Timely follow-ups are essential to manage heart failure
A healthy heart pumps about seven thousand five hundred liters of blood every day. However, many reasons may hamper the effective functioning of the heart. The inability of the heart to meet the needs of the body is referred to as heart failure. It is imperative to be aware of the causes of heart failure and its consequences as there has been a rise in mortality rate to almost more than twenty percent due to this disease. In India, ten years younger patients are seen than the global average with the rise in hypertension and diabetes.
Beat Heart Failure initiative by the Times of India in partnership with Novartis aims to educate people about heart failure, its management and treatment. As part of the initiative multiple panel discussions are being hosted with senior doctors from India's best hospitals. One such discussion was conducted with specialists from Manipal Hospital to help people understand heart failure, its clinical evaluation, diagnostic tools, and essential investigations for treatment.
Dr H Sudarshan Ballal - Chairman Manipal Hospitals, gave an important message, Heart conditions are very much prevalent, cases are rising amongst younger age groups also. Extra care especially preventive lifestyle should be adopted to prevent the onset of heart diseases and manage the disease in heart patients. If you suspect you have Covid of any variety, it is important to consult your doctor for further management. There certainly is no need to rush to the hospitals in every instance. Please do not self-medicate and stay away from work if you are unwell".
The doctors who took part in the discussion were:
1) Dr Rakesh Deshmane: Consultant- Cardiothoracic & Vascular Surgeon(Manipal Hospitals Goa).
2) Dr Suraj Pai: Consultant- Cardio thoracic & Vascular Surgeon(KMC Hospital, Mangaluru)
3) Dr Srinivas Babu Kousuru: Consultant- Cardio thoracic & Vascular Surgeon(Manipal Hospital Vijayawada) MBBS,MS(PGIMER),M.Ch.(Delhi),Former Fellow FMC, Australia
The metabolic demands of a person may differ depending on a person's daily activities and profession. When heart cannot meet the body's metabolic needs, it is known as heart failure. Heart failure affects a wide range of age groups and is not specific to any age group as thought earlier. Therefore, we are seeing a rise in heart failure cases in the younger population, mentioned by Dr Pai.
Dr Deshmane stated that heart failure and heart attack are often confused. Heart attack is the sudden stoppage of the heart's blood supply, also known as a Myocardial Infarction. Repeated heart attack or not addressing heart attack on time will gradually damage the heart muscle and lead to heart failure.
Typical symptoms are often overlooked in the earlier stages. Symptoms include shortness of breath during activities that were not felt earlier, swelling of the feet also called pedal Oedema, fatigue, and chest pain. Gradually as the disease progresses, the symptoms may worsen, such as shortness of breath which can be felt during minimum activities or even at rest, explained Dr Srinivas. Dr Pai added to the point that these symptoms are clinical diagnostic tools for heart failure.
If heart failure is left untreated, the symptoms worsen, and the patient may eventually succumb to death. Heart failure will not resolve on its own. It's crucial to find the cause and treat it. Adequate management can arrest further progress of the disease and improve the prognosis. Patients with structural heart disease, viral infection, etc., can be treated, and cardiac function can be improved.
Echocardiography is a fundamental and important test for assessing the functioning of the heart and its valves. It is one of the simplest tests and available in every health care center to comprehend the probable causes. Echocardiogram uses electrodes to check the heart rhythm and ultrasound to see how the blood moves through the heart.
Blood tests are of prime importance to diagnose heart failure. In hypertension, diabetes, or any other comorbidities, blood tests reveal an accurate picture and are recommended.
Acute heart failure expresses itself more drastically than a patient with chronic heart failure. In acute heart failure, the symptoms come suddenly, vigorously, and uncontrollably necessitating medical attention. For example, a patient presenting with a massive heart attack might have been entirely typical in the past twenty-four hours, but now heart function reduces due to decompensation. There may be many more causes in addition to a heart attack. In chronic conditions, the heart is under prolonged damage, exhibiting shortness of breath, fatigue, and valvular heart disease.
Dr Deshmane expressed his view that diagnosing acute heart failure is easy because of the suddenness of the symptoms, patients can detect their symptoms. Patients tend to ignore their signs in chronic heart failure cases, which develops slowly and almost becomes part of the daily routine. In such a scenario, patients come to the hospital when they feel uncomfortable performing their daily chores. More often than not, they come at a late stage.
The number of patients or cases presenting to the doctors is just the tip of the iceberg, the actual count is hidden. Regular annual health check-ups that include basic blood investigations are necessary to uncover the inherent adverse consequences of common risk factors and symptoms of chronic heart failure. It is essential to visit the doctor for early management.
The common misconception amongst people that doctors do unnecessary tests should be addressed. The critical importance of the tests should be explained, especially for those with hypertension, obesity, or diabetes, by positive communication.
Early intervention in management and treatment can be specific or non-specific. Specific intervention includes finding the cause and treating it.
In the optimizing phase for the patients, the doctor's objective is to improve their comfort level and stabilize them by minimizing factors like swelling, fatigue, fluid management, etc. Non-specific intervention optimizes the patient and addresses the associated symptoms, such as managing fluid retention by giving diuretics. Diuretics expel an excess amount of fluid in the body, reducing the heart's burden.
The target of the treatment is to give a near everyday life. Patients and their caregivers need to realize that regular follow-up is necessary as the first consultation is not final. Final prescription and identification of the root cause of heart failure takes time.
Regular consultation with doctors helps in managing the titration of the medicines. Moreover, if not managed under medical surveillance at the right time, heart failure may progress towards multi-organ failure, including lungs, liver, etc.
Doctors apprised that surgery is recommended when medical management stops improving the condition. Eighty to ninety percent of patients are administered medical management, and only ten percent of patients in the late stages are recommended for surgery after meticulous evaluation of the underlying condition of patients apart from expectation of living long and healthy life, the quality of life expected for each of the patients is assessed. CRT, valves replacement, LVADS, and heart transplant are surgical options.
The doctors stressed the paramount role of preventive aspects of heart failure.Doctors concurred that healthy lifestyle, regular health check-ups, healthy diet, managing comorbidities, active exercise, quitting smoking, controlling obesity, and avoiding sedentary ways of working can play an important role in preventing heart diseases. People of all ages, especially youngsters, need to remember tobacco smoking and consumption can multiply the risk of heart failure.
Remember, heart failure isn't about stopping. It's about starting life in a new way. It can be managed with regular treatment and right lifestyle modifications.
Disclaimer: The views and opinions expressed in the article by the panelists/experts are based on their independent professional judgement and are disseminated in public interest. These views should not be considered as a substitute for professional advice of a registered medical practitioner. The purpose of this article is not to promote any medical procedures or medication and/or recommend a certain doctor. For any specific health issues, please consult your registered medical practitioner.
