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Heart failure

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Heart failure, often called congestive heart failure, is a complex medical syndrome. It occurs when the heart cannot pump blood effectively to meet the body's needs. This impairment affects the heart's ability to fill with blood or pump it out.

Right side heart failure
Right side heart failure

Because the heart fails as a pump, it can cause cardiovascular insufficiency. This means the circulatory system does not receive enough blood. The term "congestive" describes a common symptom where fluid accumulates in tissues. This buildup is known as edema. Heart failure is a major global health issue. In 2015, it affected approximately 40 million people worldwide. It is a leading cause of hospital stays for older adults.

The mechanism of heart failure involves changes in heart structure or function. When the heart cannot pump well, blood can back up into the veins. This creates high filling pressure in the left atrium. This pressure leads to fluid accumulation and water retention.

Chest radiograph with signs of congestive heart failure - annotated
Chest radiograph with signs of congestive heart failure - annotated

If the heart cannot push enough blood forward, tissues may experience ischemia. Ischemia happens when there is inadequate blood flow to body tissues. Doctors often measure the severity of this condition using ejection fraction. This is a measurement of how much blood the heart pumps out with each beat. They also look at pulse pressure, which is the difference between systolic and diastolic blood pressure. A low pulse pressure, specifically 25% or less of the systolic level, can be an early warning sign.

There are three distinct types of heart failure based on which part is affected. Left-sided heart failure affects the left side of the heart. This side normally takes oxygen-rich blood from the lungs and sends it to the body. When it fails, blood backs up into the lungs. This can cause pulmonary edema, which is fluid in the air sacs of the lungs.

Kerley-B-Linien
Kerley-B-Linien

Right-sided heart failure affects the right side of the heart. This side handles blood returning from the body. Failure here often leads to systemic congestion. This causes swelling in the legs, feet, or abdomen.

Combinpedal
Combinpedal

Biventricular heart failure occurs when both sides of the heart are affected. This is common because left-sided failure can eventually stress the right ventricle. If one side fails, the condition often progresses to involve both sides.

Symptoms vary significantly depending on the specific type of failure. Left-sided failure often presents with respiratory issues. Patients may experience dyspnea, which is shortness of breath during exertion or at rest. Some people experience orthopnea, which is increased breathlessness when lying down. Severe cases might involve paroxysmal nocturnal dyspnea, a sudden attack of shortness of breath during sleep.

Heartfailure
Heartfailure

Right-sided failure symptoms are often visible in the body. This includes peripheral edema, which is swelling in the limbs. It can also cause ascites, which is fluid accumulation in the abdominal cavity. In severe cases, liver enlargement or jaundice may occur due to congestion. Patients may also experience nocturia, or frequent urination at night, as fluid returns to the bloodstream while lying down.

Many different factors can cause the heart to change its structure or function. Common causes include coronary artery disease and high blood pressure. A myocardial infarction, or heart attack, is also a frequent cause. Other factors include atrial fibrillation, valvular heart disease, and excessive alcohol consumption.

Histopathology of pulmonary congestion and siderophages
Histopathology of pulmonary congestion and siderophages

Infections like myocarditis, which is inflammation of the heart muscle, can contribute. Even sleep apnea is considered an independent cause. Some rare causes include exposure to toxins like lead or cobalt. Genetic predisposition also plays a major role in how the condition develops.

Diagnosis involves looking at symptoms and using specialized medical tools. Doctors use echocardiography to visualize how the heart is working. They may also use chest X-rays and blood tests to find underlying causes. Treatment depends on how severe the case is. For mild or stable cases, lifestyle changes like exercise and diet are recommended. Medications such as beta blockers or diuretics help manage the condition. Diuretics are used specifically to prevent fluid retention and shortness of breath.

Combinpedal
Combinpedal

For more severe cases, implanted devices like pacemakers or defibrillators may be used. In extreme situations, a ventricular assist device or a heart transplant might be necessary.

Heart failure is a serious condition with significant statistics. It affects about 2% of all adults and over 10% of people over age 70. The risk of death is quite high in the early stages. About 35% of patients die within the first year after diagnosis. However, for those who survive the first year, the risk drops to less than 10% in the second year. This mortality rate is comparable to some types of cancer. Understanding heart failure is vital because it is a common and costly condition that impacts millions of lives.

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🖼️ Images & Media (6)
File:Heartfailure.jpg
Heartfailure.jpg
File:Combinpedal.jpg
Combinpedal.jpg
File:Kerley-B-Linien.jpg
Kerley-B-Linien.jpg
File:Right side heart failure.jpg
Right side heart failure.jpg
File:Chest radiograph with signs of congestive heart failure - annotated.jpg
Chest radiograph with signs of congestive...
File:Histopathology of pulmonary congestion and siderophages.jpg
Histopathology of pulmonary congestion...
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