Cardiovascular system Heart failure

The heart failure is a heart difficulty in properly pumping blood to the body. The heart usually increases in size.

In the initial phases, the increase in the heart size or the heart difficulty in pumping blood many times do not cause symptoms, and the diagnosis is made by a thorax Rx or a routine echocardiogram. Symptoms can appear with the disease progression, with shortness of breath, initially after efforts and later after small activities and even at rest, being the most frequent. There are many causes for developing a heart failure.

The commonest cause is a long-term high pressure. Sometimes it can be a consequence of a heart valve disease and, with the valves not working properly, these require more work by the heart, causing its increase. The valves can be repaired by surgery (valvar plastic surgery) or be replaced with artificial prostheses, when needed. In other cases, it can be due to an ischemic cardiopathy, which is causing a reduction in the flow to the muscle and the death of a portion of the latter. It can be also caused by diseases in the heart muscle itself (myocardiopathies) or by a viral infection (myocarditis).

Treatment

Many patients with discrete increase in the cardiac volume or slight contraction deficit may have a normal life. The treatment will depend on the cause and the symptoms. It varies from small habit changes to heart transplant, depending on the severity. Medicines can be prescribed for high pressure. A reduction in alcohol and salt consumption is recommended, as well as alterations in lifestyle, such as regular physical exercises within the individual limits.

Intervention-Procedure

An association of medicines and surgical intervention may be needed in more severe and selected heart failure cases, depending on the cause and symptoms, including:
– coronary artery bypasses and removal of infarction zones, with reconstruction of the ventricle geometry, for ischemic cardiopathy;
– left ventricle aneurysmectomy for aneurysms;
– valvar surgery in valvulopathies;
– multisite pacemaker implantation;
– defibrillator/cardioverter implantation;
– heart transplant.

* More information on the aforementioned surgical interventions can be found in Cardiovascular System > Procedures and Interventions.

Support notes

Thorax Rx: Exam that uses the conventional radiology to form images of heart, lungs, and large vessels. Click here to go to the page of Thorax Radiography and to know more about this subject.

Echocardiogram: Exam that uses ultrasound to evaluate the heart. Click here to go to the page of Echocardiogram and to know more about this subject.

Heart valve diseases: The heart valves become unable to fully open or properly close, or to do combination of both. Click here to go to the page of Valvulopathies and to know more about this subject.

Ischemic cardiopathy: Term used to define the narrowing of coronary arteries caused by an atherosclerosis. Click here to go to the page of Ischemic Cardiopathy and to know more about this subject.

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