Heart failure

Heart failure occurs when the heart’s pumping function is reduced below normal. This results in an insufficient blood supply to other organs, such as the liver and kidneys.

The heart failure you are experiencing is sometimes of unknown origin. It is most often the consequence of coronary artery disease; your medical history then includes one or more myocardial infarctions, and possibly coronary artery bypass surgery.

It may follow heart valve disease, in which case you have probably already undergone replacement of one or more valves. It may also be caused by a viral infection, drug toxicity (chemotherapy), dietary toxicity (alcoholism), or even pregnancy (very rare!).

The course of your heart disease invariably and irreversibly leads to cardiac dilatation. Your heart is no longer able to ensure adequate perfusion of the organs, causing symptoms and dysfunction of other organs despite appropriate drug treatment.

Coronary artery disease (= ischaemic cardiomyopathies, sequelae of myocardial infarction, etc.), diabetes, valvular heart disease, high blood pressure, pulmonary embolism, and myocarditis caused by a viral infection or toxins.

A number of symptoms are associated with heart failure. Shortness of breath, which may occur at rest or during exertion, is undoubtedly one of the symptoms characteristic of heart failure. Other symptoms include rapid fatigue and fluid retention (oedema). Other symptoms, such as tachycardia, weight gain over a few days and reduced urine output, are observed in heart failure.
The diagnosis is readily suspected based on the symptoms and confirmed by cardiac ultrasound. The cause of the decompensation must then be sought among the diseases mentioned above.

Several types of medication are useful in the treatment of heart failure. These medications aim to improve the heart’s pumping function, reduce the signs and symptoms of heart failure, or reduce stress on the heart. Currently, medications known as “angiotensin-converting enzyme inhibitors” (e.g. Capoten, Zestril, Coversyl, Tritace, etc.) can be considered the cornerstone of treatment. In second place are beta-blockers (e.g. Kredex, Isoten, etc.), which, by reducing the heart’s energy requirements and oxygen consumption, are also a basic treatment for decompensated heart failure.
It should not be forgotten that certain simple dietary measures (a salt-free diet and fluid restriction) are easy-to-implement treatments for reducing the signs of heart failure.