Heart failure is a condition in which the heart muscle is weakened and is no longer able to efficiently pump blood.
DEFINITION
The term “heart failure” does not mean that your heart has stopped pumping, but rather that your heart muscle is no longer able to efficiently or sufficiently pump blood to meet your body’s needs. As a result, you feel tired, lacking in energy, short of breath, and your body is retaining water.
The heart is a fist-sized ■■■■■ whose role as a pump allows the circulation of oxygen-enriched blood throughout the body. When the heart is healthy, each cavity contracts in a coordinated effort; the upper chambers (atria) of the heart contract first, followed by the lower chambers (ventricles). These coordinated contractions help keep blood flowing between the lungs, heart and the rest of the body. If the heart does not beat in a coordinated fashion, the body is no longer receiving enough blood to function properly.
TYPES
The heart failure occurs when the heart no longer has as much force to expel blood in the arteries and it fills less blood because it is stiffened or dilated. Each contraction of the heart is therefore less efficient. Blood takes longer to pass through the arteries and tends to stagnate in the veins. It is because of this congestion of blood in the veins that it is called “congestive” heart failure.
Usually, heart failure affects one or the other of the 2 ventricles, the right or the left. In some cases, it may happen that both ventricles are affected.
- Left heart failure. It is the most frequent form. Fluids build up in the tissues and concentrate mainly in the lungs, causing marked breathing difficulties (shortness of breath, wheezing, etc.). Arterial hypertension that has not been treated or poorly treated for several years and coronary disorders a heart weakened by angina pectoris or infarcts are the main culprits.
- Right heart failure. This time, the accumulation of fluids is located mainly in the legs and ankles, causing them to swell. It is often caused by left heart failure, but can also be the result of lung diseases, such as chronic bronchitis, emphysema, or pulmonary embolism.
CAUSES
Usually, heart failure develops slowly after heart injury. There is no single cause, and sometimes the causes are not known.
The most common causes of heart failure are:
- History of heart attack (myocardial infarction)
- Coronary artery disease
- High blood pressure
- Heart valve disease (valve disease)
- Heart infection (myocarditis)
- Congenital heart disease
- Inflammation of the innermost layer of the heart (endocarditis)
- Diabetes (insufficient or insufficient use of insulin)
People at risk
- People with coronary artery disease (angina pectoris, myocardial infarction) or cardiac arrhythmia. About 40% of people who have had a myocardial infarction will have heart failure. This risk decreases when the infarction is treated well, early;
- People born with a congenital heart defect that affects the contractile function of either ventricle of the heart
- People with heart valve problems ;
- People with chronic lung disease
Risk factors
The most important
- Hypertension;
- Smoking;
- Hyperlipidemia;
- Diabetes.
- Severe anaemia;
- Untreated hyperthyroidism;
- Obesity;
- Sleep apnea;
- Physical inactivity;
- A diet rich in salt;
- Metabolic syndrome;
- Alcohol abuse.
SYMPTOMS
Heart failure is a pathology whose worsening is progressive. At first, you may not experience any symptoms, but over time your heart will gradually lose its role as a pump and you will start to experience any or all of the following symptoms 1,2,4,5 :
- Chronic lack of energy
- Difficulty falling asleep due to problems with respiratory congestion
- Confusion and/or memory impairment
- Need to urinate more frequently at night
- Swelling of feet and legs
- Shortness of breath
- Swollen and painful abdomen with loss of appetite
- Fatty cough
DIAGNOSTIC
In the presence of suggestive symptoms (fatigue, shortness of breath, oedema, etc.), an assessment is necessary. The medical check-up allows the doctor to confirm heart failure, assess its severity and look for the cause (sequelae of myocardial infarction, arterial hypertension (hypertension), heart valve disease, heart muscle disease.
Only your doctor can tell you if you have heart failure and tell you the stage of the pathology. Your doctor will review your medical history, including previous and current illnesses, family history, and lifestyle. As part of your physical examination, the doctor will check your heart, lungs, abdomen and legs to see if there are signs of heart failure 1 .
To rule out or confirm the diagnosis, your doctor may order one or more of the following diagnostic tests:
- Echocardiography
- Electrocardiogram (ECG)
- Chest x-ray
- Stress test
- Cardiac catheterization (exploration of the heart using a lead) or coronary angiography
POSSIBLE COMPLICATIONS
They vary depending on the person’s state of health, age, the cause of heart failure and its severity.
Left untreated, heart failure can quickly lead to serious complications. Fluids build up in the lungs and make it difficult to breathe. The risk of arrhythmia and cardiac arrest increases. Also, if a blood clot forms in the veins, it can block the pulmonary artery pulmonary embolism, a potentially fatal problem. Finally, if left untreated, heart failure can damage the liver and kidneys, which are vital organs.
TREATMENT OPTIONS FOR HEART FAILURE
In some patients with heart failure, the lower chambers (the ventricles) of the heart do not beat at the same time, forcing the heart to work ■■■■■■ to pump blood to the whole body.
Heart failure is a progressive pathology. Your cardiologist can offer you various treatment options that may slow the progression of the disease, make your heart more efficient, and improve your quality of life. These options may include drug treatment, a change in lifestyle, the practice of physical activity and the ■■■■■■■ of a therapeutic medical device, or even a combination of these treatments. Only your cardiologist can determine the best option for you.
LIFESTYLE CHANGES
Your doctor may recommend lifestyle changes, such as quitting smoking, limiting salt intake, losing weight, or reducing stress levels. These changes can help alleviate some of the symptoms of heart failure and decrease fatigue in your heart.
MEDICATIONS
Many medicines are used to treat heart failure. Your doctor may prescribe ACE inhibitors, beta-blockers, blood thinners, and diuretics, among others. Usually, a combination of drugs is used.
CARDIAC RESYNCHRONIZATION THERAPY
A heart device implantation called a cardiac resynchronization device may be right for you. This sends electrical impulses to the lower chambers of your heart to help them beat in a more coordinated or “synchronized” fashion. This can help in improving the pumping efficiency of the heart.
HEART SURGERY
If your heart failure is caused or worsened by a weakened valve, your doctor may consider heart surgery to repair or replace the valve. If the heart failure is severe and irreversible, a heart transplant may be considered.
Talk to your doctor about treatment options that are right for you.
BASIC PREVENTIVE MEASURES
The first preventive measures to take are to reduce the risk factors mentioned above. These risk factors are the same as those that lead to heart problems resulting from atherosclerosis (angina pectoris and myocardial infarction). They are intimately linked to lifestyle habits: a healthy and varied diet, physical exercise, stopping smoking and, if necessary, controlling hypertension, cholesterol and diabetes. For more details on prevention, see our Cardiac Disorders fact sheet.
Periodically consult your doctor for a health check. If in doubt, the doctor may suggest an evaluation of the function of the ventricles by echocardiography.
Measures to prevent worsening or complications
As soon as the first symptoms appear, immediately consult a doctor. An early diagnosis, good medical follow-up, taking medication if necessary, but also improvements in lifestyle can slow the progression of the disease.
In addition to the factors mentioned in the basic preventive measures, take care to :
- maintain a healthy weight;
- learn to better control stress;
- Limit alcohol consumption;
In addition, avoid the following factors, which exacerbate the symptoms:
- a diet too rich in salt or fat;
- excessive consumption of water, juice, drinks or soups;
- taking medicines that cause water and salt retention (for example, anti-inflammatories).
Since infections affecting the respiratory tract aggravate symptoms of heart failure, vaccination against influenza and against pneumococcal disease is recommended.