Heart Failure

• What is it?
• How is it diagnosed?
• What are the symptoms?
• What is the treatment?

What is it?

Heart failure describes the condition of the heart when it is no longer able to function effectively as a pump to supply adequate blood to meet the body's needs, or when the heart is unable to adequately fill up with blood, thereby causing insufficient blood to be sent to the rest of the body.

Causes include:

• Coronary Artery Disease
• Ischaemic Heart Disease
• Myocardial Infarction
• Hypertension
• Diabetes
• Valvular Heart Disease
• Cardiomyopathy

It is a common condition with serious consequences. The prevalence of heart failure increases as we get older. It is a progressive condition that will impact on the social, mental and physical well-being of the patient. Treatment not only targets the heart, but also aims to optimise risk factors and protect other key organs.

How is it diagnosed?

The most common tests are:

• Chest X Ray:
  • May show if the heart is enlarged or if there is fluid around the lungs.
• ECG (Electrocardiography):
  • Electrical activity of the heart can indicate if there was a recent/old myocardial infarct, if there are abnormal heart rhythms, or if the heart is enlarged.
• Echocardiogram:
  • An ultrasound study of the heart and help determine structural abnormalities, analyse blood flow within the heart,and to give an estimate of an overall function and efficiency of the heart as a pump.
• Other tests include:
  • Treadmill test
  • Cardiac catheterization (angiogram/angioplasty)

What are the symptoms?

Common symptoms include:

• Swollen ankles/legs - from fluid retention
• Angina/chest pain
• Shortness of breath - on exertion, at night, or on lying flat; due to excess fluid in the lungs
• Fatigue - a consequence of insufficient blood and oxygen delivered to the other organs and muscles
• Weight loss
• Weight gain - due to fluid overload in the body

Do not hesitate to consult your doctor should you start to experience the above.

 What is the treatment?

In the acute/emergency setting:

• Optimise lung function, eg supplemental oxygen
• Medications to help remove excess fluid in body (Diuretics)
• Pain relief
• Medications to correct arrythmias
• Medications to stimulate the heart to pump

In the long term:

• Starting on drugs that have been shown to reduce mortality and morbidity in heart failure patients (eg. Angiotensin converting enzyme inhibitors, beta blockers, spironolactone)
• Drugs for symptom relief (eg. diuretics)
• Control of risk factors (eg optimise diabtic control, hypertension)
• Regular monitoring of clinical status of heart failure patients

Procedures that can help heart failure patients include:

• Percutaneous Transluminal Coronary Angioplasty (PTCA)
• Coronary bypass grafting
• Valve surgery
• Heart transplantation

Treatment modalities are very much dependent on the patient himself: how his condition is currently, what he was like before, and what precipitated the heart failure. The doctor will be able to advise on how best to manage the heart failure in the long run based on the whole picture.  

Back to Top