In An Advanced Stage Of Heart Failure? Here Is What You Can Do

Article By: Dr Kewal Krishan - READ ORIGINAL ARTICLE

In An Advanced Stage Of Heart Failure? Here Is What You Can Do

Heart Failure is classified as a defect of the heart where it doesn't pump the blood as it should. Here are the treatments medical science can offer for people suffering from heart failure.

Heart Failure is classified as a defect of the heart where it doesn't pump the blood as it should. The most common signs of heart failure are facial swelling, pedal oedema (accumulation of fluid in the feet and lower legs), abdominal swelling, feeling of breathlessness. For instance, if previously a person used to walk 400m, now they can't walk 200m without a break.

Those with a heart disorder such as heart failure must frequently visit the doctor, especially their cardiologist/ heart failure specialist. Chronic heart failure patients that become acute heart failure patients are called acute on chronic patients. Once they reach that stage, they are admitted to the hospital often and need regular treatments. This is because heart failure is a progressive disease, the disease is not reversible and will keep increasing. One can either hold it at the stage it is in or the disease progresses.

Symptoms Of Heart Failure May Mitigate With The Right Medication
When one gets on the right medications, the facial swelling and the pedal swelling may go back to normal, the weight starts reducing, one may start peeing more, and then, the patient starts feeling good and can walk longer distances. These are some identifiable signs and effects of the drugs or medication for patients suffering from heart failure. In the beginning, many patients get better with drugs and then they go back into the same phase and their health starts deteriorating because the body starts developing immunity from the drugs.

It usually takes 4 to 5 years for people to move from chronic to acute heart failure, but if one does not opt for medications or is diagnosed on time, the disease can move to the acute stage of heart failure earlier than usual. Some people even die before they can reach the hospital, or if they are mismanaged during the acute part of their heart failure.

Treatment Options
The most commonly used medicines for heart failure are Vymada and Cadmus. Then there are devices such as single chamber shocking devices (ICDs), these can stop the bad currents in the body to spot any fibrillation/pause in the heartbeats. The third level of treatment option is CRTD, where two ventricles are contracted at the same time so that 5-10% improvement can happen in the existing situation. Then, if 100% improvement is required, they can opt for ventricle assist devices or heart transplants.

Definitive treatments are heart transplants and ventricle assist devices. However, with a new heart, there is a lot of wait time, hence, to bridge that gap, one can choose less invasive therapies like pacemakers, CRT and drugs.

How Do LVADs Work And What To Keep In Mind?
As we all know, our heart is basically a pump, it takes the blood from the body and pumps it back to the body. So, heart failure is similar to a water motor not working at home. If it starts malfunctioning, water spills down on the floor and does not reach the kitchen and the toilet. Similarly, if the heart isn't pumping the blood to different parts of the body, like the brain, kidney and liver, these organs start getting dysfunctional and instead, the blood starts collecting elsewhere like the face, feet, etc. So, when you put this ventricle assist device, it starts pumping the volume, which is elsewhere, and it starts reaching the organs again, and they function normally. The swelling also goes away, and the patient looks normal.

When they have a progressive disease that cannot be controlled by/requires escalation of drugs, the patient needs to contact a heart failure cardiologist or a heart failure surgeon who can undertake transplants, VADs, and are involved in this field.

Another thing to keep in mind is time is of great value here, the results of VADs and heart transplants are not very good if a patient comes in a bad shape like multi-organ failure. It is better to come earlier so that the patient gets the benefits and is left with a good survival chance and quality of life.

The patients should take care of their blood thinner level, which is usually 2.5 times the normal person. If they are taking care of that, they are taking care of batteries, they are taking care of the driveline, their quality of life will also be good, and they will not have an infectious and they can live for a longer time in some cases seven and half years from when we put the first one. Which mean a lot of people who would have died can live longer than 10-15 years. That device is your new heart basically, and it gives you a chance at a great quality of life.


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