Our heart plays a vital role in pumping blood to all parts of the body, meeting their demands adequately at all times. In heart diseases, its pumping capacity reduces. If it reduces to such an extent that it can’t meet the demands of the body, it leads to a condition called Heart Failure. A person with heart failure feels tired and breathless. Excess water can accumulate in the body causing it to swell and gain weight. There can be swelling of the feet, the belly can bloat and water accumulation in the chest can make a person breathless when he lies down flat. If allowed to progress it can be very incapacitating, where even simple routine activity becomes very difficult. A person can become so breathless and tired that he can’t get up from his bed and go to the bathroom, or even speak a full sentence without taking breaks to catch his breath!
Heart diseases can damage or weaken the heart and lead to heart failure. One of the common causes is coronary artery disease, where blocks develop in arteries supplying blood to the heart. It can cause heart attack and damage the heart muscle.Conditions like diabetes and hypertension can directly affect the heart muscle or predispose to coronary artery disease and lead to heart failure. Faulty heart valves can lead to heart failure over a period of time. Cardiomyopathy is a condition where the heart muscle weakens. It can be Idiopathic (where the cause is not known) or due to alcohol, infections like viral myocarditis, cancer-treating medicines, drugs like cocaine, etc. Sometimes following intense emotional or physical stress the heart muscle weakens, dilates, and leads to heart failure. This is called “Broken heart syndrome” or Takotsubo cardiomyopathy. In congenital heart disease, the heart is not formed correctly. People are born with such defects. It can lead to heart failure.
It is easy to diagnose heart failure. A simple history taking, physical exam, few blood tests, x-ray, ECG and Echocardiogram are some of the routine things done to diagnose heart disease and heart failure. Sometimes CT scan and MRI may be required. In most patients,Heart failure can be effectively managed with oral medications and simple measures. Sometimes it may require hospitalization and administration of injections. The basic underlying cause has to be rectified if possible. This may require an Intervention or Cardiac surgery. In a few patients, the condition can deteriorate to such an extent that medications become ineffective. This is called terminal heart failure. Even in such patients treatment options are available. One of them is heart transplant. Here a brain-dead patient’s healthy heart is transplanted into a suitable recipient who has been diagnosed with Terminal heart failure.
After the transplant, the recipient can go back to leading a normal life with few restrictions and precautions. They are on medications called immunosuppressants to prevent the recipient’s body from rejecting the new heart. Heart transplant has today become very successful and the whole process is very standardized. In some patients who are in terminal heart failure, but for whom a suitable heart is not available or are not eligible for one, Artificial hearts are available. These are small pumping devices that are implanted in the chest below the heart, and which take over their function. A set of rechargeable batteries and a controller are housed in a small case that is situated outside the body and which are connected via a cable that passes through the skin to the pump inside. With advancing technology these devices are becoming smaller and more efficient. It is not long before, these devices become fully implantable, with no external component. The batteries will then be charged transcutaneously, that is across the skin! The best part is that all these treatment options are available all across our country and we have international patients coming into avail of these treatments!
However, “prevention is the best cure”. One must aspire to lead a healthy life and avoid these problems. Lead an active life with plenty of exercise. A sedentary lifestyle is as bad as smoking! In fact, exercise can be fun and the benefits are much more, beyond just maintaining body fitness. Eat a balanced diet with plenty of whole grains, fruits, and vegetables. Watch your weight and maintain within range. Avoid smoking. Restrict use of alcohol. If one has diabetes, hypertension, obesity, high cholesterol, it has to be identified and treated appropriately. Most of the time it can be treated with diet and exercise. Sometimes medications will be necessary. Reduce mental stress. One can do yoga, meditation, spend time with family and friends, pursue a hobby, take breaks, go out etc. Get yourself checked regularly. If a problem is identified address it promptly with expert help. Don’t fall prey to homemade and “social-media” remedies. Identifying a problem before it manifests is better. It can then be treated before it leads to a complication and produces permanent damage.
I would like to quote this year’s world heart day slogan. “Use heart for every heart”. Everyone must take up the responsibility to do what is right to maintain not only one’s own heart health but that of their family and friends.
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