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Heart Failure: Causes, Symptoms, Treatment
Here are 10 facts about (chronic, i.e. longterm) heart failure (CHF). It is also known as congestive cardiac failure (CCF).
1. Definition
- Heart failure is a chronic progressive condition where the heart is unable to pump enough blood to meet the body’s needs for oxygen and nutrients.
2. Causes
- The most common causes of heart failure include ischaemic heart disease (IHD), high blood pressure (BP), heart valve disorders, and heart rhythm abnormalities (especially atrial fibrillation, AF).
- Cardiomyopathy and congenital causes are unusual.
3. Risk Factors
- Include age, family history, obesity, smoking, diabetes, and a sedentary lifestyle.
- Approximately 1-2% of adults in the UK have heart failure, with the prevalence increasing with age (up to 10% in those over 70 years).
4. Symptoms
- Include shortness of breath (SOB), swelling in the legs and feet, fatiguem rapid or irregular heartbeat (palpitations), and coughing up pink, frothy sputum.
5. Diagnosis
- Diagnosis of heart failure involves medical history, physical examination, electrocardiogram (ECG), echocardiogram (ECHO), and blood tests (especially B-type natriuretic peptide (BNP) which is raised in heart failure).
Note. BNP is more useful as a test to rule out heart failure (negative predictuve value). It is raised in other conditions, e.g. chronic kidney disease (CKD).
6. Treatment
- Involves a combination of lifestyle changes, medication (such as ACE inhibitors, beta-blockers, and diuretics), and device therapy (such as pacemakers and implantable cardioverter-defibrillators).
7. Complications
- Include chronic kidney disease (CKD), liver damage, heart valve problems (can be cause or effect of heart failure), heart rhythm disorders (especially AF), and thromboembolism (DVT and PE).
8. Prognosis (outlook)
- Varies depending on the underlying cause, severity of symptoms, and response to treatment
- Approximately 80-90% of people live for one year, 50% for 5 years, and 30% for 10 years – i.e. outlook is not as bad as the name sounds.
- With proper treatment and lifestyle changes, many people with heart failure can lead active and fulfilling lives.
9. Prevention
- Include maintaining a healthy weight, exercising regularly, quitting smoking, and controlling underlying conditions such as high blood pressure and diabetes.
10. Referral
- Most patients with suspected heart failure should be referred to a heart doctor (cardiologist).
- Referral criteria include symptoms of heart failure, abnormal ECG or echocardiogram results, or evidence of cardiac dysfunction on imaging tests.
