The term ‘heart failure’ in itself gives away a lot about the condition and what actually happens. It occurs when the heart muscles fail to pump blood as well and efficiently as it normally should. This leads to an insufficient supply of oxygen and nutrients to the body's tissues, causing fatigue and shortness of breath, sometimes accompanied by coughing. According to the US National Heart, Lung, and Blood Institute, a heart failure can develop suddenly or over time and depending on the location of the impact (left or right side of the heart), there may be different causes of the condition.
In this article, we will delve into the various stages of heart failure, how each stage affects the body, symptoms to note and the ways you can prevent the condition. Dr Vivek Mahajan, Consultant Interventional Cardiologist, Fortis Hospital, Kalyan, shed light on the same.
Also Read: 6-Minute Walk Test: A Doctor Explains Its Use For Patients With Chronic Heart Failure
Four Stages Of Heart Failure
The four stages of heart failure include:
Stage A: The first stage of heart failure includes people who are at risk for heart failure but do not have any structural damage to the heart. The risk factors usually are like diabetes, high blood pressure, cholesterol, bad lifestyle habits, and smoking.
Stage B: The second stage is where the patient has already developed structural damage to the heart, but there are no symptoms of heart failure.
Stage C: The third stage is when the patient has developed structural damage to the heart, and starts to experience the symptoms of heart failure.
Stage D: This is the final stage, where the patient has already developed the symptoms of heart failure and is at the end stage of heart failure. Also known as advanced heart failure, the American Heart Association (AHA) shares that this stage involves people with heart failure symptoms that interfere with daily life functions or lead to repeated hospitalisation.
Symptoms To Note
According to Dr Mahajan, heart failure is a progressive disease.
“Usually, the symptoms occur in stage C and in many of the patients it is progressive. So, there is a likelihood of an increase in the symptoms over a period of time,” the doctor said, highlighting that there is no such concept of a stable heart failure. “Even the patient with minimal symptoms is usually progressing in terms of the heart failure severity,” he added.
In order to understand the patients' heart failure, doctors look at the severity of their symptoms. This is an evaluation based on the most commonly used classification system, the New York Heart Association (NYHA) Functional Classification.
Class 1: No physical activity limitation. Normal physical activity does not cause undue fatigue, palpitation or shortness of breath.
Class II: Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, shortness of breath or chest pain.
Class III: Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, shortness of breath or chest pain.
Class IV: Symptoms of heart failure at rest. Any physical activity causes further discomfort.
Also Read: Heart Health: Essential Facts About Heart Failure, Cardiologist Weighs In
What Exactly Causes A Heart Failure?
According to Dr Mahajan, heart failure or inability of the heart to pump effectively and supply blood to various organs is caused by two major causes.
“The first one is usually a massive heart attack, rendering the sizable portion of heart muscle which makes the heart weak, leaving the patient with a weak and stiff heart. The other common cause is an inherent weakness and stiffness of the heart muscle causing the heart muscle to function ineffectively,” he explained.
Prevention And Treatment
Dr Mahajan said, “To prevent heart failure, you have to prevent development of blockages in the heart arteries.”
To do that, here are a few preventive measures:
- Maintain a healthy lifestyle
- Consume a balanced diet
- Get a good sleep
- Regular check-up of the cholesterol, sugar, and blood pressure
- Exercise regularly
- Avoid smoking alcohol and tobacco use
“Patients who already have heart failure should be in close follow up with the cardiologist in order to maintain a good lifestyle, diet and exercise regularly. They must take the medications which prolong the survival of heart failure. They may be advised to take a number of tests like 2-D ECHO or an angiography, monitor their blood sugar, cholesterol, and blood pressure,” the doctor notes, adding, “Advanced heart failures are usually treated with pacemaker devices like an ICD and CRTD. They may also be advised to bypass surgery or angioplasty, depending on whether they have blockages or not, and the end stage heart failure is treated with heart transplants or left ventricular assist device or in simple words, artificial heart like devices.”