Heart Failure (HF), often called Congestive Heart Failure (CHF), is defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including breathlessness, ankle and leg swelling, difficulty exercising and fatigue. Fluid overload is a common problem for people with heart failure. It is more common with age, but a number of causes affect younger people as well.

There are several ways to categorize heart failure, but one common classification is systolic dysfunction and diastolic dysfunction:

  • Systolic dysfunction is an abnormality of contraction of the pumping chambers of the heart.
  • Diastolic dysfunction occurs when the pumping chamber may be contracting normally but does not relax properly (i.e. they are stiff).

The treatment may vary depending on the type. With each cycle, the heart pumps less efficiently and the person becomes increasingly aware of increased restriction and effort whilst performing normal activities of living.

What are the causes of heart failure?

There are a number of different causes of heart failure, which can happen slowly over months or years. These include:

  • Heart attack
  • High blood pressure
  • Problems with the heart valves (e.g. aortic valve, mitral valve)
  • Diseases of the heart muscle (cardiomyopathies)
  • Excessive alcohol intake (over a long period)
  • Congenital conditions

Investigations for heart failure

As part of the investigations to determine the cause and to effect and plan appropriate treatment, your cardiologist will request a series of heart tests (blood tests, ECG, chest X-ray, echocardiogram and sometimes a coronary angiogram).

What are goals of heart failure treatment?

The goals of treatment for patients with heart failure include:

  • Improving heart failure symptoms (e.g. breathlessness, fatigue)
  • Reducing the number of sudden deteriorations
  • Preventing the development of heart rhythm problems
  • Maximally improving heart function
  • Enabling patients to lead as good a quality of life as possible
  • Increasing survival

What are the treatments available for heart failure?

Lifestyle changes are an essential component of treatment, especially staying active and reducing dietary salt intake. Medication forms the mainstay of treatment to reduce symptoms, improve quality of life and longer term survival. More targeted measures depend on the cause, including the need for angioplasty, coronary artery bypass or valve repair / replacement surgery for instance if the cause is CAD. Further specialized non-invasive tests may suggest benefit from certain types of pacemakers (cardiac resynchronization therapy or CRT) or the need for an implantable cardioverter defibrillator (ICD).

Heart Failure
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