This disease is also known as congestive heart failure (CHF). If the heart is affected by this disease, it cannot pump the blood to the other systems in the body, leading to lack of oxygen and nutrients in the tissues. Because of the imbalance in the blood pumping during heart failure, fluid will accumulate in the lungs and lower limbs cause oedema, which is one symptom of this disorder. In some chronic heart failure patients, the circulating levels of tumour necrosis factors may increase and in the terminal stage of this illness the serum level cytokines may elevate as well. In most heart failure patients, 40% die within one year, greater than patients with breast, prostate or bladder cancer.
Causes:
The most common cause for heart failure is coronary artery disease and heart attack, due to damage in the heart muscle and narrowing of the arteries which supply the muscle of the heart by fatty plaques leading to heart muscle ischemia. High blood pressure is also important, since as the heart muscle becomes thickened, the flexibility of the heart muscle to pump blood to the body will decrease, causing heart failure. Also, any diseases damaging the heart valves will increase heart failure, such as: alcohol, hypothyroidism and inherited heart conditions as cardiomyopathy. Sudden death in patients with heart failure is due to a number of factors. For example, the remodeling of active and passive membrane properties of the heart, altered neurohumoral signaling, myocardial ischemia, and perhaps an underlying genetic predisposition to electrical instability.
Symptoms:
The symptoms are divided into two parts:
Left sided failure:
Firstly, this causes dyspnoea which is shortness of breath at rest as well as increasing breathlessness on lying flat known as orthopnoea. The second symptom of heart failure is paroxysmal nocturnal dyspnoea which is a sudden night time attack of severe breathlessness occurring after sleeping for several hours. In some cases, cardiac asthma or wheezing may occur. Finally, dizziness, confusion and cool extremities at rest may be noticed.
Right sided failure:
If there is failure in the right side, fluid will accumulate in the body and this causes swelling under the skin known as oedema or anasarca. For example, the foot and ankle are swollen in people who are standing up, and in the sacral area in people who are predominantly lying down. Also, there may be impaired liver function, and blood clotting problems may occur.