Medicine

Medicine
This Blog is for information only. You should be treated only from a specialized physician in your area!

Tuesday, October 26, 2010

Heart failure shouldn't be your failure!

First of all, this will not be an easy topic. And it surely will be too far from funny.
Well, people die. Despite of legends, none has lived forever. The only two sure things in the world are Death and Taxes. For the fact that this website is mainly about medicine and health conditions, I’m not talking about Taxes!
But, what are the most frequent causes of death?
More than 30 % of deaths are caused only by cardiovascular problems. It means that there comes a time in life, in which the heart or the blood vessels give up! No more blood circulation, no more living. There are also a lot of other organ disorders that can make the heart stop. Then we have to mention other death causes, like Cancer, Infections, Trauma and many many others.


Congestive heart failure, edema, coughing
Heart failure symptoms

Heart failure is called the inability of heart to pump blood at the quantity that is needed for the normal functions. As it is a big muscle, big muscles can be very strong, and work very hard. Thus heart pumps blood for all the lifetime. However, what happens in heart failure, is the weakness of the muscle (the Myocardium). The weakness can come as a result of a degeneration inside the cells that form the muscle, and this is called failure from cardiomyopathy. The weakness also comes from diseases that cause the muscle to work harder and get extremely used, like Arterial Hypertension (High Blood Pressure), Thyrotoxicosis, Stress, High body mass, Sedentary lifestyle...
The symptoms of this heart condition are:
If the failure happens only in the left side:
The vessels of the lungs get congested, because of a blocked circuit. The blocked circuit is caused because the left side of the heart is congested, and the blood coming from the lungs to the heart can not enter, remaining in the lungs. The congestion of the lungs is really a severe symptom, causing dyspnea (difficulty of breathing), and low saturation of blood with oxygen!
Also cardiac asthma can occur, because of the presence of liquids from the blood in the respiratory airways.
If the failure happens in the right side of the heart:
The symptoms will be mostly systemic. Blood will not be allowed to enter the heart from the veins that collect it around the body. When remaining for too much time in the venous system, the endovascular pressure is augmented, thus making the liquids of blood come out from the vessel. Generalized edema occurs, followed by peritoneal filling with fluid (Ascitis).
The classification according to New York Heart Association:
Class I-No limitation of physical activity
Class II-Moderate limitation of physical activity
Class III-Marked limitation of physical activity
Class IV-Inability to perform of any physical activity without of symptomatology
The treatment and management of Heart failure:
If the condition is acute, the first line of treatment is the Re-oxygenation of the body. Medications include vasodilators such as nitroglycerin, diuretics such as furosemide, and non invasive positive pressure ventilation(NIPPV).
The management of the chronic heart failure:
ACE-inhibitors: Enalapril (Renitec and Vasotec)
Captopril (Capoten)
Lisinopril (Prinivil, Tensopril, Zestril, Lopril, Hipril, Prinzide and Zestoretic)
Ramipril (Prilace, Ramipro, Tritace, Altace)
Beta Blockers
Aldosterone receptor antagonists (Spironolactone, Eplerenone, Canrenone)
Automatic implantable cardioverter defibrillator(AICD)
Will I Live with heart failure?
The heart failure can be mild, moderate or severe. It is not a curable condition, unless the patient undergoes a cardiac transplant. It can be managed with drugs and other therapies. The  patient himself should be very cautious, because of the limited physical activity he can have. No stress should be present, and if so, it should be treated with medications. Also smoking should be stopped forever! If properly managed, the patient can live for years and have a low risk for worsening and death.

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