Heart failure symptoms, causes, and treatment. Heart failure is the leading cause of hospitalization and in-home care services request for older people.

The most frequent comorbidities that the older adults develop as a consequence of heart failure are both cardiovascular and non-cardiovascular. Belonging to the first group are atrial fibrillation, hypertension and ischemic heart disease; while from the second group we find anemia, chronic renal disease, diabetes, depression or dementia, among many others.

With this in mind, the Nomenial team will talk about this condition in this article:

What is Heart Failure

Heart failure is a syndrome characterized by signs that the heart is not working well. Specifically, it occurs when the heart does not eject blood properly, so that blood collects in other areas of the body such as the legs, ankles or abdomen.

Heart failure symptoms, causes, and treatment: Types of heart failure

This prevalent disorder, depending on its durability, can be of two types:

Congestive heart failure

Also known as chronic heart failure or CHF, it is the type of heart failure that lasts a long time.

Acute Heart Failure

Also called decompensated heart failure or AHF, this is the type of heart failure that comes on suddenly. It is the leading cause of hospitalization in adults over 65 years of age (in fact, people who have it will require hospitalization at least once a month).

Likewise, there are other classifications of this disease, among which the one that takes its basis from the type of ventricle it affects stands out:

• Left heart failure. The left side of the heart has to work harder than normal to pump the same amount of blood.
• Right-sided heart failure. It usually results from left ventricular failure. When the left ventricle doesn’t work normally, there are a number of consequences in the body that ultimately result in damage to the right ventricle of the heart.

Heart failure causes

Heart failure develops when the heart muscle suffers a disorder, when this organ is subjected to a great load or when both factors occur at the same time.

The disorders that most often lead to heart failure are

• Ischemic heart disease. It is the most common cause of heart failure. This condition occurs when the coronary arteries become inflamed and begin to accumulate cholesterol plaques on their walls. As these plaques take up more space, the diameter of the artery is reduced, so that blood cannot flow smoothly, causing the heart to malfunction as a result. When the obstruction is so high that it prevents the total passage of blood, the affected person suffers an acute myocardial infarction.
• High blood pressure (hypertension). Blood pressure is the force that blood exerts on the walls of the arteries. If the arteries become more rigid, the blood pressure increases, forcing the heart to pump harder to get the blood to all parts of the body. When this abnormality persists over time, the heart increases in size and becomes more rigid, so that it loses the capacity to propel the blood with each beat.

If you want to know the normal values of blood pressure that our older relative should have, we talk about it in this entry.

Heart failure symptoms, causes, and treatment: Valvular disease

Heart valves are what make it possible for blood to flow in the right direction. When these are damaged, their function must be replaced by the heart, so that the heart must make an extra effort to keep the blood in the right direction. As a result, the heart becomes weak, causing an unwanted reduction in its contraction force.

Cardiomyopathy or myocardiopathy

These are diseases of the heart muscle. With these conditions, the size of the heart increases and it becomes thicker and more fluid than its normal state. Although some people with this abnormality may not realize they have it, others may develop disorders, including treated heart failure.

Cardiomyopathy

Caused by a virus, inflammation of the heart muscle can occur, which can affect either ventricle.

Congenital heart disease

This is an abnormal development of the heart before birth.

Chronic disease

Among them, diabetes stands out as one of the most serious diseases that can affect the functioning of the heart. In this entry we talk, at length, about it.

Heart failure phases

Experts have established four stages, graded from A to D, of heart failure development:

1. The person has not experienced any symptoms that indicate he or she may have this disorder (the heart is functioning normally), although he or she is at high risk of developing it due to some of the causes previously mentioned (high blood pressure, heart disease or diabetes).

2. The patient has a structural heart disorder, so that his heart stops working normally, but has never shown symptoms of heart failure. For example, those who suffer from valve disease.

This phase and the previous one constitute mild heart failure.

3. The person has experienced symptoms of heart failure, such as those listed at the point where we treat their main symptoms.

4. Late-stage heart failure. Here we have the most severe scenario, end-stage heart failure. The patient is in the terminal phase of the disease, so the symptoms have worsened and his quality of life is greatly impaired. In this stage, the person usually stays long periods of time in the hospital receiving specialized treatment.

Before finishing with the phases it is necessary to comment a common question: from what degree is the heart failure invalidating?

When the patient’s profession requires effort, high stress or emotional tension, permanent disability may be recognized to a total degree. The worker may, however, engage in other activities that are less physically and psychologically demanding.

Likewise, absolute permanent disability shall be recognized when the degree of heart failure is totally incompatible with any action and task requiring effort, so that the patient cannot even perform sedentary work.

Heart failure symptoms

The most characteristic symptoms of heart failure are the following:

• Shortness of breath when performing certain activities such as lying down or making different efforts.
• The feeling of suffocation is worse at night.
• Fatigue: Weakness and fatigue.
• Swelling of the lower extremities (leg edema from heart failure).
• Mental fatigue: difficulty concentrating, irritability or dizziness.
• Fast and irregular heartbeat.
• Poor ability to breathe
• Fluid retention.
• Lack of appetite and nausea
• Cough with white or pink phlegm stained with blood.
• Cold and wet skin.
• Swollen veins in the neck.
• In severe cases: sudden and intense shortness of breath and cough with frothy mucus.
• If we are facing a heart attack: sharp pain in the chest.
• Heart failure treatment
• As a chronic disease that we have already indicated, those who suffer from heart failure need lifelong treatment. Thanks to the treatment, the heart of the affected person will be able to become stronger and its most serious symptoms will decrease.

In very rare cases, however, physicians may be able to reverse heart failure by treating the direct cause of the failure (i.e., repairing the abnormal heart valve or regulating the heart rate). Most commonly, however, treatment is aimed at reducing the signs and symptoms of the condition, not eliminating it entirely, but improving its quality and life expectancy.

Thus, the treatment may consist of:

• Medication: Doctors will treat this condition with one or more drugs with which they will attenuate the direct causes and consequences of the heart failure (for example, medication may be prescribed to reduce blood pressure, balance the heart rhythm as much as possible, improve the diuretic capacity or increase the strength of the heart muscle contractions).
• Surgery: Common surgical procedures include coronary artery bypass surgery, heart valve repair or, in more severe cases, a heart transplant.

Heart Failure Life expectancy

The life expectancy of a heart failure patient is much shorter than the general population believes.

As specialists never tire of warning, we cannot link heart failure to a normal consequence of aging. Considering it this way will cause us to trivialize the disorder and not treat it with the urgency and rigor it requires.

Thus, for example, heart failure in an 85-year-old is not something normal, but rather a serious condition and, as such, we must provide our older adults patient with the permanent attention that his condition requires.