20 Sep Conquer Heart Failure: Your Guide to a Healthier Heart
Conquer Heart Failure: Your Guide to a Healthier Heart
By Island Hospital | September 20, 2024 12:00:00 PM
Medical Reviewer: Dr. Lee Tjen Jhung, Cardiologist
Heart failure is often misunderstood. It isn’t about your heart stopping; instead, it means that your heart isn’t pumping blood as efficiently as it should.
This can lead to a variety of symptoms and reduced quality of life. While the term “heart failure” may be alarming, it’s essential to understand that it does not define the end of life altogether.
With advances in the medical industry, numerous preventive measures and treatment options have been developed to manage heart failure effectively.
How Your Heart Works
The heart is a complex muscular organ that circulates blood throughout the body. It is divided into four chambers: two upper atria and two lower ventricles.
- The right atrium receives oxygen-depleted blood from the body.
- This blood is pumped to the right ventricle and then circulated to the lungs for oxygenation.
- Oxygenated blood returns to the left atrium.
- The most muscular chamber’s left ventricle pumps oxygen-rich blood to the body’s tissues.
This cyclical process, known as the cardiac cycle, ensures the continuous supply of oxygen and nutrients throughout the body while removing waste products.
Understanding Heart Failure
Heart failure is one of the chronic causes of hospitalisation among older adults by which the heart compensates initially by enlarging, increasing muscle mass, and pumping faster.
Additionally, the body attempts to adjust by constricting blood vessels and retaining fluids, worsening heart failure.
However, heart failure is different from a heart attack. A heart attack occurs when blood flow to the heart is abruptly obstructed, often by a blood clot, leading to damaged heart muscles.
Types of Heart Failure
Heart failure can be classified in several ways. Here are the two primary types:
1. Based on the Heart’s Pumping Ability
- Heart failure with reduced ejection fraction (HFrEF)
This occurs when the heart’s left ventricle doesn’t pump blood as forcefully as it should. - Heart failure with preserved ejection fraction (HFpEF)
In this type, the heart’s left ventricle can pump blood efficiently but doesn’t fill with enough blood to pump out.
2. Based on the Side of the Heart Affected
- Left-sided heart failure
This is the most common type and affects the left side of the heart.
- Right-sided heart failure
This occurs when the right side of the heart struggles to pump blood to the lungs.
Causes of Heart Failure
Heart failure can be caused by various factors that weaken or damage the heart muscle. Some of the most common causes include:
- Arrhythmias
- Cardiomyopathy
- Congenital heart defects
- Coronary artery disease
- Diabetes
- Heart attack
- Heart valve problems
- High blood pressure (hypertension)
- Myocarditis
- Thyroid disorders
- Other factors – These include certain medications, alcohol abuse, drug use, and some infections.
It’s important to note that multiple factors often contribute to the development of heart failure.
Symptoms of Heart Failure
Symptoms of heart failure often develop gradually and can vary depending on the severity of the condition. Some common symptoms include:
- Confusion, memory loss, and reduced alertness
In severe cases, heart failure can affect brain function.
- Cough
A persistent cough, often worse at night, may occur due to fluid buildup in the lungs.
- Fatigue and weakness
Feeling tired and weak, even with minimal activity.
- Nausea and lack of appetite
- Rapid or irregular heartbeat
An abnormal heart rhythm can contribute to heart failure symptoms.
- Reduced ability to exercise
Difficulty performing activities you used to enjoy.
- Shortness of breath or wheezing
This is often the first noticeable symptom, especially when exerting yourself or lying down.
- Swelling in the legs, ankles, feet, and belly area
Fluid buildup can cause swelling.
- Weight gain
Very rapid weight gain can indicate fluid retention.
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Heart Failure Progression & Stages
Heart failure is a progressive condition, meaning it often worsens over time. To measure its severity, healthcare providers use two main systems:
Stages of Heart Failure
Stages | Description |
|---|---|
| Stage A (At risk of heart failure) | Individuals at high risk for developing heart failure but without current heart problems or symptoms. |
| Stage B (Pre-heart failure) | Individuals without a history of heart failure symptoms but with underlying heart structural abnormalities, increased pressure within the heart, or other risk factors. |
| Stage C (Symptomatic heart failure) | Individuals with a history of or current heart failure symptoms. |
| Stage D (Advanced heart failure) | Individuals with severe heart failure experience significant limitations in daily activities and recurrent hospitalisations. |
Classes of Heart Failure
Categorising patients with advanced heart failure (stages C and D) helps healthcare providers to tailor treatment plans more effectively.
These classifications are typically based on the severity of heart failure symptoms.
Classes | Patient Symptoms |
|---|---|
| Classes I | No physical activity limitations. Routine physical exertion does not cause excessive tiredness, rapid heartbeat, or difficulty breathing. |
| Classes II | Slight limitation of physical activity. Comfortable at rest, but routine physical exertion leads to fatigue, rapid heartbeat, or shortness of breath. |
| Classes III | Marked limitation of physical activity. Able to rest comfortably, but minimal exertion triggers fatigue, rapid heartbeat, or shortness of breath. |
| Classes IV | Symptoms present even at rest. Any physical activity significantly worsens discomfort. |
Risk Factors & Complications of Heart Failure
Risk Factors
Factors that can increase your risk of developing heart failure include:
- Chronic conditions
High blood pressure, diabetes, sleep apnea, thyroid disorders, and kidney disease. - Heart conditions
Coronary artery disease, heart attacks, arrhythmias, heart valve problems. - Lifestyle factors
Smoking, excessive alcohol consumption, drug abuse, obesity, sedentary lifestyle, unhealthy diet. - Other factors
Age, family history, certain medications, viral infections. - Sleep apnea
This disrupts sleep, leading to low oxygen levels and irregular heartbeats, which can strain the heart.
Complications
Even when symptoms improve, it’s essential to follow-up with your doctor regularly to monitor your heart health and detect potential complications.
The specific complications associated with heart failure can vary depending on individual factors such as age, overall health, and the severity of the condition.
Heart failure can lead to various complications, including:
- Additional heart complications
Heart failure can alter the heart’s structure and function, potentially damaging heart vessels and leading to irregular heart rhythms. - Liver damage
This condition also causes fluid buildup in the liver, leading to liver damage and reduced function. - Kidney dysfunction or failure
Heart failure can compromise blood flow to the kidneys, potentially leading to damage. In severe cases, this can progress to kidney failure, necessitating dialysis. - Stroke
The risk of stroke due to irregular heart rhythms and thromboembolism. - Sudden cardiac death
A weakened heart is more susceptible to fatal arrhythmias, leading to sudden cardiac death.
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Diagnosis & Treatment of Heart Failure
A comprehensive evaluation to diagnose heart failure entails revisiting your medical history, physical examinations, such as auscultation of the heart and lungs for abnormal sounds, and diagnostic tests.
Tests
To further investigate the underlying causes of suspected heart failure, additional tests may be ordered, including:
- BNP blood test
- Chest radiography
- Electrolyte levels
- Electrocardiography
- Nuclear imaging
- Renal and liver function studies
- Stress test
- Thyroid-stimulating hormone (TSH) levels
Treatments
Treatment plans for heart failure are customised based on the severity of the condition and its specific type. Therefore, early intervention can significantly improve symptoms.
The ultimate goal of heart failure treatment is to extend life, prevent complications, and enhance the overall quality of life.
1. Medications
Medications help improve heart function, relieve symptoms, and slow disease progression. Common drug types include those that regulate heart rhythm, manage blood pressure, reduce fluid retention, and lower cholesterol.
2. Surgical interventions
In advanced stages of heart failure, several surgical options may be considered to improve heart function and reduce symptoms:
- Bypass surgery
- Heart transplant
- Electrophysiologic intervention
- Percutaneous coronary intervention (PCI)
- Revascularization procedures
- Valve replacement/repair
3. Implanted devices
Implantable devices have revolutionised the management of heart failure by assisting the heart in pumping blood more efficiently or regulating abnormal heart rhythms.
Some of these devices that have improved the quality of life and survival rates for many people with heart failure are:
- Cardiac Resynchronization Therapy (CRT)
This device helps coordinate the heart’s pumping action, improving its efficiency. - Left Ventricular Assist Device (LVAD)
A mechanical pump implanted to assist the heart in pumping blood is often used as a bridge to heart transplant or as a long-term therapy. - Implantable Cardioverter-Defibrillator (ICD)
This device monitors heart rhythm and delivers electric shocks to correct dangerous arrhythmias that can lead to sudden cardiac death. - Pacemaker
A pacemaker regulates a heartbeat that is too slow by sending electrical impulses to stimulate the heart.
Living with Heart Failure
Living with heart failure can present challenges, but with proper management and support, it’s possible to maintain a good quality of life.
Here’s a breakdown of how you can manage it:
1. Managing daily life
- Adapt to a heart-healthy diet that is low in sodium.
- Take prescribed medications as directed by your doctor.
- Exercise regularly as recommended by your health professional to improve heart function.
- Follow up with consistent check ups by a healthcare provider.
- Ensure that you get adequate sleep for your overall well-being.
- Manage your stress well using techniques like relaxation and meditation.
- Connect with others with heart failure through available support groups for additional emotional support.
- Maintain a healthy weight to reduce strain on the heart.
2. Coping with emotions
Heart failure can be emotionally challenging. It’s important to:
- Communicate openly
Talk to family, friends, or a counsellor about your feelings. - Practice self-care
Prioritise activities that promote relaxation and well-being. - Set realistic goals
Focus on achievable targets to avoid frustration.
Remember, everyone’s experience with heart failure is unique. It is essential to work closely with your healthcare team to develop a personalised management plan.
Don’t Let Heart Failure Hold You Back
Heart failure can significantly impact your quality of life, but with the proper care and support, you can manage your condition and enjoy fulfilling days.
Our Cardiology Department at Island Hospital is dedicated to helping you regain control over your heart health. We offer comprehensive care, from diagnosis to treatment and ongoing management.
Our commitment to excellence has earned us local and worldwide recognition:
- A finalist for Malaysia’s Flagship Medical Tourism Hospital Programme
- A place on Newsweek’s lists of World’s Best Hospitals 2024
- A place Best Specialized Hospitals Asia Pacific 2024 (Cardiology).
Don’t let heart failure define you. Let us help you live your life to the fullest.
Schedule a consultation today and discover how we can support your heart health journey.
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FAQ
How do you slow down the progression of heart failure?
Preventing heart failure involves managing underlying conditions like high blood pressure, diabetes, and obesity.
Many habits that help manage heart failure can also prevent it from worsening. Try out these heart-healthy tips:
- Balance your fluid intake
- Don’t smoke
- Eat healthy foods and maintain a healthy body count
- Get plenty of exercise
- Limit salt (sodium)
- Manage high blood pressure
- Monitor for changes or worsening symptoms
- Reduce and manage stress well
- Take medications as prescribed by your health professional
What are other signs that my heart is slowly failing?
While some symptoms of heart failure are apparent, others can be more subtle. It’s essential to pay attention to your body and consult with a healthcare professional if you experience any of the following:
- Mental fogginess or trouble concentrating
- Gradual onset of fatigue
- Increased urination at night
- Loss of appetite or feeling full quickly
Despite this, the following symptoms can also indicate other health conditions. If you experience any concerns, it’s crucial to seek medical advice.
How long can a person live with heart failure?
Predicting life expectancy for heart failure patients is complex. While average survival rates exist, individual outcomes vary based on factors like age, overall health, and the severity of heart failure.
People under 65 generally have better survival rates of ~79% than older individuals with about 50%. Additionally, conditions like diabetes, high blood pressure, and obesity can impact life expectancy.
Despite these factors, advancements in heart failure treatment have significantly improved outcomes.
What diet should I follow?
A heart-healthy diet is crucial for managing heart failure. It helps control blood pressure, reduce fluid retention, and support heart health.
Here are some key dietary guidelines:
- Low sodium
Limit your intake of salty foods to reduce fluid retention. - Balanced nutrients
Ensure a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy. - Portion control
Maintain a healthy weight to reduce strain on the heart. - Limit unhealthy fats
Reduce consumption of saturated and trans fats. - Hydration
Drink plenty of water, but consult your doctor about fluid restrictions if necessary.
To create a long-term personalised meal plan, it is best to consult with a registered dietitian or your healthcare provider so that they can provide specific recommendations based on your individual needs.
What exercise is safe for me to do?
Always consult with your doctor before starting any new exercise regimen.
While exercise is crucial for managing heart failure, choosing activities that suit your condition is essential. Here are some generally safe options:
- Walking
A low-impact exercise that can be gradually increased in intensity. - Water aerobics
Low-impact exercises performed in water can be beneficial. - Yoga or Tai Chi
These gentle exercises can improve flexibility and balance and reduce stress.
What happens if I can no longer work?
If you’re unable to work due to heart failure, it can be a significant life change.
However, there are specific government programs that may be tailored for heart failure patients unable to work in Malaysia:
- KWSP
If you’ve contributed to the Employees Provident Fund (EPF) and meet specific criteria, you might be eligible for early retirement or disability pension. - Jabatan Kebajikan Masyarakat (JKM)
This government agency offers assistance programs for individuals with disabilities or financial hardships.
Other considerations to take note include:
- Employer Benefits
If previously employed, check if your employer offers disability benefits or insurance. - Medical Assistance
Explore options like the Medical Card (Kad Kesihatan) for subsidised healthcare costs. - Non-Governmental Organisations (NGOs)
Some NGOs like IJN Foundation provide financial or emotional support to needy heart patients.
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