Despite the way it sounds, the term “heart failure” simply means that the heart isn’t pumping blood as well as it should. Heart failure doesn’t mean the heart has stopped working or that one is having a heart attack (but people with heart failure often have had a heart attack in the past). Heart failure is also called congestive heart failure or CHF. “Congestive” means the fluid is building up in the body because the heart isn’t pumping properly.

List of problems or symptoms that people with heart failure might have:

  • Shortness of breath while walking or climbing stairs or when lying down flat in bed
  • Waking up in the night, suddenly breathless
  • General tiredness or weakness
  • Swelling of the legs (usually just the feet or ankles)
  • Rapid weight gain (1 or 2 pounds a day for 3 days in a row)
  • Chronic cough

What tests are needed?

The doctor will probably suspect heart failure based on the following tests:

  • Blood & urine tests
  • X-ray (Chest) and ECG
  • Echocardiography – This is a painless test where a probe using ultrasound waves creates moving pictures to show the doctor how well the heart is pumping.
  • Radionuclide Ventriculography – This is a medical imaging test where a special camera or scanner uses a safe substance to show the pictures of the heart functioning.

What treatment will be needed?

To improve the heart’s pumping there are some important things one should talk about with the doctor about lifestyle changes and medication.

  • Diet: Take a diet with less salt and low fat and cholesterol.
  • Alcohol: Reduce alcohol intake.
  • Exercise: The doctor helps the patient decide what kind of exercise one can do and for how long.
  • Weight: Maintain a healthy weight; lose some extra pounds, if needed.
  • Family support: Involve the family in all activities.
  • Other sources of support: A doctor can give information about support groups. It sometimes helps to talk with other people who have similar problems.
  • Drugs: Certain drugs are essential and can reduce the risk by up to 60%. These should be taken as advised, irrespective of the symptoms. Some drugs are used only meant to reduce symptoms.
  • Devices: Some patients benefit with two types of pacemaker devices — ICD which saves lives when a rhythm disorder develops suddenly and the CRT that improves heart pumping and reduces future risk. These are implanted under the skin like pacemakers. Another device which is used is LVAD which is a type of “artificial heart”. It is used for patients with severe refractory heart failure, either as a bridge for a heart transplant or in place of a transplant.
  • Heart transplant: It is recommended to patients with severe heart failure despite ‘drug’ and ‘device’ therapy. It is mainly limited by the availability of a suitable donor heart.

How often will one need to see a doctor?

At first, one may have to visit the doctor very often, at least every week, to check on the progress and how one is reacting to the medicine. After the doctor has adjusted the medicine and the patient is feeling better, one will need to visit less often.

Dr N Krishna Reddy

Senior Consultant Cardiologist

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