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Good Health starts with the Heart

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A generation ago, heart disease affected mostly men in their 50s and 60s. But now, it’s affecting more women and men in their 20s to 40s. The issue stems from the fact that most young adults don’t realize they’re at risk of a heart attack and do little or nothing to improve their health. 

Heart failure is a condition characterized by inability of the heart to pump enough blood to meet the body's needs. In some cases, the heart can't fill with enough blood and in few cases; the heart can't pump blood to the rest of the body with enough force. The term "heart failure" doesn't necessarily mean that the heart has stopped or is about to stop working. Heart failure is a common, serious, costly and potentially fatal condition that requires immediate medical care. In the first year after diagnosis the chance of fatality is about 35 per cent.

 What Causes Heart Failure?

Conditions that damage or overwork the heart muscle can cause heart failure. As the heart weakens over a period of time, certain proteins and other substances may be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen the condition further.

Common Causes of Heart Failure

The most common causes of heart failure are coronary heart disease (CHD), high blood pressure, and diabetes. Hence, treating these problems can prevent heart failure.

There are many other diseases and conditions that can also lead to heart failure, such as:

1. Cardiomyopathy or heart muscle disease: Cardiomyopathy may be present at birth or may develop due to injury or infection.

2. Heart valve disease: Problems with the heart valves may be present at birth or due to infection, heart attack, or damage from heart disease.

3. Arrhythmias or irregular heartbeats: These heart problems may be present at birth or due to heart disease or heart defects.

4. Congenital heart defects

These heart problems are present at the birth of the child. Other factors also can injure the heart muscle and lead to heart failure. Examples include:

Treatments for cancer, such as radiation and chemotherapy

· Thyroid disorders

· Alcohol abuse or cocaine and other illegal drug use

· HIV/AIDS

· Too much vitamin E

 Heart Failure Symptoms: The symptoms of heart failure include persistent coughing, tiredness and shortness of breath, pulmonary edema (excess fluid in lungs), pleural effusion (excess fluid around lungs), pumping action of the heart grows weaker, swelling in abdomen and swelling in ankles and legs. 

How is Heart Failure Diagnosed?

The diagnosis is done based on the medical and family history, a physical examination, and a couple of tests. Because the signs and symptoms of heart failure are common in other conditions, the doctor will:

· Find out whether one has a disease or condition that can cause heart failure, such as coronary heart disease (CHD), high blood pressure, or diabetes.

· Rule out other causes of the symptoms.

· Find any damage to the heart and check how well the heart pumps blood.

· If there is any medical or family history, early diagnosis and treatment of heart failure can help people live longer and be more active in their life.

Managing Heart Failure

Generally heart failure can’t be cured but one can learn to manage its symptoms. The following are some of the tips.

1. Taking medicine is a key factor in treating heart failure.

2. It is important to decrease the amount of sodium in your diet as it causes extra fluid to build up in your body.

Four basic steps to reduce sodium in your diet:

· Stop adding salt to your food

· Adapt your preferred foods to low sodium versions

· Fresh fruits and vegetables including freshly squeezed fruit and vegetable juices have very little sodium. The same is true for fresh meat, poultry and fish.

3. Exercise is good for you!

· Improve the flow of blood through the body

· Strengthen your heart and body

· Tone your energy level

· Manage stress

 Medical Management of Heart Failure

If you have heart failure, there are medications that your doctor would have advised. As with any medication, it is important that you take them as prescribed. Earlier heart failure had no cure but could only be managed through medical management. But now with the advances depending on the cause Cardiac Resynchronization Therapy (CRT), Implantable Cardioverter Defibrillator (ICD), ventricular assist devices or a heart transplant may be recommended.

 Cardiac Resynchronization Therapy for Heart Failure: CRT is a significant new treatment for symptoms associated with congestive heart failure (CHF) caused by weakening of the heart muscle that disturbs heart rhythm, leading to irregular heartbeats or irregular heart rhythm and fails to pump blood to different organs of the body. In heart failure patients CRT is used to help improve the heart's rhythm and pumping capacity. The procedure involves implanting a small coin sized pacemaker, generally just below the collarbone. Three wires connected to the device, emit tiny pulses of electricity to correct and “resynchronize” the heart and thereby improving the pumping capacity. 

Implantable Cardioverter Defibrillator (ICD): Some people who have severe heart failure or serious irregular heartbeats are candidates for implantable defibrillators. An ICD is a small device that’s placed in the chest or abdomen. An ICD uses electrical pulses or shocks to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest (SCA). SCA is a condition in which the heart suddenly stops beating. If the heart stops beating, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes. ICD acts as an emergency room in the heart and prevents sudden deaths. 

Heart transplant: Some people have severe, progressive heart failure that can't be helped by medications and dietary and lifestyle changes. In such cases a heart transplant may be the only effective treatment option. Surgeons replace the damaged heart with a healthy one taken from a donor who has been declared brain dead. The outlook for people with heart transplants is good now-a-days with the availability of current and latest generation immunosuppressive agents also because of this the chances of rejection post transplant have become less. With the exception of having to take lifelong medication to keep the body from rejecting the new heart, many heart transplant recipients lead long and productive lives. Also due to more awareness and due to increase in the availability of donors more heart transplants have become a reality and a boon for patients with refractory heart failure. In fact, we have a people who have lived a healthy life after undergoing a heart transplant for more than 20 years and the longest surviving patient is living even after 31-years after a heart transplant.

For People Who Have Healthy Hearts

If you have a healthy heart, you can take precautions to prevent heart diseases. To reduce your risk of heart diseases:

· Follow a healthy diet which includes a variety of fruits, vegetables, and whole grains. Diet also includes lean meats, poultry, fish, beans, and low-fat milk or milk products. 

· If you smoke, try to quit. Talk to your doctor about products that can help you quit smoking. Also, try to avoid second-hand smoke.

 Lose weight if you're overweight or obese

Involve yourself in physical activity regularly. People gain from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.

On a day-day basis our focus is on creating healthy heart environments. By ensuring that everyone has the chance to make healthy heart choices wherever they live, work and play. Regular heart checks encourage us to reduce our cardiovascular risk, and promote a heart-healthy planet.

Dr. Sai Sudhakar, MD, DM, FRCP (Edin), FACC (U.S.A)
Chief Cardiac Transplant Physician, Senior Interventional Cardiologist and Director, Cath Lab, Global Hospitals, Hyderabad. 

Dr. Rahul Chandola, MS, M. Ch, CTVS
Senior Consultant, Cardiothoracic Surgeon and Heart & Lung Transplantation Specialist, Global Hospitals.

CASE 1:

 “But for Global Hospitals, I might have not lived to see this day”

I hail from Krishna District and was suffering from a heart disease for a very long time. I consulted many cardiologists and visited many hospitals in Andhra Pradesh and Telangana but none were able to diagnose my condition. Then in 2010, I was referred to Global Hospitals in Hyderabad. From the very first visit the doctors diagnosed my condition and advised me correctly. They said that I had to undergo a transplant as it was the only option I had, so after undergoing all the work-ups in November 2010, I underwent the heart transplant. I am now 44 years and it is now close to five years since the transplant and I am able to do all my activities normally. But for Global Hospitals, I might have not lived to see this day; in fact my heart transplant was the first in Telangana and Andhra Pradesh.

- Ramana Rao, Heart Transplant Patient.

 CASE 2:

 “Age no barrier to get treated for heart issues”

After retiring as a professor, I was suffering from a heart related ailment called dilated cardiomyopathy. I visited many hospitals in Hyderabad but no one was able to give proper solution. Then in 2014, when I visited my relatives in Bangalore they asked me to go to Global Hospitals in Hyderabad. At Global Hospitals, the team of cardiologists at Global Heart Institute did a thorough examination and suggested that I go for an implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) combo device. Today, after the implant by following the advice of my doctors even though I am 77-years-old, I have got relief from my heart ailment and am leading a normal life.

 - Professor Venkateshwarlu Panda

Updated on December 27, 2017