There was a time when heart attacks were restricted to older people (in their 50s, 60s, or 70s). However, in today's day and age, heart attacks are becoming increasingly common in individuals under the...
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types of heart failure | Dr Raghu
There was a time when heart attacks were restricted to older people (in their 50s, 60s, or 70s). However, in today's day and age, heart attacks are becoming increasingly common in individuals under the...
Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. It’s a serious condition that requires treatment by your doctor, but there are several options available. If you’re concerned about heart failure and want to know more about your options for treatment, keep reading.
What Is Heart Failure?
Heart failure occurs when your heart doesn’t pump blood as well as it should due to one or more problems with its cardiac function. The heart can’t pump blood as well because it has to work harder than normal just in order to keep up with the body’s needs for oxygen and nutrients. The extra effort causes structural changes in the heart over time.
Types of Heart Failure
Although there are many specific types of heart failure, the two broad categories are as follows:
- Heart failure with preserved ejection fraction or diastolic heart failure
- Heart failure with reduced ejection fraction or systolic heart failure
Heart failure can also be categorized depending on the side of the heart that’s affected. These include:
- Left-sided heart failure
- Right-sided heart failure
The treatment of heart failure depends on the type of heart failure you’ve developed. The most common treatment options include:
Beta-Blockers
Beta-blockers are a class of drugs that slow your heart rate, lower blood pressure, and reduce the force of contraction in your heart muscle. They work by blocking the effect of certain hormones that cause the heart to beat quickly.
Beta-blockers can help you feel better if you have high blood pressure or chest pain (angina) due to coronary artery disease or atherosclerosis. But they’re not recommended for people who have low blood pressure (hypotension).
ACE Inhibitors
ACE inhibitors are a class of drugs that lower blood pressure and reduce the workload of the heart. They are used to treat high blood pressure, heart failure, and kidney problems.
ACE inhibitors include:
- Captopril
- Enalapril
- Lisinopril
- Ramipril
Digoxin
If you have heart failure, your doctor may prescribe digoxin. This medication is used to slow the heart rate and increase its force of contraction in order to improve blood flow to the body.
Diuretics
Diuretics, such as hydrochlorothiazide (HCTZ), furosemide and torsemide help your kidneys get rid of excess fluid. If you have heart failure or high blood pressure, your doctor may prescribe a diuretic.
Diuretics can cause side effects like dehydration and electrolyte imbalances. They also interact with other medications. Be sure to talk to your doctor about any drug interactions before taking them.
Aldosterone Antagonists
Aldosterone antagonists work by blocking the effect of aldosterone, a hormone that causes your body to hold on to sodium and water. This excess fluid can cause heart failure symptoms, including swelling and shortness of breath.
Aldosterone antagonists are used to treat primary hypertension (high blood pressure) or heart failure. They work best when combined with other medications that block the action of angiotensin II (a hormone secreted by the kidneys).
In Conclusion
Heart failure can be managed with a variety of medications, and in some cases, it may even go away on its own. If you have heart failure, talk to your doctor about what treatments might help you feel better and live longer. We hope this article has given you some insight into the different types of treatments available and how they work!
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.
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.
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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