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When the heart fails…

Dr. Anderson

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Congestive heart failure (CHF) is a clinical syndrome in which the heart fails to pump blood at the rate required by the metabolizing tissues. The heart’s inability to pump a sufficient amount of blood to meet the needs of the body’s tissues may be a result of insufficient or defective cardiac filling and/or impaired contraction and emptying.

Compensatory mechanisms increase blood volume, as well as the cardiac filling pressure, heart rate, and cardiac muscle mass, to maintain the pumping function of the heart and to cause a redistribution of blood flow. Despite these compensatory mechanisms, the ability of the heart to contract and relax declines progressively, and heart failure (HF) worsens.

 
The clinical manifestations of Heart Failure vary enormously and depend on a variety of factors, including the age of the patient, the extent and rate at which cardiac performance becomes impaired, and which ventricle (Right or Left) is initially involved in the disease process.

A broad spectrum of severity of impairment of cardiac function is ordinarily included in the definition of HF. These impairments range from the mildest forms, which are manifest clinically only during stress, to the most advanced forms, in which cardiac pump function is unable to sustain life without external support.
It is important to remember that heart failure is a multisytem disorder affecting every single part of a person’s body. The more specific complaints include

  • Generalised weakness
  • Breathlessness on activity, which progresses to breathlessness at rest
  • Chest pain
  • Breathlessness on lying flat on the back
  • Waking up gasping for breath
  • Cough (worse at night)
  • Painless swelling of both legs.

It is not unusual for symptoms to arise from various systems such as:

Gastrointestinal complaints like: Abdominal swelling, pain in the Right upper abdomen, loss of appetite, feeling of fullness, nausea and constipation.

Urinary complaints like: urinating too frequently, waking up too many times to urinate at night or drastic reduction in urinary frequency or volume.

Nervous system complaints like: headache, confusion, memory impairment, behavioural anomalies, disorientation and delirium.
Muscukoskeletal complaints like: joint pain and muscle cramps.

 
Heart failure is not a death sentence. It’s a treatable medical emergency that requires early diagnosis and prompt treatment.

An upcoming article will shine more light on the causes and precipitants of heart failure. Till then, stay safe and keep your heart unbroken.

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Dr Anderson is a graduate of Lagos State University College of Medicine who is on a mission to build a national team of healthcare professionals with international affiliations, which will bring basic healthcare to the poorest in society and increase National income from Medical tourism. He is a proud member of various reputable bodies including the Nigerian Medical Association (NMA), Lagos chapter, the World Safety Organisation and the Christian Medical and Dental Association, Nigeria (CMDA Nigeria). He also belongs to the Medical College of Surgeons. He is an MDCN(Medical and Dental Council of Nigeria) and HSE 1, 2, 3 certified doctor. When he is not busy reading, writing or doing some public speaking, you can find him dancing, playing chess or watching movies.