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Heart Failure

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VOL: 100, ISSUE: 10, PAGE NO: 31


- Heart failure occurs when the heart loses its ability to pump enough blood around the cardiovascular system.



- It usually develops slowly and may not become symptomatic for years.



- This occurs when the heart’s ability to contract decreases and it cannot pump enough blood into the circulatory system.



- Blood coming from the lungs to the heart may back up, causing fluid to leak into the lungs (this is pulmonary congestion).



- This occurs when the heart’s ability to relax decreases and it is unable to fill up with enough blood.



- This may lead to the accumulation of fluid, particularly in the legs, ankles, and feet.



- Heart failure often results from a myocardial infarction, other disease that damages the heart, problems with heart valves, or infections.



- Risk factors include coronary heart disease, smoking, high cholesterol, hypertension, diabetes, obesity, and advancing age.



- Uncontrolled hypertension doubles the risk of heart failure (National Heart, Lung and Blood Institute (NHLBI), 2004).



- People with diabetes have up to eight times the risk of heart failure as those without.



- Women with diabetes are at greater risk than men (NHLBI, 2004).



- Breathing problems at rest or during exercise.



- Fatigue.



- Oedema in the feet, ankles, legs, and occasionally the abdomen.



- Persistent cough, often producing mucus or blood-tinged sputum.



- Diagnosis is often through physical examination and identification of individual risk factors.



- Lung congestion and abnormal heart sounds may be audible when using a stethoscope.



- If symptoms are not conclusive, an electrocardiogram or echocardiograph can evaluate heart function.



- A chest X-ray will reveal an enlarged or misshapen heart and congested lungs.



- Some conditions, including severe anaemia and thyrotoxocosis, overwork the heart and produce similar symptoms. They need to be ruled out or treated.



- Anatomical problems such as valve defects can be corrected by surgery.



- There is no cure available for heart failure caused by damage to the heart muscle.



- Patients can minimise the effects of heart failure by controlling risk factors. For example, patients should be encouraged to stop smoking, lose weight, abstain from alcohol, and reduce the amount of fat and salt they consume.



- Moderate exercise may be helpful but should be carefully monitored by a physician.



- Drug treatment includes diuretics to reduce fluid retention, digitalis to increase the force of cardiac contractions and angiotensin-converting enzyme (ACE) inhibitors, which decrease pressure in the blood vessels and therefore the effort required by the heart.



- In severe cases a heart transplant may be the only option.



- Cardiomyoplasty is a surgical procedure in which partially detached latissimus dorsi muscle is wrapped round the ventricles and stimulated by an implant to assist the heart.



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