failureheart.com

Types of Heart Failures

admin — Fri, 24 Jul 2009 05:27:53 +0000

In general. there are three varieties of heart failure :
· Dilated cardiomyopathy
· Hypertrophic cardiomyopathy
· Diastolic heart failure.
Dilated cardiomyopathy
This type of heart failure is the most common variety. It also referred to as congestive cardiomyopathy or congestive heart failure often. When the ventricles (the large pumping chambers of the heart) are weakened, flaccid and dilated, it leads to dilated cardiomyopathy. Thereby, the pumping action of the ventricle becomes weak, and it fails to pump adequate amount of blood with each heart beat to various organs. Other types of heart diseases, especially coronary artery disease and valvular heart disease end in dilated cardiomyopathy.
Hypertrophic cardiomyopathy
This type of heart failure is a common congenital heart disorder (affecting almost 1 in 500 people) and it is genetic disorder occurring in members of same family. Hypertrophic cardiomyopathy (HCM) is characterized by a thickening of the heart muscle, resulting in “stiff” a ventricle which distorts the filling of the heart with blood. This leads to symptoms like extreme shortness of breath, especially during exercise. Obstruction in the left ventricle similar to that seen with aortic stenosis, may also be seen due to the thickening of the heart muscle.. Increased risk of sudden death is seen in some patients with hypertrophic cardiomyopathy.
Diastolic heart failure
This is akin to hypertrophic cardiomyopathy in terms of “stiffening” of the heart muscle, causing impairment in filling of the heart with blood. But diastolic heart failure does not involve thickening of the heart muscle, nor is it a genetic disorder. Elder people are more prone to this, more often in women and in patients with high blood pressure. The symptoms include sudden episodes of severe shortness of breath, due to blocking of fluid in the lungs. Such condition is called pulmonary edema.

Treating diastolic heart failure and diastolic dysfunction

admin — Fri, 24 Jul 2009 05:25:59 +0000

The important aspects of treating diastolic dysfunction and diastolic heart failure include aggressive management of the underlying cause. The major principles of treatment are as follows:
· Both systolic and diastolic high blood pressure is critical and should be aggressively managed.
· Coronary artery disease should be aggressively treated. Note that undiagnosed and asymptomatic coronary artery disease is a major cause of diastolic dysfunction.
Atrial fibrillation must be carefully managed. In patients with atrial fibrillation, rate control is good as arrhythmia control. But in patients with diastolic dysfunction, restoration of normal rhythm must be aggressively attempted for the better course. Aggressive heart rate management is mandatory, if atrial fibrillation persists.
· Pulmonary congestion must be controlled with diuretics pills that eliminate sodium and water via the kidneys.
Three things should be considered when there is no underlying cause for diastolic dysfunction is found. First, the common cause of diastolic dysfunction could be undiagnosed (or mild) high blood pressure. Careful management of high blood pressure would be useful. Second, undiagnosed coronary artery disease may be the cause of diastolic dysfunction although it is treatable. Undetected coronary artery disease may be identified with exercise testing in many patients with diastolic dysfunction. Third, an exercise program may be quite useful as aerobic exercise can improve the diastolic function of the heart.
What is the Prognosis of Diastolic Dysfunction?
Diastolic dysfunction is a “new” disorder” and it was unknown to cardiologists. However, it is rapidly being recognized and it is now one of the most common diagnoses by echocardiography labs.
Symptomatic diastolic dysfunction (diastolic heart failure): Somewhat better prognosis is observed in patients who have had an episode of diastolic heart failure than in patients with common systolic heart failure. But prognosis is far worse than patients without heart failure or diastolic dysfunction. Patients should be aggressively managed and treated even after their acute episodes of heart failure have been resolved considering its relatively poor prognosis.
Diastolic dysfunction without symptoms: A few studies have indicated that patients with asymptomatic diastolic dysfunction may have a higher mortality than normal. This observation may be true considering the underlying causes of diastolic dysfunction. Also, high blood pressure and undiagnosed coronary artery disease “under treated” by doctors. Diastolic dysfunction is an important condition and a careful search for underlying causes should be promptly searched. If nothing else, women who are prone to develop significant heart disease should be given careful attention considering the increasing recognition of diastolic dysfunction.

Symptoms of Heart Failure

admin — Fri, 24 Jul 2009 05:22:33 +0000

The symptoms of heart failure generally fall into three categories despite whether heart failure is caused by dilated cardiomyopathy (cardiomyopathy is heart muscle disease), hypertrophic cardiomyopathy, or diastolic dysfunction.
They are
1) Symptoms due to pulmonary congestion:
Pulmonary (or lung) congestion is a situation when the heart is fails to fill with blood, the pressures increases inside the heart and the blood builds up or “backs up” into the lungs. The symptoms of pulmonary congestion include shortness of breath, most often during exertion or while lying down. With progress of heart failure, these symptoms gradually get intensified leading to physical incapacity. “Acute pulmonary edema,” or sudden, severe episodes of shortness of breath may also occur which demand immediate medical emergencies. Much worse, changes in blood hormones occur in many patients with heart failure. These changes cause salt and water retention in the kidneys. Consequently, swelling (or edema) occurs in the legs, and in more pulmonary congestion. Pulmonary congestion symptoms are common in all three types of heart failure.
2) Symptoms due to poor cardiac pumping action:
In relatively later course of dilated cardiomyopathy, the heart muscle has become extremely weak and the symptoms caused by decreased cardiac output or poor cardiac pumping are seen. These symptoms are uncommon in Hypertrophic cardiomyopathy and diastolic heart failure as those conditions have well-preserved cardiac pumping action. The weakened heart muscle can no longer pump enough blood adequately supply the demand of body’s organs. Extreme fatigue and muscle wasting are most prominent symptoms due to poor pumping. Sometimes, the poor blood flow to organs like the brain, liver, kidneys, and intestines can reduce their function, leading to a myriad of other symptoms including lethargy, abdominal distention, extreme edema (swelling) and numerous gastrointestinal symptoms.
3) Symptoms due to cardiac arrhythmias:
All the three types of heart failure are linked with heart rhythm disturbances. The atrial fibrillation is most common. The chances of atrial fibrillation are more with the gradual worsening of the heart. Ventricular tachycardia or ventricular fibrillation is due to very rapid and disorganized heart rhythms originating in the ventricles. This leads to sudden deaths in patients with heart failure, specifically in patients with dilated cardiomyopathy, and some forms of hypertrophic cardiomyopathy. Ventricular arrhythmia is common and almost one out of three patients with dilated cardiomyopathy experiences suddenly death. Therefore, due to this reason, patients with significant dilated cardiomyopathy should be considered for implantable defibrillators.

Risk Factors of Heart Failure

admin — Fri, 24 Jul 2009 05:20:16 +0000

The annual number of patients with heart failure have risen dramatically. In 1970, there were only 250,000 cases but today, nearly 5 million Americans suffer from heart failure and about 550,000 new cases of heart failure are diagnosed each year. Such numbers indicate an increasingly older population. Heart failure is most common in people over age 65, African-Americans, and women. Although there has been a dramatic increase in heart failure patients, survival rates have also improved greatly.
High blood pressure and coronary artery disease are the main causes of heart failure. Other diseases which damage or weaken the heart muscle or heart valves can also lead to heart failure. The risk factors for heart failure include:
· Advancing Age
· Gender
· Ethnicity
· Family History and Genetics
· Diabetes
· Obesity
· Thyroid Problems
Advancing Age
Elder people have highest risk of heart failure and as the population ages, the incidence of heart failure is rising dramatically. According to a study, 10 in 1,000 people after age 65 have heart failure. The positive aspect is, however, that people are living longer despite heart failure.
Gender
Men have higher risk for heart failure than women. However, this difference narrows with age. Also, if heart failure is caused by valvular heart disease, high blood pressure, or alcohol abuse, women have a better survival rate than men do. This is possibly due to the fact that men may be more susceptible to remodeling process of heart muscle-cell, which is a damaging effect of hypertension.
When heart failure evolves from coronary artery disease or heart attack, tThe survival rates of women and men are more similar. Also, after a heart attack, women are much more likely to develop heart failure than men. The reasons for this include less aggressive approaches to treatment for the initial heart conditions.
Ethnicity
Ethnicity is also a risk factor for heart failure. African-Americans may be at higher risk for heart failure than Caucasians. Diastolic heart failure, where heart muscle fail to relax normally, is more likely in African-Americans than in Caucasians. Caucasians tend to develop systolic heart failure first.
Family History and Genetics
The risk of developing heart failure in people whose parents had heart failure is higher, particularly left-ventricular systolic heart failure. A family history of cardiomyopathies may also lead to heart failure. Research on identifying the changes in specific genes that might regulate systems involved in heart failure is on-going which may help in increasing in susceptibility in certain populations.
Diabetes
People with diabetes are at high risk for heart failure. If they also have coronary artery disease, risk is further high. Even blood sugar abnormalities also increase the risk.
Obesity
Obesity is a major risk factor for heart failure, particularly in women. Also, obesity is associated with both hypertension and type 2 diabetes. These conditions lead to heart failure.
Thyroid Problems
Risk for heart failure may be increased with an overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism).