Heart failure

Heart failure and sudden cardiac death: The Tribune India

What do you mean by heart failure?

The heart is one of the most important organs in the body, as it primarily pumps blood, distributing oxygen and nutrients throughout the body. Normally, a well-functioning adult heart can last three heart cycles or 72 beats per minute – this rate changes for children with normal and relatively faster heartbeats. However, minor malfunctions or abnormalities of the heart can affect our normal functions. When these malfunctions or abnormalities occur, our heart functions at a lower capacity and is unable to pump oxygenated blood throughout the body. This condition is known as heart failure, sometimes referred to as congestive heart failure and is a rapidly developing worldwide problem in people of different age groups. It is a condition caused by either inefficient pumping or inadequate relaxation of the heart. Heart failure is a chronic condition that occurs when the heart is unable to pump enough blood to meet the metabolic needs of body tissues. A weakened heart leads to insufficient blood supply to the cells, which leads to fatigue and shortness of breath which leads to heart failure.

Heart failure is often misinterpreted as a condition in which your heart does not work, however, it occurs when one or more heart chambers have failed to keep up with the volume of blood flowing through them. As a result, blood often backs up and fluid can build up in the lungs, leading to breathing difficulties. Conditions such as high blood pressure, high cholesterol, and diabetes can damage or weaken your heart and trigger heart failure. It also develops when the heart muscles become too stiff to pump blood. Not only this, abnormal heartbeat (arrhythmia) and inflammation of heart muscle area (myocarditis) are also some of the root causes of heart failure. Often it is mistaken for a heart attack, which is a sudden stoppage of blood supply to the core. Currently, 8-10 million Indians are diagnosed with heart failure, and 1 million are added every year. This is alarming with a death rate of more than 20% among people ten years younger than the world average.

How is heart failure related to sudden cardiac death?

Most sudden cardiac deaths are caused by abnormal heart rhythms called arrhythmias. Additionally, the most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganized discharge of pulses from the ventricles (lower chambers of the heart). According to the American Heart Journal, patients with heart failure are 6 to 9 times more likely than the general population to suffer from ventricular arrhythmias that can lead to sudden cardiac death.

What are the common causes and risk factors for heart failure?

Heart failure is common in older people, but it is also increasing in young adults due to increasing risk factors such as diabetes and hypertension. Apart from this, other factors such as valve disease, congenital heart disease, hypertension, history of heart attack, coronary artery disease, family history of the disease and an enlarged or infected heart can also lead to heart failure. heart failure. Heart failure is a progressive disease that gets worse over time because the pumping action of the heart weakens.

According to the classification of the New York Heart Association, heart failure can be classified into 4 stages. These stages range from high to advanced risk of heart failure. The first two stages are considered the pre-heart failure stage. The third stage is for patients with heart failure who had or are currently showing symptoms of the disease and the fourth stage is for patients with advanced symptoms of heart failure.

Some common symptoms of heart failure include:

· Chest pain

shortness of breath


· Fatigue

Swollen limbs

fast or irregular heartbeat

Persistent cough or wheezing with white or pink frothy tint of blood or mucus

Swelling of the abdomen

rapid weight gain

Nausea and lack of appetite

– Decreased alertness

Treatment options available to patients to manage heart failure

· Coronary bypass surgery. If severely clogged arteries are causing your heart failure, your cardiologist may recommend coronary artery bypass surgery. The procedure involves taking a healthy blood vessel from your leg, arm, or chest and connecting it below and above blocked arteries to your heart. The new pathway improves blood flow to your heart muscles.

· Repair or replacement of heart valves. The doctor may recommend repairing or replacing the valves if they witness a faulty heart valve that can cause heart failure. Heart valve repair or replacement can be done as open-heart surgery, minimally invasive surgery, or a heart procedure using flexible tubes called catheters (cardiac catheterization).

· Implantable Cardioverter Defibrillators (ICDs). An ICD is used to prevent complications from heart failure. It is a device similar to a pacemaker. It is implanted under the skin of your chest with wires running through your veins and into your heart. The ICD monitors heart rate. It tries to stimulate your heart or bring it back to a normal heart rate. An ICD also functions as a pacemaker and helps to speed up your heart rate.

Cardiac resynchronization therapy (CRT). Also called biventricular pacing, CRT is a treatment for heart failure in people whose lower heart chambers (ventricles) don’t pump in sync with each other. A device called a biventricular pacemaker sends electrical signals to the ventricles. The signals cause your ventricles to contract in a more coordinated way, which improves the pumping of blood out of your heart.

· Heart transplant. Some people have such severe heart failure that surgery or medications don’t help. These people may need to have their heart replaced with a healthy donor heart

Tips for managing heart failure

Heart failure can be managed or treated depending on the stage of the disease, as the severity increases with each stage. In the early stages, treatment consists of medications and lifestyle changes, while in more advanced stages, surgery, transplant, or device implantation becomes necessary for most patients. Maintaining a good quality of life is as important as survival for most patients with progressive chronic diseases. People with heart failure can also improve their quality of life by following their treatment plan and taking regular precautionary measures. Some of the modifiable risk factors can be controlled by the following measures:

· Refrain from consuming any substance that can interfere with the mind and body. Therefore, quit smoking and avoid using recreational drugs

· Engaging in outdoor activities and exercises is extremely crucial for maintaining heart health. However, you have to be careful about what kind of exercise your body can handle.

Eat a healthy, balanced diet rich in fruits, vegetables, whole grains, low-fat dairy products, poultry and skinless fish, nuts and legumes

Managing stress levels and getting enough sleep helps improve heart health

When it comes to treating heart failure, identifying it at an early stage may be most beneficial

When to consult the doctor?

Heart failure is a progressive disease that develops over time. With timely interventions, one can live a normal life. It is recommended to watch out for persistent symptoms and get regular checkups to monitor heart health. Ignoring these symptoms can even lead to fatal consequences in the future. If one is already diagnosed with heart failure, it is also very important to follow the appropriate medication prescribed by the cardiologist. The first step in treating heart failure is to communicate clearly with the doctor. Heart failure is treatable and manageable at every stage. Remember that heart failure is not about stopping. It’s about starting life in a new way.