Heart failure: the heart’s hidden war

In the modern world, as the lights grow brighter and the sounds seem like a captivating symphony, heart failure creeps in like unexpected attacks, making it hard for people to feel safe and secure. Every time the heart works beyond its strength, it confronts a hidden enemy – an illness that troubles the person, and in particular their most important organ, the heart.

Heart failure turns out to be a fairly common disease worldwide: a condition in which the heart’s function fails and it does not supply blood as usual to the body’s most important organs and to the periphery, when the heart does not manage to pump a sufficient amount of blood.

Symptoms of varying severity appear, such as:

• Shortness of breath.
• Weakness.
• Difficulty sleeping at night.
• Exercise intolerance.
• Fluid retention.
• Weight gain.

The disease can develop for various reasons, such as:

• Ischaemic heart disease.
• Heart valve disease.
• Heart rhythm disorders.
• In addition, conditions that make the heart work harder, such as metabolic diseases, anaemia, inflammation and infections.

For patients newly diagnosed with heart failure, and of course where there is no contraindication, treatment with a combination of medications is usually started, in order to prevent heart failure from flaring up and to reduce symptoms, in the hope that the reduced cardiac function will improve over time. Therefore, usually alongside monitoring of blood pressure, pulse and blood tests, we also recommend a follow-up echocardiogram 2–3 months after starting treatment.

A considerable proportion of patients struggle with more severe heart failure as a result of many causes, such as low adherence to treatment, irregular follow-up (leading to less than optimal treatment), concomitant diseases such as kidney failure, electrolyte problems, low baseline blood pressure and sensitivity – which limit patients in terms of maximal heart-failure treatment – and difficulty limiting fluids and salt in the daily diet.

In summary, heart failure: the heart’s hidden war. In today’s world, a systematic approach is needed to identify patients whose cardiac function is not improving and who meet the criteria for a decision between implanting a defibrillator or a biventricular pacemaker. Appropriate treatment can improve not only the patient’s quality of life and prevent repeat hospital admissions, but also prevent sudden death and improve mortality.