Heart Failure
Heart failure and cardiomyopathy represent various forms of heart muscle disease, stemming from diverse causes such as coronary artery disease, valvular heart disease, hypertension, arrhythmias, prior heart infections, and even hereditary factors within families.
Symptoms often include exertional breathlessness, exacerbated by lying flat or awakening during the night. Fatigue and abdominal and leg swelling may also occur.
Diagnosis involves several investigations, including blood tests like natriuretic peptides (NTproBNP or BNP), 12-lead ECG, chest X-ray, and echocardiography. Further assessment is necessary to pinpoint the precise cause of heart failure, which may entail procedures like coronary angiography, cardiac MRI, or nuclear myocardial perfusion scans (MPS).
Numerous medical treatments are available to alleviate symptoms, reduce hospital admissions, and enhance survival. Initial management typically involves loop diuretics, ACE inhibitors, beta-blockers, mineralocorticoid antagonists (MRA), and Ivabradine. Newer drugs like Sacubitril-Valsartan may offer benefits to select patients. For those who don't respond to medical therapy or are at high risk of life-threatening ventricular arrhythmias, invasive procedures such as biventricular pacemaker/defibrillator insertion may be necessary.
