​Heart failure

​Heart failure(HF) is a chronic and progressive condition where the heart is unable to pump sufficient blood to meet body’s needs. It is usually due to the fact that the heart has become too weak to function properly.
Causes of heart failure is multifactorial, And can be caused by a wide range of conditions, including Congenital heart defect, high blood pressure, Cardiomyopathy and Arrhythmia.
In addition as the heart is failing and becoming infirm the compensatory changes in the body accelerates the worsening of the condition which is either the heart can’t pump enough blood, or can’t fill with enough blood or both of the cases together.
The ‘gold standard’ tool for the assessment and diagnosis of HF is a transthoracic echocardiogram (TTE).

Signs and symptoms:

• Rapid or irregular heartbeat
• Fluid Buildup and Swelling, occurs most often in the feet, sudden weight gain
• Shortness of breath not related to tiredness.
• Lack of Appetite or Nausea
• Chronic Cough or Wheezing plus pinkish sputum

Heart failure is often a manageable condition, but unfortunately For most people, it’s a long-term condition that can’t be cured. Treatment for heart failure usually aims to control the symptoms and slow down it’s progression
The main treatments are:

• healthy lifestyle changes

• medication

• devices implanted in your chest to control your heart rhythm

• surger

Specific drug therapy for heart failure focuses on improving prognosis (using inhibitors of the renin–angiotensin–aldosterone system [RAAS] and sympathetic nervous system [SNS]) and diuretics. And these medications include: Angiotensin-Converting Enzyme (ACE) Inhibitors (Captopril, Enalapril, ..)

• Angiotensin II Receptor Blockers (ARBs) (Candesartan, Valsartan, ..)
• Beta Blockers (Beta-Adrenergic Blocking Agents) (Metoprolol succinate, carvedilol ,..)
• Aldosterone Antagonists (Spironolactone, ..)
• Diuretics including (Furosemide, Chlorothiazide ..)
• Neprilysin Inhibitors (ARNIs) (Sacubitril)
• hydralazine with nitrates
• digoxin

New approaches for treating this condition are two drugs, Corlanor and Entresto, were approved by the FDA for heart failure patients. Corlanor regulates heart rate by inhibiting the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel while Entresto is a combination of angiotensin receptor-neprilysin inhibitor (ARNi).

Edited by: Dr. Pavel Jalal