Heart failure is a condition where the heart has become damaged and is unable to pump blood around the body as efficiently as required. It can be caused by a variety of problems, including ischaemic heart disease (heart attacks), high blood pressure, problems with valves of the heart, and several medications used to treat cancer.
Heart failure causes a syndrome where various hormones in the body are activated. This makes the problem even worse by causing fluid retention and fast heart rates.
Most patients with heart failure complain of tiredness, breathlessness, ankle swelling and lack of energy.
Heart failure is usually diagnosed by a series of simple tests:
This is an electrical recording of the heart made by attaching electrodes to the skin. It is completely painless, and takes less than 5 minutes.
A number of blood tests are usually performed, including measurement of BNP (brain natriuretic peptide). This test is very useful in excluding heart failure in patients who come to see me with breathlessness. It also gives information about the severity of heart failure and the prognosis.
This is an ultrasound test of the heart, performed by applying some gel to the skin and a probe to the chest. It is painless and takes about half an hour. It gives information on the pumping action of the heart and its valves.
Chest X ray
This is usually required, but is often performed prior to attending my clinic.
Most patients with heart failure can be treated with tablets alone, and have no need to be admitted as inpatients. These patients often see a dramatic improvement in symptoms. Occasionally, special pacemakers and defibrillators are required, which are inserted through minor surgery.
More information about heart failure can be found on the British Heart Foundation website: www.bhf.org.uk. I particularly recommend their publication “Living with heart failure”.