Heart Failure (HF)
Dr Malik takes you through the causes of heart failure, symptoms to look out for, getting a diagnosis and available treatment options.
What is Heart Failure?
Heart failure (HF), often called congestive heart failure (CHF), means that the heart is unable to pump enough blood to meet the body’s needs.
Symptoms of heart failure
Heart failure can cause a number of symptoms, including:
- Shortness of breath, on walking or on lying down
- Leg swelling
- Exercise intolerance
The likelihood of developing heart failure increases with age. It’s most common in older people (65+) but can also occur in the young (particularly with underlying health conditions or risk factors).
Types of heart failure
Systolic Heart Failure
Systolic heart failure occurs when the heart is not able to pump sufficient blood around the body to maintain its metabolic needs. It normally occurs when the heart muscle has been damaged (for example, by a heart attack or a disease of the heart muscle called cardiomyopathy). It can also be caused if the valves are too narrow or leaking.
Diastolic Heart Failure
Diastolic heart failure refers to the heart muscle’s inability to relax and prime itself with enough blood for the next pumping cycle. The causes of diastolic heart failure are numerous, but include older age, amyloid heart disease and left ventricular hypertrophy related to blood pressure.
The heart muscle is stiff, does not relax easily and will be unable to fill with blood. Each heart cycle will pump less blood forward and will be less efficient. As a result, you’ll be aware of significant breathlessness when carrying out physical exercise.
Diagnosis of heart failure
Our cardiologist specialist Dr Malik will start off by carrying out an Electrocardiogram (ECG) to look at any evidence of a previous heart attack or an increase in heart muscle mass. He’ll examine you carefully to look for signs of high blood pressure or fluid overload.
The next key investigation is an Echocardiogram which looks for weakness of the heart muscle, valvular abnormalities or hypertrophy.
He’ll also typically recommend a chest X-ray which may show an enlarged heart (but can be normal).
In some cases, you may need an Angiogram to investigate your heart failure further.
Blood tests will look for anaemia, kidney and liver disease as well as measure a blood marker called nt_Pro-BNP, which we can use to track the progression of HF.
Treating heart failure
Drug treatments target fluid overload and may also allow you to live longer. Excess body fluid is treated with water tablets (diuretics).
In addition, several classes of drugs are known to increase survival in heart failure, such as:
- Angiotensin-Converting Enzyme Inhibitors (ACEI)
- Angiotensin Receptor Blockers (ARBs) – will be prescribed to most patients
- If symptoms are more severe, aldosterone antagonists such as spironolactone and eplerenone may be used.
- Entresto is a combination drug that can also improve quality and quantity of life
- SGLT2-inhibitors such as Empaglifozin and Dapaglifozin have recently been found to be useful in both types of heart failure
Finally, if your ECG is abnormal, or a special echocardiogram suggests you may benefit from it, a special type of pacemaker – a Biventricular Pacemaker – may be needed. Some patients may also need an Automatic Implantable Defibrillator (AICD). This is a “shock box” to prevent death form rhythm disturbances.
Book your consultation
Just give us a call, e-mail or fill out our simple contact form to arrange your consultation with Dr Malik. He’ll give you access to the best heart failure treatment in the UK so you can get the quality of your life back.
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