Heart failure
Heart failure is a medical condition in which the heart cannot pump enough blood around the body. It usually results from the heart becoming too weak or stiff. It is sometimes called congestive heart attack, although the term is not commonly used today. It does not mean that your heart has stopped working completely. Rather, it requires some assistance to function much better. It can happen at any age but is most prevalent among older people. Heart failure is a chronic condition that generally worsens over time. Its symptoms can’t usually be cured, but its course can often be controlled for many years.
Symptoms of heart failure
Congestive heart failure is a pathophysiological condition wherein there is an output below that which the body and lungs need. Much of the time, the term congestive heart attack is used because one of the most common symptoms of the disorder is congestion or fluid accumulation in the tissues and veins of the lungs or other parts of a person’s body.
Congestion occurs particularly as fluid accumulation and swelling, in the form of peripheral edema that causes swollen limbs and legs and pulmonary edema that causes shortness of breath and ascites Pulse pressure,
which is the difference between the systolic top number and diastolic bottom number blood pressure, is often narrowed by 25% or less of the level of systolic in people with heart attack, and this may be an early sign.
Conventional symptoms of heart failure have been classified into left-sided and right-sided heart failures due to the difference in supplies between the two ventricles; the left ventricle and the right ventricle supply distinct parts of the circulation. Heart attack on both sides is denoted as biventricular heart failure. Left-sided heart failure is more common than right-sided.
Causes of Heart Failure
Heart failure is a medical condition in which the heart cannot pump enough blood around the body. It usually results from the heart becoming too weak or stiff. represents a syndrome rather than a disease, the underlying cause must be determined to achieve an accurate diagnosis and treatment. In heart failure, both the structure and function of the heart, or often both are altered. Heart attack represents the potential end stage of all heart diseases.
Common causes of heart attack include coronary artery disease, including a history of myocardial infarction, hypertension, atrial fibrillation, valvular heart disease, alcoholism, infection, and cardiomyopathy of undetermined cause,
Secondary to the viral infection and resultant inflammation of the myocardial tissue of the heart, known as myocarditis, can also be a causative agent for heart attack. Genetic predisposition does play a role. If the underlying cause is more than one, it is more probable that the patient will experience progression and the prognosis is worse.
Myocardial damage may lead to the patient developing heart attack once they reach an advanced age; various causes for myocardial damage include systemic viral infections, chemotherapeutic agents such as daunorubicin, cyclophosphamide, trastuzumab, and substance use disorders of substances such as alcohol, cocaine, and methamphetamine. An uncommon cause is exposure to certain toxins such as lead and cobalt.
Other infiltrative diseases include amyloidosis and connective tissue diseases like systemic lupus erythematosus, which do the same thing. Obstructive sleep apnea has also been found as an independent trigger for heart attacks. Variability in blood pressure has also recently been found to correlate with heart attack and cardiac changes that may lead to heart attack, according to recent clinical studies.
Supplements
Some of the other alternative medicines would worsen heart attacks and are to be avoided. Examples of the above medicines include aconite, ginseng, gossypol, gynura, licorice, lily of the valley, tetrandrine, and yohimbine. Aconite causes abnormally slow heart rates and abnormal heart rhythms, including ventricular tachycardia. Ginseng causes abnormal low or high blood pressure and may tend to reverse the effects of diuretics. Gossypol enhances the effect of diuretics causing toxicity.
Gynura causes hypotension. Licorice aggravates heart failure because it increases blood pressure and fosters fluid retention. Lily of the Valley causes abnormally slow heart rates through mechanisms similar to digoxin .
Tetrandrine can cause hypotension through the inhibition of L-type calci[um channels. Yohimbine aggravates heart attack because it causes an increase in blood pressure due to antagonism of the alpha-2 adrenergic receptor.
Several potential risk factors leave breast cancer patients susceptible to heart attack. In a recent meta-analysis, researchers were able to analyze data from 26 studies involving 836,301 patients and concluded that female survivors of breast cancer were at a higher risk for heart failure in the first ten years after diagnosis. The incidence of heart attack for the survivors of breast cancer was overall 4.44 per 1000 person-years of follow-up.
Pathophysiology of heart failure
Any condition that lowers the efficiency of the heart muscle by damaging it or overloading leads to a heart attack. These increased workloads, mediated by long-term activation of neurohormonal systems such as the renin-angiotensin system and the sympathoadrenal system over time lead to fibrosis, dilation, and structural changes in the left ventricle from elliptical to spherical shape.
The force of contraction of a person’s heart with a heart attack will be reduced because the ventricle will be overloaded. Increased filling of the ventricle will result in increased contraction force by the Frank-Starling law of the heart and thus an increase in cardiac output in a normal heart.
In heart failure, this mechanism fails because the ventricle is loaded with blood to such an extent that heart muscle contraction becomes less efficient. This is due to the inability to cross-link actin and myosin myofilaments in over-stretched heart muscle.
Diagnosis for heart failure
Ultrasound for heart
An echocardiogram ultrasound of the heart is a means commonly used to support a clinical diagnosis of heart failure. This can determine the stroke volume SV, the amount of blood in the heart that exits the ventricles with each beat, the end-diastolic volume EDV, the total amount of blood at the end of diastole, and the SV in proportion to the EDV, a value known as the ejection fraction. Normally, in a systolic heart attack, the EF should be between 50 and 70%. It falls below 40% in this condition. Echocardiography can also establish valvular heart disease along with assessing the condition of the pericardium the connective tissue sac surrounding the heart.
Chest X-rays
Chest X-rays are often resorted to in aiding the diagnosis of CHF. In a compensated patient, this might show cardiomegaly apparent enlargement of the heart, measured as the cardiothoracic ratio of the size of the heart to that of the chest. In left ventricular failure, evidence might be present of vascular redistribution upper lobe blood diversion or cephalization, Kerley lines, cuffing of the areas around the bronchi, and interstitial edema. Ultrasound of the lung may also identify Kerley lines.
Electrophysiology
An electrocardiogram ECG or EKG may be used to identify arrhythmias, ischemic heart disease, right and left ventricular hypertrophy, as well as the presence of conduction delay or abnormalities in the left bundle branch block. These findings are not specific to the diagnosis of heart failure.
Blood tests for heart failure
Routine tests include electrolytes sodium, potassium, measures of kidney function, liver function tests, thyroid function tests, a full blood count, and often C-reactive protein if infection is suspected.
Hyponatremia with low serum sodium concentration is common in heart failure. Vasopressin levels are usually increased, along with renin, angiotensin II, and catecholamines to compensate for reduced circulating volume due to inadequate cardiac output. This leads to more fluid and sodium retention in the body. Fluid retention exceeds sodium retention rates in the body, and this phenomenon causes hyponatremia due to high body fluid retention but with a low sodium concentration. This phenomenon is mainly observed among old women who have low body mass. Such severe hyponatremia leads to fluid accumulation within the brain, causing cerebral edema and intracranial hemorrhage.
Angiography for heart failure
Angiography is the X-ray imaging of blood vessels. It is carried out through the injection of contrast agents into the bloodstream via a thin plastic tube that is directly introduced inside a blood vessel. The X-ray images are called angiograms. Heart failure may be secondary to coronary artery disease, and its prognosis will in part depend on the ability of the coronary arteries to deliver blood to the myocardium heart muscle. Therefore, coronary catheterization may serve to identify possibilities for revascularisation by percutaneous coronary intervention or bypass surgery.
Prevention for heart failure
A person’s chances of developing heart failure are inversely related to the level of physical activity. Those with at least 500 MET minutes per week, the minimum recommended by U.S. guidelines, were less likely to risk heart attack than those who reported no free time exercise. Even greater risk decreases for heart attack were seen among those who were more active and exceeded the minimum recommended level. There is also evidence that lowering high blood pressure, and high blood cholesterol, and managing diabetes help prevent heart attacks. Healthy weight, and reducing sodium, alcohol, and sugar intake might be responsible for these improvements. Avoiding smoking has also been reported to decrease the risk of heart failure.