Do you sometimes feel short of breath, swollen feet and ankles when you are a little tired? Or do you wake up at night with difficulty breathing? These may be small signs that your heart is working a little weakly. In medicine, we call this condition 'Congestive Heart Failure'. Don't be afraid when you hear this name. This does not mean that your heart has stopped working. However, it does mean that its efficiency has decreased a little. Let's talk about everything clearly and simply.
Simply put, what is heart failure?
Imagine that our body is a city, and the heart is the main water pumping station that supplies water to that city. This pumping station pumps the water (that is, the blood our body needs) to every house and every place in the city. Now imagine, what happens if the power of this pumping station decreases a little? The amount of water pumped becomes insufficient. As a result, water does not reach some places, and in some places (the pipes) it becomes clogged with water.
Congestive Heart Failure is a similar condition. Your heart is unable to pump enough blood to meet the body's needs. This means that the heart doesn't stop working, but its efficiency is reduced. When this blood pumping ability decreases, blood starts to pool in different parts of the body. It's like water getting stuck in pipes. The most common places where blood pools are the lungs, legs, and feet .
There are several main types of heart failure:
- Left-sided heart failure: This is the most common type.
- Right-sided heart failure: This is often caused by weakness on the left side.
- High-output heart failure: This is a somewhat rare condition.
What are the symptoms of this condition?
Symptoms of heart failure can vary from person to person. Some people may have mild symptoms, while others may have severe symptoms. Sometimes symptoms may come and go. However, having no symptoms does not mean that you are completely cured of the condition.
Be careful of these characteristics.
| Symptom | A simple explanation |
|---|---|
| Shortness of breath | Fatigue, especially when walking, climbing stairs, or engaging in any activity. |
| Waking up at night with shortness of breath | This condition can occur due to fluid accumulating in the lungs while lying in bed. It is also a symptom of this condition, which is the need to sleep with two or three pillows. |
| Swelling of the legs, ankles, and abdomen | This swelling is caused by fluid accumulation in the lower parts of the body. If it feels like a dimple when pressed with a finger, that is a significant sign. |
| Sudden weight gain | Weight gain can occur in a few days, not due to fat, but due to fluid retention in the body. |
| Frequent fatigue | You may feel tired all the time because your body's organs are not getting enough oxygenated blood. |
| Palpitations | Because the heart is weak, it tries to beat more often to compensate. |
| Dry cough | A cough that doesn't produce mucus, especially when you're sitting for a long time. |
| Loss of appetite or nausea | These symptoms can occur due to a decrease in the amount of blood flowing to the digestive system. |
The most important thing is that if you have these symptoms, you should definitely see your doctor for advice. The earlier you detect it, the easier it is to treat.
Why does this happen? What are the causes of heart failure?
The heart is a muscle. Anything that damages this muscle or puts too much strain on it can cause the heart to weaken over time.
Here are some of the main reasons:
- Heart attack and coronary artery disease: Damage to the heart muscle due to blockage of the blood vessels that supply blood to the heart.
- High blood pressure (Hypertension): The heart has to work harder over time to pump blood against high blood pressure.
- Diabetes: Diabetes can damage blood vessels and heart muscle.
- Cardiomyopathy: Weakening of the heart muscle due to genetic causes, viral infections, etc.
- Heart valve problems: When the heart valves do not close or open properly, blood begins to flow backward.
- Kidney disease: When the kidneys do not function properly, fluid and salt accumulate in the body, increasing blood pressure and putting a strain on the heart.
- Congenital heart disease: Certain defects of the heart that are present at birth.
- Unhealthy lifestyle:
- Tobacco and drug use.
- Excessive alcohol consumption.
- Obesity.
- Diet high in salt and fat.
Let's identify the stages of heart failure.
Doctors divide the condition into four stages (A, B, C, and D). This makes it easier to understand the severity of the disease and how to treat it. Most importantly, the goal of treatment is to stop or slow down the progression of these stages.
| Stage | What does this mean? |
|---|---|
| Phase A | These people do not yet have heart failure, but are at high risk of developing it in the future (e.g. high blood pressure, diabetes, family history of the disease). |
| Phase B | Some structural change or weakness in the heart has begun, but symptoms have not yet appeared . |
| Stage C | Heart failure has been confirmed, and symptoms are present or have been present in the past (such as shortness of breath, swelling of the legs). |
| Phase D | This is the final stage of the disease . It is difficult to control the symptoms with standard treatments. Specialized treatment is required. |
What are the treatment options?
The good news is that there are many treatments available today that can help manage this condition. While it cannot be cured completely, symptoms can be controlled and a person can live a comfortable and happy life. Treatment options depend on the stage of the patient and the cause.
Lifestyle changes (this is essential for everyone!)
- Salt control: It is essential to reduce salt in your diet. Salt increases fluid retention in the body, increasing the strain on the heart.
- Fluid control: Some people may be advised by their doctor to limit the amount of water they drink per day.
- Maintaining a healthy weight: Losing weight can reduce the strain on the heart.
- Exercise: As advised by your doctor, engaging in gentle exercise such as walking strengthens the heart muscle.
- Quit smoking and alcohol: These are things that directly harm the heart.
Medications
Your doctor will prescribe one or more medications depending on your condition. These medications can:
- Reducing the burden on the heart.
- Controlling the heartbeat.
- Excreting excess fluid accumulated in the body through urine (we call this `Diuretics` or `water pills`).
- Controlling blood pressure.
Important: Never stop taking your doctor's prescribed medication or change the dosage on your own. This is because these medications are designed to protect your heart.
Specialized treatments and surgeries
In some severe cases, other treatments may be needed in addition to medications.
- Implantable Cardiac Defibrillator (ICD): A small device placed under the skin to stop dangerous heart rhythm irregularities.
- Biventricular Pacemaker: A device that helps the heart's chambers contract precisely together.
- Surgery: Surgery may be required to repair blocked arteries in the heart (bypass surgery) or valves (valve surgery).
- Heart Transplant: The last option considered for those in the final stages of the disease.
What should you do? How to take care of yourself?
When living with this condition, you have to take good care of your body.
1. Weigh yourself daily: Weigh yourself at the same time, wearing the same clothes. If you suddenly gain 2 kilos in a day or two, it means that you are gaining water weight. Tell your doctor immediately.
2. Pay attention to symptoms: Pay attention if you have increasing difficulty breathing, swelling, or fatigue.
3. Take your medicine on time: Never miss a dose of medicine.
4. Follow your doctor's instructions: Follow your doctor's instructions exactly. Attend clinics on time.
When should you seek immediate medical advice?
| Talk to your doctor if these symptoms are new or worsen: | |
|---|---|
| |
| Go to the hospital's Emergency Department (ETU) immediately if you have these symptoms: | |
|
This is a long-term condition. So sometimes you may feel sad and anxious. That's normal. Talk to your family and friends about this. If necessary, seek help from a mental health professional. Talk to your doctor about everything you're feeling.
Take-Home Message
- Congestive Heart Failure does not mean that the heart has stopped working. It means that its efficiency has decreased.
- Be aware of symptoms like shortness of breath, swelling in the legs, and frequent fatigue. Don't ignore these.
- This condition can be well controlled by making lifestyle changes (reducing salt, exercising) and taking the medication prescribed by your doctor.
- Keep track of your weight and changes in your symptoms daily. If you notice any changes, tell your doctor immediately.
- You are not alone. There are doctors, family, and friends who can help you on this journey. Don't be afraid to ask for their support.
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