WHAT IS CONGESTIVE HEART FAILURE MEAN AND ITS EPIDEMIOLOGY
Congestive heart failure is a clinical syndrome that arises when the human heart is deprived of pumping adequate blood to support systemic venous return or accomplish metabolic demands.
Prevalence of Heart Failure in the world
Every year about 26 million individuals all over the world experience problems related to heart failure which become a significant global health issue. There are few data available which clearly depict that patients with heart failure in low and middle income countries die at an intense rate than in high-income nations because of many unforeseen circumstances. Also there are few nations which provide limited data on these ailment patients like Africa, Asia, the Middle East and South America whereas Europe and North America contribute a lot to make the world rectify this problem at greater pace.
Prevalence of Heart Failure in United state
Patients with heart disorder especially take 6 medications which are pivotal in this condition but 78% urgently require hospitalization which entitles a huge disturbance in the economy of the country. Over 5 million people in the United State are affected by these critical ailments at a cost of $10–38 billion per year. In the cohort of 1000 persons 10 are affected with heart failure in the USA. The frequency in both the sexes is same upto the age of 65 but men are more affected as compared to women.
LIST OF MULTIFARIOUS SYMPTOMS OF CONGESTIVE HEART DISORDER
Difficulty in breathing.
Tiredness.
Increase heartbeat.
Swollen legs, ankles and feet.
Continuous cough, mostly at night.
Coughing with mucus.
Indigestion and nausea.
Overweight
Frequent Urination
Swollen abdomen.
REASONS WHY THIS DISORDER IS INCREASING AT AN ALARMING RATE
Insufficient supply of Blood to the body
Insufficient supply of blood to the body is also referred to as Ischemia. These sorts of Incidence are burgeoning in developing countries as they adapt a Western diet more as well as improved medical care reduce the infectious rate in these countries.
Imbalance in Body mass Index
One study depicts that individuals who are overweight or obese may acquire a heart diagnosis faster than the person with a lower body mass index (BMI) due to the many reasons like increased cardiac output and myocardial demands. Patients with Congestive Heart failure who are overweight may have less severe myocardial dysfunction than those who are at a healthy weight which ultimately lowers the risk of mortality.
Kidney Disorder
Kidney is the organ which directly controls the proportion of salt and water in the body as well as maintains the amount of blood flow and pressure that the heart generates. The interdependency of one organ towards another can cause an integral cycle in which the disruption of one organ leads to the development of the other which results in a high-mortality condition.
Consumption of Drugs
Drugs may exacerbate congestive heart failure by causing cardiac toxicity, by negative lusitropic, inotropic, or chronotropic effect, via creating high blood pressure, by transferring a high sodium load or by drug-drug interactions that cease the beneficial effects of heart failure medications. To get rid of these negative effects, doctors need a complete and reliable guide of the medications and over the counter drugs that could not exacerbate Congestive heart failure.
Diabetes Mellitus
Person suffering with both diabetes and CVD have an unfavorable diagnostic conditions because in this situation rate of mortality is two to four times higher among people with diabetes compared as compare to the population with other disorders like smoking, dyslipidemia, obesity and hypertension
Intake of Alcohol
Heavy consumption of alcohol inculcates diseases like alcoholic cardiomyopathy, stroke, cirrhosis and pancreatitis. One study depict that heavy consumption of alcohol is a utmost cause of congestive heart failure, so that the diseases related to stroke somehow dependent on alcohol consumption because too much intake of alcohol appears to affect the heart muscle as well as arterial tissues directly.
Intake of chemotherapeutic drugs
There are plenty of chemotherapeutic agents which certainly come under the list of cardiotoxicity such as Cisplatin, 5-flurouracil, Capecitabine, Vinblastine, Bleomycin and Cyclophosphamide and they generally cause the circumstances of acute vascular toxicity, reversible cardiomyopathy, angina pectoris and myocardial infarction.
Genetic Cause
It is a very common way to differentiate the cause of heart disorder into genetic and nongenetic groups. Some environmental teratogens like dioxins, pesticides, polychlorinated pesticides, maternal exposures such as alcohol and antiseizure drugs while infectious agents e.g., rubella are well referred nongenetic causes of congestive heart failure.
HOW THIS COMPLEX DISORDER BORN INTO HUMAN BODY
There are plenty of mechanisms involved to maintain cardiac output and accomplish the systemic demands during the initial stages of congestive heart failure. Chronic sympathetic nervous system stimulates the lowers adrenaline level and beta-receptor sensitivity. Cardiac hypertrophy, Myocyte renewal and myocardial hyper contractility are changed as a result. When the rate of sympathetic drive elevates this causes the salt retention, renin-angiotensin-aldosterone system (RAAS) system and systemic vasoconstriction.
Reduction in the level of cardiac output while up surge of sympathetic drive encourages the RAAS and ultimately leads to increased water and salt retention along with intense vasoconstriction. This mechanism directly causes progressive heart failure additionally the RAAS system secrete angiotensin II, which has been shown to proliferate in the level of myocardial cellular hypertrophy and interstitial fibrosis. System of neuroendocrine is stimulated with the aid of a drop in cardiac output, which causes the secretion of adrenaline, vasopressin, endothelin-1 (ET-1) and norepinephrine.
These mediators bought vasoconstriction which directly increases after load and furthermore inhibits relaxation in cardiac and increases myocardial contractility. The demand of myocardial oxygen is raised with the aid of increased afterload and myocardial contractility. Myocardial cell loss and apoptosis are ultimately caused by this contradictory requirement for higher cardiac output to fulfill myocardial demand. Lastly the exclusive loss of myocytes reduces cardiac contractility, which leads to insufficient Left ventricle emptying while Increased Left ventricle volume and pressure cause congestive heart failure.
DECODING THE DISTINCTIVE WAYS TO EVALUATE CONGESTIVE HEART FAILURE IN HUMAN BODY
During the evaluation of Congestive heart disease a complete assessment is required. This instills the complete test of blood, HB profile, liver and kidney profile. Depending on the clinical and etiological data patients need further investigations in metabolic and blood rate.
Blood Test
CBC test confirm the lack of blood in the body or leukocytosis of an infection triggering Congestive heart failure.
Renal Profile
A comprehensive renal profile is important for all the patients with congestive heart failure. It reflects the degree of renal injury associated with heart failure as well as depicts the baseline renal function before consumption of medicines, like renin-angiotensin-aldosterone (RAAS) inhibitors, sodium-glucose transporter-2 (SGLT-2) inhibitors, or diuretics.
Liver profile
Elevation in the levels of gamma-glutamyl transferase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) results in hepatic congestion caused by heart failure.
Urine study
The presence of amyloidosis, then the test of urine and serum electrophoresis should be evaluated. Bone scintigraphy can be performed when clinical analysis is high rather than negative testing.
Electrocardiogram
Electrocardiogram probably indicates the history of arrhythmia, infarction, expansion of the chamber and delay in intraventricular conduction. This also suggests various hints related to etiology. In cardiac amyloidosis, an ECG with a low voltage and pseudo infarction pattern is seen.
Echocardiography
Echocardiography is the primary choice of monitoring the patients with suspected heart failure and it is very accessible and basically bedside tool. This tool depicts the right and left ventricular function as well as reflect structural disorders in cardiac chambers which aids in the visualization of focal wall motion. Whereas the patients with severe weight, pregnancy, or mechanical ventilation this tool is complicated may be challenging to obtain adequate outcomes.
Computed tomography
This technique may be utilized for the analysis of coronary artery disorder in the youngsters along with ventricular abnormality. To monitor the congenital heart diseases in patients CT is very essential and easily available. Stent patency and graft evaluation can also be performed with the aid of CT.
Genetic testing
This is completely used to know about the presence of inherited traits causing cardiomyopathies like laminin A or C, titin, myosin heavy chain and cardiac troponin-T mutations.
DIFFERENT WAYS TO RECTIFY THIS COMPLICATED DISEASE
The type of heart problem you have and the reason beside this will determine how you are treated. Every treatment approach for heart failure includes both lifestyle alteration and medications. The ideal course of therapy for you will be discussed with you by your medical practitioners. Heart failure has no known treatment. You progress to the next stage of heart failure when your congestive heart failure worsens and your heart muscle pumps less blood to your organs. Because the phases of heart failure are irreversible, the aim of treatment is to prevent you from going through them or to slow down the rate at which your heart failure is progressing. This is the type of disease that worsens with time and occurs in four stages of treatment A, B, C, and D.
Stage A treatment
Regular exercise
Intake of low sodium diet
No alcohol and other drugs
Low level of salt and sodium in diet
Intake of Angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin II receptor blocker (ARB)
Stage B treatment
Same treatment based on lifestyle and diet given in stage A.
Prescribed dosage of Angiotensin-converting enzyme inhibitor.
Prescribed dosage of Beta-blocker if you suffer from heart attack
Undergone surgery as the treatment of artery blockage, heart attack, valve disease
Stage C treatment
Beta blockers intake
Treatments from Stages A and B.
Aldosterone antagonist.
Consumption of prescribed Sodium-glucose transport 2 inhibitors (SGLT2).
Intake of Medicines which reduce your heart rate if your heart rate is faster than normal.
Intake of Diuretics.
Forbidden sodium (salt) in your diet.
Maintain the body weight ratio
Possible fluid restriction.
Stage D treatment
This included the most complicated treatment for congestive heart failure.
Transplanting of Heart
Surgery of Heart.
Continuous infusion of inotropic drugs.
Palliative care.
FREQUENTLY ASKED QUESTIONS
Question: What is Congestive Heart Failure?
Heart failure does not reflect that its working is disrupted whereas it is still in action but not with proper systematic function which is oftenly referred as congestive heart failure (CHF), this is basically a sort of chronic, progressive illness arise when the human cardiac system does not provide an adequate oxygen-rich blood to meet the body's demands.
Enlist various symptoms of Heart disease?
There are different signs and symptoms which depict the chances of heart failure like short breathing, fatigue, wet cough, irregular heart rate, too much urination, heavy chest and so on.
What are the most common causes of heart failure?
The most ubiquitous causes of heart failure in this current era are high blood pressure, difficulty in valves, inflammation in heart arteries, diabetes, lung problems, insomnia and personal tensions.
How is Congestive Heart Failure monitored?
To diagnose the failure of heart, your doctor examines you and asks questions based on symptoms and medical history. After that your physician told you about different tests for deep understanding like blood test, CT scan, Electrocardiogram, Chest x-ray, Heart MRI and so on.
How can one treat the critical circumstances of Congestive Heart Failure?
The initial goal of treatment is to rectify your signs and to reduce the progression of the disorder by smoothing the workload of your heart. Your doctor would prescribe a combination of the medications while Lifestyle changes such as smoking, eating a healthy diet and being physically active is the most appropriate way. Additionally medicine such as B-blocker, angiotensin-converting enzyme (ACE) inhibitor, diuretic, vasodilator or calcium channel blocker are also essential for rectifying this disorder.
What are the various stages defined for the treatment of Congestive Heart Failure and which one is most complicated?
There are a total of four stages such stage A, stage B, stage C and stage D while D stage is the most complicated one because this involves the need of surgery and transplantation of heart.
Discuss in a brief about the drug used in Heart Failure?
There are few drugs which are always prescribed by a patient physician according to the level of problem such as beta blockers, SGLT-2 inhibitors, RAAS inhibitors and Diuretics. They are sometimes swallowed in combination with others to increase their effectiveness.