Heart Failure - An Introduction
Dateline: 09/12/99
Almost 4.7 million people in the United States alone have heart failure. Eight out of ten men with heart failure will succumb to the disease within six years of diagnosis. Women are a bit luckier - though not very. Mortality rates are 65% at 6 years. (NHANES III data). More worrying is the fact that, as our population ages, more and more people will become victims of heart failure.
Not surprisingly, then, there has been intense research into identifying the causes of heart failure. Much interest has been shown in devising newer and better treatment methods. The glut of information that resulted has caused more than a little confusion.
In this article, I will discuss briefly the condition of heart failure. In following features, I'll present some of the accepted guidelines of managing heart failure. The data is derived from the Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. These guidelines were developed by cardiovascular specialists and are based primarily on a detailed review of published reports. However, when data from studies currently under progress become available, these guidelines may need to be modified.
What is heart failure ?
The function of the heart is to pump out blood to the different parts of the body. An efficient heart pumps out all the blood that enters it, and this blood flow is able to fulfill the needs of the different organs and tissues for oxygen and energy-giving nutrients. When the heart cannot sustain these functions, it is said to have FAILED.
What are the kinds of heart failure ?
There are many ways of classifying heart failure.
Left and Right sided heart failure - depending on which ventricle is not functioning normally. Left ventricular failure is more common, and also more dangerous. Usually, when one side fails, it is only a matter of time before the other side also fails - a condition called bi-ventricular failure or congestive heart failure or congestive cardiac failure.
Forward and Backward heart failure - based on whether the important problem is reduced blood flow to the organs (forward) or damming up of blood in the venous system leading to the heart (backward).
Low and High output failure - determined by the heart pumping out a lower volume of blood per minute than normal, or a higher amount (as occurs in conditions like hyper-thyroidism).
Acute and Chronic heart failure - reflecting the mode of onset. Acute failure happens suddenly, within hours or days, while chronic heart failure is a more insidious process, developing over weeks and months.
What are the signs of heart failure ?
The features of heart failure are dependent upon every one of the characteristics discussed above.
Left heart failure causes breathlessness, tiredness, reduced urine output (oliguria), giddiness and sometimes loss of consciousness. If acute in onset, as occurs following a heart attack, it can cause a severe drop in blood pressure (shock) and severe congestion of the lungs with blood (pulmonary edema), both of which can be life-threatening.
Right heart failure, on the contrary, causes swelling of ankles (pedal edema), abdominal distension (ascites), facial puffiness and pain in the right side of the belly (due to stretching of the liver with dammed up blood).
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