Systolic Heart Failure: Understanding the Condition

Introduction

Systolic heart failure, also known as heart failure with reduced ejection fraction (HFrEF), is a condition where the heart's left ventricle loses its ability to pump blood effectively. This leads to insufficient blood flow to meet the body's needs, causing symptoms such as fatigue, shortness of breath, and fluid retention.

Causes of Systolic Heart Failure

Several conditions can contribute to the development of systolic heart failure, including: - Coronary artery disease (CAD): Blockages in heart arteries reduce blood supply. - Hypertension (high blood pressure): Forces the heart to work harder. - Cardiomyopathy: Diseases affecting the heart muscle. - Heart valve disease: Impairs normal circulation. - Myocarditis: Inflammation of the heart muscle often due to infections.

Symptoms to Watch for

Systolic heart failure commonly presents with: - Shortness of breath (dyspnea), especially during activity or while lying down. - Fatigue and weakness. - Swelling in legs, ankles, or feet due to fluid retention. - Rapid or irregular heartbeat. - Persistent cough, often with pink-tinged mucus. - Difficulty concentrating or confusion (due to reduced oxygen supply to the brain).

Diagnosis and Tests

Doctors use several tests to diagnose systolic heart failure: - Echocardiogram: Measures ejection fraction to assess how well the heart pumps. - Electrocardiogram (ECG): Detects heartbeat irregularities. - Blood tests: Check for heart failure markers (e.g., BNP, NT-proBNP). - Chest X-ray: Shows signs of fluid buildup in the lungs. - Cardiac MRI or CT scan: Provides detailed heart imaging. - Stress test and coronary angiography: Evaluate blood flow and detect blockages.

Treatment Approaches

Treatment focuses on improving heart function and managing symptoms:

Lifestyle Changes:

• Diet: Reduce salt intake to prevent fluid retention.
• Exercise: Engage in moderate physical activity as advised by a doctor.
• Weight management: Maintain a healthy body weight.
• Avoid smoking and alcohol: These worsen heart failure.

Medications:

• ACE inhibitors or ARBs: Help relax blood vessels and improve heart function.
• Beta-blockers: Reduce heart workload and control heart rate.
• Diuretics: Help remove excess fluid and reduce swelling.
• Aldosterone antagonists: Improve survival and reduce complications.
• SGLT2 inhibitors: Recently recommended for heart failure management.

Advanced Treatments:

• Implantable devices (ICD, CRT): Help regulate heart rhythm.
• Heart transplant or mechanical assist devices (LVADs): For severe cases.

Conclusion

Systolic heart failure is a serious but manageable condition. Early diagnosis, proper treatment, and lifestyle modifications can significantly improve quality of life and heart function. If you experience symptoms, consult your doctor for evaluation and tailored management.

Source recommendations

1. American College of Cardiology/American Heart Association Heart Failure Guidelines

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
2. https://www.acc.org/Guidelines
3. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.024
4. https://www.acc.org/education-and-meetings/products-and-resources/features/global-cv-institute/heart-failure-guidelines
5. https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx

2. European Society of Cardiology Guidelines on Heart Failure

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
2. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
3. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Focused-Update-on-Heart-Failure-Guidelines
4. https://academic.oup.com/eurheartj/article/44/37/3627/7246292
5. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines