Heart Failure: Types, Causes, Symptoms & Signs
“Heart failure” is a complicated heart condition characterized by a multitude of symptoms caused by the weakening or stiffening of heart muscles which leads to depletion of blood supply to the body. This lack of blood flow then disrupts all major body functions, resulting in heart failure.
Failure of the heart can affect any of the sides of the heart: right or left or even both at the same time. The failure may be acute (short-term) or chronic (ongoing). Though common in both adults as well as older people of both sexes, women are more likely to die from it.
Symptoms & Signs of Heart Failure
Heart failure can show a variety of signs and symptoms. Seek medical assistance immediately if the following symptoms persist:
- Instant weight gain
- Loss of appetite
- Constant coughing
- Irregular heart rate
- Heart palpitations
- Swelling in the abdominal region
- Swelling in limbs
- Protruding neck vein
- Fatigue and tiredness
Causes of Heart Failure
Heart failure can be the result of various complications that might occur in and around the heart area. The major cause of heart failure is Coronary Artery Disease (CAD); in this, the arteries narrow, depleting the blood supply and oxygen to the heart.
Other causes that may increase the chances of developing a heart failure include:
- Cardiomyopathy (when heart muscles that pump blood become weak)
- Congenital heart disease
- Heart attack
- Heart valve disease
- Certain types of arrhythmias, or irregular heart rhythms
- High blood pressure
- Emphysema (a disease of the lung)
- An overactive or underactive thyroid
- Severe forms of anemia
- Certain cancer treatments, such as chemotherapy
- Consumption of alcohol or cannabis
Types of Heart Failures
Depending on the location of its occurrence, heart failure can be of two types:
Left-Sided Heart Failure:
This is the most common type of heart failure. In this, the left ventricle cannot pump blood efficiently, thus depleting the oxygen and blood supply in the body. Since the blood backs up into the lungs, it leads to shortness of breath and a build-up of fluid.
Right-Sided Heart Failure:
The right heart ventricle pumps blood to the lungs to collect oxygen. Right-sided heart failure occurs when the right side of the heart is not able to function properly. It generally happens after a left-sided heart failure; because the left side of the heart fails, the right ventricle has to work harder, thus putting more stress on it and causing it to fail. Other conditions, such as lung disease, can also lead to heart failure.
Depending on the cause, heart failure is of two types:
Diastolic Heart Failure:
This occurs when the heart muscle becomes stiffer than normal. Consequently, the blood does not flow to the heart easily, thus causing a diastolic dysfunction. It occurs more in women than in men.
Systolic Heart Failure:
Systolic heart failure occurs when the heart muscle loses its ability to contract and makes the heart weak. This leads to disruption in the heart’s functioning of pumping out oxygen-rich blood to the body. It is more common in males than in females.
Both Diastolic and Systolic heart failure can occur on either side of the heart.
Though heart failure can happen to anyone, certain factors may increase the chances of developing this condition. Some of these include:
- Eating foods high in fat or cholesterol
- Lack of exercise
- Obesity or weight gain
On experiencing the aforementioned symptoms, one should immediately visit a cardiologist or a CTVS surgeon. The cardiologist or heart surgeon will perform certain tests to get a clearer picture of the problem.
Physical Exam: First, the doctor will perform a physical exam to check for signs and symptoms of heart failure.
Echocardiogram: The physical exam is followed by an echocardiogram. In this, the frequency of sound waves is used to get a detailed picture of the heart, which helps the doctor evaluate the damage and determine the condition’s underlying causes.
Imaging Tests: Various imaging tests such as X-rays, MRI, Nuclear Scan, Catheterization, or Coronary Angiogram are done to get more precise information about the condition.
Stress Exam: This machine monitors the function of the heart while running so as to examine stress levels.
Holter Monitoring: In this, the activity of the heart is monitored for 24-48 hours through electrode patches.
Based on the diagnosis, the cardiologist/CTVS Surgeon will suggest several treatment options, including:
Medication: If the heart failure is mild or in its early stages, it can be treated with the help of medication so as to improve the heart’s ability to pump blood, reduce blood clots, reduce heart rate, remove excess sodium and replenish potassium levels, reduce cholesterol levels, etc.
These medications can include blood thinners, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta-blockers, calcium channel blockers, cholesterol-lowering medications, nitrates, etc.
Bypass surgery: In this, the surgeon will take a healthy piece of an artery and attach it to the blocked coronary artery. This will allow the blood to bypass the blocked, damaged artery and flow through the new one.
Angioplasty: In this, a catheter with a small balloon attached is inserted into the blocked or narrowed artery. Once the catheter reaches the damaged artery, the surgeon will inflate a balloon to open the artery and perform the angioplasty.
Pacemakers: In some cases, to help control the heart rhythm, pacemakers may be installed in the chest. The pacemakers will slow your heart rate when the heart is beating too quickly or increase it likewise if it is beating too slowly.
Implantable Cardioverter Defibrillator (ICD): It keeps track of the heart rate and will shock your heart on detecting an abnormal heart rhythm. This shock then restores the heart rate to its normal rhythm.
Transplant surgery: Heart transplants are used in those cases where all other treatments have failed. During a transplant, the surgeon removes one or all parts of the heart (depending on the case) and replace it with a donated heart.
Apart from medication and surgeries, making some lifestyle changes can help treat heart failure and prevent this condition from developing. These include:
- Exercising regularly and managing weight
- Lowering the intake of salt in the diet
- Limiting consumption of alcohol and quitting smoking
- Avoiding foods rich in fat
- Getting sufficient sleep
If left untreated, heart failure can eventually lead to severe complications that might lead to death such as Congestive Heart Failure or CHF (a condition in which blood builds up in other areas of the body), stroke, thromboembolism, arrhythmias, heart attack, etc.
Therefore, timely medical intervention is necessary if the symptoms persist or become worse.
Best Doctors for Heart Failure
Dr. Alok Sehgal is a highly experienced cardiologist in Delhi, with over 20 years in the field, who specializes in clinical cardiology, cardiac intervention, and intravascular imaging-guided procedures. His expertise includes diverse diagnostic and interventional cardiac procedures.
Dr. Yatin Arora is a Cardiothoracic & Vascular Surgery Consultant at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad, and holds an M.Ch. from AIIMS Delhi. With experience in teaching and surgical assistance, Dr. Arora specialises in ASD and mitral valve surgeries.
Dr. Ankur Agrawal is a skilled Cardiothoracic & Vascular Surgeon at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad, trained at AIIMS, and specializes in adult & pediatric cardiac, thoracic, and vascular surgeries. Notably, Dr. Agrawal was part of the team that performed CABG on the President of India.