Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle works less efficiently than normal and doesn't pump blood as well as it should.
 
Due to various causes, the blood moves through the heart and body at a slower rate and the pressure within the heart increases. The heart is not able to pump enough oxygen and nutrients to meet the body’s needs.
 
The chambers of the heart may stretch to hold more blood to pump through the body or become stiff and thick. This aids the movement of the blood, however the heart walls may weaken and become unable to pump as efficiently.
 
As a result, the kidneys may cause the body to retain fluid (water) and salt. A build-up of fluids within the body causes congestion and heart failure.
 
Types of heart failure
 
·       Systolic dysfunction: when the heart muscle doesn’t contract with enough force, so there is less oxygen-rich blood that is pumped throughout the body

·       Diastolic dysfunction: when the heart contracts normally, but the ventricles do not relax properly or are stiff, and less blood enters the heart during normal filling
 
Symptoms
 
Depending on the degree of heart failure, it could be ongoing (chronic), or it could start suddenly (acute). Symptoms may be constant or come and go.
 
Symptoms include:
 
·       Shortness of breath (dyspnea) when you exert yourself or when you lie down
·       Fatigue, weakness and dizziness
·       Fluid/ water retention- swelling (edema) in your legs, ankles and feet; swelling of your abdomen (ascites)
·       Rapid or irregular heartbeat
·       Reduced ability to exercise
·       Congested lungs – persistent cough or wheezing with white or pink blood-tinged phlegm
·       Increased need to urinate at night
·       Very rapid weight gain from fluid retention
·       Lack of appetite and nausea
·       Difficulty concentrating or decreased alertness
·       Chest pain if your heart failure is caused by a heart attack
 
Causes
 
Heart failure often occurs after other conditions have damaged or weakened the heart muscle. Some can even be present without one knowing their presence.
 
Causes include:
·       Coronary artery disease and heart attack
·       High blood pressure (hypertension)
·       Faulty heart valves
·       Damage to the heart muscle (cardiomyopathy)
·       Myocarditis (inflammation of the heart muscle)
·       Heart defects you're born with (congenital heart defects)
·       Abnormal heart rhythms (heart arrhythmias)
·       Other diseases- chronic diseases- such as diabetes, HIV, hyperthyroidism, hypothyroidism, or a build-up of iron (hemochromatosis) or protein (amyloidosis)- also may contribute to heart failure
 
Prevention
 
The key to preventing heart failure is to reduce one’s risk factors. Lifestyle changes along with necessary medication, aids to control or eliminate many of the risk factors for heart disease.
 
These include:
 
·       No alcohol and tobacco use
·       Staying physically active
·       Eating healthy foods – limit salt (sodium) intake
·       Maintaining a healthy weight
·       Reducing and managing stress
·       Keeping blood pressure low
·       Monitoring one’s symptoms
·       Maintaining fluid balance
·       Take medication as prescribed
·       Schedule regular doctor appointment
 
Treatment
 
The goal for treatment of heart failure is to primarily decrease the likelihood of disease progression (decrease the risk of death and hospitalisation), to decrease symptoms and improve one’s quality of life.
 
Surgical procedures may prevent further damage to the heart and improve its function. Such procedures include:

·       Coronary artery bypass grafting surgery

·       Heart valve surgery 

·       Implantable left ventricular assist device (LVAD)

·       Heart transplant

 

When to see a doctor

Seek medical treatment if you experience any of the following:

·       Chest pain
·       Fainting or severe weakness
·       Rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting
·       Sudden, severe shortness of breath and coughing up pink, foamy mucus
 
Although the signs and symptoms may be due to heart failure, there are other possible causes, including other life-threatening heart and lung conditions. Don't try to diagnose yourself.
Call your local emergency number for immediate help. The doctors will try to stabilize your condition and determine if your symptoms are due to heart failure or something else.
If you have a diagnosed heart failure and your symptoms get worse or you develop a new symptom, contact your specialist. This may mean your existing heart failure is getting worse or not responding to treatment.