What is Heart Failure and it’s treatment : Agra Heart Centre : Best Cardiac Hospital in Agra
Heart Failure signs and symptoms
What is Heart Failure?
Heart Failure, simply put, is inability of your heart to meet the demands of the body.
A person experiencing Shortness of breath, Cough, palpitations is most likely to have heart failure. Heart failure is often confused with pneumonia, however, please be reminded, that heart failure can get precipitated by pneumonia, or be diagnosed along with an infection or may even be caused during an infection (labeled as infective/viral myocarditis)
Heart Failure is a serious condition and a dedication towards treatment, lifestyle modification and follow ups are paramount to control it, and to get the best results.
We are all living in wonderful times, where the armamentarium to control heart failure is ever growing.
First let us talk about common heart failure symptoms:
1. Shortness of breath or breathlessness, especially on walking or climbing stairs or lifting weights. (A feature of left sided heart failure)- it is due to the heart not pumping effectively and the pressure being transmitted back from the LV to the LA and back to the lungs, causing an increase in lung water – leading to breathlessness.
2. Cough : It is a variant of shortness of breath. The lung receptors get irritated due to increased lung water and edema of the airways – causing cough. This cough is usually dry, and is mostly caused during lying down position. This is also a variant of left sided heart failure and often ignored symptom.
3. Pink frothy sputum : This is a bad sign, where there is blood tinged or pink frothy sputum. This is quite serious, and patient should get admitted, if he or she has not yet gotten admitted for the same.
Always remember, if your treating doctor feels you have heart failure, and you should get admitted to get treated, kindly comply. Sometimes, heart failure gets worsened dramatically and needs to be controlled and home medications may not be adequate in such cases.
4. Pedal Edema : A feature of Right sided heart failure, in this the excess fluid gets accumulated before it reaches the heart and leads to accumulation of fluid in the legs (causing an indentation when putting pressure on the lower part of the legs- like a small pit where the pressure is applied and removed).
Shortness of breath is not a feature of Right sided heart failure.
A person having both shortness of breath/cough and pedal Edema usually has biventricular failure (both sided heart failure)
There are other subtle signs of heart failure – that your cardiologist would check on you and determine your present condition.
What are the essential tests in patients with Heart Failure.
A patient with heart failure has to have a battery of tests to determine present condition, finding cause and to seek out other complications that one might have due to an inadequate cardiac output.
Tests include but not limited to,
2D echo, CBC, Creatinine, SGPT, Troponin, NT-Pro BNP levels. Chest X Ray, ECG, TSH
Patients with suspected ischemic cause- need to undergo Angiography after the heart failure has settled.
In certain cases, a cardiac MRI with late gadolinium enhancement run might be needed to determine the likelihood cause of the heart failure.
These are some of the tests that a person might be asked to get done, apart from other tests as and when necessary.
What are the types of Heart Failure?
So Heart Failure is divided into 4 different types of HF
1. HFrEF ie Heart Failure with reduced Ejection Fraction (EF) – In this the LV Ef is less than 45% and patient has symptoms of heart failure.
A long list of drugs are now available to treat this kind of heart failure along with device therapy.
Contact your cardiologist to know more about available therapy options.
2. HFpEF or Heart Failure with preserved ejection fraction. In this the LVEF is more than or equal to 55%, however patient still has features of heart failure. A lot of medications are still coming up for this kind of heart failure, but the advancements are still lagging behind, however, much better than what was previously the case.
3. HFmrEF or Heart Failure with mid range Or mildly reduced Ejection Fraction. In this the patient has symptoms of heart failure, and EF in the range of 45-55%. Treatment is mostly medical.
4. HFiEF– or Heart Failure with improved Ejection fraction. Patient had previously documented EF less than 45% with symptoms and is now either symptomatic or asymptomatic but has a jump in ejection fraction to more than 10% landing him in the HFmrEF or HFpEF range. This is a good category to be in, if at all one has to be in any category of heart failure.
Whatever be the category of the heart failure, each patient is different and has different requirements and the treatment needs to be individualized accordingly.
What are the treatment options?
We live in wonderful times, and treatment can be divided into medical therapy and device therapy.
Armamentarium includes wonder drugs like beta blockers, Diuretics, Sacubitril Valsartan, SGLT2i, MRAs, vericiguat etc. However each drug needs to be individualized.
Device therapy- in patients not finding adequate improvement with medications is CRTD in select patients for imorovement in EF and symptoms. I select patients- LBBB pacing may be all that is needed. And ICD in select patients to decrease the risk of Sudden cardiac deaths.
However, device therapy also needs to be individualized and let your cardiologist guide you accordingly.
What precautions one should take if one has heart failure?
See, for anything to recover, one needs to be relaxed and have rest. Try not to stress your body in the initial phase. The resting part is very important with minimal exertion in the first few weeks of heart failure, when one doesn’t need to be admitted.
Unless otherwise stated or told, Liquid intake should be reduced to less than 1.5 or 2 L per 24 hours (unless specifically prescribed by your doctor).
If you have diabetes- avoid all kinds of sweet tasting food and drinks.
Reduce Tel, Ghee, Chiknai, Mirch, Masala. Completely quit alcohol, smoking, pan, tobacco, pan masala, supari, tobacco brushing.
Other food and dietary precautions need to be individualized according to the patient.
Please understand, Heart Failure is a syndrome, one needs to find the case of it and treat it while giving medications to improve Heart failure.
Heart Failure doesn’t need to be a death sentence, atleast in the modern times. Heart failure does need to be treated aggressively and controlled through all the available medical and device therapies available. If one gets behind something, no feat is unachievable. Patients with Heart failure have been treated successfully and thousands are in follow up with controlled Heart failure and many have improved Heart failure at Agra Heart Centre. Systematic and correct treatment of heart failure is all that is needed with timely advice.
…..
Agra Heart Centre is well equipped with team of cardiologists, consultant and interventional for all your heart failure needs.
Agra Heart Centre is the first and only cardiac hospital in Agra with good experience in CRTD, ICD and LBBB Pacing device.
Dr CR Rawat and Dr Rajat Rawat are top most cardiologists of Uttar Pradesh and Agra, and have been in the forefront of heart failure treatment in the country.
Dr. CR Rawat has vast experience in treating heart failure cases and to optimize dose and introduce novel drugs accordingly.
Dr. Rajat Rawat takes care of the medicine and the interventional part of heart failure, by implanting CRTD, ICD, LBBB pacing in select patients. Dr. Rajat Rawat is also well versed with all heart failure medicines and well experienced with their usage.
Agra Heart Centre has been doing CRTD/ ICD and LBBB pacing cases since 2018 in Agra, and is the first hospital in Agra to do these cases and also the most experienced one.
Agra Heart Centre with the most advanced cath lab and cardiologists is the best hospital to get yourself treated for Heart failure.
Agra Heart Centre has been ranked 15th in National Rankings in Single Speciality units of Cardiology in India and highest rank in Agra amongst cardiology hospitals.