Treatment of Heart Failure has revolutionized the management of the disease
However, the recent addition of newer drugs in heart failure treatment has revolutionized the management of the disease.The hearts function is to pump blood, rich in nutrition and oxygen to every organ.
Our heart is the most robust organ in the body. The heart beats about three billion times without a break in a person's lifetime. Many factors can hamper the functioning of the heart, and this is known as heart failure. The upsurge in heart failure cases makes it essential to disseminate authentic information to increase awareness of the inherent dangers from the ever-growing menace. The mortality rate on account of the disease ranges from thirty to fifty percent if left untreated. In India, patients ten years younger than the global average are seen.
"Heart Failure continues to be a management challenge despite several advances in its early recognition and multi-pronged management. Patient counseling and compliance with the strategies is the key to reducing morbidity, mortality and above all improving the quality of life. Covid -19 symptoms can mimic heart failure and it is important to differentiate shortness of breath of heart origin from lung involvement. Biomarkers that are simple to carry out point of care blood tests are very useful in this regard. NT- Pro BNP is the most readily availed test for this purpose"- said Dr (Prof) Upendra Kaul.
According to the medical fraternity, it is essential to understand that heart failure is not the end of life, and many treatment options are available. The key to effectively addressing the challenge is to reach out to a health care provider for a healthy and longer life. Beat Heart Failure initiative by The Times of India in partnership with Novartis aims to spread awareness around heart failure, its management, and treatment options. 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 the doctors from Batra Hospital, Delhi with their core team of Cardiology at the hospital.
1. Prof. (Dr.) Upendra Kaul - Sr. Consultant, Cardiology 2. Dr Rajiv Bajaj - Sr. Consultant, Cardiology 3. Dr. Nabajit Talukdar - Sr. Consultant, Cardiology https://fb.me/e/1h4yXoJ8H The heart is an intriguing organ, remarked Dr. Nabajit. Most of the cells of the core, when damaged due to some inciting incident, cannot be restored. The loss of cells affects the contraction and relaxation of the heart leading to heart failure which impacts the patient's life and longevity. The causes can be heart attacks, toxic injuries, myocarditis, and associated comorbidities. However, the recent addition of newer drugs in heart failure treatment has revolutionized the management of the disease.
The heart's function is to pump blood, rich in nutrition and oxygen to every organ. Dr. Kaul elucidated that in a house, if the central pump gets weak and cannot lift the water to the tank, then the functioning of the house is affected. Similarly, if the heart becomes weak and the blood is not pumped adequately, the organ's functioning starts getting affected. For example, suppose the brain does not get enough oxygen, in that case, a person feels dizziness, loss in memory, and there may be kidney damage. The patient may develop the liver disorder at a later stage.
He also added that heart failure is of two types depending on the heart's ejection fraction. Ejection fraction, in simpler terms, means the amount of blood pumped by the heart. Low ejection fraction means that the contraction amount of blood pumped by the heart is low. It is seen in cardiomyopathy. Another type of heart failure is when the ejection fraction is preserved, yet the person has all the symptoms of heart failure, as seen in coronary artery disease. The treatment of patients with preserved ejection fraction is a new challenge to doctors.
According to Dr. Rajiv, cases of heart failure have always been in the country. But the medical awareness about the disease is now increasing due to the availability of dedicated hospitals and concerted efforts by the media with initiatives like Beat Heart Failure. People tend to ignore the symptoms and start living with issues in daily life. By the time a patient starts noticing the signs, the heart gets exhausted. A healthy heart can pump twenty liters of blood in a minute. As the disease progresses, blood pumping to the heart reduces to seven to eight liters per minute. When it falls below five liters per minute, it becomes a recipe for drastic lowering of life span and poor prognosis.
Heart failure could occur in every age group, remarked Dr. Kaul. He stressed that people need to be aware that symptoms develop incipiently. When a person at sixty years is diagnosed with heart failure, it's already full-fledged heart failure. At this point, the prognosis will be low despite vigorous treatment. The development of the disease had already begun many years back. The treatment should have started when the symptoms first surfaced. When the treatment is commenced early, strong positive effects on long-term health are seen.
People with risk factors such as a family history of heart disease or associated comorbidities such as hypertension, diabetes should not compromise on their annual health check-ups. B-type natriuretic peptide or BNP is a blood test produced by the ventricles, which is very helpful in determining the outlook of patients with heart failure. BNP levels go up when the heart cannot pump the way it should.
If symptoms such as newly developed breathlessness which was not observed earlier or associated comorbidities present, the patient should visit the doctor. Preliminary investigations help determine the cause and facilitate the early commencement of the treatment.
Anemia, lung disease, heart diseases, malnutrition, high blood pressure are some of the causes of breathlessness. If breathlessness has developed due to heart failure, then the patient is already in a late stage.
Dr. Rajiv added that patients should report any medicine they take to their healthcare provider. Moreover, the crucial aspect of medication effectiveness for preventing and controlling heart failure is avoiding self-medication and strictly following doctors' instructions.
The twin fold objective of knowing and managing is the objective of cardiologist diagnosis and assessment. The quality of life depends on the stage the patient is presenting and its cause. The organ's viability is checked using an angiogram or a pet scan. If the patient presents with end-stage disease, many surgical options are available such as LVADs, Left ventricular assist devices, or heart transplants.
Dr. Nabajit added that Cardiac Resynchronization Therapy (CRT) is recommended in patients with left bundle branch block (a delay or blockage to the left side of the heart). CRT uses a pacemaker to help with the right rhythm. An implantable cardioverter-defibrillator (ICD) is placed in the chest to detect and stop irregular heartbeats such as arrhythmias.
Doctors said that heart failure clinics are positively contributing to heart failure management. As the name suggests, a heart failure clinic is a specialized unit with dedicated doctors, paramedics, nurses, physiotherapists, and counselors for heart failure cases. The patient's care is integrated from drug doses, lifestyle management, diet counseling, mental health assessment, and appropriate exercises. Depending on the stages of the disease, the treatment is guided, said Dr. Kaul.
A happy heart requires a healthy lifestyle. Patients should remember that it is vital to monitor parameters like blood pressure, body weight, exercise, avoid smoking and alcohol, have a balanced diet with a focus on fruits and vegetables, and take medicine on time. People with associated comorbidities such as diabetes, hypertension, or obesity should be more careful with their diet. Never miss your doctor's appointment.
Remember, heart failure isn't about stopping. It's about starting life in a new way. It can be managed with regular treatment and the right lifestyle modifications. To know more about how to manage heart failure, visit https://www.toibeatheartfailure.com/blog Disclaimer: "The views and opinions expressed in the article by the panelists/experts are based on their independent professional judgment and are disseminated in the public interest. These views should not be considered as a substitute for the 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."