Heart failure, what is it?
We talk about heart failure when the heart is no longer pumping well enough. The heart is no longer able to send blood properly through the body. Your organs (eg kidneys, brain) and muscles therefore receive less oxygen and nutrients.
Types of heart failure
There are 2 forms of heart failure: acute heart failure and chronic heart failure. The symptoms are similar.
In acute heart failure, symptoms come on suddenly and increase rapidly. This can happen for no clear reason. However, more often than not, acute heart failure happens in a person who already has chronic heart failure. Prompt treatment is necessary;
In chronic heart failure, symptoms appear gradually. The heart gradually pumps less and less well.
Causes of heart failure
Heart failure is usually caused by another cardiovascular disease:
arterial hypertension;
arteriosclerosis;
previous heart attack;
heart rhythm disorder;
leaky heart valve.
Sometimes other causes are causing the problem, such as heart muscle disease or extensive infection.
It is important to identify and treat the cause of heart failure.
Where and how often?
Heart failure with symptoms (symptomatic heart failure) affects 1 to 2 in 100 adults in Europe.
It becomes more common with age:
out of 100 people over 70 years of age, more than 10 suffer from heart failure;
out of 100 people with heart failure, 50 are over 80 years old.
How to recognize heart failure?
The main symptoms of heart failure are:
shortness of breath during light exertion, at rest, or when lying down;
abnormal fatigue during usual activities;
swelling of the feet or legs or weight gain over a short period of time due to a build-up of fluid (edema);
loss of appetite and weight loss (in advanced heart failure);
nausea or stomach pain (only in acute heart failure).
How is the diagnosis made?
Discussion
Your doctor will first ask you questions to find out more about:
your complaints;
the evolution of your complaints;
your previous illnesses or complaints;
your possible risk of heart disease;
any medications you are already taking.
Exams
Then your doctor will do a physical exam:
he will listen to your lungs and your heart;
it will examine:
if your ankles are swollen (edema),
pressure in one of the veins.
If he thinks, based on the discussion and physical examination, that you have heart failure, he will order additional tests to confirm or exclude the diagnosis:
An electrocardiogram (ECG)
this allows you to know if:
your heart is enlarged;
you have ever had a heart attack;
your heart does not beat regularly (heart rhythm disorder).
An ultrasound of the heart (echocardiography)
this examination is carried out by a heart specialist (cardiologist);
it is used to determine:
the type of heart failure, in particular, which parts and functions of the heart are affected.
the severity of heart failure.
A chest x-ray
this allows the doctor to see:
the size of the heart;
if there is fluid in the lungs (pulmonary edema).
A blood test, with or without BNP or proBNP assay
BNP and proBNP are a type of hormone;
the heart produces it when it is not working well;
they are therefore markers of heart failure;
this exam is not reimbursed by the mutual.
Additional tests
The cardiologist may decide to perform other tests, such as monitoring your heart for 24 hours, to:
better understand the possible causes of your symptoms;
determine and adapt the treatment to your situation.
What can you do ?
If you are suffering from heart failure, it is very important to have a healthy lifestyle.
Here are a few tips.
To move
Get enough exercise and regularly, but don’t force yourself.
Exercise has a positive effect on:
maintaining your capacity for effort;
your weight, even if this effect is small.
Good forms of exercise are:
walking;
the bike ;
swimming ;
strength training: you train your muscles, for example with weights, squats, … first with the help of your physiotherapist and then on your own.
Exercise is safe, even with heart failure.
Are you hesitating? Ask your doctor or physiotherapist for advice.
If necessary, have a sports coach accompany you via a local exercise project supervised by