HEART FAILURE

WHAT IS HEART FAILURE ?

 

                                                  

Heart is said to be failing when it is unable to pump  enough  blood for the body either in its resting or more active physiological states. This lead to a variety of pathological changes in the body. Heart can fail either on left, right or both. All these types have varied pathologies and symptom states. When both the sides fail , it is commonly referred to as congestive heart failure. 

WHAT ARE THE TYPES OF HEART FAILURE ?

Boadly these are right and left heart failures. Left heart failure can again be divided into systolic and diastolic heart failures. 

Depending on the duration it can be acute or chronic.

Another description is compensated heart failure or non compensated heart failure.

 

                                                 

WHAT ARE THE CAUSES OF HEART FAILURE ?

CAUSES OF LEFT HEART FAILURE

SYSTOLIC FAILURE

Systolic heart failure is when forward ejection from the heart fails. Thia may be due to loss of musle in the left ventricle or an obstruction in the forward flow like Aortic stenosis or mitral stenosis.

  1. ISCHEMIC HEART DISEASE..
  2. Either from a stunned myocardium or scarred myocardium,effective ejection from the ventricle falls short of the required.
  3. VALVULAR HEART DISEASES
  4. Valvular heart diseases like aortic stenosis or mitral stenosis, hinders the forward flow.
  5. HYPERTENSIVE HEART DISEASES     
  6. The left ventricular hypertrophy or the thickening of muscles, hinders effective forward ejection thereby resulting in systolic heart failure.
  7. HOCM OR  HYPERTROPHIC OBSTRUCTIVE CARDIO-MYOPATHY
  8. HOCM or hpertrophic obstructive cardiomyopathy is a condition where in left ventricle and the interventricular septum gets hypertrophied without obvious reason and leads to left ventricular outlet obstruction.

DIASTOLIC HEART FAILURE

In the diastolic heart failure , there is loss of compliace of the left ventricle in diastoic filling leading to build up of pressure inside it in this phase of heart contraction and eventual high build up of pressure in the heart chamber behind,which is left atria and the consequent lung congestion.

  1. ACCOMPANIES SYSTOLIC HEART FAILURE.
  2. When the heart is not completely emptied in case of a forward pump failure, a slow build up of pressure eventually affected in the concerned chamber which is left ventricle.
  3. HYPERTENSIVE HEART FAILURE
  4. In chronic hypertensive, left ventricular wall is hypertrophied and stiffened, contractions are ineffective and pressure builds up in diastole or the relaxation phase.

CAUSES OF RIGHT HEART FAILURE

  1. PULMONARY HYPERTENTION.
  2. When pulmonary hypertention is elevated, naturally the right ventricle struggles. This elevated pulmonary pressure is noticed in primary pulmonary hypertention, left to right shunts, and in certain more complicated birth defects of the heart.
  3. CONGENITAL HEART DISEASES
  4. Congenital heart con,conditions like atrial septal defects, ventricular septal defects, patent ductus artereosus, aorto -pulmonary collaterals, post-operative tetrology of Fallot, can have isolated right ventricular faiure.
  5. VALVULAR HEART DISEASES.
  6. Conditions like tricuspid regurgitation, Ebstein anomaly,pulmonary regugitation as well as pulmonary stenosis can lead to isolated right ventricular failure.

WHAT ARE THE SYMPTOMS OF HEART FAILURE  ?

Acute heart failure can severely compromise the blood supply to vital organs like brain, kidney and liver in addition to compromising oxygenation in the lungs due to lack of forward blood flow from the lungs. In severest states this can be a cause of death.

In less acute cases, lack of adequate blood supply to vital organs results in fatigue, syncopial attacks, limitation of physical activities. May be breathless due to permanently congested lung fields. Breathlessness at the smallest of physical activities can progress to breathlessness at rest or while even lying down.

WHAT ARE THE COMPLICATIONS OF HEART FAILURE ?

Can lead to lung congestion, chronic kidney impaiment, chronic liver malfuntion, pulmonary hypertention,etc

HOW HEART FAILURE IS DIAGNOSED ?

By a combination of symptom analysis, ecg, echocardiogram, MRI scanning , biochemical tests and coronary angiogram.

WHAT ARE THE TREATMENT OPTIONS FOR HEART FAILURE  ?

  • Medical managent
  • device therapies
  • surgical treatments