The mechanism of how the heart pumps involve mainly two motions, systole (contraction) and diastole(relaxation) these sequences of events should take place so that the blood can reach the organs and back in to the heart. Heart failure is when there is a failure in the pumping activity of the heart that impairs the blood circulation resulting in the insufficient circulation of blood to meet the body’s needs. Heart failure is not the same as heart attack which is due to the absence of blood supply to the heart muscle.
There are mainly two types of heart failure, right and left sided heart failure these can exist individually or both at the same time if both sides develop, mainly because of left sided heart failure that progresses to right sided heart failure.
There can be a dysfunction in either systole, giving rise to systolic heart failure where the heart is unable to contract or diastolic heart failure where the heart muscles are so stiff that they cannot relax.
Left sided heart failure is when there is a problem in the left side of the heart that impedes the blood from reaching the body systems leading to backing up of fluid in the lungs, interrupting the oxygenation of blood. Therefore, this can result in orthopnoea or even central sleep apnea treatment. Orthopnoea refers to shortness of breath when lying down and sleep apnoea is the cessation of breath.
In right sided heart failure, there is a failure in blood reaching the lungs therefore there is blood backed up in the lower extremities leading to swelling of the lower extremities.
There are 4 main stages of heart failure
Class 1 – there is rarely any symptoms during physical activity.
Class 2- there is no symptoms during rest but when you exert yourself in physical activities you can experience symptoms like shortness of breath, fatigue and palpitations.
Class 3- during rest there are no symptoms but when engaging in physical activity even mild can cause the symptoms.
Class 4- the symptoms begin to be present at rest and you can rarely carry out any activity that won’t result in shortness of breath or fatigue or any other symptoms of heart failure.
Hypertension, there is the narrowing of arteries which makes it very difficult on the heart to pump blood which eventually leads to weakening of the heart. Coronaryartery disease, impaired functioning of the heart valves, and other conditions like diabetes, thyroid problems, obesity.
Fatigue, shortness of breath, irregular heart rate, cough due to fluid in the lungs, swelling in the lower extremities, wheezing and in severe condition, fast breathing, chest pain, cyanosis and loss of consciousness.
Patient history is taken and physical examination is performed, with auscultation of the heart and lungs, and ECG and echocardiogram are performed. A stress test is also performed to evaluate the severity of heart failure.
Drugs that are used are Angiotensin converting enzyme inhibitors that lead to dilating of blood vessels that improves the blood circulation. Beta blocker that reduces the work on the heart, diuretics helps in excreting the excess fluid.