The function of the heart is to pump blood across the body to supply oxygen to all the organs, and when it fails to work this way, it is known as heart failure. It usually happens when the heart is not strong enough to gather oxygen from the lungs or pump the oxygen rich blood around the body. The blood that should be pumped out of your heart backs up and collects in the lungs and other parts of your body. This is why you may experience shortness of breath and swelling in your hands, legs, and feet.

Some people with heart failure have enlarged hearts, which can be seen on a chest x-ray. As a weak heart struggles to pump out all its blood, the muscle fibres of the heart stretch. Over time, this extra stretching leaves the heart with larger, weaker chambers. This causes serious health problems and immediate medical attention is needed. Early diagnosis and medication may help to lead a more active life than without treatment. But with medication if the condition doesn’t change, it is referred to as end- stage heart failure. It is important to consult an experienced cardiologist for diagnosis and accurate treatment.

How to recognize heart failure?

Some are easy to confuse with normal aging or other diseases. The more advanced the heart failure is, symptoms are also more likely to get worse. The following are few common ways to get indications from the heart –

1. Shortness of breath –if you find it hard to breathe after climbing a few stairs, or feel trouble even while sitting still.
2. Sleep problems– due to breathlessness, trouble nodding off to sleep or getting up suddenly in the middle of the night gasping for air.
3. Coughing –dry cough while sleeping and phlegm with pinkish tint while lying down.
4. Fatigue – failure of heart make you feel won out.
5. Swelling –as the hear t is no more able to move blood through the body it gets built up in certain parts leading to swelling.
6. Loss of appetite –Feeling of hunger is lost and is pronounced with advanced stage.
7. Frequent urinations –Visiting bathroom in the middle of the night more
8. Heart palpitation– feeling of racing heart beat as if heart is beating too fast. To compensate for the amount of blood pumped, it tries to beat faster.

Common diseases that may lead to transplantation

1. Coronary Heart Disease: 

Coronary heart disease, also commonly called coronary artery disease, is a narrowing or blockage of the coronary arteries, the arteries that provide the heart muscle with blood. The disease occurs when these arteries become hardened and narrowed. The arteries harden and narrow due to build-up of a material called plaque on their inner walls. The build-up of plaque is known as atherosclerosis.

As the plaque increases in size, the insides of the coronary arteries get narrower and less blood can flow through them. Eventually, blood flow to the heart muscle is reduced, and, because blood carries much-needed oxygen, the heart muscle is not able to receive the amount of oxygen it needs. Heart transplantation is performed to replace a failing heart that cannot be adequately treated by other means.

2. Congestive Heart Failure (CHF) :

End-stage heart failure is a disease in which the heart muscle is failing severely in its attempt to pump blood through the body, and in which all other available treatments are no longer helping to improve the heart’s function. End-stage heart failure is the final stage of heart failure. Heart failure, also called congestive heart failure, or CHF, is a condition that occurs when the heart is unable to pump blood sufficiently. Despite its name, a diagnosis of heart failure does NOT mean the heart is about to stop beating. The term “failure” refers to the fact that the heart muscle is failing to pump blood in the normal manner because it has become weakened.

3. Cardiomayopathy:

Unlike heart disease due to heart attacks, where there is a problem with adequate blood flow to the heart, cardiomyopathy is a disease of the heart muscle itself. There are many causes of cardiomyopathy, which may include coronary artery disease and heart valve disease. Cardiomyopathy occurs in three major types – dilated, hypertrophic and restrictive – all of which affect your heart’s ability to pump blood and deliver it to the rest of your body.

Classification of heart failure

Classification helps in understanding the chronic and progressive nature of heart disease and helps direct treatment interventions.

At Stage A, patients are at high risk for developing heart failure because of pre-existing conditions, including coronary artery disease, hypertension, and diabetes mellitus.

At Stage B, patients have structural heart disease and left ventricular systolic dysfunction but are asymptomatic at rest.

At Stage C, patients have systolic dysfunction and are experiencing symptoms or they have a history of prior symptoms of heart failure. Finally,

At Stage D, patients have refractory symptoms, including dyspnoea and fatigue at rest, despite optimal medical therapy. At this stage patients are considered to be at the end stage of heart failure.

What happens during a heart transplant procedure?

The heart transplant procedure involves 3 operations. The first operation is to harvest the heart from the donor. The donor is usually a person who has suffered irreversible brain injury, leading to “brain death”. People who have had major trauma to the head, where the victim’s organs other than brain are working well under life support.

The second operation is to remove the recipient’s damaged heart. Removing the damaged heart may be very easy or very difficult, depending on whether the recipient has had previous heart surgery (as is often the case). If there has been previous surgery, cutting through the scar tissue may prolong and complicate removal of the heart.

The third operation is probably the easiest with the technological advancement, this operation basically involves the creation of only five lines of stitches, or “anastomoses”. These suture lines connect the large blood vessels entering and leaving the heart. Remarkably, if there are no complications, most patients who have had a heart transplant are home about one week after the surgery. The generosity of donors and their families makes organ transplant possible.

Dr. Kewal Krishan, Director
Heart Transplant & Ventricular Assist Devices
Principal Consultant – Cardiac Surgeon
Max Super Speciality Hospital
Saket, New Delhi

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Cardiac ailments are considered to be one of the deadliest diseases and the leading cause of mortality in India. As per the reports of WHO, Cardiac problems are estimated to kill atleast 1 in every 5 men and 1 in every 8 women. Progressive heart failure which is caused due to the plaque (fatty substance) build up in the arterial linings of the blood vessels are primarily attributed to lifestyle habits and conditions such as smoking, overweight, high cholesterol, high blood pressure and diabetes.

Heart attacks were once only associated with old age. Recently, more people in their 20s, 30s and 40s have been suffering from heart ailments. Apart from a person’s genetic disposition and family history which are the most common and uncontrollable risk factors, the Indian youth is now being succumb to heart ailments due to poor lifestyle, stress, erratic sleep patterns. This in turn causes inflammation and raise the risk of cardiac ailments. Sedentary lifestyle clubbed with smoking are further risk factors that triggers the risk symptoms among the younger generation.

Everyday about 9000 people die of heart ailments – which mean one in every 10 seconds. Out of them 900 are youths below the age of 40 years. The only way to prevent the Epidemic of Heart Disease in India is to educate the mass otherwise it is set to become the leading killer by 2020.

Cardiac Hospitals in India perform more than 2 lakh open heart surgeries and are increasing annually by 25% but they are not able to control the numbers of heart attacks. The surgeries done are only palliative. Educating the essentials about Heart disease and its risk factors is important to eradicate the casualties from the root.

What are the symptoms?

Not every CHD patient has the same symptoms and angina chest pain as its most common feature. Symptoms may vary from nil to severe, some may have an uncomfortable feeling like indigestion and some cases may be experiencing severe pain, heaviness or tightness. The pain is usually felt in centre of the chest, that spreads to the arms, neck, jaw and even to stomach, and is accompanied by palpitation and unusual breathlessness.

If arteries become completely blocked, it can cause a heart attack that can cause permanent damage to the heart muscle. The discomfort or pain of a heart attack is usually similar to that of angina, but is often more severe and may be associated with sweating, lightheadedness, nausea and breathlessness. This is more common in people with diabetes. Heart attack if not treated straight away can be fatal.

How to do prognosis in advance?

Assessment of a suspected CHD patient involves the medical and family history, assessing the lifestyle and taking blood tests. Further tests to confirm a diagnosis of CHD includes non-invasive tests like an electrocardiogram (ECG) to identify the structure, thickness and movement of each heart valve, X-ray to look at the heart, lungs and chest wall to rule out any other conditions that may be causing symptoms, Treadmill test (TMT) during exercise to know the effect of exercise on the heart, Cardiovascular cartography heart flow mapping, CT angiography and the invasive coronary angiography to identify whether the coronary arteries are narrowed and how severe any blockages are.

How to manage the heart ailments?

Although coronary heart disease cannot be cured, but treatment can help manage the symptoms, improve the functioning of the heart and reduce the chances of problems such as heart attacks. Effective management includes a combination of lifestyle changes, medicines and non-invasive treatments. Invasive and surgical treatments are required in more severe cases and the outcomes are favorable in most of the cases, where the person is able to resume their normal life.

Some simple lifestyle changes include eating a healthy balanced diet, being physically active, doing regular exercise, no smoking and controlling blood cholesterol and sugar levels. These can reduce the risk of CHD, stroke and dementia and also have other health benefits. Many different medicines are used to treat CHD. Cholesterol, high blood pressure and diabetes can usually be well controlled with medicines.

Other medicines aim to slow down the heartbeat, thinning the blood and preventing it from clotting. Some of these medicines can cause side effects such as headaches, dizziness and flushed skin, weakness, body-aches, and affect the memory and sexual drive. When taking any medicine for a prolonged period, therefore it is advised to have periodic blood tests especially for kidney and liver function.

While heart failure sounds dangerous, it can be treated with better care and diagnosis. The only and the easiest way to prevent heart failure is avoiding the lifestyle and food habits that encourage obesity, diabetes, high blood pressure. Heart Failure or Cardio Vascular disease refers to the fact that your heart is not as healthy as it should be. You have to take better care of it for better functioning. But the best part is that you can prevent it with a healthy lifestyle.

Dr Balbir Singh
Chairman, Cardiac Sciences
Max Hospital, Saket

The post Progressive heart failure – silent killer among the Indian youth appeared first on Health Vision.

1. Diabetes
2. Smoking or chewing tobacco
3. Hypertension, High cholesterol or a family history
4. Lack of excercise
5. Unhealthy eating
6. Under stress/Lack of sleep
7. And the biggest risk factor is ignorance

Heart failure can be the results of the following factors:

• Coronary artery disease, wherein there is blocking in the arteries of the heart leading to heart attacks and death of part of the heart muscle
• Prolonged valvular heart disease leading to right and left heart failures
• Weakness of the muscle of the heart itself in the absence of any coronary artery disease

Case Study: 

56-year-old smoker suffered a heart attack and was advised surgery, 3 years earlier.  But he was afraid of heart surgery and continued to be on medication, till he developed symptoms of heart failure. He was advised surgery for the blocks in the arteries of his heart along with repair of one of his heart valves. Gradually over a period of a month post-surgery, he was able to regain his normal activities and resume a normal life.

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