Heart Failure

What is Heart Failure?

Heart Failure is a condition in which the heart is unable to pump blood effectively to meet the body's needs, leading to symptoms such as breathlessness, swelling of the feet (pedal edema), fatigue, and a sensation of rapid or irregular heartbeat even with minimal activity. Early recognition and goal-directed medical treatment are essential to improve quality of life and reduce complications. Modern heart failure management rests on five key pillars: careful volume status management to prevent fluid overload, graded exercise programs to improve functional capacity, prevention of sudden cardiac death through devices like ICD (Implantable Cardioverter Defibrillator), use of disease-modifying medicines to slow disease progression, and in selected patients, cardiac resynchronization therapy (CRT) to enhance heart efficiency.

Heart Failure with Poor LV Function

Heart Failure with Low Ejection Fraction (HFrEF) occurs when the heart's pumping ability is significantly reduced, leading to inadequate blood flow to meet the body's needs. Patients often experience breathlessness, fatigue, swelling of the legs, and palpitations, even during minimal day-to-day activities. Effective management involves goal-directed medical therapy and a structured approach targeting the core pillars of care: optimizing volume status, encouraging graded exercise, preventing sudden cardiac death with devices like ICD, and using disease-modifying medications to slow disease progression and improve survival.

Heart Failure with Normal LV Function

Heart Failure with Normal Left Ventricular Function (HFpEF) occurs when the heart's pumping strength is preserved, but the heart is stiff and cannot fill properly, leading to inadequate blood flow and fluid buildup. Patients commonly experience breathlessness, fatigue, swelling of the legs, and difficulty performing everyday activities, especially with exertion. Management focuses on relieving symptoms, controlling blood pressure, managing fluid balance, and addressing underlying conditions such as diabetes, hypertension, and coronary artery disease.

Causes and Management

Heart failure can happen due to disease of the myocardium (heart muscle), heart valve problems, or pericardial disease. Patients at risk include those with high blood pressure, diabetes, coronary artery disease, previous heart attacks, obesity, chronic kidney disease, a family history of poor left ventricular function, and myocarditis. Lifestyle factors such as smoking, excessive alcohol use, and sedentary habits also increase risk. Early identification and management of these factors through regular cardiac check-ups, lifestyle modifications, and preventive medications can help reduce the likelihood of developing heart failure and improve long-term heart health.