What is heart failure?
Heart failure is a serious medical condition where the heart is unable to pump enough blood around the body to meet the body’s needs. Heart failure is a common condition which affects 1-2% of the UK population and becomes more common as patients grow older. The average age of a heart failure patient in the UK is 76 years but it can affect people of all ages.
Symptoms & Causes
Patients typically present with a combination of breathlessness and fatigue and this may be associated with swelling of the ankles or the abdomen. Initially patients may only be breathless with significant exercise but as the condition progresses breathlessness may occur with only mild exertion and may be more noticeable when lying down. Patients may start to sleep with more pillows our wake up breathless.
Heart failure is most commonly due to weakness of the heart muscle caused by coronary artery disease. Valve disease (a leaking or narrowed heart valve), high blood pressure or inherited heart muscle problems (cardiomyopathy) can also lead to heart failure.
Types of Treatment
Whilst heart failure is a very serious condition, many treatment options are available including a variety of medications which have been shown to improve symptoms and make patients live longer. These include ACE inhibitors, angiotensin II antagonists, beta-blockers and digoxin and are the first line of treatment for patients with heart failure. Patients benefit from frequent careful monitoring and gradual changes in medications. With modern therapies, most patients can lead independent fulfilling lives.
A new type of pacemaker, known as a biventricular pacemaker or cardiac resynchronisation therapy is available for certain patients with heart failure. This improves the co-ordination of the contraction of the heart chambers and usually improves quality of life and has been shown to prolong life. Another form of specialist pacemaker called an implantable cardiac defibrillator (ICD) can be implanted in patients who have survived a cardiac arrest or in patients who have had ventricular arrhythmias (fast heart rhythms from the bottom chambers of the heart) and in some patients with heart failure when the ICD can be combined with a biventricular pacemaker (BiV-ICD).
Fluid overload is a common problem in congestive heart failure resulting in prolonged hospital admissions and poor quality of life. To date, intravenous diuretics have been the standard of care to treat fluid overload in patients with heart failure. Thisit can take some time to relieve fluid overload. Ultrafiltration is a technologically sophisticated mechanical system that can remove up to a litre of fluid from the blood stream per hour without clinically significant effects on kidney function, heart rate, blood pressure or electrolyte balance. Ultrafiltration is a variety of membrane filtration (similar to dialysis therapy) used to remove almost exclusively water and salt form the body leading to reduction in fluid overload and cab thought of as a This therapy results in a shorter stay in hospital compared to intravenous diuretics and is available to a certain patients with heart failure as part of their treatment