Heart Failure

Disease Awareness Page for R3 Stem Cell – Cardiomyopathy

Cardiomyopathy

What is it? 

Heart failure is also known as chronic heart failure or congestive heart failure. It is a condition in which the heart is not able to pump enough blood throughout the body to maintain its needs. The heart’s central role as the source of blood, oxygen and nutrition to all the parts of the body makes heart failure such a critical condition.  

Heart failure is often but not exclusively caused by the weakness of the muscles of the heart. In some other conditions, it is caused by hardening or stiffening of the walls of the heart.  

Even though the name of the condition is heart failure, it doesn’t necessarily mean that the heart has stopped working completely. Heart failure refers to the fact that the heart is not functioning as it should, being unable to pump blood to all the parts of the body.  

The symptoms of heart failure include shortness of breath, leg swelling and excessive and recurrent tiredness. The shortness of breath is usually worsened by physical exertion. Additionally, it may wake the individual from sleep in the middle of the night. 

Differences between heart failure, a heart attack, and cardiac arrest 

Heart failure, as we have discussed, is a condition in which the heart cannot pump sufficient blood to the other parts of the body. In this case, the problem is from the heart’s muscles and is a result of weakness or hardening.  

A heart attack, on the other hand, is caused by muscle death. Some parts of the heart muslces die due to lack of blood supply. Without blood, there can be no oxygen, and that’s what causes the death of the muscles. Heart attacks are often a result of excess cholesterol in the body. The failure of the blood to reach the heart muscles is as a result of the obstruction of the arteries; it is not due to the insufficiency of the heart. Here the vessels are obstructed by plaques of cholesterol. 

Cardiac arrest is a term that implies that the heart stops working. There is no pulse, and no blood is being circulated in the body. A cardiac arrest is caused by anomalies in the electrical system of the heart. These are often called arrhythmias, and they occur when the heartbeat becomes irregular due to some conditions. 

The heart and blood supply to the body 

The heart is responsible for supplying blood and oxygen to all the parts of the body, and it does this through the cardiac cycle. As blood flows through the body, it receives useful substances from parts of the body and ejects unwanted substances through some other parts.  

For example, blood flows to the lungs picking up oxygen and dropping off CO2. It flows around the intestine to receive nutrients that were absorbed from the diet. It flows around the kidneys to remove excess water, salt and other substances. 

All of this blood flow is driven by the heart, and in this way, it maintains balance in the body. The heart has four compartments—the left and right auricle, and the left and right ventricle. Each of these is responsible for receiving and pumping blood to various parts of the body.  

The left side receives oxygenated blood from the lungs, pumping it into the body. The right side of the heart receives deoxygenated blood from the body and sends it back to the lungs for oxygenation. 

The compartment of the heart affected by heart failure determines the symptoms experienced. 

The types of heart failure 

Left-sided heart failure 

This is the most common type of heart failure, and it affects the left side of the heart. This is the side that’s responsible for pumping blood to the rest of the body, including the limbs and the organs.  

In left-sided heart failure, blood “backs up” in the lungs because the heart can no longer pump blood to the rest of the body. Symptoms seen in this kind of heart failure include shortness of breath and build–up of fluids 

Right-sided heart failure 

Right-sided heart failure affects the right side of the heart—the part responsible for receiving blood from the body and sending it to the heart. Very often, right-sided heart failure is caused by left-sided heart failure. When the fluid build–up in the lungs becomes excessive, it can cascade into failure of the right side as well. 

Diastolic heart failure 

When receiving blood from the lungs and the rest of the body, the heart muscles relax to accommodate the blood. However, in diastolic heart failure, the walls of the heart stiffen, making it difficult to relax and fill up with blood.  

The part of the cardiac cycle associated with filling the heart with blood is known as diastole, hence the name. Since the heart does not fill up properly, it cannot distribute blood to the rest of the body.  

Systolic heart failure 

The systolic part of the cardiac cycle is responsible for pumping blood out of the heart into the body. When the heart’s muscles are weakened or enlarged, the heart cannot pump properly. 

Causes of heart failure 

Heart failure can be caused by any condition that causes damage to the heart muscles. These include 

• Heart attacks 
• Cardiac myopathy.  
• Stress to the heart 
• Faulty heart valves 
• Myocarditis 

• Heart defects 

What are the symptoms of heart failure? 

The symptoms associated with heart failure are also seen in other conditions as well. However, these are also heart, and sometimes lungs related. The symptoms experienced in heart failure include 

• Shortness of breath 
• Fatigue and weakness 

• Swelling in the legs, ankles and feet 
• Arrhythmias 
• Persistent coughing and wheezing 
• Increased frequency of urination 
• Sudden shortness of breath  

How common is it, and who is at risk? 

A study reports that in 2015, 40 million people in the world had heart failure. About 2 out of every 100 adults have heart failure. In people over the age of 65, the number increases to 6 to 10%. In individuals over the age of 75, the number is greater than 10%. 

Heart failure is a condition that can affect anyone. However, some individuals are more predisposed to getting it than others. The risk factors include 

• Race. Africans have the highest risk of developing heart failure, relative to other races 
• Sex. Men have higher chances heart failure than women 

• Diseases like Anemia, hyperthyroidism, hypothyroidism, emphysema 
• Smoking 
• Obesity 
• High cholesterol diet 
• Diabetes 

• Cardiac arrhythmia  

How is heart failure diagnosed? 

When the symptoms appear, most people seek medical attention. Besides the symptoms and relevant history, other tests that are used to diagnose this condition include 

• Blood and urine tests. This is used to check the blood count. It also used to look for chemical markers of heart failure in the blood 
• Chest X-rays. This looks for heart enlargement and fluid in the lungs 

• Electrocardiogram. The ECG records the electrical activity in the heart and may reveal arrhythmias and other anomalies. Heart attacks often cause heart failure. 
• Echocardiogram. This is a scan that is used to check the functioning of the heard. The echocardiogram is the most conclusive test used in diagnosing heart failure. 

What are the treatment options available? 

There are several treatment options available for heart failure. However, it’s often best to take steps towards preventing the condition from ever occurring. Such steps include: 

• Quitting smoking 

• Healthy dieting 
• Regularly monitoring the blood pressure 
• Weight loss 

The treatment of heart failure is focused on preventing the progression of the condition and managing complications that might arise. Some of the means of handling this include: 

Medications 

This includes drugs like ACE inhibitors that can cause the arteries to relax and make pumping blood easier for the heart. Other drugs include Anticoagulants (reduce blood clotting), Digoxin (regulates heart rate in people with arrhythmias), Beta-Blockers and Antiplatelet drugs. 

Surgery 

If an individual does not respond to medications, surgical procedures can be performed. Valve repair and a complete heart transplant might be necessary for situations where no other means of treatment are available.

References 

https://www.ncbi.nlm.nih.gov/pubmed/27733282  

https://www.ncbi.nlm.nih.gov/pubmed/18799522 

https://www.ncbi.nlm.nih.gov/pubmed/28460827  

https://www.healthline.com/health/heart-failure#diagnosis  

https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure  

https://www.medicalnewstoday.com/articles/156849.php  

https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142