Heart failure is a chronic condition in which the heart muscle is unable to pump blood efficiently enough to meet the body’s demands. Despite its name, heart failure does not mean the heart has stopped working, it means the heart is not working as effectively as it should. Over time, this leads to a build-up of fluid in the lungs and body, causing breathlessness, fatigue, and swelling that can progressively limit a patient’s ability to carry out everyday activities.
What is Heart Failure?
Heart failure occurs when the heart’s pumping function is impaired to the point where it can no longer adequately circulate blood to the rest of the body. This can happen in two primary ways – either the heart muscle becomes too weak to pump effectively (systolic heart failure), or the heart muscle becomes too stiff to fill properly between beats (diastolic heart failure).
A key measurement used to assess heart failure severity is the ejection fraction, which represents the percentage of blood pumped out of the heart’s main chamber with each beat. In a healthy heart, the ejection fraction is 50% or higher. In systolic heart failure, this value falls significantly, indicating reduced pumping capacity. Understanding the type and severity of heart failure is essential for selecting the most appropriate treatment plan.
Symptoms of Heart Failure
Heart failure symptoms develop gradually in most patients but can also appear suddenly in acute cases. The severity of symptoms varies depending on the stage and type of heart failure.
Common symptoms include:
- Shortness of breath (dyspnea) when you exert yourself or when you lie down
- Fatigue and weakness
- Swelling (edema) in your legs, ankles and feet
- Rapid or irregular heartbeat
- Reduced ability to exercise
- Persistent cough or wheezing with white or pink blood-tinged phlegm
- Increased need to urinate at night
- Swelling of your abdomen (ascites)
- Very rapid weight gain from fluid retention
- Lack of appetite and nausea
- Difficulty concentrating or decreased alertness
- Sudden, severe shortness of breath and coughing up pink, foamy mucus
- Chest pain if your heart failure is caused by a heart attack
If you experience sudden severe breathlessness, chest pain, or coughing up pink foamy mucus, seek emergency care and consult your cardiologist.
Causes and Risk Factors of Heart Failure
Heart failure most commonly develops as a consequence of other cardiac and systemic conditions that gradually weaken or stiffen the heart muscle over time.
Common causes:
- Coronary artery disease and prior heart attack
- High blood pressure (hypertension) causing the heart to overwork
- Cardiomyopathy (disease of the heart muscle)
- Heart valve disease causing backflow or obstruction of blood
- Arrhythmias placing excessive strain on the heart
- Congenital heart defects present from birth
- Viral infections affecting the heart muscle (myocarditis)
Risk factors:
- Uncontrolled hypertension
- Diabetes and insulin resistance
- Obesity and physical inactivity
- Smoking and tobacco use
- Excessive alcohol consumption
- Obstructive sleep apnea
- Chronic kidney disease
- Family history of heart disease
- Certain medications including some chemotherapy agents and NSAIDs
Diagnosis of Heart Failure
An accurate and timely diagnosis is the foundation of effective heart failure management. At Swasthyam Superspeciality Hospital, our cardiologist in Nagpur conducts a thorough clinical assessment and uses a combination of the following investigations:
2D Echocardiography
The most important test in heart failure diagnosis, providing detailed information about the heart’s size, structure, wall motion, valve function, and ejection fraction. This guides classification of heart failure type and severity.
ECG (Electrocardiogram)
Identifies rhythm abnormalities, signs of prior heart attacks, and electrical changes associated with an enlarged or stressed heart.
Chest X Ray
Reveals enlargement of the heart and signs of fluid accumulation in the lungs, a key indicator of heart failure decompensation.
Blood Tests
Including BNP or NT-proBNP, specific biomarkers that rise significantly in heart failure and are used to confirm diagnosis and monitor treatment response. Kidney function, liver function, thyroid, and haemoglobin are also assessed.
TMT (Stress Test)
Evaluates the heart’s response to exertion and helps identify underlying coronary artery disease as a contributing cause.
Coronary Angiography
Recommended when coronary artery disease is suspected as the primary cause, allowing direct visualisation of blockages that may be treatable.
Heart Failure Treatment
Heart failure is a lifelong condition that requires consistent, structured management. At Swasthyam Hospital, our cardiologist develops a personalised treatment plan for each patient, combining lifestyle modifications, medications, and, where appropriate, device or surgical interventions. The goal is to relieve symptoms, slow disease progression, reduce hospitalisation, and improve overall quality of life.
Lifestyle Modifications
A fundamental part of heart failure management. Patients are advised to restrict daily sodium intake to reduce fluid retention, monitor body weight daily for sudden gains indicating fluid accumulation, limit fluid intake as recommended, exercise within safe limits guided by a cardiac rehabilitation program, quit smoking, avoid alcohol, and manage stress effectively.
Medications
Heart failure is primarily managed with a combination of evidence based medications that reduce the workload on the heart, control fluid retention, and improve long term survival. These include ACE inhibitors or ARBs to widen blood vessels and reduce cardiac strain, beta blockers to slow the heart rate and improve pumping efficiency, diuretics (water pills) to eliminate excess fluid from the body and lungs, aldosterone antagonists to reduce fluid retention and improve survival in severe cases, and SGLT2 inhibitors, newer agents now proven to significantly reduce heart failure hospitalisations and mortality. The specific combination and doses are carefully selected and adjusted based on each patient’s response and kidney function.
Device Therapy
In selected patients who do not respond adequately to medications, implantable devices may be recommended. A pacemaker can help when heart failure is accompanied by bradycardia or heart block. An implantable cardioverter defibrillator (ICD) is recommended for patients at risk of life threatening arrhythmias. Cardiac resynchronisation therapy (CRT) uses a specialised pacemaker to coordinate the contractions of both ventricles in patients with electrical dyssynchrony, significantly improving pump function and symptoms.
Treatment of Underlying Causes
Where heart failure is caused by a correctable condition such as a blocked coronary artery or a faulty heart valve, treating the underlying problem is an essential part of management. This may involve coronary angioplasty, bypass surgery, or heart valve repair or replacement, coordinated between our cardiology and cardiac surgery teams.
Cardiac Rehabilitation
A structured program of supervised exercise, education, and psychological support that has been shown to improve symptoms, exercise capacity, and quality of life in heart failure patients. Our team provides personalised rehabilitation guidance at every stage of treatment.
Frequently Asked Questions
Can heart failure be cured?
Heart failure cannot always be cured, but with appropriate treatment it can be effectively managed. Many patients experience significant improvement in symptoms and quality of life, and some recover normal heart function with treatment.
What is the difference between heart failure and a heart attack?
A heart attack occurs when blood flow to a part of the heart is suddenly blocked, causing muscle damage. Heart failure is a chronic condition where the heart muscle is too weak or stiff to pump blood efficiently. A heart attack is one of the common causes of heart failure.
Is heart failure the same as cardiac arrest?
No. Cardiac arrest is when the heart suddenly stops beating entirely, requiring immediate resuscitation. Heart failure is a chronic pumping problem. However, severe heart failure can increase the risk of cardiac arrest.
What foods should heart failure patients avoid?
Heart failure patients should limit high sodium foods, processed and packaged foods, excessive fluids where advised, alcohol, and saturated fats. A diet rich in vegetables, lean proteins, and whole grains is recommended.
How serious is heart failure?
Heart failure is a serious, progressive condition but with the right treatment and lifestyle changes, most patients can live active, fulfilling lives. Early diagnosis and consistent management significantly improve outcomes.
How do I consult a cardiologist in Nagpur for heart failure?
Call +91 8600888444 or visit our OPD at 97/98, Vivekanand Nagar, Near Sai Mandir, Wardha Road, Nagpur 440015. You can also book online through our website.