1 of 4

Write now Article Tools

Page 2 of 2

rest. In addition, when the patient lies down, fluid from the periphery flows back to the chest region, further complicating the matter. This results in the condition of orthopnea, which is shortness of breath when lying down. Right-sided heart failure, on the other hand, has fluid accumulation in the systemic veins throughout the body. Thus, fluid leakage would occur in the lower limbs around the ankles. The exertion that gravity has on the fluid means that ankle swelling is most prominent at the end of the day. Furthermore, build-up of fluid in the inferior vena cava would travel back to the portal veil in the liver, causing portal hypertension and in the long term, hepatomegaly (enlarged liver). While the distinction between right and left heart failure is useful, it is important to note that over time, both ventricles would become affected and the patient will suffer from all of the symptoms above.

The diminished cardiac output would result in inadequate blood supply around the body as well as a falling blood pressure. The body has several compensatory mechanisms to deal with this problem, not all of which are beneficial in the long run. Firstly, the heart would try to beat faster (tachycardia) to compensate for the fall in cardiac output. This in the long run would aid in the hypertrophy (abnormal enlargement) of the ventricles, deteriorating the condition of the heart. Secondly, total peripheral resistance and vascular tone would increase in an attempt to maintain a normal blood pressure. Thirdly, the rennin-angiotensin system would be activated to retain sodium and water via the kidneys in the hope that the increase in extra-cellular fluid would help sustain a normal blood pressure. While this does help improve the blood pressure, the increase in volume exacerbates the edema (fluid build-up leading to swelling) as well as the heart problem as the heart can't cope with the increase load.

Treatments for heart failure focus on alleviating the clinical symptoms and progression of the disease. If the underlying cause of the heart failure is reversible (e.g. infection, alcohol etc.), then the appropriate steps would be taken. Diuretics are administered to not only remove excess fluids but also prevent the kidneys from retaining more fluids. The patient would also be on a low sodium and water lifestyle to further control their extra-cellular volume. Beta-blockers, although previously contra-indicated for heart failure, is now recommended for acute heart failure as it has been shown to improve ventricular function and thus, cardiac output. If all else fails, heart transplantation should be considered.

In conclusion, heart failure is not a condition where the heart stops functioning but a clinical syndrome in which the heart fails to pump properly. After all, any heart conditions could be critical to one's health. If you suffer from any of the symptoms mentioned above, it is vital for you to seek medical attention as soon as possible. It's better to be safe than sorry.

Reference:

Harrison, T. et al. (2005) Harrison's Principles of Internal Medicine, 16th Edition. USA: McGraw-Hill Companies, Inc.

http://www.nlm.nih.gov/med lineplus/heartfailure.html

http ://en.wikipedia.org/wiki/Heart _failure

Learn more about this author, Y Tian.
Click here to send this author comments or questions.

• << previous page
• 1
• 2

Add your voice

Know something about What is heart failure??
We want to hear your view. Write now!