Heart failure
This pathology is currently one of the main causes of hospital admission and mortality. It affects 14 million people in Europe, with an increased incidence among older people and women. Heart failure is calculated to be present in 7% of over-45s in Spain, a percentage that rises to 16% for over-75s.
Heart failure is generally a consequence of other disorders that have damaged the heart or placed it under strain, such as heart attack or hypertension. As a result, before the first symptoms appear, patients may present other heart conditions that are precursors to heart failure such as left ventricular systolic or diastolic dysfunction.
Although heart failure is most frequently chronic, acute heart failure does sometimes occur – normally after having suffered an acute heart attack or due to the body compensating for chronic heart failure.
Causes of heart failure
There is no single cause of heart failure. Numerous cardiovascular and non-cardiovascular conditions can interact to have a negative impact on the heart. Identifying them is essential when making a diagnosis of heart failure, since it will be more advisable to use certain treatments than others depending on the origin of the condition.
The main causes include obstruction of the coronary arteries, which prevents blood from circulating normally to the heart, hypertension, which means that the heart has to pump the blood more forcefully in order for it to circulate properly, cardiomyopathies or myocarditis, which weaken the heart muscles, arrhythmias, or valvular heart diseases, which are characterised by deterioration in the heart valves that causes changes in the cardiac cycle.
Other causes are non-cardiovascular conditions such as anaemia, diabetes, thyroid problems, hormonal changes and certain infections that make it necessary for a higher amount of blood to be pumped to the rest of the body, and the consumption of toxic external agents such as tobacco, alcohol and drugs, which can have a negative impact on the heart.
Symptoms
The symptoms of heart failure tend to present differently from patient to patient, since the cause of the illness varies. The most common symptoms include feelings of tiredness or fatigue, a loss of strength, weakness and even difficulty breathing or dry cough, due to the accumulation of liquid in the air sacs of the lungs.
Patients can also experience swelling due to the accumulation of liquids in certain areas of the body, such as ankles, feet or legs. The retention of liquid can also cause weight gain or nocturia (a frequent need to urinate during the night), as well as loss of appetite if the accumulation occurs in the liver or digestive system.
Diagnosis and treatment
To correctly diagnose heart failure, it is necessary to observe all the symptoms that are characteristic of the condition and which the patient presents, since they are not specific to heart failure and their features may overlap with other disorders.
To carry out this observation, it will be essential to obtain a detailed medical record for the patient and to conduct a physical examination, in order to identify elements including the patient’s cardiovascular risk factors, potential swelling and blood pressure.
In cases where the medical professional suspects that the patient may be presenting heart failure, they must carry out other supplementary analyses to confirm the diagnosis of the condition and its seriousness, as well as to identify its potential causes. These analyses and tests include electrocardiogram (ECG), blood analysis that measures red blood cell and oxygen levels in the blood, chest x-ray, ECG to examine the heart and its valves, and cardiac stress test to assess tolerance of stress.
Once the diagnosis has been confirmed, it will be important for the patient to adopt healthy living habits to prevent the development of heart failure. Potential treatments include drugs, with medicines that slow the heart rate in order to improve blood flow and reduce arterial pressure, device implantation and heart surgery or transplant if the previous measures are not effective.