Chronic heart failure is a gradual invasive condition that causes the heart muscles not able to pump blood effectively to meet the body's needs. This results in a buildup of fluid in the body that leads to the development of various symptoms like fatigue, shortness of breath, and swelling in the legs and ankles. Underlying metabolic diseases such as coronary artery disease, hypertension, heart valve problems, cardiomyopathy, and congenital heart defects can weaken or damage the heart muscles and lead to the development of congestive heart failure (CHF). Behavioral risk factors, including obesity, smoking, and heavy alcohol use, can also cause CHF.
Symptoms
- You may experience persistent coughing with wheezing.
- You may develop an irregular heartbeat.
- You may have decreased Physical movements.
- You develop sudden weight gain due to fluid retention.
- You develop a Loss of appetite.
- You may find difficulties in sleeping.
- You may get Confused or impaired thinking.
- You may experience frequent urination, especially at night.
Understanding the treatment options
Chronic heart failure (CHF) is a complex condition that requires multifaceted management to improve symptoms, reduce hospitalizations, and prolong survival.
Therapeutic management:
Some of the various treatment options available are:
- Aldosterone antagonist: People with heart failure accumulate fluids because their hearts cannot pump blood as effectively as they should. Aldosterone antagonists aid in the removal of extra fluid from the bodies of those suffering from heart failure. Your heart has an easier time pumping less fluid.
- Beta-blockers: Beta blockers are known as blood pressure-lowering or antihypertensive medications. These medications prevent the effects of adrenaline hormones and cause the heart to beat less forcefully and more slowly. Blood pressure is lowered as a result. It also improves blood flow by relaxing and widening veins and arteries. Medications like Concor 10mg contain the active compound bisoprolol, widely employed to treat blood pressure, angina pectoris, and heart failure.
- ACE Inhibitors: The heart must beat harder due to the angiotensin hormone's effects, which could raise blood pressure. This action causes the narrowing of blood vessels. ACE inhibitors act by relaxing the arteries and veins, which causes reduced blood pressure and reduced load on heart muscles.
- Angiotensin receptor and Neprilysin receptor: Sacubitrivir/valsartan is the newest addition to the traditional combination therapy for heart failure. ARNI will reduce the chance of thrombosis, fibrosis, cardiac myocyte hypertrophy, and renin release while promoting the positive effects on vasodilation of arterial and venous blood vessels that reduce the symptoms of heart failure.
- Cardiac glycosides: Digoxin inhibits the action of Na+/K+ ATPase enzyme that raises intracellular calcium levels and improves heart contraction. It increases the force of heart muscle contraction, and this beneficial inotropic effect alleviates symptoms like exhaustion and dyspnea. Digoxin also lowers heart rate and enhances heart rhythm regulation.
Surgical therapy for heart failure:
- Coronary Artery Bypass Grafting (CABG): CABG surgery is performed by bypassing blocked or narrowed coronary arteries to increase blood flow to the heart muscle. This procedure may be recommended for patients with heart failure caused by coronary artery disease (CAD) to relieve symptoms and reduce the risk of heart attack.
- Valve Repair or Replacement: Heart failure can occur due to malfunctioning heart valves, such as mitral or aortic valve regurgitation or stenosis. Valve repair surgery can be performed to restore normal valve function and improve heart function.
Device therapies for heart failure:
- Implantable Cardioverter Defibrillator: ICDs are tiny electronic implants placed beneath the skin in the chest region to track the heart's rhythm continually. These devices shock the heart with electricity to reinstate normal rhythm in the event of arrhythmias, such as ventricular tachycardia or ventricular fibrillation.
- Cardiac resynchronization therapy: It involves implanting a special pacemaker with leads placed in the heart. These leads help to deliver synchronized electrical impulses to both ventricles, which ensures the coordination of heartbeats and improves overall heart function.
Conclusion
Chronic heart failure is a chronic and progressive disease that requires lifelong medications for management. However, recent advancements and improved lifestyle modifications by patients have resulted in improved survival rates.
