Depression is a mental health disorder that affects millions of people worldwide. When an individual suffers from depression, they experience sadness, hopelessness...
Depression is a mental health disorder that affects millions of people worldwide. When an individual suffers from depression, they experience sadness, hopelessness...
There are many scenarios where you might want to see a doctor and find out whether you’ve developed heart failure. Perhaps you have a history of heart disease in the family and would like to assess your risk levels.
Or you might have developed symptoms, such as shortness of breath, chest pain, and swollen feet, that are indicative of heart failure. (Check out our previous article for a detailed glimpse of heart failure symptoms.)
Or you might have completed an initial round of investigation and want a closer look at the root cause of heart failure. In any case, it’s essential to have a fair idea of the steps involved in diagnosing heart failure. Let’s take a look.
Diagnostic efforts for heart failure serve two primary purposes :
The first thing a doctor will do is get a complete picture of your medical history. They’ll want to know the details of any symptoms you might have been experiencing. Also, they’ll ask about your diet and lifestyle, including your habits pertaining to exercise, smoking, and alcohol consumption.
Additionally, they’ll ask one or more of the following questions:
Your answers to these questions will give your doctor a better idea of your current physical condition.
Next, the doctor will perform a thorough physical exam to analyze your heart activity. They’ll likely start by calculating your BMI and body fat percentage. Also, they’ll measure your vitals, including blood pressure and heart rate.
Additionally, they might use a stethoscope to identify abnormal heart sounds or murmurs that indicate a faulty heart valve. They’ll also watch out for soft noises or bruits to identify the narrowing of arteries.
They’ll examine your skin to see if it feels cold or looks discolored. They’ll also check your feet and abdomen for signs of fluid buildup. By the end of the physical exam, the doctor will have a better idea of your cardiovascular health.
While a physical exam can indicate abnormal heart function, your doctor will likely run a few diagnostic tests to confirm the underlying cause of heart failure.
The most common tests include:
Other tests like radionuclide ventriculography, exercise testing, and endomyocardial biopsy may also be prescribed.
Diagnosing heart failure involves a combination of physical examination, blood tests, and non-invasive procedures like X-rays and ECG. The key is to identify the underlying cause of heart failure, so that your doctor can decide the right course of treatment.
Dr. C Raghu is an experienced cardiologist who specializes in interventional cardiology. If you or anyone you know is at risk of developing heart failure, reach out to Dr. Raghu for a thorough diagnosis.
In our previous articles, we’ve discussed the symptoms of heart failure and the steps to diagnose the same. However, the course of treatment varies for every patient based on the type of heart failure they’ve developed.
Depending on the part of the heart’s pumping cycle that’s been affected, there are two types of heart failure. In this blog, we’ll take a closer look at diastolic dysfunction and its symptoms.
The diastolic phase refers to the part of the heart’s pumping cycle when the ventricles (lower chambers) relax and let blood flow in from the atria (upper chambers). Diastolic dysfunction is a condition in which the ventricles don’t relax enough. That, in turn, prevents the normal amount of blood from entering the heart.
Diastolic dysfunction is caused when the heart muscles become thicker and stiffer than usual. It’s more common in older women with hypertension and diabetes. If left untreated, it can lead to diastolic heart failure (also known as heart failure with preserved ejection fraction).
Ejection fraction refers to the volume of blood pumped out from the heart’s left ventricle with each contraction. For a healthy heart, the number falls in the range of 55% to 65%. A lower ejection fraction is one of the most common indicators of heart failure.
However, it’s worth noting that many people with diastolic dysfunction have an ejection fraction of 50% or more (which is known as preserved ejection fraction). That means the left ventricle expels an adequate amount of oxygenated blood.
However, the heart muscle doesn’t relax enough to let a sufficient quantity of blood in. That, in turn, causes the excess blood to back up in the lungs and results in fluid buildup in the feet and abdomen.
In contrast to systolic dysfunction where the heart muscle is “weak”, in diastolic dysfunction the heart is “stiff”. This means that the heart is unable to pump blood out of the heart in systolic dysfunction whereas the heart is unable to accept further blood in diastolic dysfunction. Both conditions lead to congestion or fluid accumulation in various organs of the body. Differentiation of heart failure from systolic and diastolic dysfunction is not possible as both diseases present with similar symptoms.
The best way to prevent and treat diastolic dysfunction is by effective control of the diseases mentioned above.
The most common symptom of diastolic dysfunction is congestion and shortness of breath due to the buildup of blood and fluid in the lungs. Breathing difficulties can get particularly worse during exertion or when lying.
Other symptoms of diastolic dysfunction include:
If you experience any of the given symptoms, it’s crucial to consult a doctor for a proper diagnosis.
Treatment of diastolic dysfunction involves a combination of medications (diuretics or water pills) and lifestyle changes. In severe cases, a patient might need left ventricular assist devices or a heart transplant.
In the long run, diastolic dysfunction can lead to diastolic heart failure. That, in turn, increases your risk of hospitalization and death. Therefore, you should pay close attention to your symptoms and reach out to a doctor whenever you notice anything unusual.
Dr. C Raghu is a renowned cardiologist who specializes in interventional cardiology. He has decades of experience in treating patients with different heart conditions. If you or anyone you know has developed symptoms like shortness of breath, swollen feet, loss of appetite, etc., contact Dr. Raghu to explore your treatment options.
Congenital heart diseases are diseases that are present from birth and affect the normal heart functioning. These are the most frequently occurring congenital disorder, responsible for 28% of all congenital birth defects. The birth prevalence of CHD is reported to be 8-12/1000 live births. Considering a rate of 9/1000, about 1.35 million babies are born with CHD each year globally.
In most cases, no obvious cause of congenital heart disease is identified. However, some things are known to increase the risk of the condition, including:
Many cases of congenital heart disease can be diagnosed before a baby is born during an ultrasound scan in pregnancy. At times a focused foetal heart scan called foetal echocardiography in specialized centers helps to diagnose the cardiac problem before birth. However, it’s not always possible to detect congenital heart defects in this way.
Congenital heart disease can have a number of symptoms, particularly in babies and children, including:
These problems are sometimes noticeable soon after birth, although mild defects may not cause any problems until later in life.
There are many types of congenital heart disease and they sometimes occur in combination. Some of the more common defects include:
Treatment for congenital heart disease usually depends on the defect you or your child has.
Mild defects, such as holes in the heart, often don’t need to be treated, as they may improve on their own and may not cause any further problems.
Surgery or interventional procedures are usually required if the defect is significant and causing problems. Modern surgical techniques can often restore most or all of the heart’s normal function.
However, people with congenital heart disease often need treatment throughout their life and therefore require specialist review during childhood and adulthood. This is because people with complex heart problems can develop further problems with their heart rhythm or valves over time.
Most surgery and interventional procedures aren’t considered to be a cure. The affected person’s ability to exercise may be limited and they may need to take extra steps to protect themselves from getting infections.
It’s important that a person with heart disease and their parents or carers discuss these issues with their specialist medical team.
An atrial septum is a muscular wall that separates the upper chambers of the heart called atria. An ASD is a common congenital heart disease where the septum is not formed properly producing a left-to-right shunt, which leads to mixing of oxygenated and deoxygenated blood. This causes pulmonary hypertension and right heart enlargement.
Small atrial defects do not need any treatment and close on its own. Even in adulthood small ASDs may remain asymptomatic. Some large defects that persists in adulthood may become symptomatic and need closure. The ASDs can be closed by:
Percutaneous device closure is the preferred treatment for certain defects type.
A noninvasive procedure known as percutaneous transcatheter approach is considered depending on the size and severity of the defect. Moderate to large-sized ASD along with pulmonary hypertension requires to be closed. The procedure is performed by inserting a special closure device either folded or attached to a catheter into the vein of the leg and is advanced to the heart through the defect, which closes the hole by a special mechanism.
The success rate of the procedure is about 95%. But the risks involved, and their estimated incidence of occurrence include:
Patients with small ASD may not develop any complications, but large-sized defects may lead to serious complications which demands surgery and prolonged hospitalization.
A detailed diagnosis of the defect should be performed which includes transthoracic and transoesophageal echocardiogram used to assess the size, location and the suitability of the procedure.
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
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:
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.
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 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 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 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.
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.
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 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 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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