Heart failure

What is a heart failure?

Heart failure is a very common term to many of us, however most people probably don’t have a clear view about it.

Heart’s prime role is to pump blood so that blood can reach to various body parts like hands, legs ,brain, kidney, brain etc. It is something similar to water pumping stations pumping water to the houses in a community. If these pumping stations fail water supply the houses gets cut.

Similarly when heart fails to pump out the blood, various body parts starve for oxygen (because blood pumped out of the heart is loaded with oxygen).

Hope, now you understand what is a heart failure.

What are the types of heart failure?

Most of us those who aren’t familiar with medical terms and mechanisms may not know that there are about three types of heart failure – left, right and biventricular.

Before going to each of these types let’s try to have a rough idea of the chambers of heart.

Heart has four chambers – 2 atrium (left and right) and 2 ventricles (left and right).

What are these 3 types?

Left heart failure – We call so when the left ventricle of the heart fails to pump blood. In general this is referred as heart failure unless mentioned otherwise.

Right heart failure – As above when right ventricle fail to pump blood, we call it right heart failure.

Biventricular failure – As the name suggests when both right and left ventricle fails we call it a biventricular failure.

So, these were the types of heart failure. In upcoming posts we will discuss why heart fails and how is the problem dealt with.

What are the causes of heart failure?

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There are various causes of heart failure.

One of the prime cause is heart attack, in which the heart muscle may become weaker due decreased supply of oxygen to perform it’s pumping job effectively.

Next in the list is irregular heart rhythm. One important such condition is known as atrial fibrillation, in which the atrium beats too fast and at an irregular rhythm. Therefore the ventricles don’t get enough blood to effectively pump it out,  and leads to a heart failure.

Similarly in case of those suffering from thyrotoxicosis ie excess of thyroid hormone production can also have atrial fibrillation and hence a heart failure. Anemia too when very severe can cause heart failure.

Then are conditions called cardiomyopathies, in which the heart muscle might be overburdened by some disease process and fail to pump blood properly.

Long standing high blood pressure is also in the list. Those who have high blood pressure their heart has to pump an extra amount of blood. This makes the heart walls weaker and can drag the heart to a heart failure. In aortic stenosis too the heart muscle becomes exhausted and surrenders from its pumping action.

Another interesting condition in which heart failure occurs is when the heart’s filling is compromised like in case of pericardial tamponade and constrictive pericarditis.

Besides heart problems lung problems too can cause a heart failure which is also sometimes referred as cor pulmonale.  Chronic obstructive lung disease can lead to such heart failures.

What tests or investigations are required for diagnosing heart failure?

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Well diagnosis of heart failure obviously requires a medical professionals help, however trying to know how the things work is probably of no harm.

So here we start. When ever we talk about heart we generally think of an ecg probably. Although an ecg may not directly let you know if you have a heart failure or not, but it definitely would identify few of the causes of heart failure like an irregular heart rhythm or a heart attack, which are some of the prime causes of heart failure. Therefore, it’s worthy to do an ecg.

Next, is a chest xray. A xray can show a large cardiac shadow, which too may provide hints towards certain causes of heart failure like long standing hypertension or a dilated cardiomyopathy. In addition to this, chest xray is a good indicator of a chest problem called pulmonary edema. Pulmonary edema is not uncommon in heart failure. Pulmonary edema is a condition in which excess water accumulates in lung tissue because of inability of heart to pump blood.

Another important test is echocardiography.  Such test shows the heart’s functioning and various measurement parameters. It particularly determines a parameter called ejection fraction. Ejection fraction is helpful to determine the amount of blood which is to be ejected in each pumping attempt of the heart.

Heart’s  pumping abilities can also be judged by certain nuclear scans too.

We will stop here, and discus the management of heart failure in some other post.

Take care!

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