ВТОРОЕ МЕДИЦИНСКОЕ ЗАКЛЮЧЕНИЕ
Heart Failure Symptoms

The heart is the vital organ that pumps a certain amount of blood to the body with each contraction, providing oxygen and nourishment of tissues and organs. In heart failures caused by different reasons, the heart cannot pump the blood that the body needs. As a result, fluid accumulation occurs in different body parts, especially in the lungs. Heart failure can be chronic as well as acute. If the disease is not treated, it can cause serious life-threatening problems. Before moving on to treatment methods for heart failure, the question "What is heart failure?" should be answered and attention should be paid to its symptoms. 


What is Heart Failure?


Heart failure is a health problem characterized by deterioration in body functions as a result of the heart's inability to pump enough blood to the body. The heart can sometimes enlarge and begin to grow in size to tolerate this deteriorating condition. For this reason, heart enlargement accompanying heart failure is among the most common conditions. Heart failure, which is mostly seen in men, leads to a higher death rate in women if left untreated. 


Heart failure is a condition that affects both sides of the heart. In cases of acute heart failure, symptoms appear suddenly and then quickly disappear. The cause of this condition may be a heart attack or a problem in the heart valves that control blood flow. However, the symptoms seen in chronic heart failure go on continuously and do not improve over time. The vast majority of heart failure cases are chronic ones. 


What is Congestive Heart Failure?


While heart failure can affect both sides of the heart, in some cases only one side of the heart is affected. In most cases, the left side of the heart is primarily affected. After diastolic failure or left ventricular systolic failure, this condition can also affect the right side of the heart. 


Congestive heart failure, also known as right heart failure, can be of unknown cause (idiopathic) or can occur with increased blood pressure (pulmonary hypertension), often in the arteries that carry blood to the lungs. Therefore, due to the slowing of the blood's entry and exit to the heart, blood accumulations can be seen in some areas of the body. 


In cases of congestive heart failure, back pressure is seen from the heart to the venous system. Peripheral edema is also seen. Peripheral edema mostly occurs in the abdomen, legs and feet. Edema is frequently observed in the hips and back in hospitalized patients. 


Symptoms mostly seen in the presence of congestive heart failure; anorexia, swollen neck veins, fatigue, weakness, shortness of breath (dyspnea), liver enlargement (hepatomegaly), spleen enlargement (splenomegaly), S3 gallop rhythm and hypertension caused by salt and water accumulation. If congestion occurs in the intestines, indigestion occurs. 


Heart Failure Symptoms

Symptoms of heart failure are those that become more severe as the disease progresses. For this reason, it is very important to know the symptoms and to follow them meticulously, to intervene before the stages of heart failure progress. A patient may experience one or more of the following symptoms: 


    Loss of appetite, 

    Quick fatigue, 

    Nausea, 

    Sudden weight gain, 

    Pink or white sputum, 

    Arrhythmia (irregular heart rate), 

    Swelling in the legs, abdomen and ankles (edema), 

    Palpitations, 

    Dizziness, 

    Constant sleepiness, 

    Difficulty concentrating, 

    Frequent urination at night, 

    Prominence of blood vessels in the neck area, 

    Depression and/or anxiety, 

    Making a whistling sound when coughing or exhaling. 


Heart Failure Treatment


The question of whether there is a cure for heart failure is a phenomenon that many people wonder. A diagnosis of heart failure should first be made for the patient who applies to the health institution with signs and symptoms before treatment methods. For this, after the physical examination, some tests are done to investigate the heart functions. Among them, the most effective method is known as echocardiography (ECHO). The heart is examined in detail with the ECHO device, in which sound waves are used. Existing structural defects and damages are detected in this way. Afterwards, blood tests, chest x-ray, exercise test, lung function test, magnetic resonance imaging, angiography, cardiac catheterization, tomography and nuclear medicine methods are used for the differential diagnosis of heart failure. 


The priority in the treatment of heart failure is to stop tissue damage and to eliminate the symptoms that affect daily life by maintaining the current health status of the person. The lifestyle and nutritional habits of the patient are examined, and recommendations are made to support the treatment of heart failure. In addition, according to the current state of the disease, treatment with medication or surgical methods can be planned. 


Heart failure drugs are used according to the severity of the disease and complaint status during the treatment process. Medicines used in this context; diuretics (diuretics), beta blockers, digoxin, angiotensin converting enzyme inhibitors, rhythm regulators, blood thinners, vasodilators, aldosterone blockers, angiotensin receptor blockers and cholesterol reducers. 


If there is a problem in the electrical conduction of the heart or a heart rhythm abnormality within the scope of device treatment and surgical intervention, special devices such as pacemakers are used to reduce the patient's complaints and prolong the life span. Apart from this, stent placement in the heart vessel, bypass surgery and heart valve operation may be required. Of course, heart transplantation can be said as the most effective and permanent treatment method for advanced heart failure. 


Stages of Heart Failure


1. Stage: Defined as the first stage of heart failure. Since the risk factors are high, the development of heart failure is considered as possible. These patients are mostly people with a family history of heart failure, high blood pressure, diabetes and coronary artery disease. These people, who are at high risk, should not smoke or drink alcohol, always keep their cholesterol levels in balance, exercise regularly, and take the medications prescribed by the doctor without interruption. In stage 1 patients, the usual daily physical activity restrictions do not occur. However, obstruction and shortness of breath during heavy exercises are among the most common complaints. 


2. Stage: Heart failure is often seen in the patients in this stage due to the diagnosis of systolic left ventricular dysfunction. It is recommended that the person use angiotensin-converting enzymes and have an active lifestyle. If these people have a heart attack, they should definitely use beta-blockers. If coronary artery occlusion or a problem in the heart valves is detected in patients who are under the constant control of a doctor, surgical intervention is performed. In stage 2 patients, complaints such as heart palpitations, shortness of breath and/or obstruction occur in daily physical activities. In other words, moderate limitation of physical activities is observed. 


3. Stage: When patients diagnosed with heart failure reach this stage, constant fatigue, shortness of breath, frequent urge to urinate at night, swollen and weakened legs and blistered abdomen are seen. Patients at this stage should never consume alcohol and cigarettes. Apart from this, beta blockers should be used in order for the heart muscle to pump strongly, salt consumption should be reduced and exercise should be done with plenty of physical activity. Patients in stage 3 have significant limitations in normal daily activities. 


4. Stage: It is considered the last stage of heart failure. In these patients, the heart cannot fully pump blood. The person should be treated with ventricular assist devices or heart surgery as soon as possible and use intravenous inotropic drugs. End stage heart failure is an extremely risky stage in terms of the lifespan. If the patient does not respond to other treatment methods, a heart transplant should be performed as soon as possible. In patients in the 4th stage, complaints are seen even at rest. Heart failure does not allow even the person's usual daily physical activities. 


Does Heart Failure Kill?

Heart failure is a very serious health problem that reduces the quality of life and threatens life in advanced stages. The best answer to the question of whether heart failure kills is that it is not heart failure, but being late in diagnosis and treatment that causes loss of life. Therefore, early diagnosis of heart failure provides a serious reduction in death cases. 

Regularly checking heart health is very important against heart failure. Detection of the disease at the initial stage is necessary in order to minimize the damage it causes on the heart. Taking the prescribed drugs on time increases the quality of life and duration of the diagnosed patients. 

Acute Heart Failure

The vast majority of heart failure cases fall into the chronic group. In such cases, there is no improvement over time as the symptoms persist. However, if the symptoms appear suddenly and then disappear rapidly, acute heart failure can be mentioned. 


The causes of acute heart failure are divided into those of "cardiac origin" and those of "non-cardiac origin". These are: 


Cardiac origin: 

    Endocarditis 

    Acute coronary syndrome, 

    Heart valve failure/stenosis 

    Acute myocarditis 

    Acute arrhythmia 

    Pericarditis


Non-cardiac origin: 

    Anemia 

    Surgical interventions 

    Alcohol use 

    Kidney dysfunction 

    Alcohol use 

    Non-compliance with the course of treatment 


In order to prevent acute heart failure, it is necessary to maintain a healthy weight, limit smoking and alcohol use, control stress, perform regular and personalized exercise, and visit the heart specialist regularly. 

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