The heart the seat of our soul and the perennial pump of our body has its own idiosyncrasies, which keeps us mere mortals on our toes. The heart can fail due to a multitude of causes ranging from the most common such as Ischemic heart disease to something as simple as poorly treated diabetes and hypertension.
Heart failure can broadly be classified into two categories
Systolic heart failure: this refers to the situation when the heart fails as a pump. The commonest causes of systolic heart failure are
Ischemic heart disease
Poorly controlled diabetes – diabetic cardiomyopathy
Valvular heart disease – especially leaking valves
Alcohol induced
Diastolic heart failure: this is a condition where the heart muscles fail to relax adequately and become stiff. The heart receives its blood supply in diastole or the relaxation stage. Failure to relax affects its ability to function resulting in heart failure. The common causes are
Poorly controlled hypertension
Restrictive cardiomyopathy HOCM
Shortness of breath
Swelling in the feet – it pits on pressing and is called pitting pedal edema
Inability to lie down flat – orthopnea
Chronic cough on lying down – due to fluid retention in the lungs
Wheezing
Abdominal swelling – called Ascites
Cold clammy toes and fingers- due to decreased circulation
Class I: no limitation is experienced in any activities; there are no symptoms from ordinary activities.
Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
Class III: marked limitation of any activity; the patient is comfortable only at rest.
Class IV: any physical activity brings on discomfort and symptoms occur at rest.
