Heart failure occurs when your heart is in the process of being successful. it cannot pump enough blood to meet the body’s demand. This can be chronic, which means that it happens slowly over time. Or it can be acute, that is, it happens suddenly.
Heart conditions that can cause shortness of breath
You may notice that you feel more often in the breath if you have a heart condition. This is because your heart is struggling to pump oxygen-rich blood into the rest of your body.
There are a variety of possible conditions that can cause this problem:
Video Credit: MidMichiganHealth
Why heart failure causes shortness of breath?
Heart failure does not mean that the heart has stopped working, but rather that the heart’s pumping power is weaker than normal.
Once heart failure sets in, blood circulates through the heart and body at a slower rate, and blood pressure in the heart increases.
As a result, the heart cannot pump enough oxygen and nutrients to meet the body’s needs.
When the heart muscle does not pump blood as well as it should, heart failure, also known as congestive heart failure, occurs.
Certain disorders weaken the heart over time, causing it to stop performing efficiently. Heart failure is a scary term, but it just indicates that the heart isn’t pumping blood as efficiently as it should be.
Blood cannot be pumped efficiently enough to supply oxygen to all of the cells when the heart muscle is weakened. Sometimes the heart dilates and becomes weak.
At other times, the heart may be stiff and the muscle thickens. Over time, the heart can no longer keep up with the workload.
When this happens, there isn’t enough oxygen-rich blood getting to the brain and muscles, and fluids start to build up in the lungs and other tissues. The lack of oxygen in the blood causes the main symptoms of heart failure.
The role of the heart is to constantly distribute blood to the organs and tissues to provide the necessary supply of nutrients and oxygen.
Heart failure is defined as the loss of the heart’s ability to pump blood properly. For various reasons, the heart has weakened or the myocardium (heart muscle) has thickened and become stiffer.
This affects the functioning of the heart, so heart failure is called a general circulation deficit, affecting all organs and tissues. A malfunction can lead to serious health complications.
The heart consists of 4 chambers: 2 atria at the top and 2 ventricles at the bottom. Between them, blood circulates constantly and each chamber has its own role.
There are cases of heart failure in which the ventricles are stiff and do not fill with blood properly. In other cases, they expand too much, which affects blood ejection. Heart failure can affect both ventricles or just one of them.
 Types of heart failure:
The heart has four chambers through which blood is pumped, circulating. Freshly oxygenated blood is pumped from the lungs to the left atrium and left ventricle and out through the aorta to circulate to the rest of the body.
After the oxygen has been used, the blood returns through the veins to the right atrium and right ventricle to the lungs to be oxygenated again.
Thus, heart failure is classified into several types, depending on which part is affected, the mechanism by which it occurred, how aggressive it is, etc.
(a) Heart failure according to the part affected
Heart failure can involve or affect the left side (left ventricle), the right side (right ventricle), or both sides of the heart (global heart failure).
In general, heart failure starts to affect the left side, especially the left ventricle – which is considered the main ‘pumping chamber’ of the heart.
Right heart failure:
As a description, right heart failure means that fluids can back up (accumulate) in the abdomen, legs, and feet, causing swelling in these areas (oedema).
In right heart failure, the patient’s physical examination will show peripheral oedema, ascites (fluid accumulation in the abdomen), and liver enlargement.
Left heart failure:
As a description, left heart failure means that fluids can back up (accumulate) in the lungs, causing shortness of breath.
Heart failure on the left side of the heart causes blood to be trapped in the lungs, causing breathing symptoms and fatigue, due to insufficiently oxygenated blood.
Global heart failure:
Global heart failure is also called biventricular failure. It occurs when both ventricles are affected.
If a person with heart failure in one ventricle lives long enough, the disease will tend to progress to heart failure in both ventricles.
For example, heart failure involving the left ventricle means the development of pulmonary edema and pulmonary hypertension, which increases the stress on the right ventricle.
(b) Heart failure by the mechanism of production
There are several types of heart failure, and one of the categories is according to the mechanism by which it occurs.
Systolic heart failure:
Systolic heart failure or systolic dysfunction describes the inability of the heart to pump efficiently after it has been filled with blood. Often this happens if the heart is weakened or enlarged.
This can happen on both sides of the heart. In this case, the left ventricle may not contract hard enough, indicating a problem with the heart’s pumping power.
Diastolic heart failure:
Diastolic heart failure occurs when the heart muscle is stiffer (harder) than normal. Because the heart is stiff, it does not fill with blood properly. This is known as diastolic dysfunction.
Because the heart does not fill with blood, it cannot carry as much blood to the body as it needs to. This can happen on both sides of the heart.
The left ventricle cannot relax or fill completely with blood, indicating a problem filling the heart with blood.
(c) Heart failure according to the aggressiveness of the condition:
Heart failure can be divided into several categories, depending on how aggressive the condition is and how long it progresses (short- or long-term).
Chronic heart failure:
Chronic heart failure is a very serious condition. Unfortunately, there is no cure, but your doctor can help you keep the problems it can cause under control.
Chronic heart failure occurs when the heart muscle becomes damaged, injured, and weaker and, because of this, stops pumping blood properly. Once the heart is damaged, it can no longer heal.
The damage can be caused by a heart attack (also called a stroke) or long-term health problems such as high blood pressure, diabetes, or cardiovascular disease.
Chronic heart failure can make daily activities seem exhausting for the patient, but if they follow the advice of their cardiologist, they can improve their quality of life.
Chronic heart failure causes excess fluid to build up in the body (water retention) and the patient may feel very weak and tired.
Acute heart failure:
Heart failure occurs when the heart cannot pump enough blood to meet the body’s needs. It can be chronic, which means it happens slowly over a long period of time, or it can be acute, which means it happens suddenly.
Shortness of breath is the most common symptom of acute heart failure. Hence, the disease shares many of the same symptoms as chronic or severe heart failure.
However, these symptoms may be more pronounced in acute heart failure: the legs and abdomen may swell suddenly and the patient may gain weight rapidly due to fluid retention.
This means as much as 1-1.5 kilograms in a 24-hour period or even 2.5 kilograms within a week. The patient may also feel nauseous or lose their appetite. If left untreated, heart failure can lead to a heart attack.
Congestive heart failure:
Congestive heart failure is a type of heart failure that requires timely medical attention, although sometimes the two terms are used interchangeably.
As the flow of blood out of the heart slows, blood returning to the heart through the veins pools, causing congestion in the tissues of the body. Oedema (swelling of the tissues) often occurs.
Most often, swelling of the feet and ankles occurs, but oedema can also occur in other parts of the body.
Decompensated heart failure:
Acute decompensated heart failure can be defined as a sudden or gradual onset (onset) of signs or symptoms of heart failure, requiring unplanned visits to the specialist’s office, emergency visits, or even hospitalization of the patient.
Acute decompensated heart failure is a sudden worsening of the signs and symptoms of heart failure, usually including shortness of breath, swelling of the legs and feet, and fatigue.
Decompensated heart failure is caused by severe congestion of several organs, which are affected by the build-up of fluid that is not circulating properly due to the heart not working as it should.
Decompensated heart failure can be caused by a heart attack, an abnormal heart rhythm, an infection, or thyroid disease.
 Causes of heart failure:
Heart failure is a condition that develops gradually and is caused by certain conditions or factors that constantly overload the heart. Thus, it deteriorates and becomes unable to meet the body’s demands.
Causes of heart failure include:
- Coronary heart disease (ischaemic heart disease) – the most common cardiovascular disease. It is represented by atherosclerosis (the deposition of fatty plaques) formed in the coronary arteries that supply the heart. The disease causes ischemia in the heart, meaning that it is deprived of oxygenated blood for a period of time. In severe cases, a myocardial infarction can occur.
- Myocardial infarction – the necrosis (death) of part of the heart. Because part of the heart no longer works, the organ will be overworked.
- Hypertension – this condition puts extra strain on the heart, which over time leads to its weakening.
- Cardiomyopathy – damage to the heart muscle caused by infections, other heart diseases, chronic alcohol or drug use, and some medications.
- Heart valve defects – the heart valves act as a valve. If they don’t work properly, blood can back up into the heart.
- Congenital malformations – structural defects.
- Myocarditis – inflammation of the myocardium.
- Arrhythmias – beating too fast overloads the heart muscle.
- Thyroid disease
- Some diabetes drugs, anti-arrhythmic, anesthetics, anti-inflammatories, and many others.
- Chronic alcohol consumption
- Smoking – affects blood circulation (thickens the blood).
- Obesity – is associated with cardiovascular problems.
Heart failure is a gradually developing condition caused by certain conditions or factors that constantly overload the heart. As a result, it deteriorates and becomes unable to meet the body’s demands.
 Symptoms of heart failure:
The signs of heart failure can differ from patient to patient, depending on the severity of the disease:
- The main symptoms of heart failure are fatigue, shortness of breath, and difficulty performing tasks that require effort. An extensive list of heart failure signs and symptoms includes:
- General fatigue and weakness
- Palpitations (chest tremor) or irregular heartbeat (too slow or too fast)
- Swelling in the lower limbs (due to fluid return)
- Swelling of the abdomen (ascites)
- Exercise intolerance (patient tires quickly during physical activity)
- Shortness of breath during physical exertion
- Weight gain (due to fluid retention)
- Lack of appetite
- Pain or numbness in limbs during physical exertion
- Shortness of breath
- Chest pain
Symptoms are usually worse at night when the patient lies still. The symptoms are very similar to those of systolic heart failure and diastolic heart failure.
Severe symptoms (e.g. chest pain that lasts for more than 10 minutes and does not improve with rest or loss of consciousness) should send the patient straight to the emergency department.
In heart failure, there is an increased risk of heart attack and stroke.
 Treatment of heart failure:
(a) Initial treatment of early-stage heart failure:
Heart failure is often a progressive disease that can worsen over time.
The stages of the disease will help you understand why a new drug has been added to your treatment plan and why you need lifestyle changes and other treatments.
People who are at high risk of developing heart failure (or who have ‘pre-heart failure’), including those with diabetes, high blood pressure, and coronary heart disease should:
- Exercise regularly;
- Stop smoking;
- Treat high blood pressure;
- Treat high cholesterol;
- Stop drinking alcohol and stop taking illegal drugs;
- The doctor may prescribe medicines especially if the patient has had a heart attack in the past or has diabetes, high blood pressure, or other heart or vascular disease;
- The doctor may prescribe beta-blocker drugs if the patient has had a heart attack in the past or has high blood pressure.
In the early stages of heart failure, treatment can help the patient with the symptoms of the disease. It is also desirable that treatment prevents further damage to the heart.
Treatment may include taking medications such as diuretics and ACE inhibitors, as well as incorporating changes in the patient’s lifestyle, such as a low-salt diet and more physical activity.
(b) Treatment for advanced stages of heart failure:
When heart failure progresses to an advanced stage, the patient has to make a number of difficult decisions about whether to receive aggressive treatment or whether to think about their quality of life, which is more important than how long they have to live.
Heart failure is considered advanced when conventional heart therapies are applied and symptom control strategies no longer work.
The patient has shortness of breath and other symptoms even when at rest, when not making any effort. So, as the disease progresses and the heart becomes weaker and weaker, treatments become increasingly complex.
This is when the patient has to have some important but difficult discussions with their family and doctor about the care they want to receive.
When heart failure reaches a very advanced stage despite medical therapies, when the prognosis is guarded and when there is no viable therapeutic alternative, the standard criteria for therapy has been heart transplantation.
However, mechanical devices that aid blood circulation, such as ventricular assist devices and artificial hearts, can create a ‘bridge’ for the patient to the pathway to heart transplantation.
In addition, ventricular assist devices are increasingly used as permanent therapy.
To diagnose heart failure, the doctor will perform a clinical examination and then some additional tests and investigations (blood tests, electrocardiogram, MRI, EKG stress test, cardiac ultrasound, CT, angiography).
The treatment of heart failure depends on the patient’s condition and what the body can tolerate.
Treatment of this condition must be followed for life, as heart failure is a chronic disease that cannot be cured but only kept under control.
(1) Drug treatment:
The doctor will prescribe medication based on pharmaceuticals with different roles: improving cardiac contraction, eliminating fluid retention, reducing blood pressure, normalizing heart rhythm, lowering cholesterol.
The patient may have to take several types of pills, combined according to their needs.
(2) Surgical treatment:
Surgical treatment for heart failure
Patients with the most severe types of heart failure may be candidates for ventricular assist devices.
These have frequently been used as a ‘bridge’ to the next stage, heart transplantation, but have more recently been used as a treatment for advanced heart failure. In certain conditions, heart transplantation may be considered for surgery.
Although it helps alleviate the symptoms of heart failure, the patient must still be on immunosuppressive medication to prevent the heart from being rejected.
The scarcity of hearts for transplant is a key drawback of this therapy method. Doctors may propose surgery to treat an underlying source of the condition that leads to heart failure in some circumstances.
Some people at risk of the surgical treatments that have been used in some heart failure patients are:
- Coronary artery bypass surgery, also called open heart surgery – in this procedure, blood vessels in the leg, arm, or chest are used to help a blocked artery in the heart to allow blood to flow better through the heart.
- Surgery to replace or repair heart valves – if a damaged valve is causing heart failure, your doctor may recommend repair or replacement. The surgeon may modify the original valve (heart valve) to eliminate the problem. The surgeon may also repair the valve, either by removing excess tissue or by reconnecting certain areas of the valve.
(3) Interventional treatment:
Interventional treatment for heart failure.
New technologies based on minimally invasive devices may offer new treatment options for heart failure patients.
These minimally invasive technologies are available in several forms to address different aspects of heart failure, such as devices that modify the structure of an enlarged heartbeat, devices that relieve intra-cardiac pressure, or pacemakers that control sympathetic nervous system involvement.
In addition to new technologies, doctors can recommend classic medical device variants that help patients with heart failure:
- Cardiac defibrillator implant – this is a device implanted under the skin in the chest with wires leading to the patient’s veins and heart. It monitors the heart rhythm. If the heart starts beating at a dangerous rate or if the heart stops, the defibrillator tries to bring it back to a normal rhythm. It can also act as a pacemaker and speed up the heartbeat if it beats too slowly.
- Cardiac resynchronization therapy, a method used in advanced stages of heart failure; a biventricular pacemaker sends electrical impulses to both lower chambers of the heart (left ventricle and right ventricle) so that they can pump blood in a more efficient and coordinated way.
- Heart-lung pumps – are mechanical devices (such as ventricular assist devices) implanted in the abdomen or chest that are connected to a weakened heart to help it pump blood to the rest of the body.
- Ventricular assist devices are most often used for the left ventricle of the heart, but can also be used for the right ventricle, as well as both ventricles.
(4) Natural treatment for heart failure:
It is important that the patient discusses with the specialist before taking any supplements or herbal remedies. In the case of heart failure, there are certain supplements that patients can take, such as:
- Supplements that have a formula with many vitamins and minerals, such as vitamin D3, fish oil;
- Vitamin B1 – as it is known that a deficiency of vitamin B1 is common in patients with congestive heart failure, and this deficiency can lead to sodium retention, dilation of blood vessels, and worsening of sometimes
- Magnesium – because it is known that a magnesium deficiency is also common in people with congestive heart failure. The level of magnesium in the blood is correlated with the ability of the heart muscle to produce enough energy to beat properly.
- Coenzyme Q10 – plays a key role in producing energy inside the heart muscle. Numerous studies have shown that this coenzyme (from dietary supplements) is highly effective in the treatment of heart failure.
- Carnitine is a vitamin-like compound that stimulates the breakdown of fats in mitochondria, the energy-producing units in cells. Several clinical studies have shown that it improves heart function in heart failure patients.
- Natural preparations of hawthorn (Crataegus monogyna) have been shown to be very effective in the early stages of congestive heart failure and in minor arrhythmias. Seek the advice of a medical specialist, who will explain the dosage of hawthorn remedies.
Repairing or replacing the heart valve with a prosthesis –
Repairing the damaged valve or replacing it with a catheterization technique.
The doctor has access to the patient’s heart through the blood vessel system, through which he inserts thin tubes and small devices, with which he works under the guidance of X-rays.
Defibrillator/stimulator implant –
A small pocket-type incision is made. A defibrillator or pacemaker is fitted under the skin – devices that are used to analyze heart rhythm and heart function.
If needed, they send electrical impulses or shocks to restore the heart rhythm. Probes connected to the pulse generator are also attached to the heart via a vascular approach (through blood vessels). This makes patient recovery quick.
 Diet in heart failure:
Many patients wonder what factors related to diet or nutrition are important when it comes to congestive heart failure.
Since congestive heart failure is most often due to chronic hypertension, the same dietary factors important in hypertension apply here as well.
The most important thing is for the patient to eliminate salt from the diet, to follow a diet with foods high in potassium and foods high in fiber and complex carbohydrates; the patient should also increase consumption of celery, garlic, and onions and reduce or eliminate consumption of saturated fats, which are harmful.
 Recommended lifestyle changes for patients diagnosed with heart failure:
Many lifestyle factors and a healthy diet can improve or worsen congestive heart failure.
Specialists can teach patients how to make lifestyle changes, especially as some of these factors can make a difference. So patients with heart failure should:
- Keep stress under control by choosing relaxation practices and techniques such as Tai Chi, yoga, and meditation;
- Give up smoking;
- Eliminate alcohol from their lives;
- Adopt a healthy diet, such as the Mediterranean, vegetarian or vegan diet;
- Be physically active and become stronger;
- Get enough sleep, get enough rest;
- Treat and control sleep apnoea syndrome;
- Take dietary supplements, including coenzyme Q10 and hawthorn remedies, magnesium Supplements, and fish oil;
- Avoid excess salt and fluids.
 Health risks of untreated heart failure:
If you suffer from heart failure, your prognosis depends on the cause and severity of the disease, your general health, and other factors such as your age.
Left untreated, heart failure can have many complications. Here are the diseases with which heart failure is associated, which may also be called complications:
- Kidneys are affected or kidney failure occurs – heart failure can reduce blood flow to the kidneys, which can eventually cause kidney failure if the disease is left untreated. Kidney failure caused by heart failure may require dialysis as treatment.
- Heart valve problems occur – Heart valves, which help blood flow in the right direction inside the heart, may stop working properly if your heart is enlarged or if the pressure in your heart (blood pressure) is very high because of heart failure.
- Heart rhythm disturbances (arrhythmias) occur – these heart rhythm disturbances can be a potential complication of heart failure.
- Your liver is affected – heart failure can lead to fluid build-up, which puts too much pressure on the liver. This fluid reserve or build-up can lead to scarring, making it increasingly difficult for the liver to function properly.
 Preventing heart failure:
The best way to prevent heart failure is to never suffer a myocardial infarction (heart attack), but even if this happens, there are some treatments that can be helpful, as well as some healthy diets that help maintain heart health.
For example, a large study (Lyon Heart) has shown that a Mediterranean diet can prevent heart failure in people who have already had a heart attack.
Regular check-ups to prevent heart failure and early detection
To maintain your heart health, it is important to schedule regular check-ups with your specialist.
During office visits, your doctor will make sure you maintain your heart health and that your heart failure does not get worse. Your doctor will ask you to constantly check your body weight and medication list.
If you have any questions, write them down and take the list with you to the office on the day of your scheduled checkup. Call your doctor if you have urgent questions.
If you have more than one specialist doctor, let them all know about your heart failure (if you have already been diagnosed with the condition), the medicines you are taking, and any restrictions.
Also, consult your cardiologist and check together any new medication that has been prescribed by another specialist.
Keep better records, keep your prescriptions and test results and bring them to every regular check-up, as it is essential to detect heart failure in its early stages.
In conclusion, heart failure is a condition that diminishes the quality of life, which requires proper management of the disease.
Patients with heart failure need to be careful when traveling as changes in atmospheric pressure and air thinning can create heart problems. In general, it is recommended to stay at a lower altitude to adapt the body.
Heart failure is a condition that diminishes the quality of life, which requires proper management of the disease.
It is, therefore, necessary to pay due attention to lifestyle, eliminate smoking, carry out regular physical activity, keep cholesterol levels and weight under control.
Even in the absence of symptoms (as in silent left ventricular dysfunction), people at risk of heart failure should receive preventative medical check-ups to ensure early identification and treatment.
I hope you will get some knowledge about heart failure, its types, causes, and its treatments by reading this article. Comment down your thoughts on this article below. If you have any queries, then ask My Voice.