About your heart

Heart failure

Heart failure occurs when the heart muscle fails to pump as much blood as the body needs. The faulty pumping means the body doesn't get the oxygen it needs. Pressure in the heart increases and the patient is aware of breathlessness.

Heart failure is usually caused by a problem with the left ventricle. Normally, it pumps out more than 50% of the blood that fills it during each heartbeat. In most heart failure patients, it pumps out less than 40% of the blood that fills it during each heartbeat. As a result, a large portion of blood remains in the chamber, and there is less room for blood coming from the lungs during the next heartbeat. Blood may back up inside the heart and lungs. The heart's lower right chamber may also not be working well.

When the heart does not pump normally, the patient's hormone and nervous systems try to respond. The body may raise the blood pressure, hold on to salt and water and make the heart beat faster. The muscular walls of the heart may get bigger and thicker. At first, all these reactions may help. In time, however, the heart is no longer able to keep up. The symptoms then get worse.

Many people with severe heart disease in time develop heart failure. When and how it develops depends on the type of underlying heart disease.

Although patients with heart disease are living longer, they now have a greater chance of developing heart failure.

The prevalence of heart failure is increasing with the majority of cases due to coronary heart disease (CHD) and hypertensive heart disease, 

Symptoms of heart failure

Heart failure can affect persons of any age, even young children, especially if they are born with a heart defect. It most often affects older persons who may already have hearts weakened by age-related conditions or disease.

In the early stages of congestive heart failure, a person may have no symptoms. When symptoms do develop, they may include:

Causes of heart failure

Heart failure is generally the result of another disease, such as:

Diagnosing heart failure

A doctor will diagnose heart failure using:

Treating heart failure

Treating conditions, such as high blood pressure, thyroid disorders and coronary artery disease, as early as possible can help prevent heart failure. Treatment depends on the cause of the heart failure, how severe the symptoms are and how well the body is able to make up for the heart's not being able to pump enough blood. While heart failure cannot be cured or made to go away, it is possible to make physical activity more comfortable, improve the quality of the life and prolong life.

Heart failure treatments focus on:

Options include:

Heart failure that develops or gets worse quickly needs to be treated on an emergency basis in a hospital. If there is fluid in the lungs, oxygen will be given through a face mask. Diuretics can be injected, and drugs (such as GTN) can be given to improve comfort. In some cases it may be necessary to use a mechanical ventilator to assist in breathing. Certain hormones similar to adrenaline can be given on a short-term basis to help the heart muscle work more effectively.

Get in touch

Dr. Richard Levy MD FACC FESC FRCP

0161 883 0366