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Heart failure

Heart failure is a dramatic term used to describe a set of symptoms that are attributed to the heart’s inability to deliver enough blood for the body’s needs.

 

Symptoms

People with heart failure experience a variety of symptoms such as breathlessness, fatigue and swelling of ankles and legs. There are also other symptoms such as difficulty lying flat in bed, waking up breathless in the night, exercise intolerance, palpitations (awareness of heart beat), dizziness, abdominal bloating and low mood.

 

Causes

There are a number of causes of heart failure. Approximately half of people of heart failure have a reduction in the heart’s ability of squeeze, also called heart failure with reduced ejection fraction. The most common causes of this are listed below:

  • Heart attack

  • Heart muscle disease (cardiomyopathy) and there are a number of different causes of this including viruses, familial causes, drugs such as alcohol and some types of chemotherapy that are used in the treatment of cancer

 

Half of people with heart failure have adequate squeezing function but are limited by the heart’s ability of stretch and accommodate the necessary blood volume it needs to eject. This is call heart failure with preserved ejection fraction. The most common causes of this are listed below:

  • High blood pressure

  • Valvular heart disease (aortic stenosis, narrowing of the aortic valve)

  • Familial cardiac conditions such as hypertrophic cardiomyopathy

  • Infiltrative causes such as cardiac amyloidosis (abnormal deposition of protein within the heart)

 

Investigations

There are a number of different tests that can be performed to diagnose heart failure and are listed below:

  • Blood tests to look for anaemia, infection, liver and kidney failure all of which can produce similar symptoms of heart failure are important to perform

  • Measurement of NT-proBNP, a protein released by the heart when it is stretched.

  • A chest X-ray to assess the lungs and assess the size of the heart

  • ECG or electrocardiogram is an electrical reading of the heart that is performed by placing electrode stickers on the skin of the chest wall.

  • Ultrasound of the heart or echocardiogram is a test used to assess the structure and function of the heart. This will determine whether the heart’s squeezing or stretching ability is inhibited.

  • Cardiac MRI can be performed to have a detailed assessment of the heart’s structure and function.

  • A coronary angiogram can be performed to assess whether the arteries of the heart are furred up.

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