Our heart beats approximately forty-two million times in a year, without a break. But our lifestyle choices many-a-times affect the functioning of our heart, which leads us to a condition of heart failure.

Heart failure is one of the most common causes of death worldwide. What do we mean by heart failure? Heart failure does not mean that the heart has stopped working. It is a condition where heart is working at a reduced capacity and not able to supply enough oxygenated blood to the body.  Heart failure is often confused with other cardiac conditions especially with heart attack, which is the sudden stoppage of the blood supply to the heart.

The mortality rate in heart failure patients is more than twenty per cent. Whereas, in advanced heart failure cases in untreated patients, the mortality rate is reportedly rising ten per cent within the first one month to thirty per cent during the first year and a whopping fifty per cent in the first five years. Therefore, it becomes very important to spread information on heart failure, its management and treatment.

Many doctors of the leading hospitals of India have joined hands to strengthen this initiative and to help people understand the condition of heart failure and medical supremacy to deal with it. One such discussion took place with the doctors from CIMS Hospital, Ahmedabad to discuss heart failure management and cardiac rehabilitation therapy for people living with heart failure.

Any person is susceptible to heart failure when exposed to certain conditions such as coronary artery disease, heart attack, diabetes, hypertension, valvular heart disease, congenital heart disease, degenerative heart disease and cardiomyopathy or acquired infective causes such as COVID-19, said Dr Milan to caution the patients.

Explaining the rising incidence of heart failure patients in India, Dr Ajay Naik said - inhabitants of the South-Asian continent especially Indians are more prone to coronary artery diseases and heart failure. In India, coronary artery diseases occur at least two decades earlier as compared to the rest of the world and attack our youngsters.

The heart is damaged more severely on account of the wide prevalence of diabetes, hypertension, and obesity. Fortunately, our present generation in India is more aware and knowledgeable about the medical issues, seeking medical attention, treatment on time, which is resulting in better reporting of cases. In addition, an increase in the average lifespan of the Indian population to above sixty-five to seventy years as compared to forty-five years earlier is adding to age-related issues of heart failure numbers.

The tremendous advances in medical sciences especially in the realm of cardiovascular diseases have made it possible to offer treatment plans at every stage of heart failure, said Dr Shah. We would like to examine the causes of heart failure in a patient from the right treatment perspective. For the early stages of heart failure, certain medications are administered and as the disease progresses, treatment plans get updated.

When there is a blockage in the artery or damage to the valves, either angioplasty or surgery is recommended. Going further, when the heart is beating irregularly, the option of a pacemaker can be exercised. For the advanced stages, surgical options such as a heart transplant or artificial hearts are suggested.

A heart failure patient coming to the hospital not only requires a proper infrastructure in emergency care and inpatient department but also a plan in place for transitional care besides, sound patient care protocol and systems for each of the wings of the hospital. A patient presenting in the casualty with the sudden appearance of symptoms of heart failure would need optimal management. Subsequently, in the inpatient department of the hospital, the plan is to stabilize the patients to ensure that they go back home with confidence elaborated Dr Prashant.

Dr Naik explained that when the heart failure patient is identified, either in an outpatient department or admitted in an inpatient department, who may have a history of the scare of acute heart failure or undergoing a certain procedure, our focus is to streamline and institute systemic treatment management to ensure recovery and rehabilitation.

Diet regulations and cardiac rehabilitation, are the two important management techniques required to be followed by the patients. A guideline-directed medical therapy is recommended, based on a checklist as practised globally, where medicines are to be prescribed by the doctors and lifestyle changes are to be adopted by the patients.

A patient is expected to be physically active and get involved in daily activities, and shouldn't stay in bed after being diagnosed and treated for heart failure. The hospital would like to ensure that patients lead comfortable life. Heart failure is lifelong management and requires lifestyle changes to avoid any complications. This may include lifelong restrictions on fluid and salt intake, and giving up on certain food items.

It is critical for the patient and the family to be aware of the prognosis and new lifestyles to be adopted by the patient, said Dr Milan. A patient after getting discharged from the hospital is referred to a heart failure clinic. A heart failure clinic consists of a specialized and multidisciplinary team of doctors, nurses and paramedics. A heart failure clinic plays a significant role in minimising hospitalization and re-hospitalization of patients.

Dr Prashant mentioned that any treatment plan requires a team decision. The purpose is to provide the patient with holistic treatment and follow up, from medications to lifestyle management. A patient is expected to monitor his vitals such as weight on daily basis, blood pressure and should be compliant with medicines. On-call consultations are also available with a doctor if a patient is not able to visit the doctor.

Congenital heart diseases, if managed during childhood can be reversed and avoid any complications during adult age. However, for the advanced stages of heart failure, surgery is the most viable option, emphasised Dr Shah. An angioplasty or a bypass surgery is recommended, when the heart has a blockage. Valve replacement is suggested when valves of the heart are not functioning properly to prevent further progression of the disease.

Doctors appeared confident and said, eighty per cent of heart failure patients survive after five years of undergoing treatment and rehabilitation. They can have good productive life if they are identified early in the progression of heart failure. Doctors also voiced their support on creating a kind of network of hospitals to leverage the strength available in the country, city or state.

People have to be responsible about their behaviour like quitting smoking, managing salt and sugar intake, monitoring vitals, lipid profile and taking a balanced diet and coping with stress by practising yoga. Remember, heart failure isn't about stopping. It's about starting life in a new way. It can be managed with regular treatment and the right lifestyle modifications. To know more about how to manage heart failure, visit https://www.toibeatheartfailure.com/patientguide.php