Heart failure is a condition in which the heart does not pump efficiently, consequently reducing the body’s supply of oxygen-rich blood. The lack of oxygen leads to a loss of energy and strength. Shortness of breath, swollen legs, coughing and fatigue are all typical symptoms. Heart failure is not, however, a normal part of aging. Timely and consistent treatment is essential to prevent, or at least delay, serious consequences.
First, if possible, it is crucial to treat the underlying disease and minimise existing risk factors. Certain medications can relieve the heart’s workload and have a beneficial effect on the course of the disease. Some people benefit from a pacemaker or cardiac surgery that increases the patient’s resilience. Acute heart failure, however, is always a medical emergency requiring immediate attention, usually in a specialised clinic. Acute heart failure is characterised by an overload of fluid in the body and lungs, which leads to shortness of breath, coughing and acute respiratory distress. Patients with symptomatic acute heart failure will receive water pills to get rid of excess fluid in the lungs and body.
- Medication can lower high blood pressure.
- Risks factors for coronary heart disease should be reduced (smoking, blood lipid level, diabetes mellitus, obesity). Generally speaking, a healthy lifestyle is a requirement rather than a recommendation for those with heart failure.
- "Biventricular stimulation" or "resynchronization therapy" (CRT) is indicated when the left heart chamber is enlarged and can therefore no longer beat synchronously. In this case, a pacemaker system is used to resynchronize the beating of both heart chambers, so that the heart can work efficiently again.
- In some cases, a special CRT device, a so-called implantable cardioverter-defibrillator (ICD) is implanted to stop potentially life-threatening cardiac arrhythmias by delivering energy to heart muscle. An ICD can also be used in resynchronization therapy.
Often patients with heart failure also suffer from comorbidities that worsen with age. Several cases can be distinguished:
- Comorbidities like high blood sugar level or coronary heart disease may be direct causes of heart failure.
- Diseases such as anemia (a deficiency of red cells or of hemoglobin in the blood), kidney failure, depression or sleep apnea are associated with heart failure and have a disease-promoting effect.
Currently a holistic approach, which takes any comorbidities into account, is used to treat heart failure. Even slight anemia can have an adverse effect on the course of the disease. The same applies to kidney failure, depression or sleep apnea. Therefore, it is essential to treat both heart failure as well as any comorbidities affecting the patient’s general condition. When treating comorbidities with medication, possible interactions need to be taken into account. For instance, certain painkillers and some antidepressants are less suitable in patients with heart failure. Patients should always talk with their doctor about their current intake of medication. Pharmacists can also provide advice on potential interactions or side effects of medication.
If affected, consider the following:
- Do not smoke or consume alcohol.
- Eat well-balanced meals that are high in fiber (whole grains). The mediterranean diet is ideal as it includes a lot of vegetables and fruit, seafood, healthy oils (such as olive and canola oil) and little animal fat
- Exercise regularly
- If you suffer from heart failure, weigh yourself daily and record your body weight. If you notice a rapid weight gain, fluid retention could be the cause, which is a possible sign of acute heart failure. In this case talk to your doctor immediately. They may recommend a maximum fluid intake per day which you should not exceed. Eat a low-salt diet. Also, look for hidden salt, for example in ham, smoked meat, tomato ketchup, salted herring, and numerous other processed foods.
- If overweight, lose weight without resorting to strict diets or fasting. Discuss a suitable diet with your physician and/ or a qualified nutritionist, along with an individualised exercise plan.
- Learn to deal with stress or avoid it. Relaxation exercises such as autogenic training or yoga can help.
- Undergo regular check ups. Have any diseases such as high blood pressure, diabetes mellitus, or elevated cholesterol level treated. Also, take your medication regularly as directed by your physician.