Causes and symptoms of heart failure
What is heart failure?
Heart failure is a series of disorders based on low contractility of the heart muscle. There is a misconception that heart failure is a heart condition, but it is not. Heart failure is a state of the body in which the contractile ability of the heart muscle (myocardium) becomes weak, as a result, the heart cannot fully provide the body with the required amount of blood.
Very often people with coronary heart disease and hypertension suffer from heart failure, and heart failure complicates many diseases of the cardiovascular system. Heart failure significantly reduces the quality of life, and sometimes becomes the cause of death of a person.
Heart failure symptoms
Given the nature and course of the disease, heart failure is divided into acute and chronic. The disease manifests itself as a slowdown in the rate of general blood flow, the amount of blood ejected by the heart becomes less, and pressure rises in the heart chambers. The excess blood volume, which the heart could not cope with, begins to accumulate in the conditionally called "depots" - the veins of the legs and abdominal cavity.
The very first symptoms of heart failure are weakness and fatigue.
Since the heart cannot cope with the entire volume of circulating blood, excess fluid from the bloodstream begins to accumulate in various organs and tissues of the body, usually in the feet, calves, thighs, abdomen and liver.
Due to the increase in pressure and the accumulation of fluid in the lungs, breathing is impaired. In a normal state, oxygen freely passes from the capillary tissue of the lungs into the general bloodstream, but when fluid accumulates in the lungs, which occurs in heart failure, oxygen does not fully pass into the capillaries. Breathing becomes more rapid due to the low concentration of oxygen in the blood. Very often the patient wakes up in the middle of the night from attacks of suffocation.
As an example, consider the American President Roosevelt, who suffered from heart failure. For a very long time he could not sleep lying down, but slept sitting in a chair due to breathing problems.
Leaking fluid from the bloodstream into tissues and organs can stimulate more than breathing problems and sleep disorders. A person quickly gains weight due to edema of soft tissues in the area of the feet, legs, thighs, and sometimes in the abdomen. When you press with your finger, you can clearly feel the swelling.
In very severe cases, fluid builds up inside the abdominal cavity. A dangerous condition begins - ascites. Ascites is a complication of advanced heart failure. When some fluid from the bloodstream is released into the lungs, a condition called "pulmonary edema" begins. Often pulmonary edema occurs with chronic heart failure, accompanied by pink, with blood sputum when coughing.
Insufficient blood supply negatively affects all organs and systems of the human body. The effect on the central nervous system in the elderly is manifested by a decrease in mental activity.
Left side or right side?
The symptoms of heart failure depend on which side of the heart is involved. The left atrium (the upper chamber of the heart) takes in oxygen-rich blood from the lungs and pumps it into the left ventricle (lower chamber), which pumps this blood to the rest of the organs. If the left side of the heart is unable to fully promote blood, it is thrown back into the pulmonary vessels, and excess fluid seeps through the capillaries into the alveoli, causing breathing difficulties. Another symptom of left-sided heart failure is weakness and excessive mucus production (sometimes even bloody).
Right-sided failure occurs when the blood outflow from the right atrium and right ventricle is difficult, this happens when the heart valve is not working properly. As a result, the pressure rises and fluid accumulates in the veins ending in the right chambers of the heart - the veins of the liver and legs. The liver increases in volume, pains bother, and the legs swell a lot. With right-sided insufficiency, such a phenomenon as nocturia is noticed - increased nighttime urination, exceeding daytime.
With congestive heart failure, the kidneys are unable to absorb large volumes of fluid, as a result of which renal failure is formed. Salt, which is normally excreted by the kidneys along with water, is retained in the body, thereby increasing the swelling. With the elimination of the main cause - heart failure - renal failure disappears.
Causes of heart failure
There are many reasons for the development of heart failure. One of the main ones is ischemic heart disease and insufficient blood supply to the heart muscle.
In turn, ischemia is caused by blockage of the heart vessels with fat-like substances. Another cause of heart failure can be a heart attack, as some part of the heart tissue dies and heals.
The next reason for the development of heart failure is arterial hypertension. It takes a lot of strength to move blood through spasmodic vessels, as a result, the heart, namely the left ventricle, increases in size. Further, weakness of the heart muscle or heart failure develops.
One of the causes affecting the development of heart failure is cardiac arrhythmia (irregular contractions). If the number of beats per minute is more than 140, it is considered dangerous and contributes to the development of the disease, since the processes of filling and ejection of blood by the heart are disrupted.
In the case when changes occur on the part of the heart valves, violations of the filling of the heart with blood occur, and this also contributes to the development of heart failure. Often, the problem is caused by an internal infectious process (endocarditis) or rheumatic disease.
Inflammation of the heart muscle due to infections, alcoholic or toxic lesions also leads to the development of heart failure.
However, not in all cases it is possible to accurately determine the cause that caused the heart failure. This condition is called idiopathic heart failure.
Heart failure classification
Depending on the manifestations of the disease at different stages, the following classification is established:
Class 1: there are no restrictions on physical activity and no effect on quality of life.
Class 2: slight restrictions on physical activity, no discomfort during rest.
Class 3: significant decrease in performance, symptoms do not bother during rest.
Class 4: loss of working capacity in whole or in part, all symptoms of heart failure and chest pain, disturbing even during rest.
Approximately 50% of patients diagnosed with heart failure live with the disease for more than five years. Although it is necessary to make predictions individually for each patient, taking into account the severity of the disease, concomitant diseases, age, effectiveness of therapy, lifestyle and many other factors. In the treatment of this disease, the following goals are pursued: improving the work of the left ventricle of the heart, improving the quality of life and restoring the patient's ability to work. Early treatment yields the best results, and the life prognosis is significantly improved.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".