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Heart Failure

A man clutches at his chest where his heart is – he looks in pain. The words – Heart Failure – can be seen

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According to the British Heart Foundation, heart failure affects around 1 to 2% of the UK’s population.

Heart failure (HF), also known as cardiac failure, is the term used to describe the medical condition when your heart cannot pump blood effectively to other parts of your body. Simply put, heart failure occurs when the heart fails to do what it is supposed to do.

Factors Contributing To Heart Failure

Heart failure usually occurs as a result of another illness. It does not occur on its own. It is a chronic problem that develops slowly over time. A number of factors have been identified as risk factors for heart failure. These include:

  • Coronary Heart Disease (CHD)
  • Heart valve problems
  • Abnormal rhythm problems of the heart
  • High blood pressure
  • Diabetes
  • Infections, such as HIV and AIDS
  • Severe anaemia
  • Drug, or alcohol abuse
  • Thyroid problems
  • Congenital heart problems.

What Causes Heart Failure

To understand how a patient develops heart failure, it is important to first understand the basic anatomy of the heart.

The heart is made up of 4 chambers surrounded by muscular walls. The top chambers are known as the atria and the 2 lower chambers are referred to as the ventricles.

The muscular walls are fragile and cannot sustain injuries. When the walls of the ventricles are injured, such as in coronary heart disease, the ventricles become weak and stiff. Consequently, the heart cannot pump blood effectively to other parts of the body. Hence, the heart is said to have failed in doing its job.

Coronary heart disease is the most common cause of heart injury. Other risk factors tend to differ in how they lead to heart failure however, the ultimate result is still the same – that of decreasing the heart’s ability to function as a blood pump.

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There are 2 main types of heart failure namely, left-sided heart failure and right-sided heart failure.

Left-sided Heart Failure

Left-sided heart failure is the most common type of heart failure. Left heart failure occurs when the left ventricle loses its pumping power. As a result, blood cannot be delivered to other parts of the body.

Right-sided Heart Failure

Right-sided heart failure occurs when the right side of the heart loses its ability to pump used blood out of the heart to the lungs. As a result, patients with right heart failure tend to present with swelling of the legs and abdomen due to the accumulation of blood in the veins.

Diagnosing Heart Failure

To diagnose heart failure, your doctor will want to carry out certain tests on your heart. Below are the usual tests used to confirm a diagnosis of HF:

  • Blood tests – your doctor will want to send samples of your blood for analysis, to look for clues pointing towards the diagnosis of heart failure, and to rule out other possible diagnoses.
  • The ECG – is a small machine attached to numerous leads that are placed onto the chest to record details about the heart.
  • Echocardiogram – is simply an ultrasound scan of the heart. The physician will want to perform this scan to locate poorly functioning areas of the heart.
  • Chest X-rays – involve taking a black and white image of the chest area to visualise the structures found in the chest cavity.

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The symptoms of heart failure can vary from person-to-person depending on the type of heart failure. The most common symptoms of heart failure are:

  • Shortness of breath, especially when performing activities that require effort
  • Leg swelling
  • Orthopnea, which is the medical term used to describe shortness of breath when lying down
  • Fatigue
  • Rapid, or irregular heartbeat
  • Persistent cough
  • Increased need to urinate.

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Living with heart failure can be challenging. Heart failure is a chronic condition that, in most cases, cannot be cured. However, there are various methods you can use to reduce the symptoms of heart failure and prevent its progression. Below is a list of some of the best management strategies to help you improve your quality of life:

Eat heart-friendly foods – doctors, nutritionists and fitness coaches can’t emphasize this enough – eat healthy foods and avoid junk food.

Consuming too much saturated fats can lead to further deposition of cholesterol in the arteries of the heart.

If you have been diagnosed with heart failure, it is crucial to change your diet. Some of the healthiest heart-friendly foods you can include in your diet are:

  • Green leafy vegetables
  • Whole grains, such as brown rice and quinoa
  • Dark chocolate
  • Avocados
  • Fatty fish
  • Green tea
  • Almonds
  • Berries, such as blackberries, blueberries and strawberries.

Foods you should avoid include:

  • Excess salt consumption
  • Butter
  • Red meat
  • Soda
  • Processed meats
  • Canned soups
  • Fatty fast foods, such as deep-fried chicken, French fries and pizza
  • Dressings that are high in fat, such as Ranch sauce.

Heart failure patients often complain of swelling around the ankle area and lower legs. Oedema is the medical term used to describe the collection of fluids in the tissues of the body, so try wearing oedema socks and elevate your legs, as this may help.

While oedema in itself is not very dangerous, it can be painful. Doctors recommend wearing special socks to help compress the legs. You can also elevate your legs above the level of your heart 2 to 3 times a day to help fluid flow back into the circulation. This helps to prevent extra fluid from accumulating in the lower extremities. The overall idea behind managing oedema is to use gravity to pull fluid back into the circulation.

Stop smoking. Cigarettes contain over 4,000 harmful chemicals, most of which are well-known for their huge impacts on health, in particular the heart.

Studies report that cigarette smoking could be held responsible for the increase in size of the left ventricle, which is the lower chamber that makes up the heart.

Carbon monoxide has also been shown to restrict blood flow towards the heart.

So, quitting smoking is a vital step towards protecting the heart from further damage. There are numerous ‘Stop Smoking’ clinics and programs that can help. These programs are well-established, most of which comprise of a five-step program. Patients who still experience difficulties in trying to stop smoking are usually offered nicotine patches, or gum, for a short period of time to counter the effects of nicotine deprivation.

Exercise Daily But Within Limits

Studies show that regular aerobic exercise can help heart patients improve their functional capacity, reduce their symptoms, and reduce their risk of being hospitalised. However, not all heart failure patients can withstand exercise training.

Use More Pillows To Keep You Upright During Sleep

Very often, heart failure patients suffer from orthopnoea.

Orthopnoea refers to the sensation of breathlessness that occurs when a person lies flat. Orthopnoea is the result of the increased pressure inside your lungs. When you lie down, blood from your legs tends to flow back to your heart and lungs. In healthy individuals, their hearts can sustain this by pumping blood back into the circulation.

Unfortunately, heart failure patients cannot pump this extra volume of blood out of the heart. Consequently, extra fluid may leak out into the lungs of HF patients. This makes breathing harder.

We can use gravity to prevent extra blood from flowing back to the heart and lungs. If you are experiencing breathing difficulties on lying down at night, use two pillows to keep yourself upright during sleep. This will help keep the extra fluid down, preventing the accumulation of fluid in your central organs.

Get Professional Medical Assistance

If you think that you might be suffering from heart failure, you should seek medical assistance. Most patients can be managed with medications. Some of the medications usually prescribed for heart failure include:

  • ACE inhibitors – work by keeping your blood pressure under control and relaxing your arteries.
  • Diuretics – also known as water pills, helps your body get rid of the extra fluid build-up. It helps reduce ankle swelling and breathlessness.
  • Digoxin – works by helping your heart pump blood more effectively. Note that digoxin has been associated with numerous side effects and should therefore be used cautiously.
  • Beta blockers – are medications that slow down the rate at which your heart beats. This allows your heart to get adequate rest.

In cases where the rhythm of the heart is abnormal, your doctor may suggest implanting a small device, known as a pacemaker, to help your heart beat as it should.

The NHS provides a very detailed explanation on the treatment strategies used in the management of heart failure. Find it here.

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The Pumping Marvellous Foundation, based in Preston, is a registered charity that provides support and hope to patients suffering from heart failure. You can visit The Pumping Marvellous Foundation by clicking on this link.

The British Society for Heart Failure (BSH) aims at promoting research and educating the population about the causes, treatment and complications of heart failure. The BSH provides healthcare advice to professionals, patients, including the National Health Service upon request. Visit the British Society for Heart Failure by clicking on the following link.

Cardiomyopathy UK is run by a team of dedicated volunteers and healthcare professionals who work towards a common goal – improving the lives of patients suffering from cardiomyopathy. Cardiomyopathy is a risk factor for heart failure. Find out more about Cardiomyopathy UK by visiting their website here.

British Heart Foundation. Founded in 1961, the BHF is a registered charity run by a team of medical professionals, all working towards a common goal – promoting heart health. Click here to visit their website.

Heart Research Institute UK dedicates its time and efforts to the prevention of cardiovascular diseases. The institute funds research to find solutions in unmet areas of cardiovascular medicine. Find out more about Heart Research Institute UK here.

Chest Heart & Stroke Scotland (CHSS) is a health charity located in Scotland dedicated to providing support to families suffering from chest, heart and stroke problems. The ultimate goal of CHSS is to ensure that no life is half lived in Scotland. You can visit Chest Heart & Stroke Scotland by clicking on this link.

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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.

Coronary heart disease, or coronary artery disease, is a medical condition that occurs when the blood supply to the heart is blocked due to the presence of fatty substances inside the coronary arteries

Ventricles – the ventricles are the two large lower chambers of the heart that collect and expel blood out of the heart. The ventricles are made up of muscular walls