Heart failure
THEHeart Failure is this inability of the heart to pump enough blood to meet the body’s needs. It is a serious health problem which results, among other things, in shortness of breath and fatigue that are disproportionate to the effort produced.
It generally occurs in individuals whose health has been weakened for several years by cardiac or respiratory disorders or by hypertension.
The number of heart failure cases has increased over the past 30 years11. Among the reasons for this increase, there is the improvement of treatments for heart problems and the extension of the life expectancy of those affected. Although recent statistics are not available, heart failure is an important cause of mortality at the elderly. The 5-year survival rate after diagnosis is approximately 50%1.
Causes
THEHeart Failure occurs when the heart does not have as much strength to push blood through the arteries or when it fills less well with blood because it has stiffened or dilated. Each contraction of the heart is therefore less efficient. The blood takes longer to pass through the arteries and tends to stagnate in the veins. It is because of this congestion blood in the veins is called “congestive” heart failure.
Usually, heart failure affects one or the other of the 2 ventricles, the right or the left. In some cases, it may happen that both ventricles are affected.
- Left heart failure. It is the most frequent form. Fluids collect in the tissues and concentrate mainly in the lungs, causing breathing difficulties marked (shortness of breath, wheezing, etc.). High blood pressure that has not been treated or has been poorly treated for several years and troubles coronariens (a heart weakened by angina attacks or infarcts) are the main culprits;
- Right heart failure. This time, the accumulation of fluids is localized mainly in the legs and ankles, causing their swelling. It is often caused by left heart failure, but can also be the result of lung disease, such as chronic bronchitis, emphysema, or pulmonary embolism.
More Information Le coeur comprises 4 cavities :
To see how the blood circulates in the heart, watch our animation by clicking on the illustration at the beginning of the sheet. When blood circulation is less well, the heart compensates by contracting harder and beating faster. The heart muscle grows so that it can pump more blood. The kidneys, which also receive less blood, respond by limiting the loss of fluids through urine. This phenomenon is called Water retention. Water retention results inswelling and an increase in blood volume, which in turn contributes to straining the heart. Fatigue and shortness of breath set in. Over time, the heart can no longer provide the extra effort. |
Evolution
In the vast majority of cases, theHeart Failure is chronic. The fatigue is often the first symptom to appear. With the progression of the disease, shortness of breath appears on exertion, then also at rest.
Sometimes treating the cause of heart failure makes it go away (for example, a heart defect that is corrected by surgery). In other cases, the pharmaceuticals and the adoption of healthy life habits provide better comfort and allow you to resume certain neglected activities.
The New York Heart Association defines 4 stages of development heart failure based on the level of physical activity tolerated2.
Stages of disease development | Limitation of physical activities | Symptoms of the disease |
Classe I (slight) | No limitation | No abnormal shortness of breath at the slightest effort, nor fatigue in everyday life. |
Class II (slight) | Slight limitation | No discomfort at rest, but symptoms appear during moderate-intensity physical activities. |
Class III (moderate) | Clear limitation | Symptoms appear during physical activity, even light. Comfortable at rest only. |
Class IV (grave) | Major limitation | Symptoms appear even at rest. |
Possible complications
They vary according to the state of health of the person, his age, the cause of theHeart Failure as well as its severity.
Left untreated, heart failure can quickly lead to serious complications. Fluids build up in the lungs and make it difficult to breathe. The risk of arrhythmia and cardiac arrest increases. Also, if a blood clot forms in the veins, it can block the pulmonary artery (pulmonary embolism), a potentially fatal problem. Finally, if left untreated, heart failure can damage the liver and kidneys, which are vital organs.
Diagnosis of heart failure
The clinical examination that allows the doctor to diagnose heart failure may be supplemented by more in-depth examinations to determine its cause and severity.
- Blood test. The dosage of the various constituents of the blood (cholesterol, glucose, potassium, creatinine, etc.) provides information on the cause of heart failure and on the condition of sensitive organs, such as the kidney or the liver. B-type natriuretic peptide (BNP) can also be assayed to determine the degree of insufficiency;
- X-ray of the chest. The silhouette of the heart visible on the x-ray provides information on its condition (its volume, for example) and also on possible causes of its dysfunction. In addition, this test allows you to check for the presence of fluid in the lungs;
- Electrocardiogram. This test consists of measuring the electrical activity of the heart. It is not invasive and does not cause pain. It can detect arrhythmias and electrical conduction disturbances inside the heart. It can be practiced at rest or during an effort;
- Echocardiography. This is an ultrasound of the heart. This visual examination of the heart makes it possible to check its condition: the existence of a malformation, the size of the ventricles, the condition of the heart valves, traces of a previous infarction, etc.