Whenever we get a little breathless walking up the stairs, which we did not feel before, we often tend to ignore it as signs of tiredness and never think of consulting a doctor. Often, the overlooked breathlessness, fatigue may be an indication of beginning of heart failure. Heart failure is the gradual weakening of heart muscle wherein the heart is pumping at a reduced capacity. The medical opinion strongly advocates to contact the physicians on noticing such discomforts or symptoms to prevent further deterioration to heart muscle.
The prognosis of heart failure is worse than that of cancer say the doctors. In India, reported patients of heart failure are ten years younger than the global average.
The incidence and knowledge about heart failure requires discussion and dissemination for benefit for common people because of the rising mortality rate of more than twenty percent, if left untreated. Therefore, the Times of India started off with an initiative called Beat Heart Failure in partnership with Novartis to spread awareness about heart failure and its management.
The campaign commenced about two and half years back and is presently in its 4th phase. Multiple discussion have been conducted with the specialized doctors of leading hospitals across India to disseminate information and create awareness about heart failure. The doctors from the prestigious Peerless Hospital, Kolkata have also joined the initiative and shared their wisdom about the management, lifestyle changes and treatment for heart failure “A beautiful poisonous plant known as Foxglove, invented in 1542 and medicinally used first in 1785, remained a lifesaver for patients with heart failure for nearly two centuries. With relentless advances in medicine and a better understanding of the disease process, the treatment of heart failure has gone through a sea of changes. This panel discussion will throw light on where we stand now. But with a cautionary note that, this may not be the end of what is going to be the most ideal treatment of this debilitating condition” said Dr. Sujit Kar Purkayastha, Managing Director, Peerless Hospital.
The doctors who have joined the discussion were: Dr Ashok Bandyopadhyay: Clinical Director – Dept of Cardiothoracic surgery Prof Dr Anjan Lal Dutta: Clinical Director – Dept of Cardiology Dr Soumik Chaudhuri: Consultant Interventional Cardiologist https://fb.me/e/1oxG70TGf The term heart failure in simpler terms refers to the inadequate functioning of the heart. It does not signify that the heart has failed, explained Dr Chaudhuri. Heart failure indicates diminished pumping of blood to the organs of the body on account of either Ischemic heart disease or any other cause. Ischemic heart disease is a block in the heart’s major blood vessels and is regarded as a major factor resulting in heart failure. The motto is “Time is muscle” at the occurrence of heart failure event. Any delay in the treatment, will cause more damage to the heart. In people with comorbidities such as hypertension, diabetes, obesity, etc., the heart is working under resistance and in the long run, it gradually weakens the organs. Therefore, always be alert to pay attention to unusual signs and symptoms.
Heart failure is the final common pathway from the life, mentioned Dr Dutta. Depending on the status of blood supply, patient may have myocardial infarction. Myocardial infarction is the primary cause of heart failure, if not treated in time. The term myocardial infarction means a blockage of the blood flow to the heart muscle. Hence, heart attack needs to be treated within a specified time limit, else the parts of heart muscle may be damaged for life, leading to heart failure.
When a patient comes to a surgeon, he is often in the late stage of heart failure and their cardiac status is poor. The objective of the surgery is to restore the normal functioning, to the extent possible, of the heart and the patient suffering from Valvular heart disease or coronary artery disease. The patients are explained about the improvement expected with surgeries, medication, and precautions to be followed by the patients at different stages.
Dr Dutta explained that there are four stage of heart failure. Stage A is when the person has risk factors for development of the disease. Stage B is when the causes of heart failure are present, structural changes have begun but, there are no symptoms. The patient has no reason to visit the doctor in the first two stages. In stage C the patient has classical symptoms of heart failure and in stage D the symptoms are present at rest. People generally come at stages C and D.
Dr Chaudhari strongly advocated on screening patients at stage A and B. The education or awareness from the initiatives such as Beat Heart Failure are required to focus on the dire necessity of getting periodic preventive health check-ups done, to ensure that risk of heart failure is kept at bay or is noted in time by prudent management of the risk factors. The loss of young celebrities, who were perfectly fit and healthy, have raised awareness among the middle-aged, especially men about their heart health. The big five risk factors are hypertension, diabetes, smoking, family history, dyslipidemia. We cannot cure them, but we can manage them.
The warning signs of heart failure include breathlessness in performing day to day routine, waking-up in the middle of the night gasping for breath, chest pain, gradually increasing fatigue, feeling out of breath when walking up the stairs, pointed out Dr Choudhuri.
People find it difficult to believe that they have heart failure. They presume that the visible symptoms in them are either due to acidity or on accounts of gaseous malfunction. They continue their unregulated lifestyle undeterred, and they consume drugs without proper medical advice. Only a handful of knowledgeable individuals visit the doctor on time. Majority of the patients rush to a doctor at late stages, on deterioration of symptoms, when they face difficulties in conducting day to day activities, tiredness in exercising, weakness, loss of appetite, severe weight loss and lack of concentration.
Dr Bandyopadhyay remarked that the heart is a robust organ with tremendous tolerance. An individual can come back to near normal everyday life after being diagnosed with heart failure, if they are compliant with the medication and adapt to recommended lifestyle. We cannot cure the risk factors but can minimize their damaging impact. The management of heart failure risk factors includes checking blood pressure, blood sugar level, joining a support program to stop smoking, a healthy balanced diet, and exercising.
The heart failure mortality rate tells us the importance of heart muscle, pointed out by Dr Chaudhari. Every time a person is admitted to the hospital for heart failure, the heart dies a bit more. Associated complications include stroke and renal failure. The patients and their family members lose their morale with repeated hospitalizations.
Dr Chaudhari also talked about the fabulous four medications for heart failure that have significantly improved the quality of life. They include Beta-blockers, Mineralocorticoid receptor antagonists, SGL2 inhibitors, ARBs. Every patient with heart failure is given these four medications. The only limitation is the prohibitive cost. When people feel a little better, they drop the drugs by themselves engendering the reversal of gains of treatment.
Dr Bandyopadhyay talked about the gold standard surgical options for end-stage of heart failure. The most common surgery is coronary artery bypass and Valve replacement in Valvular heart disease. The person can live almost an everyday life after heart transplant surgery. Other surgical options available are left ventricular assist devices for end-stage heart failure cases.
The doctors concluded the discussion with the hope for patients with heart failure. Heart failure is not an end of life but a chance to change the course of your life. Lifestyle changes, a healthy and balanced diet, compliance with medication, and doctor appointments will help reduce the symptoms of heart failure, if not completely reversed.
Remember, heart failure isn’t about stopping. It’s about starting life in a new way. It can be managed with regular treatment and right lifestyle modifications. To know more about how to manage heart failure, visit https://www.toibeatheartfailure.com/patientguide.php 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
