Heart Failure In Today’s World

Heart failure may be a commonly rising medical problem these days, especially within the elderly population. The prevalence of heart failure ranges from 1.3-4.5 million with an annual incidence of 0.5-1.8 million people worldwide. quite 65 years aged contribute about 10-15% of heart failure patients within the general population. The mortality is about 30% in 1st one year and as high to 50% within the next 5 years even with treatment. The common causes of heart failure are ischemic heart condition (blockage of arteries), rheumatic heart disease (valvular disease), uncontrolled blood pressure, thyroid abnormality, and cardiomyopathies (heart muscle disease).

Heart failure may be a complex syndrome where the guts isn’t capable of meeting the nutritional or oxygen requirement of the body thanks to its structural or functional abnormality.

Manifestation/symptoms of Heart Failure:
The most common symptom of coronary failure is shortness of breath on exertion or at rest or sometimes while sleeping. coronary failure patients often present themselves with swelling of both feet, abdominal distension thanks to fluid overload within the body. Generalized weakness and fatigue with exercise intolerance also are common symptoms. Sometimes, coughing during the already dark might be an indicator of incipient coronary failure .

How Indian coronary failure patients are different?
Heart failure within the Indian community presents a few decade earlier, more commonly with low pumping of the guts and with the more severe outcome on treatment as compared to the western population.

Tests useful within the evaluation of heart failure:
ECG could show abnormal cardiac rhythm , ECHO cardiography delineates the structure and performance of the guts , Chest X-ray helps in detecting cardiomegaly or fluid within the lungs.

Blood tests like thyroid profile, BNP/NT-Pro BNP differentiates between breathlessness thanks to coronary failure from other causes.

Coronary Angiography or Cardiac MRI might be needed in selected patients.

Treatment modality for coronary failure patients:
Lifestyle modification
– restriction of salt & fluid as advised by the doctor. Regular exercise training to take care of physical endurance. Weight reduction for overweight and obese patients. Control of vital sign , blood glucose , and cholesterol.

The available medications for coronary failure are ACE inhibitors, beta-blockers, diuretics, digoxin, newer drug valsartan/secubitril combination, and aldosterone antagonist have shown promising role over decades in prolonging the lifetime of coronary failure patients.

Devices helpful in coronary failure patients:
Automated Intracardiac Defibrillator (AICD). Biventricular Pacing Device (CRT-D/P). Mechanical heart (left ventricular assisted device).

Role of heart transplantation in heart failure:
Patients who are in refractory coronary failure even on the simplest of medicines are the candidates for heart transplantation. Heart transplantation has grown well within the past one to two-decade with good results but in fact with limitation of the donor heart and life long immuno-suppressive medications.

Conclusion:
Observing the increasing trend of coronary failure patients within the community needs early identification and treatment in order that morbidity, mortality, and financial burden over the family and country health system might be placed on check.

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