Heart Failure

What is heart failure?

Heart failure is a condition in which the heart’s ability to pump blood and oxygen around the body is impaired.

What are the symptoms of heart failure?

The main symptoms include shortness of breath on exertion, swelling in the ankles, or abdomen and lower back because of fluid retention; as well as lethargy and weakness. 

What are the causes of heart failure?

The most common cause of heart failure include heart attacks, high blood pressure and dilated cardiomyopathy (in which the main pumping chamber in the heart becomes enlarged and weakened). There are a large number of other causes of heart failure including valve disease, anaemia, thyroid disease, heart arrhythmias, cancer treatments such as chemotherapy, viral infection or excessive alcohol consumption.

What tests will I need to diagnose heart failure?

Your cardiologist will take a detailed history and examination and is then likely to move onto further tests, to confirm the diagnosis of heart failure. There a number of tests which can be done to diagnose heart failure. The basic tests include an ECG and echocardiogram (echo).  Further tests might be necessary to look into the causes in more detail and these might include: a cardiac MRI, an angiogram of the heart arteries and a holter monitor.  These tests will be organised in selective patients after detailed discussion with your cardiologist.

What treatments are available for patients with heart failure?

While heart failure is a serious heart condition, your quality and quantity of life can be significantly improved by a number of possible treatments.  This might include:

Medication

Regular medication such as beta-blockers, diuretics and blood pressure medication can be helpful. They need to be started cautiously and the doses gradually increased with careful monitoring of your blood pressure and blood tests (such as kidney function).  These tablets are usually taken life-long but together they can have very significant impacts on reducing both the symptoms of heart failure and improving life-expectancy for patients with heart failure.

Pacemakers and Implantable Cardioverter defibrillators

In some patients pacemakers maybe helpful in reducing the symptoms of heart failure and reducing the risk of hospitalisation with symptoms of heart failure. Implantable cardioverter defibrillators (ICDs) are sophisticated types of pacemakers, which can treat dangerous slow or dangerous fast heart rhythms, in patients with heart failure. This can be done either because the patients has suffered from a dangerous heart rhythm already (secondary prevention) or because their cardiologist believes they are at risk of developing dangerous heart rhythms in the future (primary prevention).  The ICD can be combined with a pacemaker in a device called CRTD and this device can help improve both quality and quantity of life as well.  Further information about pacemakers and ICDs can be seen in the pacemaker section of this website.

How can I help keep my heart healthy?

There are a number of life-style changes you can make to keep your heart as healthy as possible, including:

 

    1) stopping smoking

    2) reducing or even stopping alcohol 

    3) taking regular exercise such as  a brisk walk of at least 30-40 mins per day

    4) eating a healthy diet

    5) reducing your salt intake 

    6) keeping a healthy weight

    7) watching your weight regularly (a sudden increase in your weight, might reflect         an increase in fluid retention in your body)

    8) restricting your fluid intake 

What about emotional wellbeing?

Low mood, anxiety and depression are all common in patient living with heart failure.  Exercise can often be helpful in improving these symptoms and a graded exercise programme should be done in consultation with your cardiologist.  Some patients can also benefit from counselling and in some cases medication may be required. Please discuss these options with your family doctor.

Useful websites

The following websites can provide useful further information about heart failure including their causes and treatments:

British Heart Foundation

Pumping Marvellous

Cardiomyopathy UK

Dr. Raj Khiani | Consultant Cardiologist | 020 3598 9200 | drkhianisec@medserv.co.uk

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