Heart Failure | Dr Raghu - Page 2


Depending on the side of the heart that’s been affected, heart failure can be of two types – left-sided and right-sided. We’ve already discussed the causes and symptoms of right-sided heart failure in one of our previous blogs.

It’s now time for us to dig deeper into left-sided heart failure, which is the most likely cause of right-sided heart failure. Let’s jump right in.

Related: What Is a Normal Ejection Fraction by Age?

What Is Left-Sided Heart Failure?

left sided heart failure

Left-sided heart failure is characterized by a decline in the heart’s pumping function. In this condition, the heart gradually loses its ability to pump blood from the left ventricle into the arteries.

The ejection fraction for a patient with left-sided heart failure is often lower than 50%. That, in turn, leads to a buildup of blood in the lungs and fluid in the body. Also, left-sided heart failure depletes vital organs of oxygen-rich blood.

Related: What Is Systolic Heart Failure?

What Are the Symptoms of Left-Sided Heart Failure?

The most common left-sided heart failure symptoms include:

  • Shortness of breath
  • Coughing and wheezing
  • Weight gain (due to fluid buildup)

Additionally, a lack of an adequate blood supply to the brain can cause confusion. Also, it can result in fatigue.

What Causes Left-Sided Heart Failure?

Left-sided heart failure is the result of a gradual weakening of the heart’s left ventricle. It can happen due to underlying conditions, such as coronary artery disease, hypertension, and heart valve damage. It can also be the result of heart muscle damage due to a previous heart attack.

Related: Understanding Congestive Heart Failure Symptoms

Treatment of Left-Sided Heart Failure

Doctors treat left-sided heart failure based on its underlying cause. They can prescribe medication, such as ACE inhibitors and beta-blockers, to manage conditions like hypertension. Additionally, many patients are prescribed diuretic pills to prevent fluid buildup due to heart failure.

Left-sided heart failure treatment also involves a healthy diet and lifestyle changes. For instance, a doctor might recommend that you follow an exercise routine and lose weight. Also, they’ll ask you to avoid smoking and alcohol consumption.

Left-Sided Heart Failure vs. Right-Sided Heart Failure

left sided heart failure


In right-sided heart failure, the right ventricle becomes weak and has trouble pumping deoxygenated blood to the lungs. It’s usually a result of progression of a left-sided heart failure. People with right heart failure present with swelling of feet, face, abdomen and distended pulsatile neck veins. They can also present with generalised weakness and easy fatiguability. 

When the left ventricle doesn’t pump out an adequate amount of oxygenated blood to the circulatory system, some of the excess blood flows back into the lungs. This leads to breathlessness as the predominant symptom of left heart failure. This breathlessness can present initially on unaccustomed exertion to progress with less severe exercise and finally to breathlessness on lying flat. Left heart failure in turn, makes it difficult for the right ventricle to pump deoxygenated blood to the lungs. In the long run, it exerts the walls of the right ventricle and results in right-sided heart failure.

In Conclusion

Left-sided heart failure is a serious condition that can result in organ damage and right-sided heart failure. The condition can be treated with a combination of medicines, like beta-blockers and diuretics, and lifestyle changes.

Dr. C Raghu is an eminent cardiologist with more than two decades of experience. He’s been treating patients with various heart conditions, helping them live longer and healthier lives. If you or anyone you know has developed symptoms of left-sided heart failure, don’t hesitate to consult Dr. Raghu right away.

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      The heart is a critical organ that powers the human body. It beats roughly 100,000 times a day and pumps more than 2,000 tons of blood throughout the body. 

      Heart failure is a condition in which the heart gradually loses its pumping capacity. It can lead to symptoms like breathlessness, fluid buildup, and mental confusion. In the long run, it can result in organ damage and even death.

      In this blog, we’ll take a closer look at the symptoms, causes, and treatment of congestive cardiac failure. Let’s dive right in.

      Congestive Cardiac Failure and Heart Failure: Are They the Same?

      Traditionally, doctors used the terms congestive cardiac failure or congestive heart failure to refer to the progressive deterioration of the heart’s pumping action. They used “congestion” to describe the buildup of fluid in the lungs due to heart failure.

      congestive cardiac failure

      However, subsequent studies have shown that the condition can lead to other symptoms, such as swollen feet, fatigue, and mental confusion. That’s why doctors use the term heart failure nowadays.

      Causes of Congestive Heart Failure

      Irrespective of whether you call it congestive cardiac failure or simply heart failure, its most common causes include:

      Additionally, damaged or dying heart tissue due to an infection or a previous heart attack can result in congestive cardiac failure. 

      Related : Mitral Valve Stenosis : Symptoms, Diagnosis, Treatment

      Symptoms of Congestive Heart Failure

      congestive cardiac failure

      The symptoms of congestive heart failure depend on whether it causes a lack of oxygen supply to the organs or excess fluid buildup in the body.

      In the first case, the symptoms include mental confusion, fatigue, and discolored or bluish skin. In the second case, heart failure can lead to symptoms, such as shortness of breath, coughing, wheezing, weight gain, swelling in the feet, legs, and abdomen, and loss of appetite.

      Treatment of Congestive Heart Failure

      The treatment of congestive heart failure depends on its underlying cause and the side of the heart that’s affected. A doctor will order a series of tests, such as chest X-ray, ECG, echocardiogram, and coronary angiography. Routine blood tests, such as lipid panel and electrolyte tests, might be needed, too.

      Once the root cause is identified, your doctor can prescribe one or more of the following medications:

      • Diuretic or water pills
      • Beta-blockers
      • ACE inhibitors or Angiotension receptor Neprilysin inhibitor 
      • Digoxin
      • Anticoagulants

      Additionally, the doctor will recommend lifestyle changes, including exercise, a low-sodium diet, and weight loss. Also, they’ll ask you to quit smoking and limit alcohol consumption. In extreme cases, patients need a heart transplant or ventricular assist device (VAD) to improve their quality of life.

      Wrapping Up

      Congestive cardiac failure is a chronic condition with no known cure. If left untreated, it can lead to organ damage and death. However, a proper treatment plan comprising lifestyle changes and medications can help manage various symptoms.

      Dr. C Raghu is a renowned cardiologist and a specialist in interventional cardiology. If you or anyone you know is experiencing symptoms of heart failure, don’t hesitate to contact Dr. Raghu right away.

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        Congestive Cardiac Failure – Blog


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          Role of ECG in Heart Failure 


          ECG is a simple inexpensive test to asses heart function. ECG is the short form for electrocardiogram  or electrocardiography.

          ECG equips the doctor with basic heart information such as

          • Rhythm of heart – Regular or irregular. The most common irregular heart rhythm is atrial  fibrillation and frequently seen in heart failure patients. 
          • Heart rate – Normal heart rate is between 50-100 beats per minute. A slow heart rate (less  than 50) is called bradycardia and a fast rate (more than 100) is tachycardia.
          • Heart enlargement – Heart chambers enlargement can also be reasonably assessed. But the  best test to assess heart chamber enlargement is cardiac magnetic resonance imaging (Cardiac MRI).
          • Heart attack – current and those in the past can be identified by predefined patterns on ECG.

          Advanced information from ECG in Heart Failure 

          • Reduced blood supply to heart – if a patient had a previous heart attack it usually can be  diagnosed through an ECG. It is not necessary that all patients with reduced blood supply  can be identified through ECG. Coronary angiography is a common test performed by  doctors to estimate the blood supply to the heart.
          • Pumping efficiency of the heart – presence of an abnormal ECG usually indicates abnormal  heart efficiency. The common abnormalities on ECG include but not limited to – complete  bundle branch block, hemiblock, features indicating a previous heart attack or chamber  enlargement.  
          • Left bundle branch block (LBBB) – presence of LBBB (if the QRS duration is more than 150 m  seconds on ECG) and a reduced EF on echo (less than 35%) is a indication for specialized  therapies such as cardiac resynchronization therapy (CRT). Resynchronization means re  establishing the synchronous beating of the heart. 
          • Abnormal rhythm may indicate need for advanced therapies such as pacemaker in heart  block, implantable cardioverter defibrillator (ICD) if EF is less than 35% on echo, catheter  ablation in atrial fibrillation and abnormal ventricular rhythm.  
          • Unique and uncommon problems of the heart such as infiltrative disorder (amyloidosis,  restrictive cardiomyopathy) and rare diseases such as or arrhythmogenic RV dysplasia can be  identified on ECG.

          Does a normal ECG rule out a heart attack? 

          An ECG is a simple yet powerful tool to assess the heart function. But at the same time a normal ECG  does not rule out a heart attack or other diseases if the disease is quite early stage. If the disease is  advanced the ECG remains a quite predictable and powerful tool. So, if the person had a heart  attack, we do not entirely rely upon ECG but we additionally incorporate the value of high sensitive  troponin to make a confirmed diagnosis of heart attack.

          ECG complements advanced investigations 

          Information obtained from ECG is utilized while interpreting advanced tests such as  echocardiography (echo), coronary angiography, cardiac MRI, PET CT scan etc.  

          ECG is a powerful tool in advanced disease but in the early disease too it could be used as an adjunct  to other tests.

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              Heart failure can be categorized into different types depending on various factors. While most conditions cause similar symptoms, clear identification of the type of heart failure is crucial for doctors to determine the proper course of treatment.

              You can check out our previous blogs for a detailed glimpse of heart failure symptoms. In this article, we’ll take a closer look at different types of heart failure. Let’s get started.

              Diastolic vs. Systolic Heart Failure

              Systolic heart failure is a condition characterized by an ejection fraction lower than 50%. Also known as heart failure with reduced ejection fraction, it’s the result of a problem in the contraction phase of the heart’s pumping cycle.

              It happens when the left ventricle weakens and fails to contract properly and pump an adequate amount of oxygenated blood into the arteries. As the condition worsens, it can compromise the right ventricle, too.

              Diastolic heart failure represents a problem in the relaxed phase of the heart’s pumping cycle. It happens when the ventricles become stiff and thick and can’t relax enough. That means an adequate amount of blood doesn’t fill the heart, causing it to back up in the lungs. Also known as heart failure with preserved ejection fraction, the condition is more common in elderly women with hypertension or diabetes.

              Left-Sided vs. Right-Sided Heart Failure

              In left-sided heart failure, the left ventricle becomes weak and doesn’t expel enough blood into the arteries. It causes fluid buildup in the lungs and leads to shortness of breath, coughing, and wheezing. Also, it results in a lack of adequate blood supply to the organs, resulting in confusion, fatigue, and pale skin color.

              The most common causes of left-sided heart failure include coronary artery disease, hypertension, heart valve damage, and dilated cardiomyopathy.

              Right-sided heart failure is characterized by a weak right ventricle, due to which an adequate amount of deoxygenated blood doesn’t reach the lungs. Instead, it flows back into the veins and results in swelling in the legs and abdomen. The most common cause of right-sided heart failure is left-sided heart failure.

              Compensated vs. Decompensated Heart Failure

              When a patient has heart failure, but their heart is functioning well enough not to cause any visible symptoms, the condition is known as compensated heart failure. As the condition progresses, it causes serious symptoms, such as breathlessness and fluid buildup, that require medical attention. This condition is known as decompensated heart failure.

              Decompensated heart failure is usually the result of a gradual deterioration of the heart pumping capacity due to pre-existing heart failure. However, if the onset of the condition is new and sudden, it is known as acute decompensated heart failure.

              End-Stage Heart Failure

              The American College of Cardiology and the American Heart Association have defined four distinct stages of heart failure. End-stage heart failure refers to the final (most advanced stage), where a patient’s symptoms are severe enough to require hospitalization. Also, they might need specialized treatment to stay out of the hospital.

              In Conclusion

              Heart failure can be of various types, depending on its underlying causes and the severity of symptoms. Doctors use tests like ECG, echocardiogram, stress testing, etc., to identify the type of heart failure and determine the right course of treatment.

              If you or anyone you know has been experiencing symptoms of heart failure, feel free to reach out to Dr. C Raghu, one of India’s leading cardiologists.

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                Types of Heart Failure Blog

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                  What is Heart Failure? 

                  Heart failure is not a single disease instead it is a constellation of symptoms. In this disease the heart  is unable to meet the requirements of the body by its inability to pump or be able to do so by increasing the filling pressures so that it might pump effectively.

                  Heart Failure

                  Heart Failure is not a disease but a  group of symptoms. It is the result of  many diseases affecting not only the  heart but other organs of body.

                  Related : Types of Heart Failure

                  Heart Failure vs Heart attack vs Cardiac Arrest

                  All the three terms refer to different medical issues.

                  • Heart failure is consequent to inefficient functioning of heart.
                  • Heart attack is due to the interruption of blood supply to the heart.
                  • Cardiac arrest is a situation where the heart stops to beat.

                  Symptoms of Heart Failure

                  Inefficient functioning of the heart leads to fluid logging in the body

                  • Fluid logging in the lungs – presents as breathlessness – Left Heart failure in medical parlance Early stages of heart failure – breathlessness can be present on walking.
                  • Advanced stages of heart failure –Breathlessness can be present at rest or, Inability to lie flat or may be awakened from sleep.
                  • Fluid accumulation in other organs of the body – Right heart failure in medical parlance Legs causing swelling of the feet, Swelling of face, abdomen, Pain in upper right abdomen.
                  • Heart failure symptoms which are related to the lungs are called left heart failure symptoms, those symptoms which are related to other organs are called right heart failure symptoms.
                  • Concept of left and right heart
                  • failure is important in treatment
                  Related : What Is Systolic Heart Failure?

                  What causes heart failure?

                  Heart failure is a result of many disease processes in the body. Common among them being: Coronary artery disease

                  • The most common disease that is responsible for heart failure is coronary artery disease. • Coronary artery disease means accumulation of cholesterol in the blood vessels supplying the heart leading to interruption of blood supply to the heart.This interruption of blood supply can either directly reduce the blood supply to the heart resulting in dysfunction or can cause heart attack which can also reduce the heart pumping ability.
                  • Common diseases – such as diabetes, hypertension and sometimes abnormalities of the valves of the heart and fast beating of the heart of which most commonly atrial fibrillation can all result in reduced efficiency of the heart.

                  In addition, advanced age itself beyond the age of 65-70 the efficiency of the heart reduces leading to heart failure.

                  What tests are required for diagnosis of heart failure?

                  The tests for the diagnosis of heart failure are

                  • Imaging test
                  • ECG
                  • Blood test

                  Blood tests in heart failure :

                  • The most common blood test that is done is a pro-BNP test. If it is less than 125, we can safely exclude heart failure as the cause for breathlessness.
                  • In addition, we look at presence of Anaemia, Renal dysfunction and blood glucose elevation in a patient with heart failure.

                  Electrocardiogram (ECG) : This remains an important test

                  Electrocardiogram (ECG) : This remains an important test

                  ecg report

                  • Can detect the presence of previous heart attack.
                  • Irregular heart beat – most common is atrial fibrillation.
                  • Presence of any Bundle branch block.

                  Echocardiogram : The most common and important test for the diagnosis of heart failure is the  echocardiogram where we estimate the left ventricular ejection fraction (measures the pumping  ability of the heart) or in short called as EF.

                  Other test done to manage heart failure are cardiac MRI and nuclear test.

                  Related : Heart Failure – Role of Electrocardiogram (ECG)

                  What is the role of Angiography in heart  failure?

                  For every 3 patients with heart failure 2 have underlying obstruction to the heart’s blood supply. Identifying this is super important because removal of these obstructions by angioplasty and stent can lead to improved cardiac function. 

                  The blood vessels supplying the heart are the  coronary arteries and obstructions are called coronary artery disease. So, whenever there is a  coronary artery disease, we can identify that only by performing a coronary angiography.

                  The major advantage of this investigation is apart from diagnosis in coronary artery disease, in case  if any blocks in heart vessels are identified they can be treated by performing a balloon angioplasty  and a stent procedure.

                  The benefit of removing the cholesterol plaques in the heart vessels is that – there can be a strong  chance for the heart functioning to recover once the blood flow is restored back to the heart.

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                      Life is precious and to live life to the fullest, one should pay a little attention to his/her health- physical and mental. So, what do we do to be healthy- eat right and exercise, isn’t it? Actually, that isn’t it, though diet and exercise are very important for fitness but there is many more measures that we should take to keep ourselves healthy in and out. So, let us understand them one by one:

                      1. Let food be the medicine:

                      Ensuring that what goes inside your body is right- is the best thing you could do for your body. For a healthy heart, a 2000 calorie diet is recommended. Keep these points in mind:

                      1. Eat at least 4.5 cups of vegetables and fruits a day
                      2. At least two 3.5 oz. servings of fish per week, preferably oily fish
                      3. At least three 1-ounce servings of fiber-rich whole grains per day
                      4. Limit sodium intake to less than 1,500 milligrams a day
                      5. Don’t drink more than 36 ounces/week of sweetened beverages

                      2. Let exercise be a part of your daily life:

                      All of us should spare atleast 30 minutes each day for exercise. Exercise doesn’t necessarily mean you should hit the gym, it means you need to keep your body moving- do brisk walk in the park, do yoga, or the best option would be, switch on your favorite music and groove on the beats.

                      3. Explore ways to be more physically active:

                      In addition to exercises, inculcating physical activity in your daily routine like using stairs instead of the elevator, parking your car further and walking down to office, using a manual bike to go to office, or having standing desks to work on.

                      4. Be a weightwatcher:

                      Obesity is a killer. You need to keep your weight in check. The best way to find out if your weight is just right is to measure the body mass index.The BMI calculation is very easy, divide your weight in kilograms by their height in metres squared. If your BMI is:

                      1. below 18.5 – you’re in the underweight range
                      2. between 18.5 and 24.9 – you’re in the healthy weight range
                      3. between 25 and 29.9 – you’re in the overweight range
                      4. between 30 and 39.9 – you’re in the obese range

                      5. Check your health numbers:

                      Go for regular health checks. Remember these numbers:

                      1. Blood pressure < 120/80
                      2. Fasting blood sugar< 100 mg/dL
                      3. Total cholesterol < 200 mg/dL

                      6. Smoking:

                      Smoking is one of the chief risk factors for not only heart disease but also deadly cancers, lung diseases and chronic disorders like high blood pressure. Quitting smoking is one of the best gift that you could give your body today.

                      7. Switch off your stress mode:

                      People with stress and mental illnesses like depression are at greater risk of heart diseases. Have a good social life, spend time with friends and family, explore new places, give some time to your hobbies and interests- do anything that relaxes you. A relaxed mind and body makes you a more productive person and helps you stay healthy.

                      8. Laugh your way to health:

                      Research suggests laughing lowers stress hormones, decreases inflammation in your arteries, and raises good cholesterol levels.

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                          Call us now if you are in a medical emergency need, we will reply swiftly and provide you with a medical aid.

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