eLanka UK | Heart Failure is preventable-video and transcript-by Harold Gunatillake


Harold Gunatillake

Web Site:www.Doctorharold.com

The is a terminal situation where the heart muscle pumping system gets weaker, and the blood circulation gets affected. The brain gets disorientated, Lungs becomes congested with incoming venous blood for oxygenation, the body swells starting from your feet, and kidneys start failing. It is a terminal condition which can be reversed if detected early.

The incidence in Australia is high- over 10,000 cases per year, when medical treatments are at its best compared to most other countries.
In Sri Lanka, heart failure incidence from heart disease is extremely high compared to the more developed countries. One reason is that coronary procedures (such as angioplasty/stent and bypass surgery) are carried out in Sri Lanka, it is not financially affordable to most Sri Lankans. For instance, a coronary bypass surgery costs around $2000 whereas the average income of a Sri Lankan is around $3362 per annum.
People do not seem to realize the seriousness of the condition through neglect, until the terminal stages are reached. The best of treatment facilities may not suffice during the irreversible stage.
It is common after the age of 60, more common in women than men.

This condition is also called congestive cardiac failure, where the congestion of blood occurring in the lungs causing breathlessness. Also referred to as cardiac asthma.
Your heart start beating from your early fetal stage till you exhale your last breath. By the time you are 60, a healthy heart would have beaten continuously over two billion times. The efficient working and pumping blood from your heart can become weakened with age, but if you are aware of it, you can always adjust your lifestyle to prevent it. This decline in its efficiency is called “heart failure”.
The first phase of heart failure is hypertrophy of the smooth muscles of the heart. This occurs when the heart must work more strenuously to pump blood to all organs and tissues of the body. The heart muscles have the inherent power to contract and relax, but its rhythm and rate are controlled by nerve bundles.

The muscles in the upper two chambers of the heart (atrium) have thinner walls, because they are temporary reservoirs of the blood. The two lower chambers are composed of thick layers of involuntary muscles which takes the stresses and strain throughout life.
So, heart failure means that the heart’s ability to deliver enough oxygenated blood to each part of the body’s organs and tissues is lessened. If this state is unattended the next stage is fatal damage.
There are many other diseases that cause heart failure. There is right heart failure and left heart failure.
Coronary heart disease due to blockage of the main coronary arteries is one of the most common conditions for failure if remedial measures are not taken early to release the blockage.
Today, with the facilities available such as stenting coronary arteries can be opened for a good blood flow to the heart muscles, and they remain patent for quite a long time. You do not have to worry about heart failure.
The next common condition that produces heart failure is untreated high blood pressure. For this reason, it is important to check your blood pressure frequently with your own BP apparatus at home.
Heart failure affects both the right and left chambers of the heart.

In heart failure less deoxygenated blood enters the right side of the heart and less oxygenated blood flows out of the heart.
That is the reason why your fingernails because blue due to the lack of oxygen in your blood. This blue color is called cyanosis.
How do you know that your heart is failing?
The earliest sign or symptom would be breathlessness on exertion, and with further progressing, breathless at rest. The other term we use for breathlessness is ‘dyspnea. The reason why this happens is due to congestion or ‘back up’ of blood in the pulmonary veins that returns blood from the lungs to the left chambers of the heart. Fluid from the blood leaks out and fills the lung tissue. The blood pressure in the pulmonary veins rise,
and doctors refer to this as ‘pulmonary hypertension. Do not mix this situation with peripheral hypertension,
which is more common.Your doctor will put you on a diuretic for life which helps to reduce the fluid in the lungs.
Persistent coughing and wheezing will occur due to fluid build-up in the lungs. Sometimes, this state mimics an asthmatic attack, and the doctor calls it ‘cardiac asthma’. Do not confuse this situation with bronchial asthma which is more related to allergies.
If you neglect, feet start swelling, then the legs, and abdomen. You gain weight due to waterlogging.
If left untreated, oedema can lead to increasingly painful swelling, stiffness, difficulty walking, stretched or itchy skin, skin ulcers, scarring, and decreased blood circulation.
Another cause of heart failure is due to valvular defects of the heart.
As you know, there are valves in the heart and in the main artery of the heart called the aorta, which prevents blood refluxing back into the chambers.
Between the left upper chamber called the atrium and the lower chamber called the left ventricle there is a valve called the mitral valve which has three cusps. On the right heart there is the bicuspid valve that has two cusps, then there is a valve in the outward blood flow artery called aortic valves.
With age they invariably get weak and incompetent.
Then the blood seems to reflux back producing a sound called the murmur.
The leak from the aortic valves cause left ventricular failure.
These valves also could stiffen and cause narrowing of the opening and the heart needs to work harder to pump blood through it.
Both valvular reflux and stenosis can lead to heart failure.
In the early stages with a soft murmur, your cardiologist will observe the progress by doing yearly echograms.
In advanced situation you will need surgery to repair the valves.

Please do not neglect this condition, because with time the heart can fail.
There are a few other conditions that lead to heart failure. They are not discussed here.
If you suffer from any heart condition, please see your doctor, and get investigated and treated
properly to prevent heart failure.
Hope this video was useful
Stay safe and goodbye for now.


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