Heart failure
What is heart failure?
Heart failure occurs when there is an imbalance between the heart’s ability to pump blood and the body’s needs.
Causes of heart failure
The heart can fail due to a problem itself or because their resilience is not enough to satisfy what the body will demand.
Heart failure due to heart disease
These diseases can cause heart failure:
Ischemic heart disease
Occurs when the coronary arteries that deliver blood to the heart suffer strictures that reduce or prevent blood flow and therefore oxygen supply. In some patients is slow and progressive. In others, consists of a clot or thrombus that produces speedy and complete obstruction of the blood vessel. The latter is what is known as heart attack, and can cause death of heart muscle loses its blood.
Heart muscle disease
Are conditions that affect the heart muscle:
Hypertensive cardiomyopathy (caused by uncontrolled hypertension).
Diabetic cardiomyopathy (caused by diabetes).
Hypertrophic cardiomyopathy.
Alcoholic cardiomyopathy (for abuse of alcohol).
Idopatica dilated cardiomyopathy (when unknown origin).
Myocarditis (inflammation of the heart muscle).
In general, these diseases cause dilation and significant loss of core strength. Some, such as alcohol or miocarditidis cardiomyopathy may be reversible with treatment.
Valvular
Occur when the valves do not function properly and the heart muscle is unable to compensate for the malfunctioning of these increased the strength or number of beats.
Arrhythmias
Both fast arrhythmias such as slow arrhythmias can cause heart failure.
Heart failure due to increased demand
Anemia, systemic infections in the body, thyroid disease, arteriovenous fistula or increased blood pressure cause a greater demand for blood body that sometimes, a healthy heart is not able to attend. Thus, treatment of these patients should focus on the disease that is causing the failure rather than the heart.
Symptoms of heart failure
Heart failure can be a disease without symptoms for a long time. Still, the predominant symptoms are:
- Unusual tiredness strain previously not caused. Blood does not adequately reach the muscle and causes muscle fatigue situation.
- Labored breathing due to stagnation of fluids in the alveoli of the lungs. If lying down is a feeling of suffocation forced to get up and sleep sitting up.
- Persistent dry cough and motivated by the retention of fluid in the lungs or by treatment with inhibitors of conversion. It is the latter case, the specialist can assess a change in treatment.
- The reduced blood flow to the brain can cause dizziness, confusion, mind blank and brief loss of consciousness. If these episodes associated with low levels of stress it is advisable to sit or lie down.
- The i insufficiency can cause blood flow to the kidneys is not sufficient, and produces fluid retention. This swelling is usually located in the legs, ankles or abdomen.
- Dyspnea and poor exercise tolerance and fatigue.
Diagnosis of heart failure
The specialist performs a detailed medical history:
- Cardiovascular risk factors in the patient.
- History of coronary artery disease.
- Hypertension or diabetes.
- Family history of cardiomyopathy or valvular heart disease.
- Recent infections.
- Symptoms related to exercise tolerance.
- Swelling.
- Heart rhythm disturbances.
- Physical examination to check blood pressure and heart rate.
- Heart and lung auscultation.
- Abdominal exploration.
In some cases additional tests are needed, such as X-ray, echocardiogram or stress test.
Prognosis of heart failure
Although the word failure, suggests a benign process, heart failure, without treatment, prognosis is worse than most of cancers and AIDS. With treatment the prognosis differs greatly from the causes behind it. For this reason reslta so important to prevent its occurrence and proper monitoring of indications and controls.
Treatment of heart failure
There are effective treatments to slow the progression of heart failure, improve quality of life, exercise capacity and prolong survival. They are:
- Diuretics improve congestive symptoms and reduce swelling or pulmonary congestion.
- Vasodilator drugs (such as nitrates or inhibitors of angiotensin converting enzyme) reduce the load at which the heart must work, increasing performance and lowering blood pressure.
- Beta-blockers reduce the heart rate.
- Digoxin is indicated in patients with atrial fibrillation.
In any case, the initial focus of any treatment for heart failure should always control hypertension or diabetes and restore the flow of blood supply.