Causes, Symptoms And Treatment Of Heart Failure

What is heart failure?

Heart failure, or cardiac insufficiency (congestive heart failure) is a condition in which the heart is no longer able to pump sufficient blood to meet the needs of the tissues to meet. Under normal circumstances, there is a balance between the amount of blood that the heart pumps out (cardiac output) and the needs of the tissues with oxygen and nutrients . When changing needs of the tissues in cardiac output is adjusted accordingly. The tissues also arrange their own optimal blood flow by squeezing their arteries or just need to open.

Heart failure symptoms

As a result of the decreased pumping function of the heart get a lot of organs , in particular, initially at elevated question, not enough oxygen and nutrients more. This in turn leads to rapid fatigue and shortness of breath on slight exertion. The body attempts by regulatory mechanisms to increase the filling of the vascular bed, which again ensures that the body retain fluid. Patients suffering from heart failure also often experience more fluid in the longvaatbed (often anatomically incorrect as fluid behind the lungs' indicated), in severe cases resulting in pulmonary edema causing the shortness of breath worsens significantly, especially when lying flat. The symptoms often resemble those of asthma (shortness of breath, fatigue, acute decompensation therefore called cardiac asthma ). Further, there remains fluid behind in the lowest parts of the body causing swollen legs and ankles (peripheral edema) occur. As a result of the symptoms of heart failure occur in the body compensatory mechanisms. These short-term may have a beneficial effect on the above symptoms, but in the long term, worsen these compensatory mechanisms correct the failure. The patient is then in a vicious circle justified. The heart failure can be especially on the left or on the right ventricle be due. However, the long then go join both rooms.

There is a distinction between acute and chronic heart weakness. In acute heart failure, the heart is functioning suddenly less well. In chronic heart failure has been a gradual onset operating deficit.

 is a condition in which the heart is no longer able to pump sufficient blood to meet the  Causes, Symptoms And Treatment Of Heart Failure

Causes of heart failure

Heart failure has many different causes.
  • Systolic heart failure, corresponding to a reduced clamping force of the left ventricle, or both chambers of the heart, caused by:
-A heart attack . As a result of a myocardial infarction is a portion of the heart muscle dead and scarred, and therefore a part of the pumping function is lost.
-A metabolic variety of chemicals which accumulate in the muscle and eventually affect muscle function adversely. eg iron overload ( hemochromatosis ).
-An infection of the heart muscle either ( myocarditis ), typically caused by viruses.
-Toxic alcohol, and certain anticancer drugs damage the heart muscle.
-Metabolic: lack of certain vitamins leads to heart failure (wet beriberi "or Shoshin ).
-Certain types of cardiomyopathies , eg dilated cardiomyopathy or arrhythmogenic cardiomyopathy.

  • Diastolic heart failure, or a disorder of the heart in the relaxation so that during the filling phase but little blood to flow into the left ventricle. The mechanism for this is not fully understood, but the following factors:
-Longstanding hypertension.
-Certain types of cardiomyopathies , eg hypertrophic cardiomyopathy.
  • Heart Valve Defects - Valve Defects caused by an infection, by degeneration or congenital.
-A leaking heart valve (valve insufficiency) to give (a part of) the blood from flowing back again and again has to travel the same path. For example, a mitral regurgitation or aortic regurgitation .
-A narrowed heart valve, eg aortic stenosis.
  • Cardiac arrhythmias .
-Sometimes, heart failure is caused by long-lasting cardiac arrhythmias, in which by a long-lasting increased heart rate less well the heart is able to pump blood.
  • Restrictive cardiomyopathies , previously mentioned stapelingsziekfen may also give a relexatiestoornis in addition to a reduced pinch force.
  • Pericardziekten . These are diseases of the pericardium that surrounds the heart largely. Diseases of the pericardium can result in an inflow obstruction of the heart. The heart then has enough space to fully develop, causing insufficient blood flow into the heart. Causes include:
-A pericarditis exudative. This is an inflammation of the pericardium, so that increase in moisture occurs in the pericardium. This can be caused by viruses, bacteria, metabolic causes, drug therapy, etc, and also by cancer. In the latter case it is called pericarditis carcinomatosis .
-An armored heart or a constrictive pericarditis . Here the pericardium is stiff and heart. This can be infectious (tuberculosis), but also (rarely) develop after open heart surgery.
-A trauma or after an operation, allowing blood to accumulate in the pericardium.

Incidentally, in a part of the cases, the cause of the heart failure unknown.

Heart failure diagnosis

Heart failure is not a single disease but a symptom complex resulting from a heart disease resulting in impaired cardiac function. In a combination of the symptoms can physician using various techniques to determine the severity and cause.
  • ECG
  • Radiographs of the thorax ( chest radiograph )
  • Blood tests (BNP determination)
  • Echocardiography .

Heart failure can be divided on the basis of the symptoms according to the NYHA classification, this condition for the New York Heart Association. NYHA classification consists of four classes.
  • Class I: dyspnea only with considerable effort, no symptoms during normal activities.
  • Class II: shortness of breath occurs at moderate effort.
  • Class III: dyspnea has been performing with little effort.
  • Class IV: dyspnea at rest.

Heart failure treatment

The treatment of heart failure is primarily directed to the trace and treatment of the underlying cause. Causes may include severe coronary artery disease, a leak valve or a valve stenosis.

If there is a reduced muscle of the heart, the drug treatment consists of the following medications:
  • Beta-blockers : bisoprolol , carvedilol and metoprolol , reduce heart rate, and are the only beta blockers which have a beneficial effect has been demonstrated in the long term
  • ACE inhibitors and ARBs : Breaking the compensatory mechanisms that worsen heart failure. ACE inhibitors and ARBs are roughly equally effective. There are indications that the addition of an ARB to existing medication gives positive effects. For ARBs is that they may serve as an alternative for those ACE inhibitors poorly tolerated.
In addition, the following drugs should be considered:
  • Coumarins : reduce the chance of the formation of clots in the affected heart.
  • Diuretics (water pills) stimulate the expulsion of moisture through the kidneys causing the edema decrease. They are therefore given only if edema are present.
  • Digoxin . This is the last step in the drug treatment. This drug improves the contractile force of the heart (positive inotropic effect).
If despite optimal medication still there is in class III or IV heart failure of NYHA classification of a can, biventricular pacemaker should be considered.


Heart failure brings with it many changes in everyday life, including strenuous activities and food and moisture. As a heart failure patient's fluid in the body can be bad "process" the patient is usually imposed on a fluid restriction. This means that the patient is not more than a certain number of liters of fluid per day should consume. A sodium restricted diet will also be recommended, because sodium (salt) water retention.

Because the heart is functioning worse, the less well pump blood through the body. This allows the patient has less energy, so for example a floor stairs all can be tiring. Tools such as a wheelchair or scooter will therefore be quickly recommended. This can cause a heart failure patient have much impact, especially if the care recipient before the failure instance did a runner.

People with heart failure, there will be at fairs , in amusement parks , swimming pools , and should take into account that certain museums them to several attractions, with some degree g-forces are present, no access. For example, in a roller coaster the body has to deal with a lot of g-forces. This blood is different sides of the body 'pushed'. A heart with heart failure can not adapt to it, because it may not be powerful enough pumps. In the worst case this can be a cardiac arrest cause. The symbol on the right figure is therefore very important for heart failure patients.

Heart failure prognosis

Heart failure is a chronic condition, and the longer-term prospects are usually pretty bad. If the cause can not be handled (e.g., by replacement of a heart valve) is the life expectancy , statistically, only a few years - worse than for most forms of cancer . The treatment with drugs leads to a reduction of symptoms and a delay of the progression of the disease, but can never be more completely cure the patient. When someone with heart failure has been observed in addition to drug therapy is recommended to live as healthy as possible, for example by stopping smoking. Death occurs occasionally in by gradual deterioration of the failure to the point that it is untreatable, sometimes suddenly by a fatal heart arrhythmia .

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