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Acute heart failure: Treatment, symptoms, advice and help

About acute heart failure

Acute heart failure, also known as ‘congestive heart failure’ is a medical emergency requiring immediate hospitalisation. As the name suggests, the heart fails to carry out its function of filling and pumping out blood to the other organs.

Acute heart failure: Incidence, age and sex

This condition mainly occurs in old people. Acute heart failure is one of the principal causes of hospital admissions in people above 65 years of age. Acute heart failure has no gender bias.

Signs and symptoms of acute heart failure: Diagnosis

The features of acute heart failure may present within hours. The patient may complain of difficulty in breathing, especially on lying down. This is the most significant symptom and may be accompanied by chest pain, cough palpitations and swelling in the ankle region. On examination by a cardiologist, signs like collection of fluid in lungs, low blood pressure or enlarged liver may be observed. The patient may also have a history of increased fatigue during physical activity.

Causes and prevention of acute heart failure

The heart consists of four chambers two or which are called atria and the other two ventricles. The function of the heart is to take in all the impure blood coming from different organs, purify it by circulating it through lungs, and then collecting it in the left sided ventricle which will eventually pump it out to be distributed to all the organs. Acute heart failure occurs when the heart suddenly under-performs the function of collecting and pumping out blood.

When the right side of heart constituting one atrium and one ventricle fail to function, it is termed as right heart failure. Left heart failure occurs when atrium and ventricle on the left side stop functioning. Acute heart failure can present as either right-sided or left-sided heart failure but it is the left side of heart which is most commonly affected in an acute stage.

Several diseases can cause heart failure, of which long-standing high blood pressure and history of coronary artery disease are the commonest. A person with a history of heart attacks is especially prone to a case of heart failure. It is always advisable to educate such patients and motivate them to encompass healthy lifestyle changes. These lifestyle modifications may include reduction in psychological stress, regular physical exercise, weight control, healthy eating and smoking cessation. Other heart problems which may result in heart failure include disease of the heart valves and cardiomyopathy which is a disorder of the heart muscles. Some conditions which demand an increased blood output from the heart like anaemia and high levels of thyroid hormones may also precipitate acute heart failure. Diabetes and obesity are some other factors which enhance the risk of heart problems which may result in heart failure.

Acute heart failure: Complications

Since the heart supplies blood to all the organs of the body; any failure in its function may impact other organs too, especially the major organs like the liver, the lungs, the kidneys and the brain. Reduced blood supply may result in a kidney failure or heart attack. Diminished blood flow also affects the brain causing a stroke in which the limbs get paralysed. The liver may also get damaged due to the increased collection of fluids. Consequently it is tremendously important to manage acute heart failure so as to prevent any life-threatening complications.

Acute heart failure: Treatment

If acute heart failure is suspected, no time should be lost in confirming the diagnosis which is done by lab tests, and imaging techniques like x-ray and echo. Once confirmed, patient with acute heart failure is immediately treated in an ICU setting with medication and oxygen. The patient is advised to remain in a half lying position and given high flow oxygen. Intravenous medications like morphine and diuretics (drugs which remove excess fluid) are administered. The patient is educated and motivated to adopt a healthy lifestyle changes which may prevent recurrence of such instances in future.