The heart of the matter.
Dr Vinay K Bhatia PhD, FRCP, Consultant Cardiologist at Spire Tunbridge Wells Hospital provides an overview of a common and serious heart condition – Heart Failure.
Heart failure is a term used to denote a general inability of the heart to pump blood around daily life. There are about 68,000 new cases of heart failure each year in the UK and in general it becomes more common as people get older. Heart failure is a common cause of repeated hospital admissions and despite progressive advances in medical treatment, the overall lifespan for many patients remains
What causes heart failure?
The most common causes include underlying coronary artery disease (especially people who have suffered a previous heart attack); high blood pressure (hypertension); disease of the heart valves and some types of abnormal heart rhythms.
What are the symptoms and signs of heart failure?
These include breathlessness (especially on exertion), which may be associated with a persistent cough, swelling of the ankles or legs, generalised tiredness and reduced energy levels. Patients may also experience chest discomfort (angina) or palpitations.
How is heart failure diagnosed?
There are various tests that may show suggestive abnormalities (blood tests, Chest X Ray, and electrocardiogram) but the diagnostic investigation is nearly always a detailed cardiac ultrasound (Echocardiogram). Some patients will also need to undergo more invasive cardiac investigations (e.g. coronary angiography).
What treatment options are available?
A. Drug treatment usually start on a number of drugs that can be broadly divided into two categories. There are medications that mainly help to alleviate symptoms (e.g. breathlessness, leg swelling) but do not really affect the underlying disease process (e.g. diuretics – frusemide, bumetanide) and then there are drugs that help the heart to become clearly demonstrated that when these types of drugs are taken at reasonable doses it results in people living longer with a better quality of life. All these drugs need term aspirin type drugs for analgesia.
B. Special Pacemakers for heart failure In certain patients, the heart contraction is out of sync and in this particular situation a special type of pacemaker can help the heart beat synchronously leading to improvement in function (chronic resynchronisation therapy – CRT). Patients with severe threatening rhythm disturbances and may therefore
C. Other treatable conditions causing heart failure Some patients will have an underlying treatable cause for their heart failure. This includes patients with some types of chronic heart rhythm disturbance (atrial valve disease). Some patients will get better after they receive therapy to improve the blood supply to the heart (e.g. coronary artery bypass surgery).
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132