Have you ever wondered what causes heart failure?

Understanding the reasons behind this condition is crucial for maintaining a healthy heart.

In this article, Karetrip explores five common causes of heart failure, explaining them in simple terms to help you better comprehend and safeguard your heart health.

Let's explore these factors together to promote a stronger and healthier heart.

Causes of Heart Failure

• High blood pressure - also called hypertension , narrowed arteries increases pressure making your heart to work harder,overtime leading to an enlarged heart with less efficient work, resulting in heart failure.

• High cholesterol levels and Diabetes -elevated lipid levels, triglycerides and LDL cholesterol leading to hardening, inflammation of arteries and atherosclerosis

• Tobacco smoking- Nicotine and carbon monoxide from smoke increases the tendency for blood to clot and deposition of plaques leading to narrowed blood vessels leading to hypertension

• Aging- stiffen heart, over 65 years of age.

• Family history

• Lack of physical exercise

• Certain types of radiation and chemotherapy

• Overweight or obesity

• Excessive alcohol intake- leads to vasoconstriction and hypertension

• Depression, anxiety and social isolation

• Not following heart healthy diet

• HIV

• Thyroid - This condition can cause a consistent elevation in heart rate and the heart muscle will thicken over time.

• Congenital heart disease - present since birth , affecting heart’s function, size or shape

• Heart valve disease - heart valves work to balance blood flow,when damaged,blood cannot flow and puts extra strain on heart

• Myocarditis - inflammation of heart muscle,caused by virus or other infections

• Illicit drugs like cocaine

• Abnormal heart rhythms - a fault in electrical activity of the heart making it to beat rapidly or irregularly,which often leads to arrhythmias and heart failure in the long run.

• Low red blood cell count (anemia) - When there aren't enough red blood cells to carry oxygen to the organs, the heart tries to move at a faster heart rate to maintain the circulation. It can become overtaxed from the effort.

• Metabolic syndrome - > 3 risk factors of the following 5 factors: large waist circumference(abdominal obesity),high fasting triglycerides,low HDL (good) cholesterol, high blood pressure and high blood sugar.

• Heart muscle disease - dilated or hypertrophic cardiomyopathy or inflammation (myocarditis)

• Any damage to the heart muscle – whether because of drug or alcohol use, viral or other infections or unknown reasons – increases the risk of heart failure.

Types of Heart Failure

• Left sided - more common than right sided. Reduced ejection fraction (HFrEF) type leads to the left ventricle of your heart not being able to pump enough blood to the rest of your body.Chronic conditions like coronary heart disease,damaged heart valves,inherited conditions.

• Preserved ejection fraction- left side of the heart becomes weak and stiff so can’t receive enough blood making it difficult to supply to the rest of your body.High blood pressure,obesity,Diabetes involves this type.

• Right sided - right side of the heart can’t supply enough blood to lungs, mainly because of the left sided failure making it build up and increase the pressure inside lungs. Conditions related to lungs like Chronic Obstructive Pulmonary Disease (COPD) also can lead to this.

• High output- conditions like anemia(low blood count), hypothyroidism,higher altitude, common in children.

Heart Failure vs. Heart Attack

Heart Attack

Blocking of the blood supply to heart by a blood clot or a buildup/ plaque ,which gradually decreases oxygen and heart muscles begins to weaken and die, needing quick treatment to open the blocked blood vessel and restoration of the normal flow to heart.

Heart Failure

This is a slower process in which heart becomes damaged gradually from working too hard to meet the demands and overtime ,less able to pump enough blood out to meet our body’s required

Symptoms of Heart Failure

• New or worsening shortness of breath - during physical activity or at night when lying flat.You may need several pillows to raise your upper body so you can breathe more easily.

Blood "backs up" in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can't keep up with the supply. This causes fluid to leak into the lungs.

• Coughing produces white or pink blood-tinged mucus and wheezing

• Dizziness,confusion - due to changes in sodium in blood, resulting in reduced blood flow to the brain.

• Weight changes - Reduced blood flow makes it harder to absorb nutrients from your food and may cause weight loss. Extra fluid retention may cause weight gain

• Fatigue, weakness - while shopping, climbing stairs, carrying groceries or walking.The heart can't pump enough blood to meet the needs of body tissues.

Hence the body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain.

• Swelling - as the heart is not able to empty,blood returning from the body can’t enter the heart and backs up in the veins.This forces fluid from the blood vessels into other tissues, causing swelling(edema).

• Heart palpitations- feeling of a racing or pounding in your chest,to substitute for the loss in pumping capacity,the heart beats faster.

• Chest pain

• Discomfort in parts of the upper body

• Loss of appetite or nausea- Digestive system receives less blood and that’s why you feel loss of appetite.

• Constipation

Heart Failure Questions to Ask Your Doctor

• What's my diagnosis? Is heart failure mild? Moderate? Severe?

• What should I expect within the next few weeks, months and years? How is the condition likely to progress?

• What are some specific ways that my daily life will change? Can I still work, play,have sex or do the laundry?

• What are the most important things my family and I can do to manage this condition?

• What strategies have other patients found useful for motivating themselves to eat better, exercise, stop smoking and make other lifestyle changes?

• Do you recommend a cardiac rehabilitation program? If so, where will it take place? How often?

• It’s difficult to keep the medication schedule straight. Is there any way we can simplify it?

• A certain medication is causing side effects that are hard to deal with. Is there some way to minimize those side effects? Is there another equally effective medication available?

• If any symptoms seem to get worse or change suddenly, what’s the best way for us to contact you?

Diagnosing Heart Failure

• Physical examination- Your health care team will ask you about your medical history,list of medications and symptoms,note down your blood pressure,weight,listen to heart sounds with a stethoscope,any swelling of your body and assess your cognition.

• Blood tests - sodium,potassium (electrolytes), albumin (a protein), creatinine (kidney function) and Troponin I.

• Chest X-rays - Whether the heart is enlarged(cardiomegaly),any congestion or fluid in the lungs,and any lung conditions.

• Electrocardiogram (EKG or ECG)- painless and captures your heart’s electrical activity.Whether you've had a heart attack,any thickening,heart rhythm,strength and timing of your heartbeat.

• Echocardiography - painless imaging that uses sound waves to examine the heart's structure and motion like thickness and pumping capacity, size and shape, ejection fraction, condition and function of your 4 heart valves (tricuspid, pulmonic, mitral, aortic).

• Exercise stress test- measures how much exercise your body can handle and how well it works during physical activity on a treadmill.

Some heart problems are easier to diagnose when your heart is working hard and beating fast, monitors your heart rate, rhythm, breathing, blood pressure and how tired you feel during the test.

• B-type natriuretic peptide (BNP)- BNP is a hormone your heart releases. High BNP blood levels can mean your heart doesn't pump well

• Cardiac catheterization - This procedure shows your doctor how well your heart works and whether CAD caused your congestive heart failure.

• Imaging - CT or MRI, coronary angiography etc reveals any heart blockages

Lifestyle Changes for Heart Failure

“Small changes can make a big difference” A good place to start is with the ABCS of heart health:

• Aspirin: Aspirin helps reduce your risk for heart disease and stroke.Before taking aspirin, talk to your doctor about whether aspirin is right for you.

• Blood pressure: Control your blood pressure.

• Cholesterol: Manage your cholesterol.

• Smoking: Quit smoking, or don’t start

• Monitoring your weight - Weighing at the same time each morning, before breakfast and after urinating.

Always wear the same types of clothes without shoes and use the same scale in the same location, will help you see actual changes in weight from day to day.

Write down your weight and bring a copy with you each time you visit your health care professional.

• Quitting smoking

• Being physically active- Regular, moderate-intensity physical activity can help your heart get stronger, such as walking, raking leaves, climbing stairs or playing sports.

Schedule physical activity at the same time every day so it becomes a regular part of your lifestyle.

• Getting enough rest- Rest times are essential because they give the heart a chance to pump more easily.

Like, napping after lunch, putting your feet up for a few minutes every couple of hours or sitting down while performing household tasks such as preparing food or ironing.

• Improve your sleep at night - Use pillows to prop up your head. Avoid naps and big meals, caffeine, and alcohol right before bedtime.

Talk to your health care team to see if you can time your diuretic use so that you’re less likely to wake up to urinate.

• Trying a class in yoga or meditation.

• Anger management- Counting to 10 before answering or responding when you feel angry.

• Joining a support group.

• Tracking your daily fluid intake

• Avoiding or limiting alcohol-This means no more than one to two drinks per day for men and one drink per day for women.

• Eating for a healthy heart- emphasizes a variety of fruits , vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and non-tropical vegetable oils.

Also, limit saturated fat, trans fat, cholesterol, sodium, red meat, sweets and sugar-sweetened beverages.

• Monitoring your blood pressure- monitoring and charting your blood pressure readings at home over time.

• Avoiding flu and pneumonia with vaccinations- Flu (influenza) and pneumonia pose greater dangers for people who have heart failure than for healthy people.

Pneumonia is a lung infection , which keeps your body from using oxygen as well as it should.

Your heart has to work harder to pump oxygenated blood through the body.Get a yearly flu vaccine and a one-time pneumococcal vaccine to guard against the most common form of bacterial pneumonia.

• Washing your hands well and often - especially after using the bathroom and before eating. Keep your hands away from your face.

• Staying safe from COVID-19- People with cardiovascular risk factors or heart disease, along with heart attack and stroke survivors, generally should get vaccinated against COVID-19.

• Following heart patient guidelines for sexual activity- If you have heart failure, being able to have sex depends on your symptoms and the severity of your heart failure. Good communication may lead to resuming sex earlier and enjoying it more.

With the right care, heart failure may not stop you from doing the things you enjoy. Your outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.

If you have a long-term illness such as heart failure should discuss their desires for extended medical care with their doctor and family.

If you have more severe heart failure symptoms, sex should be avoided until your condition is stable and well managed.You should have open and honest talks with your partner about sex.