cardiomyopathy | Dr Raghu


Congestive heart disease or heart failure is a serious condition that can be life-threatening (if left untreated). It can diminish blood supply to vital organs, such as the brain, liver, and kidneys. That, in turn, can lead to organ damage.

Congestive Heart Disease

In this blog, we’ll delve deeper into the causes and types of congestive heart failure. Also, we’ll understand the outlook for patients living with the condition. Let’s get started.

What Are the Causes of Congestive Heart Failure?

Congestive heart failure is characterized by a gradual deterioration in the heart’s ability to pump blood throughout the body. It can result in various symptoms, such as swelling in the abdomen, feet, and legs, shortness of breath, fatigue, weight gain, and loss of appetite. Read our blog post on heart failure symptoms for more details.

Typically, the condition is the result of an abnormality in the cardiac muscles that interferes with the heart’s pumping function. It can be due to a congenital defect or an underlying illness that exerts the heart muscles.

The most common causes of congestive heart disease include :

The following factors also increase an individual’s risk of developing the condition:

  • A family history of cardiovascular diseases
  • Tobacco smoking
  • Alcohol consumption
  • Sedentary lifestyle
  • Substance abuse

Types of Congestive Heart Failure

Depending on the part of the heart’s pumping cycle that’s been affected, congestive heart failure can be of two types: systolic heart failure and diastolic heart failure.

In systolic heart failure, the left ventricle becomes thin and weak and is unable to push an adequate amount of oxygen-rich blood into the arteries. It’s also known as heart failure with reduced ejection fraction.

In diastolic heart failure, the ventricles become thick and stick, due to which the heart can relax and let an adequate amount of blood fill the chambers. It’s also known as heart failure with preserved ejection fraction.

Congestive heart failure can also be categorized into two types depending on the side of the heart that’s affected. This includes left-sided heart failure and right-sided heart failure.

Acute Congestive Heart Failure

The American College of Cardiology and the American Heart Association have outlined four distinct stages of the progression of heart failure. Stage four, or the most advanced stage, is characterized by acute heart failure.

At this stage, a patient experiences severe symptoms that don’t respond to standard treatments. They might need frequent hospitalization or specialized treatment to stay out of the hospital.

Congestive Heart Failure Prognosis

There’s no known cure for congestive heart failure. However, timely diagnosis, proper treatment, and lifestyle changes can be instrumental in improving a patient’s quality of life and longevity. Doctors usually use a cardiopulmonary stress test to predict your prognosis.

The prognosis of congestive heart failure for a patient depends on various factors, including their age, sex, medical history, and lifestyle. Chronic ailments like diabetes can worsen your prognosis. Also, the stage at which heart failure is diagnosed influences the outlook.

Dr. C Raghu is a world-renowned cardiologist who’s helped thousands of patients with cardiac ailments. He specializes in interventional cardiology and has nearly two decades of experience. If you or anyone you know has been diagnosed with congestive heart disease, feel free to consult Dr. Raghu right away.

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    Congestive Heart Disease: An Overview – Blog

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      Heart failure is a serious condition that can result in organ damage and death (if left untreated). If you want more information about the different types and symptoms of heart failure, take a look at our previous blog posts.

      In this article, we’ll explore the different causes of heart failure in greater detail. Let’s get started.

      Heart Failure: A Closer Look

      Heart failure refers to a condition where the heart is unable to pump blood throughout the body with maximum efficiency. It’s usually the result of progressive weakening, thickening, or stiffening of the heart muscles.

      In the past, doctors used to refer to the condition as congestive cardiac failure because it leads to fluid buildup and congestion in the lungs. However, recent research shows that heart failure can cause several other symptoms.

      Symptoms of Heart Failure

      It’s possible for patients to develop heart failure without showing symptoms for months. That’s because they might attribute signs like confusion and fatigue to other factors, such as old age and stress.

      However, if you’re at risk of developing heart failure, you should watch out for the following symptoms:

      • Swelling in the abdomen, feet, and legs
      • Shortness of breath that worsens due to physical exertion or when lying down
      • Weight gain due to fluid buildup
      • Loss of appetite
      • Pale or bluish skin
      Related : Understanding Congestive Heart Failure Symptoms

      Causes of Heart Failure

      Heart failure can be the result of various underlying conditions, including hypertension, diabetes, chronic respiratory disease, cardiomyopathy, and coronary artery disease. Also, it can be caused by damage to the heart muscles due to a viral or bacterial infection or a previous heart attack.

      Moreover, faulty heart valves can strain the cardiac muscles and lead to heart failure. Similarly, heart rhythm disturbances can create structural changes in the left ventricle and cause heart failure.

      It’s worth noting that people with a family history of cardiac ailments are more prone to developing heart failure. Also, the risk is higher in seniors and people with an African-American ethnic background. Alcohol consumption, tobacco smoking, and substance abuse also increase the risk.

      Types of Heart Failure

      Depending on the phase of the heart’s pumping cycle that’s affected by congestive cardiac failure, the condition can be of two types:

      • Systolic heart failure – Heart failure due to a problem in the contraction (systolic) phase of the pumping cycle; also known as heart failure with reduced ejection fraction.
      • Diastolic heart failure – Heart failure due to a problem in the relaxed (diastolic) phase of the pumping cycle; also known as heart failure with preserved ejection fraction.

      Heart failure can also be categorized as:

      • Left-sided heart failure (caused by a weak left ventricle)
      • Right-sided heart failure (caused by a weak right ventricle)
      Related : Types of Heart Failure

      Stages of Heart Failure

      The American Heart Association (AHA) and the American College of Cardiology (ACC) have identified four distinct stages of heart failure based on the degree of severity. The course of treatment for a patient depends on the stage of heart failure they’re at.

      Diagnosing Heart Failure

      Heart failure is diagnosed through a series of lab tests, including ECG, echocardiogram, coronary angiography, chest X-ray, brain natriuretic peptide test, etc. Doctors recommend the right combination of tests to identify the causes of heart failure and devise a suitable treatment plan.

      Dr. C Raghu is an eminent cardiologist with more than two decades of experience. He specializes in interventional cardiology and has helped a plethora of patients with different heart conditions. If you’ve been diagnosed with heart failure, feel free to consult Dr. Raghu to explore your treatment options.

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        Causes of Heart Failure – Blog

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          Systolic-heart-failure-img.jpg

          Heart failure is a common condition with no known cure. However, proper treatment can control the disease progression and thus improve a patient’s quality of life and longevity. To decide the proper course of treatment, a doctor must first determine the type of heart failure a patient has developed.

          Depending on the part of the heart’s pumping cycle that’s been affected, heart failure can be of two types – diastolic and systolic. You can learn more about the symptoms, causes, treatment of diastolic dysfunction and differentiation from systolic dysfunction in our previous article.

          In this blog, we’ll delve deeper into systolic heart failure and understand its causes and symptoms.

          Systolic Heart Failure: A Closer Look

          Systolic Heart Failure

          Systolic heart failure occurs due to a problem in the heart’s contraction (or systolic) phase. It’s characterized by stretching and weakening of the left ventricular muscle, due to which the heart pumps out less oxygenated blood to the body.

          It’s also known as heart failure with reduced ejection infraction. As the condition worsens, it can also weaken the right ventricle and take a toll on its pumping power too.

          Related: What Are the Symptoms of Diastolic Dysfunction?

          Causes of Systolic Heart Failure

          Systolic heart failure is caused by underlying medical conditions that damage the left ventricle. The most common causes include :

          • Hypertension (the left ventricle has to use increased pressure to pump blood through the body)
          • Coronary artery disease (buildup of cholesterol in the arteries) – with or without a heart attack.
          • Dilated cardiomyopathy (weakening of the left ventricle due to an infection or long-term exposure to alcohol and narcotics)
          • Abnormal heart rhythm (also known as atrial fibrillation)
          • Previous heart attack

          Additionally, people who are older or have diabetes are at a higher risk of developing systolic heart failure.

          Related: Understanding Congestive Heart Failure Symptoms

          Symptoms of Systolic Heart Failure

          In systolic heart failure, an adequate amount of oxygen-rich blood doesn’t reach all organs. The most common indicator of the condition is a lower ejection fraction.

          It can result in the following symptoms:

          • Breathlessness – initially on exertion and in later stages even at rest or lying down. 
          • Swelling of feet, face, abdomen – due to fluid accumulation in various organs 
          • Engorged and pulsatile neck veins
          • Confusion (due to a lack of oxygen supply in the brain)
          • Weight gain (due to a buildup of excess fluid in the body)
          • Fatigue (due to reduced blood supply to the muscles)
          • Pale or bluish skin tone (due to restricted blood supply to the skin and other vital organs).

          Diagnosis and Treatment Options

          Typically, a doctor prescribes various tests, such as chest X-ray, ECG, and echocardiography, to diagnose systolic heart failure and its root cause. The treatment plan depends on the underlying cause.

          In most cases, systolic heart failure is treated using one or more of the following medications:

          • Beta-blockers
          • Diuretics or water pills
          • ACE inhibitors
          • Digoxin
          • Anticoagulants

          Additionally, doctors recommend a healthy diet and lifestyle changes to improve cardiac health and manage underlying conditions, such as hypertension and diabetes.

          Related: Diagnosing Congestive Heart Failure

          In Conclusion

          If left untreated, systolic heart failure can damage vital organs and even lead to death. It’s crucial that patients watch out for symptoms like swollen feet, mental confusion, and bluish skin color and seek medical treatment at the earliest.

          Dr. C Raghu is an experienced cardiologist who specializes in interventional cardiology and TAVR. If you or anyone you know is experiencing symptoms of systolic heart failure, connect with Dr. Raghu for proper diagnosis and treatment.

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            What Is Systolic Heart Failure ? – Blog

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              Normal-Ejection-Fraction.jpg

              The ejection fraction is one of the most common parameters used to diagnose heart failure. If you want to know more about the cause, symptoms, and types of heart failure, check out our previous blog posts.

              In this article, we’ll delve deeper into ejection fraction and understand its relevance in heart failure diagnosis and treatment. Let’s get started.

              What Is Ejection Fraction?

              Ejection fraction refers to the percentage of blood the left ventricle pumps out during the systolic (or contraction) phase. The left atrium receives oxygen-rich blood from the lungs and sends it to the left ventricle. The walls of the left ventricle contract and pump blood into the arteries, which then carry it to different cells and tissues.

              Ejection Fraction

              What Is a Normal Ejection Fraction by Age ?

              Even a healthy heart doesn’t pump all the blood from the left ventricle in a single cycle. Therefore, an ejection fraction of 55 to 65% is considered normal. 

              Ejection Fraction and Heart Failure: Understanding the Connection

              Heart failure is the result of a gradual decline of the heart’s pumping function. It’s often caused by a weakening or thinning of the left ventricle, due to which the heart can’t contract with full force. That, in turn, means it can’t pump the required amount of blood into the arteries.

              The remaining blood backs up in the lungs, causing symptoms like shortness of breath. Also, lack of blood supply to vital organs like kidneys can lead to fluid buildup, resulting in swelling in the abdomen, feet, and legs. All these are telltale signs of heart failure.

              A weak left ventricle results in a lower than normal ejection fraction (under 50%). Thus, a low ejection fraction is often the first indicator of heart failure. It can be caused by various factors, such as dilated cardiomyopathy, coronary artery disease, hypertension, and diabetes.

              However, it’s worth noting that some patients might develop heart failure despite a normal ejection fraction. It happens when heart failure is the result of a problem in the diastolic (relaxed) phase of the heart’s pumping cycle. It’s caused when the walls of the ventricles become stiff and thick, thus letting less blood flow from the lungs into the heart.

              Related: What Are the Symptoms of Diastolic Dysfunction?

              Is It Possible to Improve Ejection Fraction?

              The likelihood of improving ejection fraction depends on a patient’s overall physical health and medical history. In most cases, doctors will recommend lifestyle, diet changes and medicines to improve or maintain normal ejection fraction. Also, it’s crucial for patients to stay physically active, so that their organs receive sufficient oxygen-rich blood.

              In Conclusion

              A normal ejection fraction of 55 to 65% is considered a sign of a healthy heart. People with an ejection fraction lower than 50% might be suffering from systolic heart failure. This is also termed Heart Failure with reduced ejection fraction. However, it’s also possible for you to develop heart failure and still have an ejection fraction of more than 50%. This condition is called diastolic heart failure or Heart Failure with preserved ejection fraction. 

              The good news is that it’s possible to improve ejection fraction with a combination of medications and lifestyle changes. If you’ve been diagnosed with heart failure with a reduced ejection fraction, feel free to contact Dr. C Raghu to explore your treatment options.

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                What Is a Normal Ejection Fraction by Age ? – Blog

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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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                      New-Project-6.jpg

                      Heart is a complex organ and can get affected by diseases that can affect various systems of the heart. The common heart ailments that would be observed include:

                      Coronary Artery Disease (CAD) – accumulation of cholesterol plaques within the walls of the blood vessels (coronary arteries) supplying the heart. This leads to obstruction to blood flow of the heart that can cause chest pain or heart attack. 

                      Valvular heart disease: Heart valves are flap-like structures akin to doors between rooms. They control the blood flow between various chambers of the heart. They play a key role in blood circulation. 

                      There are four valves in the heart

                      • mitral and aortic valves on the left side of the heart 
                      • tricuspid and pulmonary valves on the right. 

                      These valves can either get narrowed (stenosis) or get “leaky” (regurgitation).

                      Cardiomyopathy: This disease affects the heart muscle leading to inefficient heart pumping efficiency. Cardiomyopathy can be either due to:

                      • Direct heart muscle diseases – Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy and Restrictive Cardiomyopathy.
                      • Indirect heart muscle diseases –
                        • Consequent to 
                          • heart attack (ischemic cardiomyopathy)
                          • infective (myocarditis) and 
                          • heart rhythm problems
                      • Heart Rhythm problems (Arrhythmias)- Normal heart rate is between 50-100 beats per minute. The maintenance of heart rhythm within a specific range is possible due to an efficient electrical system of the heart also called the conduction system.
                        • Slow heart rate – Bradycardia usually due to retardation of conduction within the conduction system of the heart. The most common cause is due to age related degeneration of the conduction system. The garden variety disease causing slow heart rate is called complete heart block.
                        • Fast heart rate – Tachycardia in this disease there is an accelerated conduction of electrical impulses – if the fast heart arises in the lower chambers of the heart (ventricles) it is called ventricular tachycardia if it arises in the upper chambers (atria) of the heart it is called supraventricular tachycardia.

                      Doctors usually recommend a battery of tests based on the system of the heart that has been affected. Based on a detailed history followed by a detailed physical examination, appropriate battery of tests would be suggested. The diagnosis of the heart ailment is critically dependent on the results of tests.

                      In addition to confirming the diagnosis, test results might indicate the disease complications and thus your doctor is able to stage the disease and the possible outcomes.

                      Related : Basics about Heart Failure

                      Blood tests:

                      1. Complete blood count (CBC): A complete blood count helps to detect infection, anaemia and other blood disorders. Anaemia is a common finding in heart failure, plus it also contributes to worsening of heart failure. A low platelet count may be caused by medications such as diuretics or heparin.
                      2. Cardiac troponins (cTn1, cTnT, high sensitivity troponins): It is an important blood biomarker useful for the detection and predicting outcomes of chest pain or heart attack. Cardiac troponins may also be high in other heart related conditions like acute myocarditis, coronary vasospasm and non-cardiac conditions (e.g. sepsis, chronic kidney disease).
                      3. Electrolytes, urea and creatinine: Assessment of kidney function is essential in all cardiac patients. Both kidney and cardiac disease share the same risk factors and either disease can lead to poor outcomes of the other disease. In addition, cardiac drugs’ doses need to be modified considering the kidney function.
                      4. Liver function tests:: Certain drugs such as statins and amiodarone, which are commonly prescribed for patients with heart disease, can trigger liver failure. Liver failure could also be a consequence of heart failure.
                      5. Thyroid function test: Medication for heart disease like amiodarone may cause hyper or hypo thyroidism. Altered thyroid hormone can also cause heart dysfunction and responsible for coronary artery disease.
                      6. Brain Natriuretic Peptides (BNP or N-terminal pro BNP): BNP is a useful tool to differentiate between cardiac and non-cardiac causes of shortness of breath. High levels of BNP and N terminal pro BNP is associated with increased severity of heart disease and greater risk of hospitalization.
                      Related: Types of Heart Failure

                      Electrocardiography(ECG):

                      This test detects and records the electrical activity of the heart. This is a simple, non-invasive test which is very useful to determine abnormalities in the heart rate, rhythm and to identify risk of damaged heart muscle or other structural changes in the heart. This test detects the presence of arrhythmias and coronary artery disease.

                      Exercise stress testing:

                      Exercise makes your heart work harder. Exercise stress testing is done either on a treadmill or cycle ergometry with the patient connected to an electrocardiogram. Exercise stress testing may identify myocardial ischaemia, haemodynamic/ electrical instability, or other exertion-related signs or symptoms. When an individual is not able to exercise, medications are given to stress the heart and the response is evaluated.

                      Chest X-ray:

                      Chest X ray is very useful to differentiate whether shortness of breath is due to a respiratory disease or heart disease. It can also help in detecting complications of heart failure such as cardiomegaly, interstitial oedema, pulmonary oedema and pleural effusions.

                      Coronary angiography:

                      Coronary angiography is useful to determine the health of the coronary arteries. In this test, a catheter is inserted into the coronary arteries and a dye is injected to produce clear X ray images of the coronary arteries. This helps to find out the presence, location and extent of vessel narrowing. The results also help to decide which type of treatment would be most appropriate for correction of heart problem.

                      Echocardiography:

                      This test gives an ultrasound image of the heart. Echocardiography can provide information about the size and shape of heart chambers, blood flow velocities, heart muscle function when they contract and relax, abnormalities of the movement of the heart wall, valve function, and presence of thrombus (blood clot) in the heart.

                      Stress echocardiography helps in detecting decreased blood flow to heart during exertion. In this test, echocardiography is done immediately post stress. The stress can be exercise or could be induced by medications.

                      Myocardial perfusion scanning (MPS):

                      MPS is a non-invasive test which helps to determine how well blood flows through your heart muscles. In this test, a small amount of a radioactive substance is injected into the blood. The test evaluates the severity of coronary artery disease and provides guidance regarding the need as well as success of invasive procedures like angioplasty and stent insertion. 

                      Cardiac Computerized Tomography (CT):

                      Cardiac CT provides detailed images of the heart. This helps to identify structural abnormalities in the heart and blood vessels such as aneurysms, valve dysfunction and damage to the pulmonary vasculature. Cardiac CT also provides information about patency of grafts following coronary artery bypass graft.

                      Cardiac Magnetic Resonance Imaging (MRI):

                      Cardiac MRI uses strong magnetic fields and radiofrequency to provide detailed 3D images of the heart and surrounding structures. The image provides accurate information about cardiac volumes, muscle mass, contractility, and how efficiently the heart is pumping. Like cardiac CT, cardiac MRI also helps to provide information about patency of grafts following coronary artery bypass graft.

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