There are many risk factors that lead to heart failure. By knowing these risk factors, early detection as prevention before heart failure occurs can be done.
Definition of heart failure
Heart failure is a condition that occurs when the heart cannot pump or fill with enough blood to meet the body's needs for blood and oxygen, which means that the heart has to work harder to provide blood throughout the body. The term "heart failure" is misleading because the heart does not completely fail or stop. Manifestations of heart failure can be mild and provide minor symptoms, or may be severe and even life-threatening.
Symptoms of heart failure
The most common symptoms of heart failure are shortness of breath, feeling tired, swelling of the legs, and other signs of fluid retention. Although heart failure is a serious condition, safe and effective treatments are available. Treatment can help you to feel better and live longer.
What are the symptoms of heart failure?
As a result of the decreased amount of blood pumped by the heart ( cardiac output ), various symptoms can be found, including:
- Feeling weak especially legs when exercising
- Head feels lightheaded or dizzy
- Shortness of breath, which may require you to be less active or sleep using multiple pillows
- Fast heart rate, even when resting
- Swelling in the feet and lower legs (edema) or in the abdomen (ascites)
- Feeling tired or exhausted quickly
Are there tests to detect heart failure?
If your doctor suspects the possibility of having heart failure, the following examinations will be carried out:
- Electrocardiogram (EKG) – This test measures the electrical activity in your heart. This can show whether you have an abnormal heartbeat or had a heart attack in the past.
- A blood test known as “brain natriuretic peptide” (BNP) or “N-terminal pro-BNP” (NT-proBNP). BNP or NT-proBNP levels will be increased in patients with heart failure.
- A chest X-ray (or chest x-ray) will show if there is fluid in the lungs, and will also show the size and size of the heart and major blood vessels in the chest.
- Echocardiogram Examination. This examination uses sound waves to create a real-time picture or imaging of the heart. This examination will show the dimensions of the heart chambers, how well the heart is pumping ( ejection fraction ), and how well the heart valves are working and other functions.
- Stress test. During the stress test, you will be asked to walk or run on a treadmill while an ECG is being recorded. Physical activity will make the heart pump work harder and increase the heart's need for blood (oxygen).
- Cardiac catheterization (also known as “cardiac cath”). During this exam, your doctor will place a thin tube (catheter) into a vein in your thigh or arm. When the catheter reaches your heart or blood vessels, it will take measurements. The doctor will also give a dye (contrast substance). This examination can provide information about the condition of your coronary arteries that are narrowed or blocked. (this exam is known as “coronary angiography”).
Types of Heart Failure
There are two types of heart failure (based on the results of the Ejection Fraction test).
- "Heart Failure with reduced Ejection Fraction" ("HfrEF" or "Systolic Heart Failure"), here the heart is too weak so it can't pump blood adequately.
- "Heart Failure with preserved Ejection Fraction" ("HfpEF" or "Diastolic Heart Failure"), here the heart muscles have experienced stiffness, so that when the heart pumps, relaxation and heart filling problems occur.
Causes of Heart Failure
Heart failure can be caused by diseases or conditions that damage the heart. Fortunately, treating this condition at an early stage will be able to prevent or slow the development / progression of heart failure. The most common causes of heart failure include:
- Hypertension
- Coronary heart disease
- Heart valve disorders
- Cardiomyopathy
Heart Failure Complications
Untreated heart failure is progressive and can cause serious and life-threatening complications. The goals of treatment are to reduce symptoms, reduce the risk of complications and slow or stop the progression of the underlying disease. Complications of heart failure can include: cardiac arrhythmia (irregular heart rhythm), decreased kidney and liver function.
Heart Failure Treatment
In addition to lifestyle and diet changes, it can generally be controlled with a variety of currently available drugs such as diuretics, ACE inhibitors, ARBs, beta blockers, Mineralocorticoid receptor antagonists, etc. Heart failure with progressive rhythm disturbances can be done by installing a cardiac device (Pacemaker, ICD, CRTP, CRTD). Other treatment is in the form of angioplasty or PCI if the cause is coronary heart disease or cardiac surgery or CABG for valvular and coronary abnormalities.
What can I do to protect my heart?
If you do the following, you will feel better and reduce your chances of being treated:
- Take regular medication according to your doctor's advice, even if you feel good. Medicines your doctor prescribes will help you feel better and live longer.
- Consult your doctor if medicines cause side effects or other problems. Your doctor may be able to replace it with another drug or lower the dose, so you won't have this problem.
- Be alert and immediately go to your doctor if your heart signs and symptoms are getting worse
- Reduce salt consumption
- Quit smoking
- Stop consuming alcohol
- Lose weight
- Consult your doctor every time you take new medicines and supplements.
In addition to adopting a healthy lifestyle, carrying out regular health checks is the best early detection step that can be done to find out health problems that can trigger heart failure.
Article written by dr. Hengky Gosal, Sp.PD – KKV, FINASIM (Internal Medicine Specialist – Cardiovascular Consultant at EMC Alam Sutera Hospital)