Heart failure

Heart failure is a condition defined by the inability of the heart to pump out enough blood to meet the needs of the brain and the body. Most frequently this is due to reduced pumping function of the heart, but it can also be due to a reduction in the heart’s ability to relax and fill in between heart beats.

Well recognised causes of heart failure include coronary artery disease or previous heart attack, heart valve problems, high blood pressure, congenital heart disease, toxins (such as alcohol), metabolic conditions or inherited conditions which affect the heart muscle itself.

Investigations to look into the cause of heart failure typically include an echocardiogram (heart ultrasound scan), blood tests, chest X-ray, assessment of the coronary arteries or blood supply to the heart and frequently a cardiac MRI scan is helpful.

Tablet treatment is a long established and effective treatment for heart failure. Lifestyle modification such as smoking cessation, reducing salt and alcohol intake, losing weight and taking more exercise in the setting of a rehabilitation programme may also be appropriate.

Some patients with heart failure may benefit from implantation of a specific form of pacemaker treatment called Cardiac Resynchronisation Therapy (CRT). This is a treatment which is suitable when there is evidence of uncoordinated contraction of the heart’s muscular walls.

When the heart’s pumping function is severely reduced, there is an increase in the risk of faster rhythm disturbances coming from the pumping chambers in the heart (ventricular arrhythmias) which can cause blackouts or even sudden death. People with heart failure should therefore be assessed as to whether the option of an implantable cardioverter defibrillator (ICD) is appropriate for them.

In specific circumstances, surgical treatment for heart failure may be suitable.