Our heart is the strongest muscle in the body. It pumps blood eighty times a minute from fetal life till the day we die without any rest. However, it may become weak and unable to pump blood as required by the body. It may happen due to various reasons such as diabetes, hypertension, coronary artery disease, valvular heart disease, and cardiomyopathies. This gradual weakening of the heart muscle is known as heart failure. The common symptoms include breathlessness, fatigue, edema of the legs or abdomen. It is necessary to talk about it because of the rise in mortality between thirty to fifty percent, if left untreated. It is now being called a pandemic of sorts.
When the doctor uses the term Heart Failure, people often believe that the heart will stop today or tomorrow. Diagnosed patients tend to take advice from neighbors, relatives, etc., instead of relying on professional advice thereby worsening their prognosis. These kinds of dangerous self-medication may also be related to cost factors depending on the economic strata of the patients.
To help spread awareness around Heart Failure and its management, The Times of India in partnership with Novartis launched Beat Heart Failure. The initiative was joined by leading doctors from Apollo Hospital, Kolkata. They talked about the non-pharmaceutical way of managing the disease, reducing re-hospitalization, also educating and preparing patients for a heart transplant for a better life.
“Dr. Surinder Singh Bhatia, Director Medical Service – Eastern Region also emphasis that Heart failure is among the frequent reasons for an urgent admission to hospitals. The high incidence, frequent admissions pose a high public health burden and staggering cost to the society. Better understanding of the physiology and modern drugs have gradually improved the prognosis and quality of life in these patients” The doctors joining the discussion are: 1. Prof. (Dr.) Suvro Banerjee: Senior Consultant Interventional Cardiologist 2. Dr. Raja Nag: Consultant Interventional Cardiologist 3. Dr. Sushan Mukhopadhyay: Director, Department of Cardiothoracic & Vascular Surgery https://fb.me/e/2kdozTqEP One of the main reasons for an increase in heart failure cases in the twenty-first century is the improvement in healthcare. We, Indians, are outliving our ancestors with the advancement of medical science, remarked Dr. Mukhopadhyay. A rise in life expectancy is unraveling a vast area of diseases that were not seen earlier, such as cardiovascular, coronary vascular diseases, diabetes, and hypertension. Longevity in life span seemed to have opened a new clinical arena. The mortality rate of heart failure is between thirty to fifty percent, and ten years younger patients are seen here than the global average.
There are two different types of heart failure depending on the heart’s pumping capacity, which are challenging to differentiate, explained Dr. Banerjee. The heart’s pumping capacity gets reduced due to coronary artery disease and high blood pressure. In the elderly, the pumping capacity does not decrease, but the heart muscles become stiff without increasing the pressure inside the heart. It is seen that the risk factors are already present for a long time, and the patients live longer with impaired heart function, adversely impacting the individual’s health. We have observed a kind of bimodal distribution of heart failure occurrence. There is a peak of heart failure between the thirties, then it stabilizes for some time and then again rises after sixties with advancing age. Patients should focus on signs and symptoms and get expeditious treatment for managing the visible causes and heart function for better longevity. They should not brood over the negatives that the end of life is not far away.
Dr. Nag mentioned sudden stoppage of the heart’s blood supply is known as a heart attack. It needs immediate treatment in the golden hour to reduce muscle damage. Earlier the treatment, the lesser the chances of further complications. Some patients recover fully without any manifestation of any discomfort to their heart and health. A delay in seeking treatment for any reason will increase the risk of developing complications of heart failure. Time is the muscle, and hence critical to have medical care under a cardiologist in the golden hour to prevent further debility.
Dr. Mukhopadhyay added that the best time to visit a doctor is when early signs and symptoms are observed, such as shortness of breath, fatigue, swelling, and cooling of limbs. Delayed treatment would have an alarming impact on the individual’s health, minimizing his chances of survival with repeated hospital admissions. Unfortunately, the peoples’ negligent attitude or absence of elementary medical literacy may be adding to the rise in mortality rate to 30% to 40% due to heart failure and related causes.
Management of heart failure aims to take care of the symptoms of heart failure and control their harmful effects, bring down repeated hospitalization, and improve daily life, work productivity, and longevity of life. Lowering repeated hospitalization is amongst the major objectives of heart failure management. This factor affects not only the individual’s overall mortality, but it’s also great stress on their family, averred Dr. Banerjee.
Dr. Nag strongly advocated that the patient needs to proactively work with his physician to lead a good quality of life. There is no shortcut or substitute to prescribed follow-ups and assessments with the cardiologist. It is essential to derive the maximum benefits from medical treatment administered.
Dr. Mukhopadhya stated that doctors have devised guideline-directed medical therapy for heart patients. Regular consultation with the cardiologist is the cornerstone of management at home to ensure that the patient’s life becomes better and prevent repeated hospitalization. Besides seeking cardiologist guidance from time to time, the patient should ensure adherence to prescribed health schedules to avoid repeated hospitalization.
Dr. Banerjee elaborated that one of the primary reasons for heart failure is diabetes with no focused attention on its management. It causes heart failure in various ways, such as cardiomyopathy and coronary artery disease. Medications are available that control the body sugar and prevent any development of heart failure later in life. Some medicines improve mortality, such as beta-blockers, ARBs, ACE inhibitors, SGL2 inhibitors, MRA’s. The number of drugs is a small price to pay to live a long and healthy life. The extent of heart damage is assessed, and medications are titrated accordingly.
Fluid intake should be restricted to prevent edema or swelling caused by liquid retention in the legs, abdomen, water in the lungs, or suffocation. The patient should maintain an ideal body weight. Dr. Banerjee added further that it primarily prevents heart failure by managing comorbidities and eating healthy.
Stating that the damage to the heart can be halted if not reversed completely, Dr. Mukhopadhya stressed the essentiality of early management of signs and systems of heart failure. The initial medicines can be reduced; however, some medication would continue throughout life.
In the opinion of doctors, a minimal number of patients require surgery when all other treatment options have been exhausted. Ventricular assist devices or a heart transplant are available in the end stages of heart diseases. Dr. Banerjee commented that these therapies have a long-term beneficial effect. There are a few precautions to be kept in mind when thinking about a heart transplant. The patient should not be more than sixty-five years of age, should not have any other organ end-stage disease, and should be willing to take immunosuppressive drugs throughout their life. Of course, a donor is also required.
Tremendous positive improvements are seen with medications, provided regular follow-ups with the cardiologist. The doctors emphasized that patients should not discontinue the medicines to avoid deterioration of the symptoms. It is essential to talk to a physician before making any such decision. Self-prescription or taking suggestions from lateral sources should be avoided.
Remember, heart failure isn’t about stopping. It’s about starting life in a new way. To know more about how to manage heart failure, visit https://www.toibeatheartfailure.com/blog Disclaimer: “The views and opinions expressed in the article by the panelists/experts are based on their independent professional judgement and are disseminated in public interest. These views should not be considered as a substitute for professional advice of a registered medical practitioner. The purpose of this article is not to promote any medical procedures or medication and/or recommend a certain doctor. For any specific health issues, please consult your registered medical practitioner.” PWR PWR
