Heart failure : Some vital information

Smoking, eating salt, being overweight and drinking alcohol all aggravate heart failure as do extremes of room temperature. When salt restriction alone doesn't reduce fluid retention, diuretic drugs are prescribed to increase urine formation and remove sodium and water from the body through the kidneys. Digoxin increases the power of each heartbeat and slows a heart rate that is too rapid. Vasodilators are also used. A vasodilator may dilate arteries, veins or both. Arterial dilators expand arteries and lower blood pressure, which in turn reduces the work required of the heart.

dr. maswoodur rahman prince

Although some people mistakenly believe that the term heart failure means the heart has stopped, the term actually refers to the diminished ability of the heart to keep up with its work-load.
Heart failure has many causes, including a number of diseases; heart failure is much more common in older people .
Heart failure (congestive heart failure) is a serious condition in which the quantity of blood pumped by the heart each minute (cardiac output) is insufficient to meet the body's normal requirements for oxygen and nutrients. Causes
Any disease that affects the heart failure and interferes with the circulation can lead to heart failure. Diseases may selectively affect the heart muscle, impairing its ability to contract and pump blood. By far, the most common of these is coronary artery disease, which limits blood flow to the heart muscle and can cause a heart attack. Myocarditis (an infection of heart muscle caused by bacteria, viruses, or other microscopic organisms) may damage the heart muscle as may diabetes, an overactive thyroid gland, or extreme obesity. Heart valve disease may obstruct blood flow between the heart's chambers or between the heart and the major arteries. Alternately, a valve that leaks may allow blood to flow backward. These conditions increase the heart muscles workload, which eventually weakens the force of the heart's contractions. Other diseases, primarily affect the heart's electrical conduction system, resulting in slow, fast, or irregular heartbeats that can't pump blood effectively. If the heart has to work unusually hard over months or years, it gets larger. At first, this enlargement provides a stronger contraction, but eventually an enlarged heart may result in decreased primping qbllity and heart failure. High blood pressure (Hypertension) can make the heart work harder. The heart also has to work harder when it has to force the blood through a narrowed exit from the heart, usually a narrowed aortic valve In some people, the stiffening of the pericardium the thin, transparent covering of the heart prevents the heart from fully expanding between beats and thus keeps it from filling adequately with
blood. Failure may also develop due to myocardial infarction, congenital heart disease or chronic lung disease.
Consequences of heart failure
When the heart is unable to pump all the blood it receives from the lungs and the rest of the body, there is stagnation of the blood in heart chambers at a high pressure: Stagnation of the blood in the heart also prevents return of the blood from the lungs and the rest of the body
This results in pooling of the blood in the lung veins and the veins of the body. This gives rise to a state of congestion in the lungs, and the body. That is why heart failure is commonly known as congestive cardical failure.    
Compensatory mechanisms
The body has a number of response mechanisms to compensate for heart failure. The initial short-term emergency (within minutes to hours) response is fight or flight reaction caused
by the releases of adrenaline and noradrenaline into the
blood stream.
Adrenaline and nor adrenaline released from the adrenal gland and the nerves respectively, are the body's first line defences against any sudden stress. In compensated heart failure, adrenaline and noradrenaline cause the heart to work harder, helping it to increase its output of blood and compensate to some degree for the pumping problem. As another corrective mechanism, the kidneys retain salt (sodium) to keep the body's sodium concentration constant, the body simultaneously retains water. This additional water increases the volume of blood in the circulation and, at first, improves the heart's performance. One of the major consequences of fluid retention is that the larger volume of blood stretches the heart muscle. This stretched muscles contract more forcefully. This is one of the heart's main mechanisms for increasing its performance in heart failure. As heart failure progresses, however, the excess fluid escapes from the circulation and accumulates in various body sites, causing swelling (oedema) The other major mechanism by which the heart compensates is enlargement of the heart muscle (hypertrophy) The enlarged heart muscle can contract with greater force, but eventually in malfunctions, marking the heart failure worse.
Symptoms
Congestion in the lungs causes shortness of breath, inability to sleep flat and dry hacking cough. Congestion in rest of the body causes salt and water retention which leads to rapid weight gain and swelling in the legs, hands, and sometimes face. Heart failure also causes enlargement of the heart, seen on X-Ray chest.
Severity of the symptoms of heart failure may vary from just mild fatigue to severe shortness of breath and swelling. Acute breathlessness due to heart failure requires urgent hospitalisation
Diagnosis
The symptoms alone are enough for a doctor to make a diagnosis of heart failure. The following findings can confirm the initial diagnosis: a weak and often rapid pulse rate, reduced blood pressure, certain abnormalities in heart sounds. an enlarged heart, swollen neck veins, fluid in the lungs, an enlarged liver, rapid weight gain, and a swollen abdomen or legs. A chest X-Ray can show an enlarged heart and, fluid accumulated in the lungs. An echocardiography may also be done.
Treatment
At one time, there was no effective treatment of heart failure. Now a days, most instance's heart failure can be controlled with:
Rest:
1. Rest enables the heart
muscle to regain its strength for activity
2. Salt restriction: Salt holds water in the body, which gives the heart more to pump
3. Medicines: Four types of medications are commonly used for heart failure:
a. Those making the pumping action of the heart stronger
b. Those reducing the amount of water retained in the body other
c. Those relaxing blood vessels
d.  Vital minerals, which are lost due to treatment with medicines.
Much can be done to make physical activity more comfortable, improve the quality of life and prolong life, but for most people with heart failure, no cure exists. Much benefits could be derived if contributing factors aggravating heart failure could be removed Smoking, eating
salt; being overweight and drinking alcohol all aggravate heart failure as do extremes of room temperature.
When salt restriction alone doesn't reduce fluid retention, diuretic drugs are prescribed to increase urine formation and remove sodium and water from the body through the kidneys.
Digoxin increases the power of each heartbeat and slows a heart rate that is too rapid. Vasodilators are also used.
A vasodilator may dilate arteries, veins or both. Arterial dilators expand arteries and lower blood pressure, which in turn reduces the work required of the heart venous dilators expand the veins, providing more rooms for the blood that has accumulated.
This extra room removes congestion and reduces the load on the heart. The most widely used vasodilators are the ACE (angiotensin converting enzyme) inhibitors.
 These drugs not only improve symptoms but also prolong life. The ACE inhibitors dilate both arteries and veins.
Dilated and poorly contracting heart chambers may allow blood clots to form in them. The danger here is that these clots can brew off, travel through the circulation and cause damage to the vessel and/or partially or completely block an artery elsewhere. If a clot blocks an artery to the brain, a stroke may result.
Congestive heart failure and  blood pressure link
Controlling blood pressure is the best way to avoid congestive heart failure (CHF).
Trap : Doctors often overlook isolated systolic high blood pressure, the type most likely to cause CHF. In this form of high blood pressure, the first (systolic)
number is 140 or higher while the second (diastolic) number is
below 90.
Patients with such blood pressure need close surveillance and may require treatment.
New surgical procedure for heart failure sufferers
Cardiomyoplasty involves transplanting nuascle tissue from the patients own back to the ventricles of the failing heart.
A pace maker-like device implanted at the same time stimulates the transplanted tissue to contract, assisting the heart as it pumps. Cardiomyoplasty is especially promising for older people who fail to respond to less drastic treatments, yet who have other medical problems that disqualify them for a heart transplant.

Heart failure : Some vital information

Smoking, eating salt, being overweight and drinking alcohol all aggravate heart failure as do extremes of room temperature. When salt restriction alone doesnt reduce fluid retention, diuretic drugs are prescribed to increase urine formation and remove sodium and water from the body through the kidneys. Digoxin increases the power of each heartbeat and slows a heart rate that is too rapid. Vasodilators are also used. A vasodilator may dilate arteries, veins or both. Arterial dilators expand arteries and lower blood pressure, which in turn reduces the work required of the heart. dr. maswoodur rahman prince Although some people mistakenly believe that the term heart failure means the heart has stopped, the term actually refers to the diminished ability of the heart to keep up with its work-load. Heart failure has many causes, including a number of diseases; heart failure is much more common in older people . Heart failure (congestive heart failure) is a serious condition in which the quantity of blood pumped by the heart each minute (cardiac output) is insufficient to meet the bodys normal requirements for oxygen and nutrients. Causes Any disease that affects the heart failure and interferes with the circulation can lead to heart failure. Diseases may selectively affect the heart muscle, impairing its ability to contract and pump blood. By far, the most common of these is coronary artery disease, which limits blood flow to the heart muscle and can cause a heart attack. Myocarditis (an infection of heart muscle caused by bacteria, viruses, or other microscopic organisms) may damage the heart muscle as may diabetes, an overactive thyroid gland, or extreme obesity. Heart valve disease may obstruct blood flow between the hearts chambers or between the heart and the major arteries. Alternately, a valve that leaks may allow blood to flow backward. These conditions increase the heart muscles workload, which eventually weakens the force of the hearts contractions. Other diseases, primarily affect the hearts electrical conduction system, resulting in slow, fast, or irregular heartbeats that cant pump blood effectively. If the heart has to work unusually hard over months or years, it gets larger. At first, this enlargement provides a stronger contraction, but eventually an enlarged heart may result in decreased primping qbllity and heart failure. High blood pressure (Hypertension) can make the heart work harder. The heart also has to work harder when it has to force the blood through a narrowed exit from the heart, usually a narrowed aortic valve In some people, the stiffening of the pericardium the thin, transparent covering of the heart prevents the heart from fully expanding between beats and thus keeps it from filling adequately with blood. Failure may also develop due to myocardial infarction, congenital heart disease or chronic lung disease. Consequences of heart failure When the heart is unable to pump all the blood it receives from the lungs and the rest of the body, there is stagnation of the blood in heart chambers at a high pressure: Stagnation of the blood in the heart also prevents return of the blood from the lungs and the rest of the body This results in pooling of the blood in the lung veins and the veins of the body. This gives rise to a state of congestion in the lungs, and the body. That is why heart failure is commonly known as congestive cardical failure. Compensatory mechanisms The body has a number of response mechanisms to compensate for heart failure. The initial short-term emergency (within minutes to hours) response is fight or flight reaction caused by the releases of adrenaline and noradrenaline into the blood stream. Adrenaline and nor adrenaline released from the adrenal gland and the nerves respectively, are the bodys first line defences against any sudden stress. In compensated heart failure, adrenaline and noradrenaline cause the heart to work harder, helping it to increase its output of blood and compensate to some degree for the pumping problem. As another corrective mechanism, the kidneys retain salt (sodium) to keep the bodys sodium concentration constant, the body simultaneously retains water. This additional water increases the volume of blood in the circulation and, at first, improves the hearts performance. One of the major consequences of fluid retention is that the larger volume of blood stretches the heart muscle. This stretched muscles contract more forcefully. This is one of the hearts main mechanisms for increasing its performance in heart failure. As heart failure progresses, however, the excess fluid escapes from the circulation and accumulates in various body sites, causing swelling (oedema) The other major mechanism by which the heart compensates is enlargement of the heart muscle (hypertrophy) The enlarged heart muscle can contract with greater force, but eventually in malfunctions, marking the heart failure worse. Symptoms Congestion in the lungs causes shortness of breath, inability to sleep flat and dry hacking cough. Congestion in rest of the body causes salt and water retention which leads to rapid weight gain and swelling in the legs, hands, and sometimes face. Heart failure also causes enlargement of the heart, seen on X-Ray chest. Severity of the symptoms of heart failure may vary from just mild fatigue to severe shortness of breath and swelling. Acute breathlessness due to heart failure requires urgent hospitalisation Diagnosis The symptoms alone are enough for a doctor to make a diagnosis of heart failure. The following findings can confirm the initial diagnosis: a weak and often rapid pulse rate, reduced blood pressure, certain abnormalities in heart sounds. an enlarged heart, swollen neck veins, fluid in the lungs, an enlarged liver, rapid weight gain, and a swollen abdomen or legs. A chest X-Ray can show an enlarged heart and, fluid accumulated in the lungs. An echocardiography may also be done. Treatment At one time, there was no effective treatment of heart failure. Now a days, most instances heart failure can be controlled with: Rest: 1. Rest enables the heart muscle to regain its strength for activity 2. Salt restriction: Salt holds water in the body, which gives the heart more to pump 3. Medicines: Four types of medications are commonly used for heart failure: a. Those making the pumping action of the heart stronger b. Those reducing the amount of water retained in the body other c. Those relaxing blood vessels d. Vital minerals, which are lost due to treatment with medicines. Much can be done to make physical activity more comfortable, improve the quality of life and prolong life, but for most people with heart failure, no cure exists. Much benefits could be derived if contributing factors aggravating heart failure could be removed Smoking, eating salt; being overweight and drinking alcohol all aggravate heart failure as do extremes of room temperature. When salt restriction alone doesnt reduce fluid retention, diuretic drugs are prescribed to increase urine formation and remove sodium and water from the body through the kidneys. Digoxin increases the power of each heartbeat and slows a heart rate that is too rapid. Vasodilators are also used. A vasodilator may dilate arteries, veins or both. Arterial dilators expand arteries and lower blood pressure, which in turn reduces the work required of the heart venous dilators expand the veins, providing more rooms for the blood that has accumulated. This extra room removes congestion and reduces the load on the heart. The most widely used vasodilators are the ACE (angiotensin converting enzyme) inhibitors. These drugs not only improve symptoms but also prolong life. The ACE inhibitors dilate both arteries and veins. Dilated and poorly contracting heart chambers may allow blood clots to form in them. The danger here is that these clots can brew off, travel through the circulation and cause damage to the vessel and/or partially or completely block an artery elsewhere. If a clot blocks an artery to the brain, a stroke may result. Congestive heart failure and blood pressure link Controlling blood pressure is the best way to avoid congestive heart failure (CHF). Trap : Doctors often overlook isolated systolic high blood pressure, the type most likely to cause CHF. In this form of high blood pressure, the first (systolic) number is 140 or higher while the second (diastolic) number is below 90. Patients with such blood pressure need close surveillance and may require treatment. New surgical procedure for heart failure sufferers Cardiomyoplasty involves transplanting nuascle tissue from the patients own back to the ventricles of the failing heart. A pace maker-like device implanted at the same time stimulates the transplanted tissue to contract, assisting the heart as it pumps. Cardiomyoplasty is especially promising for older people who fail to respond to less drastic treatments, yet who have other medical problems that disqualify them for a heart transplant.