What is heart failure?
Heart failure is a series of disorders that are based on low contractility of the heart muscle. There is a misconception that heart failure is a heart disease, but it is not. Heart failure is a state of the body in which the contractility of the heart muscle (myocardium) becomes weak, as a result, the heart cannot fully provide the body with the necessary amount of blood.
Very often, people with coronary heart disease and hypertension suffer from heart failure, and heart failure complicates many diseases of the cardiovascular system. Heart failure significantly reduces the quality of life, and sometimes causes death of a person.
Symptoms of heart failure
Given the nature and course of the disease, heart failure is divided into acute and chronic. The disease manifests itself by slowing down the rate of general blood flow, the amount of blood ejected by the heart becomes smaller, and the pressure in the heart chambers increases. The excess volume of blood, which the heart could not cope with, begins to accumulate in the conditionally called “depot” – the veins of the legs and abdominal cavity.
The very first symptoms of heart failure are weakness and fatigue.
Since the heart cannot handle the entire volume of circulating blood, excess fluid from the bloodstream begins to accumulate in various organs and tissues of the body, usually in the feet, calves, thighs, abdomen and liver.
Due to increased pressure and accumulation of fluid in the lungs, respiratory failure is noted. In the normal state, oxygen freely passes from the lung tissue rich in capillaries into the general circulation, but with the accumulation of fluid in the lungs, which occurs with heart failure, oxygen does not fully pass into the capillaries. Breathing becomes faster due to the low concentration of oxygen in the blood. Very often the patient wakes up in the middle of the night from attacks of suffocation.
As an example, consider the American President Roosevelt, who suffered from heart failure. For a very long time he could not sleep lying down, but slept sitting in a chair due to breathing problems.
Fluid leaving the bloodstream into tissues and organs can stimulate not only breathing problems and sleep disorders. A person quickly gains weight due to soft tissue edema in the area of the feet, lower leg, thighs, and sometimes in the abdomen. When pressed with a finger, you can clearly feel swelling.
In very severe cases, fluid accumulates inside the abdominal cavity. A dangerous condition begins – ascites. Ascites is a complication of advanced heart failure. In cases where a certain amount of fluid from the bloodstream enters the lungs, a condition called “pulmonary edema” begins. Often, pulmonary edema occurs in chronically current heart failure, accompanied by pink, bloody sputum when coughing.
Lack of blood supply negatively affects all organs and systems of the human body. The effect on the central nervous system in the elderly affects the decrease in mental activity.
Left side or right?
The symptoms of heart failure depend on which side of the heart is involved. The left atrium (upper chamber of the heart) receives oxygenated blood from the lungs and pumps it into the left ventricle (lower chamber), which pumps this blood to the rest of the body. If the left side of the heart is not able to fully move the blood, it is thrown back into the pulmonary vessels, and excess fluid seeps through the capillaries into the alveoli, causing difficulty in breathing. Another symptom of left-sided heart failure is weakness and excessive secretion of mucus (sometimes even mixed with blood).
Right-sided insufficiency occurs if the outflow of blood from the right atrium and right ventricle is difficult, this happens when the heart valve does not work properly. As a result, pressure rises and fluid accumulates in the veins that terminate in the right chambers of the heart – the veins of the liver and legs. The liver increases in volume, the pain is disturbing, the legs swell greatly. With right-sided insufficiency, a phenomenon such as nocturia is noticed – increased nighttime urination, exceeding daytime.
In congestive heart failure, the kidneys are unable to handle large volumes of fluid, resulting in kidney failure. Salt, which is normally excreted by the kidneys along with water, is retained in the body, thereby increasing swelling. With the elimination of the main cause – heart failure – kidney failure disappears.
Causes of heart failure
There are many reasons for the development of heart failure. One of the main ones is coronary heart disease and insufficient blood supply to the heart muscle.
In turn, ischemia is caused by blockage of the heart vessels by fatty substances. Another cause of heart failure can be a heart attack, as some part of the heart tissue dies and scars.
The next cause of heart failure is arterial hypertension. It takes a lot of strength to move blood through spasmodic vessels, as a result, the heart, namely the left ventricle, increases in size. Further, weakness of the heart muscle or heart failure develops.
One of the reasons affecting the development of heart failure is cardiac arrhythmia (irregular contractions). If the number of beats is more than 140 per minute, this is considered dangerous and contributes to the development of the disease, since the processes of filling and ejection of blood by the heart are disturbed.
In the case when there are changes in the valves of the heart, there are violations of the filling of the heart with blood, and this also contributes to the development of heart failure. Often the problem is caused by an internal infectious process (endocarditis) or a rheumatic disease.
Inflammation of the heart muscle due to infections, alcohol or toxic damage also leads to the development of heart failure.
However, not in all cases it is possible to accurately determine the cause that caused heart failure. This condition is called idiopathic heart failure.
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