From Failure to Success: Treating Advanced Heart Failure Through Treatment Options – News18

Heart failure is a chronic and progressive condition where the heart is unable to pump blood effectively, leading to insufficient oxygen and nutrients reaching the body’s tissues. Advanced heart failure refers to the later stages of this condition, characterized by severe symptoms and complications that significantly impact a person’s daily life.

Advanced heart failure is a complex condition where the heart struggles to pump blood effectively, leading to limitations in meeting the body’s metabolic needs. It’s a silent threat that demands our attention, with health experts and cardiologists drawing parallels to the challenges posed by advanced cancer.

In a recent report, ‘Accidental Deaths & Suicides in India’ (2022), a stark reality emerges — the number of deaths caused by heart failure ranged from 25,000 to 28,000 in the last four years. This sheds light on the critical impact cardiovascular diseases, including advanced heart failure, have on our nation. Alarmingly, 27% of all recorded deaths in India have been attributed to cardiovascular diseases, emphasizing the urgent need for awareness and preventive measures.

What do we understand by advanced heart failure?

Advanced heart failure (HF) is a condition where individuals suffering from heart failure experience continual and severe symptoms that disrupt their daily activities, even when receiving the highest tolerated levels of evidence-based medical treatment. This condition makes simpler activities like walking or climbing up the stairs a difficult task and thus impacts the quality of life considerably. One shouldn’t forget that since it affects quality of life, it therefore impacts the person at the psychological level too, as it affects an individual’s ability to function independently. Congenital heart disease, hypertension, heart attack or coronary artery disease, diabetes, valve disease, and an enlarged or infected heart are some of the causes of advanced heart failure.

If a person experiences the following, then the possibility of advancement comes into play:

1. Severe shortness of breathExperiencing severe shortness of breath even at rest is a major indication of advanced heart failure. Additionally, the inability to perform routine tasks can be a symptom.
2. Continuous coughing and wheezingConsistent coughing accompanied by pink-tinged phlegm might occur in this condition.
3. Irregular HeartbeatIn this condition, the risk of irregular heart rhythms, fluttering of the heart, and palpations tends to increase.
4. Swelling and fluid retentionFluid buildup can lead to swelling in the legs, ankles, and abdomen. This can significantly affect the heart’s health.

Other symptoms: These would include loss of appetite, difficulty sleeping, fatigue, and unplanned weight loss or gain.

Challenges in diagnosing advanced heart failure

Determining whether the person is suffering from advanced heart failure remains a major challenge. Some several factors or challenges might hinder the diagnosis of this condition; these include:

1. Non-specific symptomsDuring the early stages, symptoms are non-specific and can be caused by other conditions, such as chronic lung disease or chronic kidney disease. Symptoms like fatigue, weakness, and shortness of breath are not specific to heart failure alone.
2. Subjective presentationThere is variability in the presentation of advanced heart failure among patients. On one hand, some might majorly experience respiratory symptoms, while others might face more fluid retention or fatigue.
3. Delayed recognition of symptomsSince this condition is progressive in nature, individuals tend to adapt to the changes they experience, which makes the recognition of symptoms difficult.
4. Overlap with other conditionsAdvanced heart failure symptoms may share similarities with other cardiovascular and respiratory conditions like chronic obstructive pulmonary disease (COPD), pulmonary hypertension, or valvular heart disease.Differentiating between these conditions might necessitate undergoing various diagnostic tests.These challenges make it important for individuals suffering from heart diseases to be cautious and take cognizance of any unusual experience.
   

   Treating advanced heart failure

   1. MedicationsVarious drugs, including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, aldosterone antagonists, and diuretics, can be employed in the treatment of advanced heart failure.2. Implantable DevicesSeveral implantable devices, such as pacemakers, implantable cardioverter-defibrillators (ICDs), and left ventricular assist devices (LVADs), can be utilized to manage advanced heart failure. Pacemakers regulate heartbeats, ICDs identify and correct hazardous heart rhythms, and LVADs are mechanical pumps implanted to enhance blood circulation.3. SurgerySurgical interventions may be necessary in certain instances to treat advanced heart failure. Procedures like coronary artery bypass grafting (CABG) or heart valve replacement may be required to improve blood flow and reduce the heart’s workload. In some cases, a heart transplant may be explored as an option.4. Lifestyle ModificationsImplementing lifestyle changes can be advantageous in addressing advanced heart failure. These changes may encompass maintaining a healthy weight, engaging in regular exercise, quitting smoking, restricting alcohol consumption, and adopting a low-sodium diet.5. Psychosocial SupportTo treat patients with advanced heart failure, a palliative approach can be adopted. This includes extending emotional support to the patients and incorporating activities that can help improve the patient’s quality of life.There are certain challenges in the diagnosis of advanced heart failure; however, there are several treatment options available today that can help overcome the difficulties. With the advent of advanced technologies and increased awareness, treatment for this condition has become relatively easier.