Understanding Heart Failure: Causes, Symptoms, Diagnosis, and Treatments

Understanding Heart Failure

Heart failure (HF) is a complex condition where the heart struggles to pump sufficient blood to satisfy the body's demands, ultimately resulting in diminished functionality. Common triggers involve damage to the heart muscle due to diseases like high blood pressure, coronary artery disease, diabetes, obesity, or genetic influences. Symptoms range from exhaustion to difficulty breathing and include swollen extremities, weight gain, and cough.

Causes

Heart failure encompasses various etiologies depending upon how much blood the heart pumps (ejection fraction) and the type of damage sustained by the heart muscle. Key causes include:

• Left Ventricle Systolic Dysfunction: The left ventricle fails to squeeze effectively (left ventricular systolic dysfunction), notably seen in left ventricular ejection fraction (LVEF) less than 50%. Primary reasons include coronary artery disease, heart attacks, and inherited conditions.
• Right Ventricle Dysfunction: Right ventricle dysfunction typically occurs secondary to left ventricle issues, causing right ventricular systolic dysfunction (RVSD).
• Preserved Left Ventricle Function (HFpEF): Heart failure with preserved ejection fraction (HFpEF) develops when the heart maintains normal contraction capabilities despite having difficulty supplying blood flow to the body.

Symptoms

Symptoms vary between individuals based on the severity of heart failure and the degree of fluid accumulation within bodily tissues. These may manifest as:

• Fatigue, lack of energy
• Shortness of breath, especially during physical exertion or lying down
• Swelling of ankles and feet due to water buildup
• Persistent dry cough, especially at night
• Less frequent urination
• Loss of appetite and nausea
• Rapid or fluttering heartbeats
• Confusion and disorientation, particularly in older adults

Diagnosis

Healthcare providers diagnose heart failure using multiple methods, considering both patient history and test findings. Methods generally employed include:

• Thorough medical interview and physical examinations
• Blood tests
• Electrocardiograms (ECG) for detecting electrical disturbances
• Chest X-rays to assess lung and heart structures
• Transthoracic echocardiography for visualizing heart structure and function

Treatments

Although there is currently no cure for heart failure, appropriate management strategies can enhance longevity, minimize symptoms, and reduce the likelihood of complications. Depending on the severity and stage of the disorder, potential therapies comprise:

• Medications, primarily targeting blood pressure control, reducing fluid retention, and optimizing heart performance
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Beta-adrenergic blockers
  • Mineralocorticoid receptor antagonists (MRAs)
  • Digoxin
  • Sacubitril/valsartan (angiotensin receptor–neprilysin inhibitor; ARNI)
• Nonpharmacological approaches, centering around lifestyle modification
  • Regular exercise
  • Balanced diet
  • Smoking cessation
  • Limiting alcohol consumption
  • Weight control
  • Sleep apnea screening and treatment

While the diagnosis and management of heart failure require specialized expertise, following established guidelines and seeking guidance from healthcare teams can further enhance treatment success and patient outcomes.