Heart failure

heart failure is a disease that occurs when the heart is unable to pump enough blood to the rest of the body, thus a situation of imbalance occurs since the blood supply is less than the body's requirements.

This disease appears in both men and women, however, in women it usually appears at a later age. Although it can occur at any age, its frequency increases over the years, being generally a disease of the elderly population.

How is it produced?

Under normal conditions, the heart is able to adapt to the different needs of the body and perform its function properly. When the heart has a lower power, the blood pumping is insufficient and the oxygen and nutrient needs that the body requires are not met.

heart failure can affect the right side, the left side, or all the heart.

If the left side of the heart is not working well (left heart failure), fluid builds up in the lungs. If the right side of the heart is not working well (right heart failure), liquid accumulates in different parts of the body such as the abdomen and legs.

heart failure affects the function of the kidneys that lose their ability to remove water and sodium. This accumulation of fluids in the body (arms, legs, lungs, abdomen, etc.) leads to the term of congestive heart failure.

What are the causes?

There are a large number of causes that can lead to heart failure. The two most common are high blood pressure and high blood pressure.

Among the causes of heart failure we can find:

• Ischemic heart disease: diseases of the coronary arteries such as angina pectoris or myocardial infarction that prevent proper blood supply to the heart muscle.
• Arterial hypertension: its long-term effects cause heart failure.
• Valvular disease: diseases of the heart valves that are defective for which the heart works with greater difficulty.
• Cardiomyopathies by involvement of the myocardium (heart muscle), they can be caused by the consumption of alcohol, drugs or by viral infections.
• Congenital heart disease: structural congenital defects of the anatomy of the heart and its vessels.
• heart rhythm disturbances: arrhythmias.
• Diseases that are accompanied by heart involvement such as multiple myeloma, hyperthyroidism, and neuromuscular diseases.
• Lung diseases such as chronic obstructive pulmonary disease or pulmonary thromboembolism. The alteration of the pulmonary circulation affects the functioning of the heart.
• Drugs and toxins.

Symptoms

One of the most frequent symptoms and one that most alarms the patient is feeling short of breath, which is known as dyspnea. It typically worsens when the patient lies down (orthopnea), with physical activity (exertional dyspnea), and at night (paroxysmal nocturnal dyspnea).

• Night cough
• Acute lung edema: it is a serious manifestation of heart failure caused by the presence of fluid in the lungs. It requires urgent medical attention.
• Palpitations, especially in those cases in which there is a basic arrhythmia.
• Chest pain
• Tiredness and weakness
• Confusion.
• Decreased amount of urine.
• Accumulation of fluids in different parts of the body: legs (edema), ascites (abdomen). This causes rapid weight gain.

Diagnosis

Diagnosis is based on the characteristic symptoms and signs of this disease together with imaging evidence of heart dysfunction.

The physical exploration it allows to detect signs of heart failure such as the accumulation of fluid in the legs (edema), abnormal cardiac and pulmonary auscultation (rales), enlargement of the liver (hepatomegaly), abnormal skin coloration due to poor oxygenation.

The scans that are usually performed routinely in a patient with heart failure include:

• blood and urine analysis.
• Electrocardiogram.
• Chest X-ray: allows you to see the size and shape of the heart as well as the lung fields.
• Echocardiography: studies the function of the heart and its morphology.

Treatment

The treatment of heart failure has been changing, going from treating only the symptoms of the disease to performing other treatments aimed at slowing its progression and thus reducing its complications and mortality.

General lifestyle recommendations. It is important to follow them as they will help to greatly improve the quality of life of the patient.

• Physical activity: regular physical exercise adapted to each patient is beneficial. For example, walking for half an hour 4-5 times a week or cycling for 20 minutes. The doctor can carry out a tailored exercise program.
• Working life: the patient's work must be adapted to his physical capacity. It is recommended that you maintain an active work and social life.
• Diet: it is advisable to reduce your salt intake and follow a balanced diet low in fat and cholesterol. Overweight should be avoided with a proper diet.
• Tobacco and alcohol: the consumption of tobacco and alcohol is contraindicated.
• Vaccines: annual flu and pneumococcal vaccination is recommended.

Treatment of underlying cause of heart failure, that is, of the disease that is causing it.

Treatment pharmacological: there are a large number of drugs available that act in various ways in heart failure such as eliminating excess fluids (diuretics), improving the contraction of the heart, regulating the blood supply to it or the heart rate.

Currently there are new treatments different from the usual traditional drugs. These treatments include cardiac resynchronization (use of a type of device similar to a pacemaker), heart surgery, and heart transplantation. The indication of these treatments will be given by the specific clinical situation of each patient.

Prevention

heart failure is a chronic disease, therefore it is important to educate the patient about his disease to maintain the best quality of life and avoid complications of the disease. Prevention is aimed at avoiding all those situations or diseases that may aggravate it. Avoiding tobacco and alcohol, controlling blood pressure and cholesterol, exercising, managing stress, and taking medications prescribed by your doctor are very useful measures.