Heart Failure
Heart failure is a condition in which the heart cannot pump blood effectively enough to meet the body’s needs. It does not mean that the heart has stopped working. With timely diagnosis, appropriate treatment, and regular follow-up, many people with heart failure can manage their symptoms and maintain a good quality of life.
At DHEE Hospitals Cardiology, heart failure is evaluated based on the underlying cause, heart function, symptoms, and overall health. Treatment is tailored to each patient’s condition and may include medicines, lifestyle changes, procedures, or device-based therapy when appropriate.
What Is Heart Failure?
Heart failure develops when the heart muscle becomes too weak or too stiff to pump or fill with blood normally. This can reduce blood flow to organs and cause fluid to build up in the lungs, legs, feet, or other parts of the body.
Heart failure can develop gradually over time or occur suddenly. It may affect the left side, right side, or both sides of the heart.
Types of Heart Failure
Heart failure can be classified according to how well the heart pumps blood:
- Heart failure with reduced ejection fraction: The heart’s pumping ability is reduced.
- Heart failure with preserved ejection fraction: The heart pumps with a relatively preserved ejection fraction but may have difficulty relaxing and filling properly.
- Heart failure with mildly reduced ejection fraction: The pumping function falls between the reduced and preserved categories.
The type of heart failure helps the cardiologist determine the most appropriate treatment.
Causes of Heart Failure
Several conditions can damage or weaken the heart and eventually lead to heart failure. Common causes include:
- Coronary artery disease
- Previous heart attack
- Long-standing high blood pressure
- Heart valve disease
- Cardiomyopathy
- Abnormal heart rhythms
- Congenital heart disease
- Heart muscle inflammation or other forms of heart damage
In some patients, more than one condition may contribute to heart failure.
Symptoms of Heart Failure
Symptoms can develop gradually and may initially be mistaken for normal tiredness or ageing. Common symptoms include:
- Shortness of breath, especially during activity
- Breathlessness while lying flat
- Waking up at night feeling short of breath
- Persistent tiredness or weakness
- Swelling of the feet, ankles, or legs
- Rapid or irregular heartbeat
- Persistent cough or wheezing
- Reduced ability to exercise
- Rapid weight gain due to fluid retention
- Reduced appetite or a feeling of fullness
When Should You Seek Emergency Care?
Severe or sudden symptoms can indicate an acute worsening of heart failure or another serious cardiac problem. Seek emergency medical attention for severe breathlessness, chest pain or pressure, fainting, sudden severe weakness, confusion, or coughing up pink or blood-tinged frothy sputum.
Risk Factors for Heart Failure
The risk of developing heart failure increases with certain cardiovascular conditions and lifestyle factors, including:
- High blood pressure
- Coronary artery disease
- Previous heart attack
- Diabetes
- Obesity
- High cholesterol
- Smoking
- Excessive alcohol consumption
- Family history of certain heart conditions
How Is Heart Failure Diagnosed?
A cardiologist may use several tests to determine whether heart failure is present and identify its underlying cause.
Medical History and Physical Examination
The doctor evaluates symptoms, medical history, blood pressure, heart rate, breathing, and signs of fluid retention.
Electrocardiogram
An ECG records the heart’s electrical activity and can help identify abnormal rhythms, previous heart damage, or other cardiac abnormalities.
Echocardiogram
An echocardiogram uses ultrasound to examine the heart’s structure and pumping function. It can also evaluate the heart valves and provide information about the ejection fraction.
Blood Tests
Blood tests may include tests for BNP or NT-proBNP, kidney function, electrolytes, blood count, thyroid function, and other conditions that can contribute to or worsen heart failure.
Other Cardiac Tests
Depending on the patient’s symptoms and suspected cause, the cardiologist may recommend a chest X-ray, stress testing, coronary angiography, cardiac MRI, or other investigations.
Treatment for Heart Failure
Heart failure treatment depends on its type, severity, underlying cause, and other health conditions. The goals are to control symptoms, reduce hospitalisation, improve heart function where possible, and support long-term health.
Medicines
Depending on the type of heart failure, doctors may prescribe medicines such as ACE inhibitors, ARBs, ARNIs, beta blockers, mineralocorticoid receptor antagonists, SGLT2 inhibitors, and diuretics. The choice and combination of medicines are individualised for each patient.
Treatment of the Underlying Cause
Managing conditions such as coronary artery disease, high blood pressure, abnormal heart rhythms, or heart valve disease can be an important part of heart failure treatment.
Device-Based Treatment
Selected patients may benefit from devices such as an implantable cardioverter-defibrillator or cardiac resynchronization therapy. These treatments are considered based on heart function, symptoms, heart rhythm, and other clinical factors.
Surgery and Other Procedures
When heart failure is caused or worsened by severe coronary artery disease or heart valve disease, procedures such as coronary revascularisation or valve treatment may be considered when appropriate.
Lifestyle Management
Lifestyle changes can support medical treatment and help manage symptoms. Depending on individual medical advice, patients may be advised to:
- Take prescribed medicines regularly.
- Monitor blood pressure and other relevant health measurements.
- Maintain a healthy body weight.
- Follow recommended dietary and fluid guidelines.
- Limit excessive salt intake when advised.
- Stay physically active within recommended limits.
- Avoid smoking.
- Limit alcohol consumption.
- Attend regular cardiology follow-up appointments.
Can Heart Failure Be Prevented?
Not every case of heart failure can be prevented, but controlling cardiovascular risk factors can reduce the risk. Managing blood pressure, cholesterol, diabetes, and coronary artery disease, avoiding tobacco, maintaining a healthy weight, and seeking treatment for heart disease can all contribute to better cardiovascular health.
Living With Heart Failure
Heart failure often requires long-term management. Patients should pay attention to changes in symptoms, swelling, breathing difficulty, exercise tolerance, and body weight. A sudden increase in weight over a short period can sometimes indicate fluid retention and should be discussed with a healthcare professional.
Regular follow-up allows the cardiology team to monitor heart function, adjust medicines, and identify complications early.
Heart Failure Care at DHEE Hospitals Cardiology
DHEE Hospitals Cardiology provides evaluation and management for patients with heart failure and related cardiovascular conditions. Assessment may include clinical evaluation, cardiac imaging, ECG, laboratory investigations, and other tests depending on the patient’s symptoms and suspected cause.
Treatment is planned according to the individual’s heart function, underlying condition, symptoms, and overall health, with ongoing monitoring when long-term management is required.
Frequently Asked Questions About Heart Failure
Is heart failure the same as a heart attack?
No. A heart attack occurs when blood flow to part of the heart muscle is suddenly blocked. Heart failure occurs when the heart cannot pump or fill with blood effectively enough to meet the body’s needs. A heart attack can damage the heart and become one of the causes of heart failure.
Can heart failure be cured?
Heart failure is usually a long-term condition, but appropriate treatment can control symptoms, reduce complications, and improve quality of life. In some cases, treating the underlying cause can significantly improve heart function.
Can people with heart failure exercise?
Many people with stable heart failure can benefit from appropriately prescribed physical activity or cardiac rehabilitation. The type and intensity of exercise should be discussed with the treating cardiologist.
Why do the legs swell in heart failure?
Heart failure can cause the body to retain fluid. This fluid can accumulate in the lower legs and ankles, causing swelling known as oedema.
Is shortness of breath always caused by heart failure?
No. Breathlessness can have many causes, including lung conditions, anaemia, infections, and other medical problems. A proper medical evaluation is needed to determine the cause.
