Heart Failure: A Patient's Guide

Introduction

Heart failure (HF) is a chronic condition in which the heart is unable to pump blood efficiently to meet the body's needs. Despite its name, heart failure does not mean that the heart has stopped working; rather, it functions less effectively than normal.

Causes of Heart Failure

There are many possible causes of heart failure, including:

• Coronary artery disease (CAD) – Narrowing or blockage of the arteries supplying the heart.
• Hypertension (high blood pressure) – Increased pressure puts extra strain on the heart.
• Cardiomyopathy – Diseases that affect the heart muscle.
• Heart valve disease – Malfunctioning heart valves can lead to heart failure.
• Arrhythmias – Irregular heart rhythms can weaken the heart over time.
• Diabetes – High blood sugar can damage the heart and blood vessels.
• Obesity – Excess weight increases the workload on the heart.

Symptoms of Heart Failure

Heart failure can cause various symptoms, including:

• Shortness of breath (dyspnea) – Especially during physical activity or when lying down.
• Fatigue and weakness – Less oxygen reaches muscles and organs.
• Swelling (edema) – Especially in the legs, ankles, and feet.
• Rapid or irregular heartbeat – The heart tries to compensate by beating faster.
• Persistent cough or wheezing – Due to fluid accumulation in the lungs.
• Rapid weight gain – From fluid retention.

Diagnosis

Doctors use several tests to diagnose HF:

• Echocardiogram – Assesses heart structure and function.
• Electrocardiogram (ECG) – Detects abnormal heart rhythms.
• Blood tests – Measure levels of certain heart-related biomarkers.
• Chest X-ray – Checks for heart enlargement and fluid in the lungs.
• Cardiac MRI or CT scan – For detailed imaging of heart tissues.

Treatment Strategies

Treatment depends on the severity of HF and may include:

1. Lifestyle Modifications

• Dietary changes – Reduce salt and fluid intake.
• Regular exercise – Under medical supervision.
• Weight management – Maintain a healthy weight.
• Quit smoking and limit alcohol – These reduce heart strain.
• Manage stress – Through relaxation techniques and better sleep.

2. Medications

Several types of medications help manage HF:

• ACE inhibitors & ARBs – Lower blood pressure and reduce heart strain.
• Beta-blockers – Improve heart function and lower heart rate.
• Diuretics – Remove excess fluid and reduce swelling.
• Aldosterone antagonists – Help prevent heart deterioration.
• SGLT2 inhibitors – Beneficial for HF in patients with or without diabetes.

3. Medical Devices & Procedures

• Implantable cardioverter-defibrillators (ICDs) – Prevent sudden cardiac arrest.
• Cardiac resynchronization therapy (CRT) – Improves heart function in some cases.
• Heart transplant – Considered in severe cases when other treatments fail.

Prevention

To lower the risk of HF:

• Control high blood pressure and cholesterol.
• Manage diabetes and ensure proper medication adherence.
• Maintain a heart-healthy diet (rich in vegetables, lean proteins, and whole grains).
• Avoid smoking and excessive alcohol use.
• Stay physically active within medical limits.

Conclusion

Heart failure is a serious but manageable condition. With the right treatment plan, many people can live a good-quality life and slow disease progression. Regular medical checkups and adherence to prescribed treatment are essential for managing this condition.

Source recommendations

1. American Heart Association Guidelines for the Management of Heart Failure

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
2. https://professional.heart.org/en/guidelines-and-statements
3. https://www.heart.org/en/health-topics/heart-failure
4. https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
5. https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure

2. European Society of Cardiology Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
2. https://pubmed.ncbi.nlm.nih.gov/34447992/
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
4. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
5. https://pubmed.ncbi.nlm.nih.gov/27206819/