A beating heart is what keeps all of us well and alive. Not only does it pump oxygen-rich blood to every organ in our body, it also sends blood filled with carbon dioxide and waste products to the lung and kidney respectively so that our body does not accumulate harmful substances.
We take a beating heart for granted throughout our entire life; and it is only when our heart starts failing that we realized how essential it is.
In this article, we would like to introduce you to a medical syndrome called heart failure.
Heart failure is a term used to describe a heart that cannot keep up with its workload, which leads to an overworking heart and reduced oxygen for your body.
Heart failure is not a spontaneous disease that suddenly develops out of nowhere; rather it is what awaits many patients with cardiovascular diseases at the end of their disease progress. Heart failure is often seen in elderly aged 65 years old and above, and many elderly were in and out the hospitals frequently because of this problem.
Did you know that heart failure is actually deadlier than many cancers?
If we ask you: what do you think is the scariest disease in the modern times? We bet you might answer cancer. (at least prior to the COVID-19 pandemic you are very likely to answer as such)
But statistics data tell us otherwise. Heart failure actually kills more people than colorectal cancer, non Hodgkin’s lymphoma and breast cancer. In fact, 48% of people died within 5 years of onset of heart failure.
Symptoms of heart failure
Heart failure is not a disease but a clinical syndrome: it is a collective of signs and symptoms due to the structural or physiological abnormalities of the heart. Some classical symptoms of heart failure include:
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Shortness of breath, i.e. always out of breath even just walking or sitting
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Swelling in the feet, ankles, legs or abdomen; as a result, you may gain weight or find the shoes you wear become tighter
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Feeling tired all the time, which makes it harder for you to carry out your daily activities
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Inability to carry out physical activity
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Persistent coughing or wheezing; the mucus may be white or pink (blood-tinged)
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Increased heart rate or heart palpitations
Depending on the severity of heart failure, each person diagnosed with heart failure may experience these symptoms differently.
How does the heart fail?
Heart failure usually happens as a result of an underlying medical condition. The common underlying disease that can cause heart failure include:
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High blood pressure
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Coronary artery disease (CAD)
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Previous heart attack
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Abnormal heart valves
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Heart muscle disease (dilated cardiomyopathy, hypertrophic cardiomyopathy) or inflammation (myocarditis)
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Heart defects present at birth (congenital heart disease)
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Severe lung disease
These medical conditions can add more burden to the heart, which makes your heart work harder than it is capable of. At first, your heart would try to make up for its ‘extra responsibilities’ by:
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Enlarging. The heart stretches to contract more strongly and keep up with the demand to pump more blood. Over time this causes the heart to become enlarged.
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Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
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Pumping faster. This helps increase the heart’s output.
Your body also tries to compensate in other ways:
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The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power.
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The body diverts blood away from less important tissues and organs (like the kidneys), the heart and brain.
The quote ‘what doesn’t kill you makes you stronger’ unfortunately does not apply to our heart’s health in the long run. These temporary measures mask the problem of heart failure, but they don’t solve it. Heart failure continues and worsens until these compensating processes no longer work. Eventually the heart and body just can’t keep up, and the person experiences the fatigue, breathing problems or other symptoms that usually prompt a trip to the doctor.
This also explains why many people do not seem to realize the condition until years after their heart declined badly.
Living with heart failure
Unfortunately, there is no cure for heart failure. People with heart failure usually have to deal with the condition for the rest of their lives. Without extra care, people can be easily killed by heart failure or suffer a great deal if they are alive. Nonetheless, this is not to say that people with heart failure will not be able to enjoy a good life. Many people with heart failure lead a full, enjoyable life when the condition is managed with heart failure medications and healthy lifestyle changes.
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Always take your medications on time according to the doctor’s instruction.
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If you are diagnosed with high blood pressure, make sure you follow the doctor’s advice to always take medication and keep your blood pressure in check. This is because high blood pressure can increase your risk of developing ischemic heart diseases and heart failure.
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It is also important that you keep your blood lipid level at the normal level. If you have a high blood cholesterol level, it is likely that you are taking a prescription drug from the drug class called statin. Here’s a good news - studies have found that individuals who take statin have significantly lower risk for heart failure.
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Monitor any signs of deterioration of your health, including:
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Measure your dry weight (i.e. your body weight before eating anything, preferably without clothes on). A sudden increase in dry weight (by >2kg) may indicate severe swelling in your body, which is a sign of your heart failure worsening.
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Observe any changes to the severity of your shortness of breath. For instance, if you realised you ran out of breath easier when making the same trip to a particular destination, it may indicate that your condition has worsened.
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Observe if there’s any swelling on your feet, ankle, leg, and abdomen.
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Strictly follow your doctor’s instruction on the volume of fluids you are allowed to take per day, if any. Any slight increase in the intake of fluids, whether it is in the form of plain water, juice, coffee or soup, may add extra burden to your heart.
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Attend follow-up with your healthcare provider regularly.
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If you also have diabetes, ensuring you have a good control of blood sugar is important to relieve your heart failure symptoms.
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Adopting a healthy lifestyle has been shown to lower the risk of heart failure. Such adoption includes quit smoking, maintaining a healthy body weight, higher consumption of fruits and vegetables and regular exercise.
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Avoid consuming alcohol, as long-term alcohol abuse can lead to alcoholic heart muscle diseases.
You only have one heart, take good care of it while it is still beating.
Sources:
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American Heart Association - Heart Failure. https://www.heart.org/en/health-topics/heart-failure
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CPG Management of Heart Failure 2019. https://www.malaysianheart.org/files/5d6f717e6d58e.pdf
