Heart failure

Heart failure is a condition where the heart is not able to pump enough blood to meet the body's demands. This can happen when the heart muscle is not able to contract or it is stiff and cannot relax properly.

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There are many causes of heart failure, including coronary artery disease, high blood pressure, heart valve problems, arrhythmias and heart muscle damage resulting from infections or drugs.

 

Symptoms of heart failure can vary, but often include shortness of breath, fatigue, swelling of the legs or abdomen, and decrease in exercise capacity.

 

Diagnosing heart failure involves a thorough physical examination, as well as a variety of tests, including an electrocardiogram (ECG), an echocardiogram and various blood tests.

 

Treatment for heart failure is dependant on the underlying cause and often include medications such as diuretics, beta-blockers, and ACE inhibitors, which help reduce symptoms and improve heart function.

Two new drugs, Sacubitril/Valsartan and Dapagliflozin, have recently been shown to be effective in patients with a heart failure due to pump function.

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It is also important to follow a healthy lifestyle characterised by low-salt intake, regular exercise, smoking cessation and moderate alcohol intake. 

 

Invasive treatments may also be necessary in order to repair or replace damaged heart valves, improve blood flow and facilitate the more efficient pumping function of the heart. Such treatments may involve open heart surgery or take the form of minimally invasive procedures such as transcatheter aortic valve implantation (also known as TAVI) and Transcatheter Mitral Valve Edge to Edge Repair (also referred to as TEER).

 

The presence of  coronary artery disease can adversely affect the pumping function of the heart and, therefore, where appropriate, stent implantation (known as Percutaneous Coronary Intervention- PCI) or Coronary Artery Bypass Grafting (CABG) may be required. Finally, where the cause for heart failure is an underlying arrhythmia, ablation and cardioversion procedures can be used to treat the underlying cause.