When the heart loses the ability to pump blood to all the cells of the body in an adequate way, maintaining the adequate supply of oxygen and nutrients, hundreds of problems begin to appear and unfortunately, if they are not treated properly, the signs of heart failure will become more evident and intense, compromising the life of the individual who suffers it.

What is heart failure?

Heart failure occurs when the heart is unable to pump enough blood to maintain the body's demands or requirements, either at rest or during strenuous activity.

Signs of heart failure

The signs of heart failure are universally recognizable and become obvious to the untrained eye when this condition is not adequately treated or is decompensated.

Not all signs of heart failure will be present early in the disease, as the heart may fail only during intense exercise and progress until it is unable to maintain or meet the requirements at complete rest.

• Dyspnea during exercise. In the early stages, shortness of breath (dyspnea) only becomes evident during exercise, the patient will only be able to climb one floor of stairs or walk a couple of blocks before feeling drowned. Then as the disease progresses, this difficulty will be present even at rest.
• Orthopnea. It is the lack of air or the inability to breathe while lying horizontally. Patients require raising the head of the bed, and sleeping with three or more pillows.
• Weakness and chronic fatigue. The patient is always tired, he sleeps at any time, he has no energy because oxygen or nutrients do not reach his tissues.
• Nocturia. The patient must go to the bathroom to urinate several times during the night, even when not consuming fluids.
• Oliguria. It means that the patient produces very little urine.
• Cyanosis. It is the bluish or purple coloration of the skin that can be seen centrally on the lips or face of the patient or peripherally, on nails, fingers and skin in general. Also heart failure patients are often pale.
• Tachycardia. The heart rate is usually faster than normal.
• Pulmonary edema. Caused by the accumulation of fluid in the lungs, secondary to the inability of the heart to pump all the blood accumulated during cardiac cycles, which is taken to the lungs for gas exchange (elimination of carbon dioxide and absorption of oxygen).
• Distension. Of the veins in the neck (jugular distention) because the heart is not able to mobilize the blood that enters the lungs, the accumulation of this allows a column of blood to be created in the neck, which can be observed with a slight inclination of the neck and head.
• Pain chest. Chest pain is cardiac in origin and is caused by a lack of oxygen in the muscle tissue of the heart.
• Palpitations. Tachycardia, which means that the heart beats more than 105 beats per minute, is referred to by the patient as palpitations in the chest.
• Weight gain. Generated by the accumulation or retention of fluid secondary to oliguria (decrease in urine production)
• Hepatojugular reflux. By sustained compression of the lower edge of the liver, it is possible to observe how the blood from the neck veins (jugular veins) form a visible column and the blood rises through them.
• Anorexia, nausea, and weight loss. Lack of appetite (anorexia) is common in heart failure patients as they are very tired. Nausea is common due to irritation and dizziness, there may be loss of muscle mass by not ingesting the required caloric amount.
• Auscultation abnormalities. When the doctor examines the heart sounds, the heart will find a third sound called s3
• Edema. Initially the ankles will be swollen, then the whole body called anasarca.

How to treat heart failure?

The way you treat heart failure is made up of two fundamental categories.

Non-pharmacological management or lifestyle modifications

• Diet. Sodium and potassium restriction, fat restriction, increased intake of Omega 3.
• Physical activity. After compensating for heart failure, 45 to 90 minutes of tolerable aerobic exercise should be indicated each day.
• Sleeping with the head elevated 45 degrees or more.

Pharmacological management

• Diuretics. To remove excess retained fluids
• Antihypertensive. Lower blood pressure
• ACE Inhibitors and Angiotensin Receptor Blockers. They lower blood pressure, dilate blood vessels, and improve survival.
• Beta blockers. They prevent cardiac arrhythmias
• Inotropics. They improve the contraction of the heart muscles and its function as a pump.

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