Heart failure discussion on occasion of world heart day

[gothamprince]

You can ask anything from pulse to pulseless

from the one aspiring to be one of the greatest cardiologists

let's make it the greatest thread ever

DEFINITION: Heart failure can be defined as left ventricular ejection fraction of < 50%, increased cardiac chamber size, left ventricular hypertrophy, moderate valvular disease

Heart failure can be basically said as inability of heart to pump enough blood to maintain blood supply to vital organs such as brain, kidney, liver etc or unable to stretch to accommodate enough blood to later be pumped out

SYMPTOMS

heart failure symptoms can be classified based on which side of the heart is failed 

Left side failure

-Breathlessness on exertion

-Orthopnea : breathlessness on immediate lying down so that they need to getup , these people start using pillows to compensate the feeling the more the pillows they use more severe is heart failure

-Paroxysmal nocturnal dyspnea : these people suddenly getup from the middle of the sleep usually after 3-4 hours of sleep then they sit at the edge of the bed dangling their legs or go near the open window to get fresh air ; sometimes they can't express the sensation they may complain of bad dreams

-Nocturia : increase in urine frequency during night time

-Cardiac asthma : asthma like symptoms this is the reason  most women are misdiagnosed with asthma and use asthma medications but remember new onset asthma will not not occur after 50-60 years so beware of asthma in elderly

Right side failure

-Swelling of lower limbs, or dependent areas, abdominal swelling

-decrease in appetite , nausea, vomiting

Low cardiac output symptoms

-Fatigue

-Mental confusion

-Cool skin [extremities]

-Bluish discoloration of fingers

FOLLOWING ARE THE PATIENTS AT RISK FOR HEART FAILURE

Patients with Hypertension, Coronary vascular disease, Diabetes, obesity, family history of cardiac disease or death [ all these patients are in Stage A  heart failure according to American heart association classification

Heart failure can be basically classified based on the underlying mechanism and treatment implications into 

-Heart failure with reduced ejection fraction [ systolic heart failure]

-Heart failure with preserved ejection fraction [ not exactly but can be described as diastolic heart failure]

ejection fraction is the percentage of blood pumped out of end diastolic volume [that is amount of blood pooled from heart relaxation]

 

Additional risk factors for Heart failure

chronic obstructive pulmonary disease

chronic kidney disease

chronic liver disease

cancer

obstructive sleep apnea

HIV

Covid 19

 

there is drastic rise in cases of heart failure with preserved ejection fraction in recent years mainly due to rise in Diabetes, obesity, hypertension

the thing is heart failure preserved ejection fraction is not yet studied completely the treatments are not yet completely proved but the best thing is it can be prevented with regular exercise and also it's outcome can be improved even after it's onset greatly by exercise

GUIDELINE RECOMMENDED MINIMUM PHYSICAL ACTIVITY  

150 minutes of brisk walking per week

or

75 minutes of jogging 

the more activity you do than this minimum activity the better the results

THE FOUR PILLARS OF HEART FAILURE TREATMENT

Angiotensin Receptor neprilysin inhibitor

Beta blockers

Mineralocorticoid receptor antagonists

Sodium glucose co-transporter inhibitor 2

 

 

[gothamprince]

you can ask any queries related to Heart health

[gothamprince]

the biomarkers for heart failure are NT-Pro BNP , troponin t which are key

NT-Pro BNP raises even before the heart failure symptoms develop and very good prognostic marker it correctly detects the severity of the disease , and also how good therapy is working is guaged by NT-Pro BNP levels

[gothamprince]

THE MOST CAUSES OF HEART FAILURE

- Coronary artery disease

-Chronic arterial hypertension

-Vlavular heart disease

[Suhaas]

Bro, 

Last two months ninchi daily apple watch notifying low resting heart rate while sleeping. Resting heart rate dips to around 36 - 38 while asleep. 

Avg Resting heart rate is lower 40s. 

Echo came back clean. 

I run/train 5 to 6 days a week. Run close to 30 to 35 miles a week.

Anything to worry? 

[Swatkat]

Just now, Suhaas said:

Bro, 

Last two months ninchi daily apple watch notifying low resting heart rate while sleeping. Resting heart rate dips to around 36 - 38 while asleep. 

Avg Resting heart rate is lower 40s. 

Echo came back clean. 

I run/train 5 to 6 days a week. Run close to 30 to 35 miles a week.

Anything to worry? 

Super ga your heart is oerfect bro

[southeast]

7 minutes ago, gothamprince said:

the biomarkers for heart failure are NT-Pro BNP , troponin t which are key

NT-Pro BNP raises even before the heart failure symptoms develop and very good prognostic marker it correctly detects the severity of the disease , and also how good therapy is working is guaged by NT-Pro BNP levels

Thanks for the post! how early these markers can be detected and what are diagnostic tests called? 

[gothamprince]

1 minute ago, Suhaas said:

Bro, 

Last two months ninchi daily apple watch notifying low resting heart rate while sleeping. Resting heart rate dips to around 36 - 38 while asleep. 

Avg Resting heart rate is lower 40s. 

Echo came back clean. 

I run/train 5 to 6 days a week. Run close to 30 to 35 miles a week.

Anything to worry? 

low resting heart is nothing to worry unless it's symptomatic like fatigue, sensation of dizziness, breathlessness

or you feel heart rate is irregular

[gothamprince]

5 minutes ago, southeast said:

Thanks for the post! how early these markers can be detected and what are diagnostic tests called? 

these markers can be detected atleast 2-3 years even before the symptoms develop according to expert consensus those people with risk factors such as diabetes and hypertension it's better to monitor yearly basis, you can just ask for cardiac biomarkers to know these values very common tests

[Suhaas]

1 minute ago, gothamprince said:

low resting heart is nothing to worry unless it's symptomatic like fatigue, sensation of dizziness, breathlessness

or you feel heart rate is irregular

Thank you for the response Bro. One other thing, monna yearly physical ki poinapudu doc took an EKG. It showed Sinus Arrhythmia in EKG but doctor said it can show arrhythmia in EKG incorrectly based on your breathing patterns(exhale/inhale). As you long as your ECHO is good nothing to worry annadu. Any comments. 

[csrcsr]

Emo anna looks heart attack become a lottery

First obesity,  tarvtha oils, travtha stress , trvtha no exercise,  tarvtha covid vasthe don't do strenuous exercise 

 

Recent deaths chusthe oka alavatu leni manishi, stress ledu , bakaga unaru entho mandhi ppyaru , I think adi just lottery atipoyindi anna ninna monna gowtham reddy, pu eeth valu full exercise enduku poyaru ante covid tarvtha exercise,  inkodu enduku poyadu ante vadiki asalu exercise ledu antaru I tho m heart atta k has just become lottery anna

Medical field doctor can only help if we have ro have stunt, angio gram,bypass etc

 

[MutaMestri]

Hi Bro ,

ma brother ki recent ga they did a scan to rule out CAD and also they did a calcium test that report is 0% clacium . He is perfectly normal , but usually enni years varaku eee test valid untadi.

Like Dr's said taking this test is valid for next 5 years , Please confirm 

TIA

[gothamprince]

1 minute ago, Suhaas said:

Thank you for the response Bro. One other thing, monna yearly physical ki poinapudu doc took an EKG. It showed Sinus Arrhythmia in EKG but doctor said it can show arrhythmia in EKG incorrectly based on your breathing patterns(exhale/inhale). As you long as your ECHO is good nothing to worry annadu. Any comments. 

yes it's true EKG findings should be confirmed by ECHO but if anytime you feel the sensation of racing heart or sensation of your heart beat clearly [palpitations] please consult your doctor again don't wait he may advice repeat ecg and monitor for 24 hours EKG using holter monitor

if not no need to worry

[Suhaas]

Just now, gothamprince said:

yes it's true EKG findings should be confirmed by ECHO but if anytime you feel the sensation of racing heart or sensation of your heart beat clearly [palpitations] please consult your doctor again don't wait he may advice repeat ecg and monitor for 24 hours EKG using holter monitor

if not no need to worry

No symptoms whatsoever Bro. But doctor did suggest getting a 14 day ZIO Patch(A sleeker version of the holter) just to be sure. I will just try that once time permits. 

Thanks again Doc. 

[gothamprince]

4 minutes ago, csrcsr said:

Emo anna looks heart attack become a lottery

First obesity,  tarvtha oils, travtha stress , trvtha no exercise,  tarvtha covid vasthe don't do strenuous exercise 

 

Recent deaths chusthe oka alavatu leni manishi, stress ledu , bakaga unaru entho mandhi ppyaru , I think adi just lottery atipoyindi anna ninna monna gowtham reddy, pu eeth valu full exercise enduku poyaru ante covid tarvtha exercise,  inkodu enduku poyadu ante vadiki asalu exercise ledu antaru I tho m heart atta k has just become lottery anna

Medical field doctor can only help if we have ro have stunt, angio gram,bypass etc

 

like you said the risk factors are preventable like obesity or controllable like hypertension, diabetes 

but the thing is with COVID itself can cause heart failure irrespective of the exercise whose severity can only be controlled by vaccination other than that the exact mechanism by which COVID causing heart failure is not completely clear

and there far more risk factors that i haven't mentioned above we are not sure the family history Gowtham reddy , maybe he has something related to rhythm disorder which i am not sure just guessing which cannot be reduced by just exercise

the thing is we can only prevent risk factors what we can