Heart failure is a condition when the heart becomes weak and fails to pump the adequate amount of blood vital organs of the body, which affects the body at a cellular level and hampers the body from functioning effectively and consequent failure of organs.
In India, most heart failures are diagnosed after succumbing to heart attacks. During this one or more blood vessels supplying blood to the heart muscles get blocked completely and the portion of heart deprived of blood eventually turn into scarred tissue, unable to contract the overall efficiency of the heart reduces. If the scar is big and the effect covers a large area, then it could indefinitely cause death.
In the past 40 years, treatments in cardiac care have tremendously improved through heart bypass surgery and the usage of stents for more stable conditions, while most patients survive but do so with a poor pumping of heart which could eventually lead to heart failure. As of now, we are facing an epidemic of heart failures caused by cardiac diseases. Also, since viral infections are becoming more common, they can induce inflammation in the heart and cause viral myocarditis. This infection can run its course in three types of ways
1. It can be treated and may never affect the patient again
2. It may worsen and affect the overall lifestyle, but with the intake of medicine and treatment it can be stabilised
3. It can affect the entire heart, which may hamper its overall functioning to a large extent.
Various other reasons like vitamin deficiencies, childbirth, family history etc can trigger myocardial failure.
Heart failure can affect the left part of the heart (responsible for pumping blood to the entire body) or the right part of it (pumps impure blood to the lungs and returns pure blood to the heart). A person who has problems in the right part will often face issues like a stiff heart or congested lungs which can affect air exchange and cause breathlessness.
People with left heart failure will have symptoms like fatigue, which is caused when the impure blood which comes back cannot be pumped and blood gets trapped which causing oedema or swellings in various parts of the body. Sometimes advancements in left/right failure can lead to mixed heart failure which occurs due to intense backpressure.
Various diagnostic methods are used to identify such problems through clinical examination, ECG and ECHO which uses ultrasound to image the heart through which, all structural and mechanical problems of the heart can be identified.
The most common aetiology that leads to heart failure are caused by coronary artery disease that supply blood to the heart muscles. When a person is diagnosed with diabetes, one of the most prevalent diseases in India, both the major and minor coronary arteries can get affected, they make these vessels wall thicker, narrow and block them leading to stiffer hearts. Many a time, heart failures may be due to systolic and diastolic pressure caused due to squeezing or stiffening of the heart which may not allow it to relax properly. Through ECG and the expertise of a Cardiologist, it can be managed and diagnosed by taking appropriate measures and treatments. Various Magnetic Resonance (MR) scans can help in finding a reputable reserve to opt for the right treatment to save lives. It can also check the effectiveness of the treatment and take necessary measures to improve the same.
Other diseases like valve diseases which can cause pressure or volume overload in the heart can also weaken heart muscles. Comorbidities like high blood pressure and diabetes, can also affect the heart eventually. This is why patients must be counselled on how to check sugar and blood pressure and manage their medications depending on their condition.
(Dr Vishal Jawali, Director, Cardiac Sciences, Fortis Hospital, Cunningham Road)
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