Heart Failure

Heart failure occurs in people of any age, even in young children, especially those born with a heart defect.  However, it is  much more common among older people, because older people are more likely to have disorders that damage the heart muscle and the heart valves. Also, age related changes in the heart tend to make the heart pump less efficiently.

Heart failure develops in about 1 of 100 people. The disorder is likely to become more common because people are living longer and because, in some countries, certain risk factors for heart disease such as (smoking, high blood pressure, and a high fat diet) are affecting more people.

Heart failure does not mean that the heart has stopped. It means that the heart cannot keep up with the work required to pump adequate blood to all parts of the body (its workload) definition is somewhat simplistic. Heart failure is extremely complex, and no simple definition can encompass its many causes, aspects, forms, and consequences.

The function of the heart is to pump blood. A pump moves fluid out of one place and into another. For example, the right side of the heart pumps from the veins into the lungs. The left side of the heart pumps blood from the lungs out through the arteries to the rest of the body. Blood goes out when the heart muscle contacts (called systole) and comes in when the heart muscle relaxes (called diastole). Heart failure develops when the pumping action of the heart is inadequate; typically because the heart muscle is weaker, stiffer, or both. As a result, blood may not flow out in adequate amounts. Blood may also build up in the tissues from which it is coming, causing congestion in those tissues. That That is why heart failure is sometimes known as congestive heart failure.

Accumulation of blood coming into the left side of the heart causes congestion in the lungs, making breathing difficult. Accumulation of blood coming into the right side of the heart causes congestion and fluid accumulation in other parts of the body, such as the legs and the liver. Heart failure usually affects both the right and left side of the heart to some degree. However, one side may be affected by disease more than the other. In such cases, heart failure may be described as right-sided heart failure or left-sided heart failure.

In heart failure, the heart may not pump enough blood to met the body’s need for oxygen and nutrients, which are supplied by the blood. As a result, arm or leg muscles may tire more quickly, and the kidneys may not function normally. The kidneys filter fluid and waste products from the blood into the urine, but when the heart cannot pump adequately, the kidneys malfunction and cannot remove excess fluid from the blood. As a result, the amount of fluid in the blood-stream increases, and the workload of the failing heart  increases, creating a vicious circle. Thus, heart failure becomes even worse.

Causes

Any disorder that directly affects the heart can lead to heart failure, as can some disorders that indirectly affect the heart. Some disorders cause heart failure quickly; others do so only after many years. Some disorders cause systolic dysfunction, others cause diastolic dysfunction, and some disorders, such as high blood pressure and some heart valve disorders, can cause both types of dysfunction.

Treatment

Treatment of heart failure requires several general measures, along with treatment of the disorder causing heat failure, lifestyle changes, and drugs for heart failure.

General measures: Although heart failure is a chronic disorder for most people, much can be done to make physical activity more comfortable, improve the quality of life, and prolong life. Affected people and their family members should learn all they can about heart failure because much care occurs at home. In particular, they should know how to recognize the early warning symptoms of worsening heart failure and should be aware of the actions they need to take (for example, take an extra dose of a diuretic or contact their doctor).

Regular communication with health care practitioners and examinations by doctors are critical because heart failure can worsen suddenly. For example, nurses may regularly call people who have heart failure to ask about changes in weight and in symptoms. Thus, they can gauge whether people need to see a doctor.

People may also go to specialized heart failure clinics. These clinics have doctors with expertise in heart failure who work closely with specially trained nurses and other health care practitioners, such as pharmacists, dietitians, and social workers, to care for people with heart failure. These clinics can help decrease symptoms. Reduce hospitalizations and improve life expectancy by making sure that people receive the most effective treatments.

This care complements rather than replaces care provided by primary care doctors.

People with heart failure should always check with their doctor before taking a new drug, even a nonprescription drug. Some drugs (including many used to treat arthritis) can cause salt and fluid retention, and other drugs may make the heart function more slowly. Forgetting to take necessary drug is a common cause of worsening symptoms, and people should be given ways to remind themselves to take their drugs.

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