Heart Failure – What do We Need to Know?

12 Jan 2023

At first read, the term “heart failure” sounds scary. Heart failure is a serious, often irreversible disease, but many patients live their lives to the fullest when it is well-controlled with adequate treatment. This text will give you more information from a cardiologist’s point of view about the condition and the important measures that can be taken to prevent its occurrence in the first place.

How does Our Heart Work?

A normal healthy heart is a strong muscular pump, slightly larger than a fist. It constantly pumps blood through the circulatory system in two circles – a large and a small one. The heart helps deliver blood (and through it – oxygen) to all tissues and organs, as well as returns it to the lungs to be re-oxygenated. The heart consists of four chambers - left ventricle (LV), left atrium (LA), right ventricle (RV) and right atrium (RA). For it to be a fully functioning organ, all these cavities must work in unison.

What is Heart Failure?

Heart failure is a chronic progressive condition when the heart’s muscles are unable to “pump” enough blood to meet the body’s oxygen needs. Explained in a more understandable language: the heart “cannot cope” with the load to which it is exposed.

Initially, several compensatory mechanisms are involved:

- Dilatation (expansion) - the heart expands to “fit” more blood in its cavities and pushes more with each beat accordingly

- Hypertrophy (thickening of the muscle) - the muscle mass of the heart increases so that the beats are “stronger”

- Heart rate increase - to be able to push more blood per minute

Unfortunately, these mechanisms can compensate for heart malfunction in the short term, but subsequently, they have an adverse long-term effect. Over time, the disease progresses and the patient begins to experience fatigue, shortness of breath and swelling of the lower limbs. These are the most common symptoms that prompt patients to seek medical attention.

Without delving further into the etymology and pathophysiology of heart failure, I would like to give you some health tips on how to improve your heart health to avoid the onset of this disease.

Preventive Measures to Implement

1. Get active – it’s never too late to start an exercise regime. It should, of course, be tailored to your current health condition as well as your physical capabilities. It is best to first consult your doctor before getting any strenuous exercises. Aim for at least two and a half hours a week of moderate aerobic exercise - i.e. one that makes your heart beat faster.

2. Don’t stay still for too long – studies show that even if you exercise, the risk of heart failure increases if you spend a long time sitting.

3. Stop tobacco intake – nothing new to say here. We are all aware of the damage smoking has to the arteries.

4. Limit alcohol intake – we will refer to the millennial saying “The poison is in the dose”. Moderate alcohol intake - up to 400 ml of wine / 60 ml of concentrate /; a maximum of 750 ml of beer for men and 200 ml of wine / 30 ml of concentrate /; and a max of 350 ml of beer for women per day - has a beneficial effect on the work of the heart. Exceeding these limits is not recommended.

5. Eat a balanced diet – this advice, of course, applies to disease prevention. Here the main points are all about limiting the intake of salt and saturated fat and increasing the intake of “good” sources of fat like those contained in nuts, avocados and saltwater fish.

6. Sleep is equally important – sleep disorders, especially sleep apnea, seriously increase the risk of heart failure. Consult your doctor if you have problems sleeping because they tend to be far from harmless.

7. Treat your accompanying diseases – hypertension (high blood pressure) and atrial fibrillation are not harmless and should be well controlled to avoid long-term consequences. The same applies to metabolic diseases - diabetes mellitus, thyroid gland function disorders, and all other chronic diseases.

Of course, we cannot help but mention that these are general measures and definitely – not absolute. In case you feel a negative change in your overall health, do not ignore the problem but consult your cardiologist as soon as possible.

Telemedicine and Cardiology

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Author: Dr. Ivan-Asen Shishmanov, a cardiologist at “N.I. Pirogov” UMBALSM and member of the Medical Board of Sirma Medical Systems