Wash your hands frequently and avoid close contact with individuals who are ill. Report any fever or signs of infection to your doctor.

• Use Devices or Advanced Care if Needed

Follow instructions for pacemakers or heart pumps. Discuss transplant options or palliative care for advanced heart failure.

Prevention of Heart Failure

• Control Blood Pressure

Monitor your blood pressure, follow a low-sodium diet, and manage stress through meditation and relaxation techniques. Controlling high blood pressure reduces the risk of heart strain and heart failure.

• Manage Diabetes

Monitor your blood sugar, follow a balanced diet, and take your medications as prescribed. Tight diabetes control prevents vessel and heart damage, thereby lowering the risk of heart failure.

• Maintain a Healthy Weight

Eat a balanced diet and engage in regular exercise, such as walking, to maintain a healthy weight. Weight control helps reduce heart strain and the risk of heart failure.

• Exercise Regularly

Engage in 150 minutes of moderate exercise per week, such as cycling, to strengthen your heart. Regular physical activity helps control weight and blood pressure, thereby reducing the risk of these conditions.

• Quit Smoking

Stop smoking and avoid secondhand smoke with quit programs. Tobacco damages vessels, increasing heart failure risk.

• Limit Alcohol

Drink no more than one alcoholic beverage daily for women and no more than two for men. Limiting alcohol prevents heart muscle damage and heart failure.

• Eat a Heart-Healthy Diet

Choose low-fat, low-sodium foods, such as whole grains and fish. A healthy diet helps reduce artery buildup, thereby protecting the heart.

• Manage Cholesterol

Maintain a healthy cholesterol level by following a balanced diet, engaging in regular exercise, and undergoing routine screenings. Low cholesterol helps prevent the formation of artery plaque, thereby reducing the risk of heart failure.

• Get Enough Sleep

Aim for 7-9 hours of sleep and address any sleep apnea issues. A good night's sleep regulates blood pressure and supports heart health.

• Reduce Stress

Use yoga or hobbies to manage stress. Lowering chronic stress can reduce blood pressure and the risk of heart failure.

Sterling Hospital is Your Partner in Heart Health Across Gujarat

At Sterling Hospital, we provide you with the utmost care and comfort throughout your journey to a healthier heart. If you are looking for the best  cardiovascular surgeons in Ahmedabad, Vadodara, Rajkot, or  Gandhidham, we've got you. With considerable years of experience, we have built a team of the best cardiologists in these regions to provide you with premium treatment and the best results. Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier heart.