Heart Failure
ENGLISH / MALTESE
What is heart failure?
Heart failure is a term that is frequently used, however, is often not understood
The heart acts as a pump that pushes your blood throughout the body
Occasionally, your heart may not pump blood out efficiently
This does not mean your heart has stopped pumping altogether
Heart Failure is a chronic disease that is controlled by lifestyle changes and treatment.
The disease can occur at any age; however, it is more common in older people
“Internationally, heart failure is the number 1 cause for hospitalisation with 26 million heart failure patients worldwide”
How common is heart failure in Malta?
Heart failure is a common disease in Malta, with approximately 8000 patients suffering from it. It contributes to approximately 5.7% of all deaths and this rate is increasing at an alarming pace.
What will I feel if I have heart failure?
Shortness of breath
Weakness and fatigue.
Swelling of your legs, starting from the feet, extending upwards
Most of these symptoms are because of the lack of strength of the heart’s pumping mechanism which leads to fluid build-up in your lungs, legs, ankles, feet, abdomen and back.
What causes heart failure?
Hypertension (High blood pressure) - places extra strain on your heart over time
Heart attack- causes damage to your heart muscle leading directly to a reduced pumping function
Inherited or acquired cardiomyopathy- disease of your heart muscle
Less common causes of heart failure include:
Abnormal heart rhythm (arrhythmia); such as atrial fibrillation.
Anaemia - low blood level
Damaged heart valves
Heart conditions that you are born with (congenital heart disease)
Certain medications including types of chemotherapy
Excessive alcohol intake
Abnormal thyroid hormone levels
Pulmonary hypertension – high blood pressure within the blood vessels of your lung
How will I know if I have heart failure?
Visit your doctor if you are concerned you have heart failure
Your doctor will ask you questions and examine you
Several tests may be performed including:
Blood tests
Chest X-ray - this helps the physician to view the condition of your heart and lung.
Electrocardiogram (ECG): a device which helps assess the electrical activity of your heart
Exercise stress test: helps determine your heart’s function and exercise capabilities
Echocardiogram: An ultrasound of your heart. This is perhaps the most important test which allows your doctor to examine the heart’s function.
Other tests may include MRI scan, CT scan and a coronary angiogram of your heart.
Some of the commonest symptoms of Heart Failure are shortness of breath, tiredness and fatigue.
How can I treat heart failure?
No cure exists for heart failure
Treatment aims to improve your symptoms and reduce the progression of heart failure
Lifestyle changes are also important:
Regular exercise
Maintain a healthy weight
Blood pressure control
Stop smoking
Limit your fluid intake to avoid fluid accumulation (only if advised by your doctor)
Weigh yourself regularly to get an early indication of fluid accumulation
You may be prescribed medication:
Prognostic medications like ACE inhibitors (for example perindopril, enalapril), B-blockers (for example carvedilol) and Mineralocorticosteroids (like spironolactone or eplerenone).
Symptoms relief medications like diuretics (for example bumetanide) which help the body remove excess fluid which accumulates due to heart failure
Occasionally, you may benefit from an implantable t device such as a Pacemaker, Implantable cardioverter defibrillator (ICD) or cardiac resynchronisation therapy (CRT). These devices may help improve the pumping action of your heart by regulating the electrical activity.
You may be referred to the Heart Failure Clinic at Mater Dei Hospital. This clinic specialises in heart failure and follows up, assesses, and evaluates you closely
Take-Home Messages
Heart failure occurs when your heart’s pumping function does not work effectively
Heart failure may result from several causes, commonly hypertension and a heart attack
An echocardiogram is often needed to diagnose heart failure
Treatment is aimed at improving your survival rate, decrease hospitalisation and relieving your symptoms
Lifestyle changes are important in heart failure
HELP AND SUPPORT
If you have any questions regarding our article feel free to contact us on info@maltaheartfoundation.org or our Facebook page.
This article was authored by Dr. Samuel Attard and edited by Dr. Neil Grech, in collaboration with the Malta Heart Foundation and Maltese Cardiac Society.