What is Heart Failure?

Heart Failure is a situation when pumping efficiency of the heart is reduced, and it is not able to pump enough blood to different organs of the body. Heart Failure may be a result of many diseases of the Heart, viz., Coronary Artery Disease (blockage in arteries), blockage or leakage in the valve of the heart or damage to heart muscles due to infarction, etc.

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SYMPTOMS OF HEART FAILURE

The main symptoms of Heart Failure are breathlessness on exertion initially and then at rest also. Other symptoms are chronic cough, increased urination at night, swelling at face and feet, weight loss, etc.

FATE OF A PATIENT SUFFERING FROM HEART FAILURE

Irrespective of the underlying cause and irrespective of the treatment offered, Heart Failure is a progressive disease. The end result is death. The death in Heart Failure happens due to two reasons.  One is pumping failure, which happens when the Heart is too weak to pump enough blood to different organs to survive and patient dies of multi organ failure. This type of death happens late in the course of Heart Failure and is a manifestation of the end stage of Heart Failure. Another cause is sudden cardiac arrest, which happens due to disturbances in rhythm of the Heart called Ventricular tachycardia (VT) or Ventricular Fibrillation (VF). This type of sudden death may be untimely or much before patient could have died of pump failure.

CAN THIS FATE BE CHANGED?   IS HEART FAILURE REVERSIBLE?

The answer is YES. 

For ACUTE conditions, there are some implantable devises available for such patients who are at higher risk of Sudden Cardiac Death or remain symptomatic despite good medication. One such device is ICD (Implantable Cardioverter Defibrillator), which can prevent sudden cardiac arrest by providing automatic electric shock whenever needed. Other is CRT (Cardiac Resynchronisation Therapy), which can increase pumping efficiency of the Heart. The combination of both devices is called CRT-D (Combo) device.

For CRONIC conditions:  Stop Oil intake completely. Vegetables have no Cholesterol switch to being a vegetarian. Take a walk for 35 to 45 minutes 4 to 5 times a week. Reduce weight, especially on the abdominal area, Take at least 35 hours of treatment on an IECP. This will create new path ways in your heart and will enhance oxygen flow in deprived areas of the heart.  With this you are sure to lead a normal life.

TREATMENT OF HEART FAILURE

With the new treatment modalities coming in Treatment of Heart Failure depend on the many conditions.  The Primary of which is what your doctor is capable of performing and what facilities he has at his work place.

Patient may need Angioplasty or Bypass Surgery if he has a blockage in the arteries and is in acute stage or end stage. A valve may need to be repaired or replaced if it has leakage or blockage resulting to Heart Failure. Some drugs are essential for Heart Failure like Diuretics, Beta blockers and ACE inhibitors, whatever the cause.

In conditions when a patient can wait and is under medication or is unsuitable for any intervention an IECP treatment is recommended to increase the EF of the heart. IECP therapy increases the blood flow to the deprived areas of the heart by increasing the collaterals. The therapy is carried out on an Out-Patient (OPD) basis for a period of 4 to 5 weeks, where a patient lies on a recliner like comfortable therapy couch for a period of one hour every day. During the therapy cuffs are wrapped around the patient's calves, thighs and arms, which inflate and deflate in synchronisation with the cardiac rhythm.  Collateralisation is a gradual process and it takes about a week or more before the patient starts feeling the improvement.

It is said that when nothing works IECP works. So why not give it the first chance if you are suitable for this therapy. Reluctantly interventionists have also started to bring IECP into the main stream by using it as a rehabilitation equipment but post intervention.

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