Heart Failure

Heart failure (HF), often referred to as chronic heart failure (CHF), occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the body's needs.

The terms congestive heart failure (CHF) or congestive cardiac failure (CCF) are often used interchangeably with chronic heart failure.

• Other names:
  • Left-sided heart failure - Heart is unable to pump enough oxygen-rich blood to the body
  • Right-sided heart failure - Heart can’t fill with enough blood
  • Cor pulmonale - refers to right-sided heart failure caused by high blood pressure in the pulmonary arteries and right ventricle (right lower chamber)

Types of heart failure:

• Left-sided heart failure - blood may back up in lungs, causing shortness of breath
  • Systolic heart failure - The left ventricle can’t contract vigorously, indicating a pumping problem
  • Diastolic heart failure (also called heart failure with preserved ejection fraction) - The left ventricle can’t relax or fill fully, indicating a filling problem
• Right-sided heart failure - blood may back up into the abdomen, legs and feet, causing swelling because the right side of the heart loses pumping power

The severity of disease is usually graded by the degree of problems with exercise.

Heart failure is not the same as myocardial infarction (in which part of the heart muscle dies) or cardiac arrest (in which blood flow stops altogether).

Other diseases that may have symptoms similar to heart failure include obesity, kidney failure, liver problems, anemia and thyroid disease.

Signs and symptoms: commonly include shortness of breath, excessive tiredness, and leg swelling. The shortness of breath is usually worse with exercise, while lying down, and may wake the person at night. A limited ability to exercise is also a common feature.

Common causes of heart failure:

These cause heart failure by changing either the structure or the functioning of the heart.

• Coronary artery disease including a previous myocardial infarction (heart attack)
  • Is most common form & cause
  • Results from buildup of fatty deposits (plaque) in arteries, reducing blood flow
• High blood pressure (hypertension) - makes heart work harder; over time can make heart muscle too stiff or too weak to effectively pump blood
• Heart arrhythmias such as atrial fibrillation (beats too fast), or bradycardia (beats too slow)
• Valvular heart disease - damaged valve may be due to heart defect, coronary artery disease or heart infection
• Cardiomyopathy - heart muscle damage caused by several diseases, infections, alcohol abuse, toxic effect of drugs; genetic factors can also influence
• Myocarditis - an inflammation of the heart muscle commonly caused by a virus can lead to left-sided heart failure
• Congenital heart defects - if heart, chambers or valves haven’t formed correctly, the healthy parts of the heart have to work harder to pump blood thru the heart
• Some chronic diseases - such as diabetes, HIV, hyperthyroidism, hypothyroidism, or hemochromatosis (iron buildup) or amyloidosis (high protein) may contribute
• Causes of acute heart failure include viruses that attack the heart muscle, severe infections, allergic reactions, blood clots in the lungs, the use of certain medications or any illness that affects the whole body.

The condition is diagnosed based on the history of the symptoms and a physical examination with confirmation by echocardiography. Blood tests, electrocardiography, and chest radiography may be useful to determine the underlying cause.

Treatment depends on the severity and cause of the disease.

• In people with chronic stable mild heart failure, treatment commonly consists of lifestyle modifications such as stopping smoking, physical exercise, and dietary changes, as well as medications.
• In those with heart failure due to left ventricular dysfunction, angiotensin converting enzyme inhibitors or angiotensin receptor blockers along with beta blockers are recommended.
• For those with severe disease, aldosterone antagonists, or hydralazine plus a nitrate may be used. Diuretics are useful for preventing fluid retention.
• Sometimes, depending on the cause, an implanted device such as a pacemaker or an implantable cardiac defibrillator may be recommended.
• In some moderate or severe cases cardiac resynchronization therapy (CRT) may be suggested or cardiac contractility modulation may be of benefit.
• A ventricular assist device or occasionally a heart transplant may be recommended in those with severe disease despite all other measures.

Complications

If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age.

• Kidney damage or failure. Heart failure can reduce the blood flow to your kidneys, which can eventually cause kidney failure if left untreated. Kidney damage from heart failure can require dialysis for treatment.
• Heart valve problems. The valves of your heart, which keep blood flowing in the proper direction through your heart, may not function properly if your heart is enlarged or if the pressure in your heart is very high due to heart failure.
• Heart rhythm problems. Heart rhythm problems (arrhythmias) can be a potential complication of heart failure.
• Liver damage. Heart failure can lead to a buildup of fluid that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes it more difficult for your liver to function properly.

Statistics

• Heart failure is a common, costly, and potentially fatal condition.
• In 2015, it affected about 40 million people globally.
  • Overall in developed countries around 2% of adults have heart failure[ and in those over the age of 65, this increases to 6–10%. Above 75 years old rates are greater than 10%.
  • Rates are predicted to increase. Increasing rates are mostly because of increasing life span, but also because of increased risk factors (hypertension, diabetes, dyslipidemia, and obesity) and improved survival rates from other types of cardiovascular disease (myocardial infarction, valvular disease, and arrhythmias).
  • Heart failure is the leading cause of hospitalization in people older than 65
• In the year after diagnosis the risk of death is about 35% after which it decreases to below 10% each year. This is similar to the risks with a number of types of cancer.
• Heart failure is much higher in African Americans, Hispanics, Native Americans and recent immigrants from the eastern bloc countries like Russia. This high prevalence in these ethnic minority populations has been linked to high incidence of diabetes and hypertension.
• In the United Kingdom the disease is the reason for 5% of emergency hospital admissions.
• Heart failure has been known since ancient times with the Ebers papyrus commenting on it around 1550 BCE.
• About 5.7 million Americans have heart failure, according to the Centers for Disease Control and Prevention in 2017.
  • Most of these people are men. However, women are more likely to die from heart failure when the condition goes untreated.
  • One in 9 deaths in 2009 included heart failure as contributing cause.

Notables who died from heart failure

1. Ranker - Famous People Who Died of Heart Failure (427 listed)
2. Who2 Biographies - Famous People Who Died of Heart Failure (85 listed)
3. Famous People Who Died of Heart Failure (69 listed)

• Elizabeth Taylor (1932-2011) - British-born American actress; Wikipedia - Elizabeth Taylor She was diagnosed with congestive heart failure in 2004; she was hospitalized in 2011 and six weeks later died of the illness.
• George Carlin (1937-2008) - American comedian, social critic, actor, and author; Wikipedia - George Carlin had a long history of numerous cardiac problems including a significant episode of heart failure in late 2005 & died of cardiac arrest.
• Jim Morrison (1943-1971) (aka: James Douglas “Jim” Morrison) - singer, poet, songwriter; Wikipedia - Jim Morrison The official cause of death was listed as heart failure
• Eddie Guerrero (1967-2005) - (aka: Eduardo Gory Guerrero Lianes) - Mexican American professional wrestler; Wikipedia - Eddie Guerrero An autopsy revealed that Guerrero died as a result of acute heart failure due to underlying atherosclerotic cardiovascular disease.
• André René Roussimoff (1946-1993) (aka: André the Giant) - French professional wrestler, actor; Wikipedia - André the Giant Died in his sleep of congestive heart failure.C
• Salvador Dalí (1904-1989) (aka: Salvador Domingo Felipe Jacinto Dalí i Domènech, 1st Marqués de Dalí de Pubol) - Spanish surrealist painter; Wikipedia - Salvador Dalí He died of heart failure.
• Ricardo Montalbán (1920-2009) (aka: Ricardo Gonzalo Pedro Montalbán y Merino) - Actor; Wikipedia - Ricardo Montalbán The precise cause of death was later revealed to be congestive heart failure.
• Lena Horne (1917-2010) (aka: Lena Mary Calhoun Horne) - American singer, dancer, actress, civil rights activist; Wikipedia - Lena Horne
• Isaac Asimov (1920-1992) - American author & professor of biochemistry; Wikipedia - Isaac Asimov In 1977, Asimov suffered a heart attack. In December 1983, he had triple bypass surgery, during which he contracted HIV from a blood transfusion. His brother, Stanley, reported the cause of death as heart and kidney failure.
• Greer Garson (1904-1996) (aka: Eileen Evelyn Greer Garson Fogelson) - English-American actress; Wikipedia - Greer Garson She died from heart failure.

Resources & Additional Reading

• Wikipedia - Heart failure
• Mayo Clinic - Heart failure
• American Heart Association - What is Heart Failure?
• NIH - Heart Failure
• Healthline - Heart Failure. By Kristeen Moore, Erica Roth. 20 Dec 2017

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