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Heart failure treatment

Heart failure, also referred to as congestive heart failure, occurs when the heart experiences difficulties in efficiently pumping blood. It occurs due to weakness or damage caused by diseases or injuries, which hampers the heart's effectiveness.

Despite its intimidating name, heart failure does not indicate a cessation of heartbeats. Instead, it implies that the heart is weak or rigid, making it challenging to pump an adequate amount of blood throughout the body, especially during physical exertion. Consequently, symptoms such as breathlessness, swollen ankles, and fatigue (tiredness) may manifest.

Heart failure tends to affect men more frequently than women, and individuals over the age of 75 face a higher risk.

If you have concerns about your heart health, we recommend consulting a cardiac specialist as soon as possible.

Heart failure can be caused by various factors, including:

Coronary Artery Disease: This condition develops when plaque and fatty deposits accumulate in the inner lining of the arteries supplying blood to the heart (coronary arteries). This narrowing and potential blockage (atherosclerosis) can eventually lead to heart attacks or strokes.

Heart Attack: A heart attack, or myocardial infarction, occurs when a portion of the heart muscle does not receive enough blood. The longer the delay in restoring blood flow, the greater the damage to the heart muscle. Coronary artery disease is the primary cause of heart attacks.

Cardiomyopathy: This term encompasses various conditions that affect the functioning of the heart muscle or its ability to effectively pump blood throughout the body. It may also result in irregular heart rhythms known as arrhythmias.

Congenital Heart Defects (CHDs): Some babies are born with structural abnormalities in their hearts, affecting their heart's structure and functionality. These defects can range from minor, such as small holes in the heart, to severe cases involving missing or underdeveloped heart components.

Diabetes: This disease impairs the body's ability to process blood glucose (blood sugar). Over time, persistently high glucose levels can contribute to the development of heart failure.

High Blood Pressure (Hypertension)
: This commonly occurring condition arises when the force of blood against the walls of the arteries is excessively high. As a result, the heart and blood vessels have to work harder, leading to potential health problems, including heart failure.

Cardiac Arrhythmia: Irregular heartbeats occur when the electrical signals responsible for coordinating the heart's rhythm do not function properly. This can result in a heart beating too fast (tachycardia), too slow (bradycardia), or irregularly.

Obesity: Excessive weight is associated with various health issues, including diabetes, high blood pressure, certain cancers, and heart disease.

Smoking: Smoking can contribute to the formation of fatty deposits on the walls of coronary arteries, a process known as atherosclerosis. Over time, this narrowing of blood vessels puts strain on the heart muscle and can lead to heart failure.

Treatment for heart failure focuses on managing symptoms and slowing disease progression. It typically involves a combination of lifestyle changes, medication, and surgery.

Lifestyle changes include:

Adopting a heart-healthy diet rich in fresh fruits and vegetables, while minimizing processed meats, fats, and sugars.

Maintaining a healthy weight, and considering weight loss if necessary.

Limiting alcohol consumption.

Quitting smoking.

Engaging in regular exercise, starting gradually and seeking guidance from a doctor before initiating a new exercise routine.

Medication options for relieving heart failure symptoms include:

Beta blockers, which reduce heart rate and prevent angina attacks associated with heart failure.

Ivabradine, an alternative to beta blockers that works similarly.

ACE inhibitors, which help relax veins and arteries, reducing blood pressure.

Angiotensin II receptor blockers (ARBs), prescribed if ACE inhibitors cause troublesome side effects. ARBs relax veins and arteries, lower blood pressure, and enhance heart function.

Diuretics, which eliminate excess water and salts through urine, relieving heart failure symptoms.

Mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone, increase urine production, lower blood pressure, and reduce fluid accumulation around the heart.

Digoxin is recommended for individuals with persistent symptoms despite other treatments. It strengthens heart contractions and slows heart rate.

Sacubitril valsartan, a combination medication that improves heart function and oxygenated blood circulation for severe heart failure cases.

Hydralazine with nitrate, a drug combination that dilates arteries, reduces pressure on the heart muscle. It may be prescribed when ACE inhibitors or ARBs cannot be used.

In certain cases, medical devices may be necessary:

Pacemakers, implanted beneath the skin, monitor and regulate heart rate through electrical pulses.

Cardiac resynchronisation therapy (CRT) devices ensure synchronised contractions of the heart's main pumping chamber, enhancing overall pumping efficiency.

Implantable cardioverter defibrillators (ICDs) are used for abnormal heart rhythms. They monitor heart rhythm and deliver controlled electrical shocks to restore normal rhythm if it becomes too fast.

CRT-D devices combine cardiac resynchronisation therapy with defibrillation capabilities for patients requiring both treatments.

For those with severe heart failure medical procedures and surgery may need to be considered.

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