Heart failure is a common cause of many residents of Anguilla being patients in the hospital. Heart failure causes a variety of clinical findings some of which can be fatal if not treated.

What is Heart failure?

Dr. Brett Hodge

Heart failure is the inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. It does not mean that the heart has stopped beating, but that the heart’s pumping power is reduced and blood moves through the heart and the body at a slower rate. As a result the chambers of the heart starts to stretch to hold more blood but over a period of time the heart’s muscle walls weaken and are unable to pump as normal.
Heart failure develops and as a result the kidneys often respond by causing the body to retain water and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs or other organs, the body becomes congested and the condition is then termed congestive cardiac failure.

What causes Heart failure?
There are many causes of heart failure. Common causes include the following:
• High blood pressure
• Coronary artery disease-disease of the arteries of the heart
• Heart attack-causes damage to heart tissue
• Longstanding alcohol abuse
• Heart valve disease
• Kidney disease
• Heart defects from birth

How do you know that you have heart failure?
The symptoms may vary from one individual to another. Some symptoms are not severe while others are very severe. Symptoms of heart failure include:
• Shortness of breathe - the lungs become congested and shortness of breath may occur with mild exercise or when lying flat in bed. A dry, hackling cough may occur
• Oedema - fluid retention results in swollen ankles, legs and abdomen and weigh gain. There may be increase need to urinate especially at nights
• Dizziness, fatigue and weakness
• Rapid or irregular heartbeats
If you have one or any of these symptoms you should see your doctor for a complete evaluation as the symptoms may also occur in other diseases.

How is Heart failure diagnosed?
Your doctor will take a complete history and carry out a physical examination. Your doctor will then arrange for a number of other tests to determine the cause and severity if your heart failure.

Treatment
There are a number of treatment options now available to successfully treat heart failure. The main aim is to decrease further progression of heart failure and lessen the symptoms. Individuals with heart failure have to work with their doctor closely and take medications as prescribed. Surgery may be required in some cases.

Can I prevent heart failure from worsening?
If you are hypertensive it is advisable to keep your blood pressure as low as possible so that the heart can pump effectively.
If you are a smoker you should stop smoking.
If you are obese or overweight try to reach and maintain your healthy weight.
Do not abuse alcohol.
Exercise regularly as directed by your doctor.
Follow your diet plan as directed.
Monitor your symptoms and contact your doctor if new symptoms occur or if symptoms worsen.

Medications to avoid
You should discus this topic with your doctor, but it a good idea to avoid the following if you have moderate to severe heart failure:
• Painkillers such as Motrin or Aleve
• Some nutritional supplements
• Antacid that contains sodium
• Decongestants such as Sudafed.

Prognosis
Treating heart failure is a team effort and involves many professionals, but the patient is the most important person in the team. The prognosis of individuals with heart failure will depend on how well their heart muscle is functioning, severity of symptoms and how well individuals respond to and follow their treatment plan. The majority of patients with heart failure with the right care can be treated successfully. Heart failure like other chronic long-term conditions requires the support of the entire family and other relatives as well.

Conclusion
Heart failure is a group of clinical findings rather than a single disease. The underlying causes of heart failure are numerous but the most common are high blood pressure and coronary heart disease. Individuals with symptoms suggestive of heart failure should see their doctor and once diagnosed should follow the treatment plan developed with their healthcare provider. Treatment will allow patients with heart failure to improve their quality of life and even prolong their lives.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr. Brett Hodge is an obstetrician/gynaecologist and family doctor who has over twenty years in clinical practice. Dr. Hodge has a medical practice in the Johnson Building in The Valley.

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