What is it
Heart failure, also called heart failure, is the inability of the heart to pump blood into the blood vessels to an adequate extent.
In other words, the heart muscle (myocardium) does not “work” as intensely as it should: it does not fill adequately with blood or does not have enough strength to empty itself and therefore cannot push blood throughout the body.
This results in less blood in peripheral tissues and organs, and therefore less oxygen and nutrient supply.
Find out why Coenzyme Q10 is useful in case of decompensation by reading this article.
Diffusion
It is estimated that there are 22 million people in the world suffering from heart failure, of which over 12 million in Europe.
In Italy, the latest surveys speak of about one million cases. Every year in our country there are 170 thousand new cases and every day there are 500 hospital admissions.
In recent years, the number of hospitalizations for decompensation has increased by 40 percent.
Heart failure is strongly linked to age: it affects between 6 and 10 percent of the population aged 65 and over, while about half of those suffering from heart failure are over 65 years old.
Causes
There are many risk factors for heart failure: in most cases they can be reduced if not eliminated by intervening on lifestyles and behaviors.
The main risk factors are:
- elevated cholesterol (hypercholesterolemia)
- smoke
- hypertension
- diabetes
- overweight and obesity
The most common causes are diseases that affect the coronary arteries, such as myocardial infarction. Also some dysfunctions of the heart muscle, such as dilated cardiomyopathies, infections or inflammation of the same, called myocarditis, can cause heart failure.
It has also been shown that some people are more likely to develop heart failure than others. However, it is practically impossible to predict with certainty whether there will be an imbalance, both in the short term and in the long term.
Symptoms
Heart failure can be asymptomatic or symptomatic. In the first case, no symptoms are observed, and therefore it is difficult to recognize.
Symptomatic decompensation, on the other hand, is felt with its typical symptoms, such as:
- feeling tired and weak
- difficulty breathing, shortness of breath, shortness of breath (dyspnoea).
These first signs usually arise after physical exertion. The following may also arise:
- coughing attacks
- shortness of breath at night
- Dizziness associated with mental confusion.
When the disease enters the more advanced stages, the symptoms worsen both in terms of frequency and intensity: you may feel a difficulty breathing even after performing simple activities, such as dressing or walking around the house.
Diagnosis
Based on the symptoms, the doctor can assess whether they are temporary abnormalities or whether it is necessary to investigate the situation.
Diagnostic tests generally consist of:
- Chest X-ray
- electrocardiogram
- echocardiogram
The diagnosis of heart failure derives from an overall evaluation of the clinical picture, especially when age is advanced: with the passing of the years it is easier to find the concomitance of multiple pathologies such as peripheral vasculopathies, kidney diseases, lung diseases that can influence the diagnosis.
The four stages of heart failure
The evolution of heart failure consists of four phases: Phase 1. The heart is not yet decompensated, but some diseases, including high blood pressure, diabetes mellitus, coronary heart disease, and the use of cardiotoxic drugs can promote the evolution towards heart failure. At first, normal everyday physical activity does not cause fatigue, difficulty breathing, or palpitations. Step 2. Heart disease is present, even in the absence of symptoms. At this stage you may feel a slight physical limitation. Step 3. Symptoms of decompensation appear, and limitation of physical activity becomes relevant. At rest they are not felt, but arise by performing physical activity of intensity below the daily threshold. Step 4. At this stage, it is almost impossible to perform any physical activity without experiencing symptoms, which are perceived even during rest. Many of the therapies available are not effective and hospitalization in specialized centers or, ultimately, heart transplantation is often necessary.
Therapies
Heart failure is not easy to cure, and the complexity of treatment is proportional to the stage of the disease.
Often, in addition to pharmacological treatment, non-pharmacological interventions are prescribed in order to contain the symptoms and control the physiological mechanisms that regulate the progress of the disease.
The most commonly used drugs are:
- ACE inhibitors
- Diuretics
- Beta-adrenergic receptor antagonists
- Aldosterone receptor antagonists
- Angiotensin II receptor antagonists
- Cardiac glucosides
- Vasodilators
- Positive inotropics
- Anticoagulants
- Antiarrhythmic
- Oxygen
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.