Heart Failure

... does not mean that the heart failed

Heart failure is a serious medical condition in which the heart is failing as a pump and is not able to provide sufficient blood supply to the body. The heart can therefore no longer deliver enough oxygen to meet metabolic demands of the organism. The most common cause of heart failure is heart attack due to coronary artery disease and dilated cardiomyopathy (enlarged and weakly pumping heart muscle with normal coronary arteries).

Heart failure can affect people of any age but it is most common in the elderly. More than 5% of individuals aged 60-69 are suffering from some stage of heart failure, and in over 65s, it is the main cause of hospitalization. Heart failure is slightly more frequent in men than in women, mainly due to the differences in the prevalence of coronary artery disease. Survival rates depend on the severity of the heart impairment, age, general health and the treatment.

A plenty of treatment options for heart failure are available today. Medication combined with dietary and lifestyle changes give good results in the early stages of the disease. Some of the drugs useful in heart failure are ACE inhibitors, ARBs (angiotensin receptor blockers), beta blockers, aldosterone antagonists, ivabradine, diuretics and digoxin.

Sometimes, surgical procedures are required. CABG (coronary artery bypass grafting) improves blood supply to the heart muscle which can improve contractility. Valve surgery (valve repair or valve replacement) can help to offload the heart and thus also improve its pumping function. Patients with dyssynchronous cardiac contraction  with LBBB (left bundle branch block on ECG) benefit from biventricular pacemakers which may be combined with ICD (i.e. cardiac resynchronisation therapy with or without defibrillator, CRT-D or CRT-P. One of the newest treatment options is the implantation of LVAD (Left Ventricular Assist Device) or TAH (total artificial heart) which take over some of all pumping for the failing heart. The ultimate resort in some patients may need to be heart transplant, which is however often not available immediately due to the lack of suitable donors.

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