Heart failure – causes, symptoms + video
Heart failure may be chronic or acute (sudden onset or chronic decompensation), left (when the heart left ventricular function is affected), right (right ventricular function is affected), global (whole heart is affected ). You can also encounter the concept of systolic heart failure (left ventricular contraction capacity is affected) or diastolic heart failure (in which the capacity of the distension of the ventricle is impaired).
Like a disease, heart failure occurs as evolutionary stage of other heart diseases. These diseases aggravated and / or untreated cause heart failure:
- Hypertension and valvular stenosis (mitral stenosis, aortic stenosis) strain and weaken the heart due to increased pressure that appears;
- By volume overload, causes may be insufficient valve (aortic insufficiency, mitral insufficiency) intracardiac shunts (congenital) or arteriovenous fistulas (as those of dialysis);
- There are also a number of diseases that directly affect the ability of contraction of heart muscle (myocardium): myocardial ischemia (with its forms, from angina to myocardial infarction), cardiomyopathy, myocarditis, neuromuscular diseases, endocrine diseases like severe thyroid dysfunction, infiltrative diseases like hemochromatosis, cardiac toxicity (alcohol, antraciclines, cobalt);
- Heart failure as a pump may be due to diseases that affect the ability of filling of the heart, such as constrictive pericarditis, cardiac tamponade, cardiac tumors, excessive tachyarrhythmias.
Heart failure – symptoms and clinical signs:
A patient with heart failure most often accuse trouble breathing, inability to breathe (dyspnea).
Due to declining heart contractility, blood tends to flow backward from the heart (left atrium) in the pulmonary veins. Dyspnea is due to increased blood pressure in the pulmonary veins, where it can extravasated into the lungs making it hard to breath.
Specific dyspnea of heart failure may increase during effort or when lying down (orthopnoea), reason why the patient is advised to sleep on an inclined plane, the upper part of the body at an angle of 45 degrees.
Dyspnea (breathing problems) may occur at rest, to begin suddenly at night (paroxysmal nocturnal dyspnea) or be accompanied by cough (worse with exertion or lying position) with haemoptysis (blood in sputum due to rupture of small bronchial vessels overloaded with blood).
Often in heart failure appear signs like tiredness, muscle weakness, even dizziness due to decreased cardiac output. Syncope or palpitations can occur on a background of arrhythmia that accompanies heart failure.
More prepoderent seen in right heart failure, but with a large share in the global failure are: liver pain, with abdominal bloating, anorexia (loss of appetite with weight loss), peripheral edema (swollen legs usually in the ankle, with feeling of heaviness and traces at finger compression).
As heart failure worsens blood stagnation it appears water retention in tissues: edema of the abdominal wall, scrotum and sacral (posterior area of the basin) for the bedridden.
This is due to stasis (stagnation) in retrograde territories of the heart. A heart that can not pump can not fill effectively and blood which has to be returned to the heart is mostly stagnant in the veins and liver.