The heart is a muscular organ with four valves. Its function is to receive deoxygenated blood from the body and pump oxygenated blood to the whole body. Dysfunction in any part of the heart leads to heart failure. When the term Heart Failure is used by doctors, people tend to think that it’s the end of life, however, it just means that the heart is working at a reduced capacity. Anything that can damage the heart to work at an optimum level can cause heart failure. As medical science has advanced, newer treatment options are now available to improve the patient’s life expectancy. Dr H Sudarshan Ballal, chairman Manipal Hospitals has said that “Heart conditions are very much prevalent, cases are rising amongst younger age groups also. Extra care especially preventive lifestyle should be adopted to prevent the onset of heart diseases and manage the disease in heart patients. If you suspect you have Covid of any variety, it is important to consult your doctor for further management. There certainly is no need to rush to the hospitals in every instance. Please do not self-medicate and stay away from work if you are unwell.” Beat Heart Failure, an initiative by The Times of India in partnership with Novartis aims to spread awareness about heart failure and its management. Timely identification, treatment, and management are a cornerstone of a good prognosis. The doctors from esteemed Manipal Hospital joined the Beat Heart Failure discussion to spread awareness– 1. Dr. Samanjoy Mukherjee: Consultant – Senior Interventional Cardiology 2. Dr. Rasheed Ahmed: Consultant – Interventional Cardiology 3. Dr. (Col) Monik Mehta: Cardiology – Interventional Chief & Sr Consultant Cardiology How will you explain heart failure to your patients? Heart failure is the weakening or stiffening of the heart. Every part of the heart’s structure is essential, and dysfunction like weakening of any segment, say leaking valves, will lead to heart failure. Dr. Mukherjee explained that as the demand of the body increases, the heart would also augment its performance, but it can enhance its performance to a limited extent. However, when the body’s need for oxygen-rich blood continues to shoot up either due to increased physical activities or some disease like coronary heart disease, the heart may not be able to cope, resulting in heart failure.
https://www.facebook.com/events/5054077557945392/?ref=newsfeed What are the common causes of heart failure and a rise in heart failure patients? In India, the most common type of heart failure is due to reduced ejection fraction (measure of how well your left or right ventricle pumps blood). Majority of patients in India have coronary artery disease (blockage in the heart’s blood supply). Other causes include valvular heart disease, hypertension, diabetes, cardiomyopathy, post-partum cardiomyopathy, and some idiopathic with no reasons, answered Dr. Ahmed.
Dr. Mukherjee cited that the heart must contract and relax; both are equally important. If the heart becomes weak and at the same time stiff, the heart must work against resistance (such as in hypertension), the muscles of the heart work harder, and if they work beyond the threshold, they might collapse. Obstructive sleep apnea or, in easier words, snoring associated with an increase in weight, the heart must work harder and may result in heart failure.
What are the symptoms of heart failure? The patient will feel shortness of breath while walking, which he did not feel earlier, described Dr. Ahmed. This shortness of breath will gradually increase as the disease progresses. Other symptoms include swelling of the legs, heightened fatigue. Irrespective of the causes of heart failure, either due to reduced ejection fraction or preserved ejection fraction, the symptoms are the same.
What are the risk factors for heart failure? The awareness about heart failure is low. Many risk factors are preventable. There is a rise in smoking among the young population. Smoking affects both the heart and lungs. Obstruction in the airway comes with smoking, and there are almost more than four thousand toxins in smoke. A poor lifestyle that includes lack of exercise or eating fast foods might also eventually lead to heart diseases. There may also be a family history of heart diseases or increased mental stress and could also be one of the risk factors.
Is heart failure reversible? What are the treatment options available? Most heart failure cases are reversible. The goal is to check whether the cause is treatable or not. Dr. Mukherjee explained that to relieves the shortage of blood supply, revascularization is done using a stent or bypass surgery. If the valves are damaged, then they are repaired.
Medications are of prime assistance in treatment and help in reducing the pressure on the heart to manage heart failure.
Dr. Ahmed added that the timing of treatment is essential. Time is muscle, and it is easier to manage those cases which come at an early stage.
Generally, patients come at a late stage when the symptoms of heart failure have worsened. In the late stages, more vigorous efforts are required. During a heart attack, patients ignore the signs like acidity, live in locations where facilities are not available, and any delay leads to damage to the heart. The patients are started with Guideline Directed Medical Therapy (GDMT). GDMT refers to initial medical therapy with ACE inhibitors or Angiotensin receptor blockers, beta-blockers, Mineralocorticoid receptor antagonists.
Dr. Mehta said that surgical options such as a left ventricular assist device or heart transplant are recommended in cases where there is irreversible damage to the heart. In India, the success rate of heart transplants is good, and patients can resume a near-normal life.
What is the quality of life after a heart transplant? Dr. Mukherjee said that the quality of life depends on the response to treatment. Early management can arrest the progression. The patient will benefit from acting towards the cause. Recent devices and medication have shown tremendous results in patients.
After being diagnosed with heart failure, management should be the primary goal. Diligence in compliance with any doctor’s advice is essential. It’s necessary to get investigations done on time and regularly getting the vitals checked – such as blood pressure, heart rate, weight and fluid intake.
A good lifestyle and a healthy diet may not be able to reverse heart failure but will reduce the severity of symptoms. We should inculcate the attitude of addressing any new sign and rather than taking advice from family or friends, we should reach out to doctors for timely diagnosis.
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
