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Today, 09 February 2010

› Strike three, Mr President

› Cooked head discovered

› Zuma apology 'unwelcome'

› 'Illegal' traps blasted

› Madiba to grace Parliament

Yesterday, 08 February 2010

› No credit to FW - Zuma

› Zapiro revives showerhead

› 'Our president has failed'

› Praise for Amla

› 'Zuma should be forgiven'

Question

What is heart failure?

Answer

Heart failure is a clinical syndrome (a collection of symptoms) which has a number of different causes. It is an abnormality in the mechanical function of the heart muscle which results in inadequate cardiac output. Cardiac output can be thought of as the amount of blood which is pumped by the heart to supply oxygen and other nutrients to the muscles and vital organs.

It is caused by diseases of the heart valves, coronary arteries or the heart muscle (myocardium) itself. So, it will be found in ischaemic heart disease(see Ischaemic heart disease), long term high blood pressure causing the left ventricle (chamber) of the heart to enlarge, and in diseases in which the heart valves are damaged. Disturbances in heart rhythm can also cause heart failure. There are a number of other conditions which can result in heart failure such as anaemia, vitamin B1 defficiency (Beriberi), hyperthyroidisim, pregnancy, and some types of liver disease.

The symptoms are usually gradual, with a deterioration in effort tolarance over time. You notice that you are getting more short of breath when you climb stairs, or go for your usual cycle or gym session. Your ankles start to swell, particularly towards the end of the day, and you may wake up at night feeling short of breath. Another symptom is a persistant dry cough, an early sign of fluid building up on your lungs. These are the main symptoms of left-sided heart failure.

In right-sided heart failure the main symptoms are tiredness, an awareness of fullness in the neck, fullness in the abdomen, ankle swelling, and in the late stages, swelling of the abdomen due to excess fluid.

Treatment is aimed at the particular underlying condition. So, if the problem is a distrubance of rhythm, then that will be controlled. In situations where the underlying cause cannot be completely corrected, then treatment is aimed at increasing the contractility of the heart and relieving the load of excess fluid. Certain drugs such as the ACE Inhibitors (eg. Capoten) are used to increase contractility. Diuretics, or water tablets, are used to relieve the fluid load. Furosemide (Lasix) is the most commonly used.

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