Heart failure as a concept is very broad. It is said in medicines and cardiology that all heart diseases lead to heart failure. Heart failure is often misunderstood, and people attribute any sudden death to heart failure. Heart failure is the gradual weakening of the heart muscle compromising its ability to assist the circulatory system to transport blood to various parts of the human body.

The general estimate for heart failure suggests that one per cent of the adult population is affected by heart failure in some form or the other. The prognosis of heart failure is almost the same as in cancer. The alarm bells have already risen in India in the last couple of years, as patients ten years younger than the global average have presented as heart failure patients and the mortality rate is also reported to be rising. The seriousness of the developing scenario makes it incumbent upon the people to discuss and understand heart failure, its causes and how it can be effectively managed.

The heart is the most talked about topic in any social forum said, Dr Nakul Sinha. Still, people pay scant attention to ways and means of keeping it healthy and thereby impacting their well-being. The main reason for ignoring heart health is the lack of awareness about heart diseases, which results in heart failure. Beat Heart Failure is one such initiative by the Times of India in partnership with Novartis to disseminate the authentic facts about heart failure, its signs, symptoms, risk factors, its management and treatment options.

The campaign is in the fourth phase and doctors from the best hospitals of India from different parts of the country has joined the movement to instil confidence amongst people that heart failure is preventable, reversible, and treatable if diagnosed in time. Doctors continue to lend their support to this noble cause. Doctors from Medanta Hospital, Lucknow have joined to share their knowledge about diagnosis, treatment, management and required lifestyle modifications -
Dr Nakul Sinha, Director - Interventional Cardiology
Dr RK Saran, Director - Clinical & Preventive Cardiology

Heart failure is the outcome of the heart's inability to keep up with blood flow to meet the demands of the human body due to its weakness. The symptoms of persistent breathlessness and fatigue in the daily life of an ordinary individual is a signal for him or her to visit the physician for diagnosis and investigation to discover the root cause of the symptoms, averred Dr Nakul Sinha. The sportspersons showing fatigue or breathlessness during their workout may also need to get some preliminary investigation.

Dr Saran said, that heart failure manifests itself as a syndrome of symptoms like breathlessness which can be acute or chronic. Acute breathlessness is a kind of fast and sudden in a short duration of less than half an hour or so. The other form of breathlessness, develops gradually, which was non-existent a few months before. Dr Saran further elaborated that acute breathlessness occurs when the pumping power of the heart is reduced by fifteen per cent to twenty per cent below the normal ejection level of sixty-five per cent. Patients with severe disorders may have to go for repeated hospitalisations.

Breathlessness when appears with oedema i.e., swelling in the legs, on the stomach, in the lungs, the physicians recommend tests like NT pro-BNP and 2D Echocardiogram to ascertain the stage of heart failure in the patient. A patient with heart failure shows acute or chronic dyspnea, adversely impacting him and resulting in severe breathlessness.

Prevention is the only cure for heart disease, stated Dr Nakul Sinha. He had outlined the various risk factors which cause the onset of heart failure. The risk factors are diabetes, high blood pressure, overweight, lack of sleep, excess salt intake, consuming foods rich in fats especially trans-fat and saturated fat. The outcome of treatments varies depending on the stage at which evaluation is done. Symptoms may not be visible, at times impatient and in other cases, the symptoms manifest in various forms.

Any treatment begins with the focus on providing symptomatic relief to the patients and medications are administered to lessen the risk or worsening of symptoms in almost all cases barring patients with complications. The noticeable relief can be observed in a fortnight or so. Post that further treatment options are reviewed with the patients. It is important for patients to control fluid intake to not more than 1 to 1.5 litres and salt intake within permissible limits. This will help them to control weight.

The advancement in medical sciences brought impactful medications, which are doing wonders in heart failure treatment. Treatment through these modern therapies with medicines is the first preference of the doctors, however, depending on the stage of the patient, CRT devices are recommended. CRT devices are like a pacemaker. LVAD or artificial heart implant is considered in severe heart failure patients. But, when no therapy shows results, the patient is suggested to go for a heart transplant.

Heart transplant has emerged as an important milestone in the treatment of last stage heart failure patients. The challenge lies not only in getting a brain-dead donor, but alertness of the family, coordination, and establishment of the system of harvesting the heart. There is a seventy per cent chance that a person with a heart transplant may expect to live, five to seven years under massive immunological suppressive drugs. A heart transplant enables a person to work normally as he would have an ejection fraction equal to a person with a healthy heart, said Dr Nakul Sinha.

Treatment focuses on improving the quality of life and longevity of heart failure patients. Patients must cut down on smoking and adopt healthy lifestyles for a healthy heart. Cutting down on junk food and fatty foods is also important. Heart failure does imply some degree of bed rest, but not excessive bed rest said, Dr Nakul Sinha. Excessive bed rest adds problems in the form of adverse impact on muscles and the blood pressure of the person may be unstable. Doctors recommend commencement of resumption of limited exercise and increasing it further based on symptomatic experience. Remember, heart failure isn't about stopping. It's about starting life in a new way.