What is heart failure?
Heart failure (HF) is a serious and chronic disease that occurs when the heart is unable to:
- pump blood to the body in the required amount
- relax and receive blood again in a normal way
This means that the blood may not be able to supply the body with enough nutrients and oxygen to function normally.
Are there different types of heart failure?
yes. Heart failure can be classified using a parameter obtained through cardiac imaging (e.g. echocardiogram) – the Left Left Left Electricular Injection E Fraction (LVEF). LVEF is a parameter that quantifies the heart's ability to pump blood to the different organs of the body.
Thus, there are three categories of heart failure:
- heart failure with reduced LVEF: the heart's ability to pump blood is decreased when the LVEF value is less than 40%. This is the type of heart failure that is of most concern and is associated with the most risks
- heart failure with intermediate LVEF: the ability to pump blood is slightly decreased, which happens when the LVEF value is between 40 and 49%
- heart failure with preserved/normal LVEF: when the heart pumps blood normally. That is, LVEF is normal, or greater than 50%, but the heart has structural changes, such as very thickened walls, or functional changes, such as high pressures, which causes the ability to relax or receive blood to be altered
What are the risk factors for developing heart failure?
Usually, heart failure develops because the person has (or has had) a health problem that has affected the heart, such as:
- coronary artery disease
- heart attack
- high blood pressure
and left lesions or overstrained the heart.
However, there are many other factors that cause heart failure, such as:
- High cholesterol
- smoking
- diabetes
- obesity
- Sedentary lifestyle
- family history of heart disease or genetic mutations
Heart failure is a disease that affects about 400,000 Portuguese, a number that is likely to increase. It is estimated that the number of people with the disease (prevalence) will increase between 50% and 70% by 2030.
How does heart failure manifest itself?
The main warning signs of heart failure are:
- extreme tiredness
- difficulty breathing, which limits physical activity or forces you to sleep with an extra pillow
- constant tachycardia
- swelling (oedema) in the legs or abdomen
- increased frequency and need to urinate at night
- Dizziness
- Fainting
- weight gain
When patients have these types of symptoms, they should seek help from a doctor to try to understand if there is, in fact, heart failure.
Can the symptoms of heart failure be confused with other diseases?
yes. The symptoms of heart failure can be confused with other diseases, so it is always necessary to do some tests to confirm the diagnosis.
Can age influence the onset of heart failure?
yes. Heart failure can develop at any age, however, it is a disease closely associated with the aging of the population, and is even the main cause of hospitalization in individuals over 65 years of age.
Does having heart failure mean the heart has stopped beating?
No. Heart failure occurs when there are injuries to the heart muscle or valves, and the heart cannot pump blood to the body as it should.
What are the main complications of heart failure?
Heart failure is associated with complications inherent in the heart's inability to pump blood to the body. That is, you can:
- affect the different organs due to the lack of oxygen and nutrients, causing symptoms of extreme tiredness, dizziness or fainting
- fluid buildup in the lungs or legs (oedema), causing shortness of breath or swollen legs
In addition, the lesions that exist in the heart can lead to the occurrence of arrhythmias, which can be severe to the point of causing sudden death.
If this disease is not treated early, it may be necessary to be admitted to the hospital to administer medication that helps the heart and reduces accumulated fluids.
At a later stage of the disease, when medication or other interventions are not sufficient, a heart transplant may be necessary.
If I have heart failure, can I exercise?
yes. It is very important for people with heart failure to exercise. However, it's also important that they don't overdo it. The right amount of exercise can help improve blood flow and relieve some of the symptoms.
How is heart failure diagnosed?
It is not always easy to diagnose heart failure because the symptoms are not very specific and can be confused with other pathologies. However, the diagnosis can only be made through clinical history and tests such as:
- Blood tests
- Chest X-ray
- electrocardiogram (ECG)
- Echocardiogram
After diagnosis, the patient should be referred to a cardiology consultation specializing in heart failure.
Can a person with heart failure live a normal life?
yes. Although heart failure is a very serious disease that can shorten the lifespan, the patient should together with their doctor and nurse make sure that:
- receives effective treatments
- Implements changes in your lifestyle
These attitudes allow you not only to relieve the symptoms, but also to prolong your life.
Is it possible to prevent heart failure?
Yes, in most situations it is possible to prevent heart failure. To this end, it is necessary to prevent and avoid the emergence of risk factors, such as:
- High cholesterol
- high blood pressure
- diabetes
- obesity
- Sedentary lifestyle
- smoking
- alcoholism
Thus, some of the measures to prevent you from suffering from heart failure are:
- Have a healthy lifestyle
- Regular physical exercise
- Maintain a balanced diet
- no smoking
- Do not drink alcoholic beverages
In addition, if you suffer from high cholesterol, high blood pressure or diabetes, you should be monitored regularly by a doctor and strictly comply with the medication.
What is the treatment for heart failure?
Treatment for heart failure should be individualised for each patient, as it depends largely on the degree of heart failure and its progression. However, as a rule, the treatment consists of:
- lifestyle changes (no smoking, healthy eating and exercise)
- medications, which should be taken without interruption
- Interventions such as catheterization, surgery, or pacemaker placement
When heart failure is very severe and does not respond favorably to treatment, heart transplantation may be indicated.
When is transplantation a solution for heart failure?
A heart transplant can be done when heart failure is very severe or terminal. That is, when the patient does not respond to medical, surgical and conventional treatment.
Are all people with severe heart failure selectable for transplantation?
No. Only patients who, after a thorough evaluation, guarantee absolute compliance with medical indications, such as:
- Be motivated, well-informed, and emotionally stable
- able to comply with the intensive and complex treatment required in the postoperative period
What is the heart transplant procedure?
When a matching heart donor emerges, the person eligible to receive the transplant is called to the hospital. Heart transplantation is a surgery that takes place in the operating room and is performed by heart surgeons.
First, the donor's "healthy" heart is harvested by surgeons and transported to the heart transplant site. In this place, the surgery begins, in which the "diseased" heart of the person who is going to receive the transplant is removed and the "healthy" heart is placed. This is possible with the help of machines that help maintain blood circulation throughout the procedure.
Source: Portuguese Society of Cardiology