HEART FAILURE

Heart failure is also known as congestive heart failure, which means the heart does not pump effectively. Enough amount of oxygen and nutrients cannot be supplied to the body due to this. Heart failure can be acute or chronic. Various factors are responsible for slow blood flow and increased heart rate.

Diagnosis and Treatment

The doctor will ask questions about your symptoms and medical history. You will be asked about conditions such as coronary artery disease, diabetes, heart valve disease, and high blood pressure, smoking and drinking habits that can cause heart failure.
The doctor will ask for a complete physical check-up of the heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Physical tests will include:

  • Blood tests are used to evaluate kidney and thyroid function, cholesterol and -haemoglobin level in blood. NT- proBNP test is performed for determining the progression of heart failure. Based on the results of the test, best treatment plans are chosen for the patient.
    Normal level of NT-proBNP
    • Less than 125 pg/mL for 0-75 years
    • Less than 450 pg/mL for 75-99 years
    If you have heart failure
    • Higher than 450 pg/mL for under 50 years
    • Higher than 900 pg/mL for older than 50 years
  • A chest X-ray for observing the size of the heart and fluid build-up around the heart and lungs.
  • An echocardiogram is an ultrasound that shows the heart's movement, structure, and function.
  • An Electrocardiogram for recording the electrical impulses travelling through the heart.
  • Cardiac catheterization for determining coronary artery disease that could be the cause of congestive heart failure.

Your physicians may order other tests depending on your condition. The number of physical tests done depends on the patient’s clinical assessments and case severity.

Causes of Heart Failuree

Heart failure isn't caused directly, it occurs due to factors and damages caused by other diseases contributing to the weakening of cardiac muscles. Causes of heart failure:

  • Conditions that overwork the heart like high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects since birth and several diseases or conditions are present at once.
  • Blockage in the arteries leading to coronary artery disease.
  • Cardiomyopathy- A condition in which the condition of deteriorates due to infection, alcohol, drug abuse and blood flow

Symptoms of Heart Failure

Heart failure signs and symptoms include:

  • Shortness of breath
  • Fatigue and weakness
  • Swelling (oedema) of legs, ankles and feet.
  • Rapid or irregular heartbeat.
  • Reduced ability to exercise.
  • Persistent cough or wheezing.
  • Increased need to urinate at night,
  • Swelling of the abdomen (ascites).
  • Rapid weight gain from fluid retention.
  • Lack of appetite and nausea.

The symptoms might overlap with other heart and lung conditions but in any case, one must seek immediate help as it can be life threatening.

Treatment for Heart Failure

Heart failure is a chronic disease that requires lifelong management. Proper treatment will reduce the chance of sudden death and improve heart condition.

  • Non-pharmacological
    1. Lifestyle modification: Eat foods high in fibre and limiting foods high in trans-fat, cholesterol, and sugar. A regular cardiovascular exercise program can help decrease heart failure progression.
    2. Enhanced External Counterpulsation (EECP): It is a non-invasive treatment designed to help lower the intensity of angina. It involves application of external inflatable cuffs around the lower legs, upper legs and buttocks.
  • Pharmacological- Medications should be taken for increasing the heart's ability to pump blood, decrease stress, decrease the progression of heart failure, and prevent fluid retention. Drugs are prescribed for blood vessel dilation and stop the release of harmful chemicals.
  • Device related- CRTP(Cardiac resynchronisation therapy), AICD and finally heart transplant option can be looked at.
  • Surgery for valve replacement and coronary artery repair

Complications

If you have heart failure, complications can include:

  • Heart rhythm problems
  • Liver damage
  • Heart failure can cause kidney damage by reducing the flow of blood to the kidneys.
  • Heart failure stops functioning of valve due to increased pressure and enlargement of heart.

Prevention And Treatment for Heart Failure

Prevention And Treatment for Heart Failure :

  • Not smoking
  • Controlling certain conditions such as high B.P. and diabetes.
  • Staying physically fit.
  • Eating healthy food
  • Maintaining a healthy weight.
  • Reducing and managing stress.

When is it ordered?

  • A BNP or NT-proBNP test may be ordered by a healthcare practitioner when you have signs and symptoms that could be due to heart failure. These may include :
  • Difficulty breathing, shortness of breath.
  • Fatigue
  • Swelling in feet, abdomen, ankle and legs is observed.

What does the test result mean?

  • Higher-than-normal results suggest that you have some degree of heart failure, and the level of BNP or NT-proBNP are often associated with an increase need for aggressive therapy.Though in some individuals the values may remain elevated and true condition cannot be monitored.
  • Reports showing normal levels, indicates the presence of some other disease or problem than heart failure.

What are Normal and High BNP Levels?

Sr. No Condition Ages BNP Level (pg/mL)
1. Normal Any Less than 300
2. Possible heart failure Under age 50 More than 450
3. Possible heart failure Between ages 50 to 75 More than 900
4. Possible heart failure Over age 75 More than 1,800
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