The heart is directly responsible for pumping oxygen to our vital organs and tissues. During our daily activities, oxygenated blood is being used up during our functioning and thus, needs to be replenished. Deoxygenated blood is returned to the heart via the superior and inferior vena cava. Once blood is returned to the right atrium, the heart cycle begins. The right atrium contracts and pumps deoxygenated blood through the tricuspid valve to the right ventricle. From here, the right ventricle sends the blood out through the pulmonary valve to the lungs, where it can be oxygenated. Thus, the consequences of right heart failure can be vast. If an adequate supply of blood is not being sent to the right ventricle, or the right ventricle simply loses its ability to hold a large blood volume supply, the heart cycle suffers. Once the blood is oxygenated in the lungs, it is returned to the heart via the pulmonary vein to the left atrium. This vein is rare as it is one of the only veins in the body that carries oxygenated blood. The left atrium contracts, and pumps blood through the mitral valve into the left ventricle. The left ventricle pumps this oxygenated blood out through the aortic valve and the aorta to the whole body and thus, it is bigger than the right ventricle. Left heart failure is very serious as the oxygenated blood supply is cut off and tissues begin to suffer from hypoxia. It should be apparent that the left side of the heart carries only oxygenated blood and the right side of the heart carries only deoxygenated blood. Thus, they must work in conjunction to deliver blood to the body. Some heart failure symptoms include chest pain, fatigue, and shortness of breath. Diagnosis of heart failure should be done by a licensed health professional if you experience any of these symptoms.
Heart Failure Causes
Left heart failure and right heart failure causes are essentially very similar. Heart failure pathophysiology results from the being unable to work at 100% efficiency due to damage to the surrounding muscles. Common heart failure causes include coronary artery disease, cardiomyopathy, heart attack, high blood pressure, diabetes and thyroid disease.
Coronary Artery Disease
Coronary artery disease is especially troubling as it directly relates to the arteries of heart. Heart failure pathophysiology relates to the arteries becoming narrowed and thus, having a decreased supply of oxygen and blood flow that is allowed to go to the heart. Depending on the specific artery involve, this can result in both left and right heart failure.
Cardiomyopathy is a term that is used to describe diseases of the heart muscle (myocardium). Cardiomyopathy results from excessive alcohol consumption, prolonged smoking, and obesity. The myocardium becomes stiff and non-elastic which evidently promotes smaller contractions and a decreased capacity of blood volume. This contributes to less blood being pumped out of the heart per cycle and the heart tries to compensate for this, becoming overworked. Depending on the type and severity of cardiomyopathy, treatment may include lifestyle changes and heart failure medication.
Heart Attack and decompensated heart failure are directly related. Decompensated heart failure is an immediate increase in the severity of heart failure symptoms, which can trigger a heart attack. Heart attacks contribute to scarring of the myocardium and the heart tends to stiffen and become less flexible to accommodate blood volume. It is imperative to receive an accurate diagnosis of heart failure to prevent decompensated heart failure and heart attacks.
High blood pressure is arguably the most common cause of left heart failure and right heart failure. Hypertension has many causes, with the most common being narrowing of the arteries and added stress in our lives. Hypertension is added pressure for the arteries to pump blood to the body, increasing the hearts workload. This is correlated with increased risks of left and right heart failure. Monitoring blood pressure is absolutely critical in avoiding heart related problems in the future.
As diabetes rises, so does left heart failure and right heart failure. Heart failure pathophysiology is related to high blood sugar levels, which can be damaging to the blood vessels in the body. Any damage can create an excessive workload on the heart that promotes the risk of heart failure symptoms and failure.
Depending on the type of thyroid disease, the thyroid can release increased levels of a hormone called thryoxine. This hormone can indirectly increase heart rate and thus, the hearts workload. Prolonged exposure to this hormone can lead to heart failure.
If you have a history of any of the above causes of heart failure, it is best to consult with a licensed health professional to discuss how you can minimize your risks of left heart failure and right heart failure.
Heart Failure Symptoms
Heart Failure symptoms have the potential to drastically impact of lives, thus a proper diagnosis of heart failure is critical for accurate treatment. Heart failure symptoms include chest pains, swelling, shortness of breath, fatigue and trouble exercising.
Chest Pain is a direct result of the heart becoming overworked. The heart is trying to compensate for a decreased blood flow to the body and has to work harder to achieve the same efficiency as someone without left heart failure and right heart failure. If you experience any form of chest pain, you should immediately seek medical assistance.
Swelling is another common heart failure symptom. Swelling is caused by a decreased blood flow out of the heart, and thus as blood returns to the heart, it begins to pool in the tissues. Common places for heart failure swelling are in the limbs and ankles.
Shortness of Breath
Shortness of breath relates to the heart slowly becoming less efficient. The heart cannot keep up with the demand of oxygen for the tissues. This creates a situation where shortness of breath is inevitable and very common in people with left heart failure especially.
Fatigue or Trouble Exercising
This is also a result of the heart not being able to adequately supply the muscle and tissues of the body with the oxygen it needs. Thus, with heart failure, it is imperative to ask your doctor what level of exercising is good for you.
If you are currently experiencing any of the above symptoms, you should seek out medical assistance immediately.
Diagnosis of Heart Failure
An accurate diagnosis of heart failure is critical in providing the right treatment to improve a patient’s daily life. Tests and procedures that are done involve blood tests, chest x-rays, electrocardiograms, echocardiograms, and cardiac catheterization.
Blood tests are usually one of the first tests done to provide a diagnosis of heart failure. Abnormal levels of certain proteins such as albumin can help better understand if heart failure is present. Usually, doctors will elect to perform more procedures if the results are not average.
Chest X-Rays are another common form for providing a diagnosis of heart failure. Chest X-Rays can show whether or not the heart is enlarged due to added strain and stress from the heart becoming overworked. This is vital in determining whether heart failure is present.
Electrocardiograms are common in examining the reasoning behind a heart attack or why an abnormal heart beat is present. Electrocardiograms are non-invasive and show the electrical impulses of the heart during a heart beat.
Echocardiograms are the gold standard as the best non-invasive way to determine heart size and functioning. Using sound waves, echocardiograms provide images of the hearts size and how it is pumping. This is crucial in determining if the heart muscle is enlarged due to heart failure and whether heart failure treatment is necessary.
Cardiac Catheterization is an invasive procedure and involves the insertion of a small tube into one of the blood vessels in the leg. This tube then travels to the heart via this blood vessel to give an accurate representation of blood flow and if the vessels of the heart have become blocked due to atherosclerosis.
Heart Failure Treatment
Heart failure treatment depends on the stage and severity of left heart failure and right heart failure. For non-life threatening situations, doctors usually elect to encourage lifestyle changes such as healthy eating, exercising and avoiding smoking. If the situation is more serious, heart failure medications may be needed along with lifestyle changes. As an absolute last resort, surgery may be required to replace the heart or help promote better functioning.
This is arguably the most important method for heart failure treatment and prevention. A healthy heart diet includes consuming omega-3 fatty acids, leafy green vegetables, fruits and whole grains. Also, patients should limit consumption of high salt foods, foods high in saturated and trans fat, and cholesterol. Also, exercising daily is critical in heart failure treatment and prevention. Exercising has been shown to benefit not only heart health, but also overall health in general. Exercising daily promotes the heart to become more fit and able to pump greater amounts of blood to the body with less effort. Quitting smoking and consuming alcohol are also important as they both contribute to the development of atherosclerosis by promoting higher than normal levels of low-density lipoprotein (LDL/bad cholesterol).
Heart Failure Medication
If your doctor deems it necessary, heart failure medication may also be prescribed in conjunction with improving your lifestyle. Heart failure medications help lower cholesterol, decrease blood pressure, heart rate and blood volume. Some common forms of the heart failure medication are angiotensin converting enzyme inhibitors, aldosterone antagonists, angiotensin receptor blockers, beta-blockers, and diuretics.
Angiotensin is a hormone that is released in the body that constricts blood vessels and thus, raises blood pressure. In the cases of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, they directly impede with the formation and binding respectively of angiotensin to the blood vessels in the body. This promotes vasodilation and a decreased blood pressure, which eases the workload on the heart.
Aldosterone is directly related to blood volume as it contributes to the reabsorption and excretion of substances like sodium and potassium. Aldosterone thus, increases blood volume when it is able to work and increases blood pressure. Aldosterone antagonists act to block aldosterone’s function and thus, help to lower blood volume and blood pressure.
The heart is covered in receptors called beta-receptors that when stimulated, they act to increase heart rate. When hormones such as epinephrine and norepinephrine are released, they bind to these beta-receptors and elicit their function of increasing heart rate. Beta-blockers, as the name implies, bind to the beta-receptor and block the ability of these hormones to reach the heart and complete their function. In turn, heart rate is decreased and the heart is not overworked.
It is best to consult with your doctor to see what medication is right to treat heart failure.
If lifestyle changes and medications are not enough, implanted devices and surgery may be used as a last resort. These can include implantable cardioverter defibrillators (ICDS), left ventricular assist devices and full heart transplants.
Implantable Cardioverter Defibrillators
These devices are surgically implantable and monitors heart rate. If it detects an irregular heart beat, it sends out an electrical shock to correct the heart beat and promote a normal heart rate..
Left Ventricular Assist Devices
As the name implies, left ventricular assist devices assist the left ventricle. They provide an added boost to the left ventricle in patients with left heart failure. This evidently increases the amount of blood being pumped to the body to decrease heart failure symptoms such as fatigue and shortness of breath. It also helps lower the workload on the heart.
As an absolute last resort, open-heart surgery may be necessary. This involves a donor that has a matching blood type to the patient. The patient’s heart is removed and the new heart is put in its place. Heart transplant is usually done only if it is necessary for patient survival because it is not without potential complications such as autoimmune rejection.
It is best to consult with your doctor to accurately diagnose and treatment heart failure.