MEDICAL SECOND OPINION

Heart Failure Symptoms

What is Heart Failure?

Heart failure is a health problem characterized by deterioration in body functions due to the heart's inability to pump enough blood to the body. The heart can sometimes enlarge and grow to tolerate this deteriorating condition. For this reason, heart enlargement accompanying heart failure is among the most common conditions. Heart failure, which is mainly seen in men, leads to a higher death rate in women if left untreated.

Heart failure affects both sides of the heart. In acute heart failure, symptoms appear suddenly and then quickly disappear. This condition may cause a heart attack or a problem with the heart valves that control blood flow. However, the symptoms seen in chronic heart failure continue and do not improve over time. The vast majority of heart failure cases are regular.

What is Congestive Heart Failure?

While heart failure can affect both sides of the heart, in some cases, only one side is affected. In most cases, the left side of the heart is primarily affected. After diastolic failure or left ventricular systolic failure, this condition can also affect the right side of the heart.
Congestive heart failure, also known as right heart failure, can be of unknown cause (idiopathic) or can occur with increased blood pressure (pulmonary hypertension), often in the arteries that carry blood to the lungs. Therefore, due to the slowing of the blood's entry and exit to the heart, blood accumulations can be seen in some areas of the body.
In cases of congestive heart failure, back pressure is seen from the heart to the venous system. Peripheral edema is also seen. Peripheral edema mainly occurs in the abdomen, legs, and feet. Edema is frequently observed in the hips and back in hospitalized patients.
The symptoms most commonly seen in congestive heart failure are anorexia, swollen neck veins, fatigue, weakness, shortness of breath (dyspnea), liver enlargement (hepatomegaly), and spleen enlargement (splenomegaly). Other symptoms include an S3 gallop rhythm and hypertension caused by salt and water accumulation. If congestion occurs in the intestines, indigestion occurs.

Heart Failure Symptoms

Symptoms of heart failure are those that become more severe as the disease progresses. For this reason, it is essential to know the symptoms, follow them meticulously, and intervene before the stages of heart failure progress. A patient may experience one or more of the following symptoms:

  • Loss of appetite, 
  • Quick fatigue, 
  • Nausea, 
  • Sudden weight gain, 
  • Pink or white sputum, 
  • Arrhythmia (irregular heart rate), 
  • Swelling in the legs, abdomen, and ankles (edema), 
  • Palpitations, 
  • Dizziness, 
  • Constant sleepiness, 
  • Difficulty concentrating, 
  • Frequent urination at night, 
  • The prominence of blood vessels in the neck area, 
  • Depression and anxiety, 
  • Making a whistling sound when coughing or exhaling. 

Heart Failure Treatment

The question of whether there is a cure for heart failure is a phenomenon that many people wonder. A diagnosis of heart failure should first be made for the patient who applies to the health institution with signs and symptoms before treatment methods. After the physical examination, some tests are done to investigate the heart's functions. Among them, echocardiography (ECHO) is the most effective method. The heart is examined in detail with the ECHO device, which uses sound waves. Existing structural defects and damages are detected in this way. Afterward, blood tests, chest X-rays, exercise tests, lung function tests, magnetic resonance imaging, angiography, cardiac catheterization, tomography, and nuclear medicine methods are used for the differential diagnosis of heart failure. 

The priority in treating heart failure is stopping tissue damage and eliminating the symptoms that affect daily life while maintaining the patient's current health status. The patient's lifestyle and nutritional habits are examined, and recommendations are made to support the treatment of heart failure. In addition, according to the current state of the disease, treatment with medication or surgical methods can be planned. 
Heart failure drugs are used according to the severity of the disease and complaint status during the treatment process. Medicines used in this context: diuretics (diuretics), beta-blockers, digoxin, angiotensin-converting enzyme inhibitors, rhythm regulators, blood thinners, vasodilators, aldosterone blockers, angiotensin receptor blockers, and cholesterol reducers. 

Should there be an issue with the heart's electrical conduction system or a cardiac rhythm disorder that falls within the realm of device therapy and surgical procedures, specialized equipment like pacemakers can alleviate symptoms and extend the patient's lifespan. Additionally, interventions such as stent insertion in cardiac vessels, bypass surgery, and heart valve procedures might be necessary. For severe heart failure, heart transplantation stands as the most definitive and lasting solution.

Stages of Heart Failure

1. Stage: Defined as the first stage of heart failure. Since the risk factors are high, the development of heart failure is considered possible. These patients are primarily people with a family history of heart failure, high blood pressure, diabetes, and coronary artery disease. These people, who are at increased risk, should not smoke or drink alcohol, always keep their cholesterol levels in balance, exercise regularly, and take the medications prescribed by the doctor without interruption. In stage 1 patients, the usual daily physical activity restrictions do not occur. However, the most common complaints are obstruction and shortness of breath during heavy exercises. 

2. Stage: Heart failure is often seen in patients in this stage due to the diagnosis of systolic left ventricular dysfunction. It is recommended that the person use angiotensin-converting enzymes and have an active lifestyle. If these people have a heart attack, they should use beta-blockers. If coronary artery occlusion or a problem in the heart valves is detected in patients who are under the constant control of a doctor, surgical intervention is performed. In stage 2 patients, complaints such as heart palpitations, shortness of breath, and obstruction occur in daily physical activities. In other words, moderate limitation of physical activities is observed. 

3. Stage: When patients diagnosed with heart failure reach this stage, constant fatigue, shortness of breath, frequent urge to urinate at night, swollen and weakened legs, and blistered abdomen are seen. Patients at this stage should never consume alcohol or cigarettes. Apart from this, beta-blockers should be used for the heart muscle to pump vigorously, salt consumption should be reduced, and exercise should be done with plenty of physical activity. Patients in stage 3 have significant limitations in normal daily activities. 

4. Stage: It is considered the last stage of heart failure. In these patients, the heart cannot fully pump blood. The person should be treated with ventricular assist devices or heart surgery as soon as possible and use intravenous inotropic drugs. End-stage heart failure is a precarious stage in terms of lifespan. If the patient does not respond to other treatment methods, a heart transplant should be performed as soon as possible. In patients in the 4th stage, complaints are seen even at rest. Heart failure does not allow even the person's usual daily physical activities. 

Does Heart Failure Kill?

Heart failure is a severe health problem that reduces the quality of life and threatens life in advanced stages. The best answer to the question of whether heart failure kills is that it is not heart failure but being late in diagnosis and treatment that causes loss of life. Therefore, early diagnosis of heart failure provides a severe reduction in death cases. 

Regularly checking heart health is very important in the prevention of heart failure. Detection of the disease at the initial stage is necessary to minimize the damage it causes to the heart. Taking the prescribed drugs on time increases the quality of life and lifespan of the diagnosed patients.

Acute Heart Failure

The vast majority of heart failure cases fall into the chronic group. In such cases, there is no improvement over time as the symptoms persist. However, if the symptoms appear suddenly and then disappear rapidly, acute heart failure can be mentioned. 
The causes of acute heart failure are divided into those of "cardiac origin" and those of "non-cardiac origin." These are: 

Cardiac origin

  • Endocarditis 
  • Acute coronary syndrome 
  • Heart valve failure/stenosis 
  • Acute myocarditis 
  • Acute arrhythmia 
  • Pericarditis

Non-cardiac origin

  • Anemia 
  • Surgical interventions 
  • Alcohol use 
  • Kidney dysfunction 
  • Non-compliance with the course of treatment 

To prevent acute heart failure, it is necessary to maintain a healthy weight, limit smoking and alcohol use, control stress, perform regular and personalized exercise, and visit the heart specialist regularly. 

Created at 11.10.2023 06:20
Updated at 04.04.2024 10:07
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