Heart Failure

May 13, 2017

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. It can affect one or both sides of the heart. Heart failure can affect both children and adults but studies and researches show that there is as strong correlation between incidence of heart failure and old age therefore, it’s more common among older population. 

Heart failure can be determined by special blood tests and echocardiography which shows the structure of the heart mainly the left ventricle which is considered to be the main chamber and responsible for pumping the blood to the whole body.

Heart failure leads to blood and fluid to back up into the lungs, the build-up of fluid in the feet, ankles and legs - called oedema.

Heart failure can be ongoing (chronic), or it may start suddenly (acute).

Patients with heart failure usually get the following symptoms:

  • Feel tired
  • Shortness of breath with physical activity
  • Difficulty breathing while sleeping
  • Wheezing
  • Coughing (especially at night)
  • Gaining weight for no reason
  • Swollen ankles and veins because of fluid that build up in the body


Causes of heart failure

The most common causes of heart failure are diseases or conditions that damage the heart are coronary artery diseases, high blood pressure, diabetes and obesity.

Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help patients live longer. Lifestyle changes can improve patient’s quality of life.

One way to prevent heart failure is to control conditions that cause heart failure, such as coronary artery diseases, high blood pressure, diabetes or obesity.

Management of Heart failure

Different types of medications should be used in the treatment of heart failure and it depends on severity of the symptoms. In this article I will concentrate on brands that are commonly prescribed and available in Oman

The following medications are usually prescribed for patients who suffer from heart failure:

Diuretics ( Furosemide (brand-name Lasix )):

Help gets rid of fluids that gets accumulated in the feet and ankles.

ACE inhibitors (Lisinopril (brand-name Prinivil, Zestril) ):

It relaxes blood vessels and makes them wider so blood can flow more easily. It also reduce the possibility of an early death and slows down the progress of the disease

If patient can't tolerate an ACE inhibitor the doctor may switch to another type of medicine called angiotensin receptor blockers or ARBs (Valsartan). This medicine works similar to ACE inhibitors.

Beta-blockers ( Bisoprolol (brand-name Zebeta) Carvedilol (brand-name Coreg)) :

According to vast researches on beta blocker in heart failure it shows that it protects the heart by slowing down the heartbeat, reduces the possibility of an early death and improves the quality of life of the person with heart failure.

These medications areconsidered to be as first line treatment for chronic heart failure. Other medications too can be prescribed which depend on the severity of the disease which is not covered in this story.

Patient should avoid

There are some medications which patients usually use for pain control which is actually considered to be harmful in patients with heart failure as it worsens the heart failure and patients should avoid them. These medications are ibuprofen and naproxen, and some diabetes medicines such us pioglitazone (brand-name Actos) and rosiglitazone (brand-name Avandia).

Patient are also advised to cut on salt as it leads to water retention. This forces the heart to pump harder. Patients are also advised to do physical activity as much as they can in order to cope and improve their quality of life.