Heart Failure: Main Causes, Early Symptoms, and Prevention

(Robina Weermejijer)

According to the American Heart Association’s 2020 report, an estimated 5.7 million Americans over the age of 20 suffered from heart failure between 2009 and 2012, and the number grew to be 6.2 million between 2013 and 2016. This is a significant increase in the number of heart failure patients.

Heart failure is a disease that can affect young and old alike, with a high mortality rate worse than many types of cancer. There are several typical symptoms of heart failure, and when three of these symptoms occur it should raise a red flag.

The heart is the organ responsible for sending blood, oxygen, and nutrients throughout the body. It is like a motor that pumps blood throughout the body: upwards to the head and downwards to the feet. When something goes wrong, and the heart loses its contractility and is unable to pump blood, heart failure will result.

According to Dr. Liu Zhongping, cardiologist and director of the Yuping Clinic, there are three main causes of decreased cardiac contractility.

3 Reasons for Heart Failure

High blood pressure: This is the most common cause of heart failure. Having high blood pressure over a long period of time makes the heart less flexible, resulting in poor diastolic function and symptoms of heart failure.

Coronary artery diseases: including myocardial infarction and stenocardia. When the coronary arteries supplying blood flow to the heart become embolized and stenosed, the heart’s contractility will be reduced.

Valvular heart disease: If the heart’s valves are not functioning well, it will also reduce the heart’s contractility.

Other causes include diabetes and excessive alcohol consumption.

According to Dr. Liu, heart failure is not exclusive to any age group. For patients in their 20s and 30s, valvular heart disease or myocarditis is usually the cause; for patients in their 40s and 50s, coronary artery problems are the common causes; and after the age of 60, age-related degeneration and valve calcification are the main causes.

Patients with hypertension and/or heart disease (including heart aging), the elderly, obese people, and diabetics are high-risk groups for heart failure. Nowadays, since most people have a chaotic lifestyle, a refined diet that’s high in oil, sugar, and salt, and a general lack of exercise, patients with hypertension and/or heart aging are getting younger, and there are more and more obese and diabetic patients.

Common Symptoms Indicative of Heart Failure

When heart failure occurs, the heart is unable to properly send blood to its destinations, resulting in a lack of oxygen in the organs, which can cause the following symptoms:

• Dizziness due to lack of oxygen;
• Pulmonary edema due to impaired gas exchange or the inability of the lungs to properly send oxygen-rich blood to the heart, which can cause people to feel shortness of breath;
• Cold, numb and weak limbs;
• Poor absorption in the stomach and intestines;
• The kidneys need one-fifth of the entire body’s blood flow to filter out the toxins. When the blood supply to the kidneys is inadequate, there will be less urine, and the kidney functions will become poor.
• Severe heart failure can cause poor circulation in the liver, resulting in hepatomegaly and affecting the liver functions.

Although heart failure causes symptoms to appear throughout the body, there are three typical symptoms: wheezing, edema (swelling), and fatigue.

Heart failure can be acute or chronic.

Acute heart failure patients may feel fine one day, but experience a sudden shortness of breath the next day, and go into a low blood pressure coma that lands them in the ICU immediately. The cause is often myocardial infarction or bacterial endocarditis.

In the case of chronic heart failure, the patient gradually feels increasing shortness of breath, and fatigue. For instance, if patients with hypertension don’t control their blood pressure well on a regular basis, their heart functions will gradually deteriorate.

According to Dr. Liu, regardless of the situation, as long as a patient feels prone to wheezing, edema ,and increasing fatigue, he or she should immediately seek medical assistance, because in one third of the cases, these symptoms are caused by heart problems.

He warned that for people over 60 years old, as long as they frequently feel shortness of breath lasting for more than a month, it is recommended to do a cardiac function assessment.

People in their 70s and 80s who have been walking more slowly than before and are experiencing shortness of breath after a short walk may also have deteriorating heart functions. He recommends them seek medical attention as soon as possible.

In addition, the aging of the heart can also cause heart failure. And patients with aging hearts are becoming increasingly younger. Therefore, middle-aged people should also pay attention to their hearts, if they have been prone to shortness of breath after a short walk or some light activities for over a month.

Preventative Measures

Heart failure is a disease with a high mortality rate. According to a 2017 paper in the medical journal Circulation, the mortality rate for heart failure patients after 30 days of hospitalization is 10.4%, after one year is 22%, and after five years is 42.3%.

This mortality rate is higher than those of many types of cancer, such as breast, colorectal, skin and prostate cancers.

Therefore, heart failure patients must pay attention to cardiac health care to avoid recurrences, which can worsen the condition. Heart failure patients should:

Take their medication on a regular basis: Such patients should receive treatment on a regular basis. “This is the most important, as some patients really don’t take their medications on time,” said Dr. Liu.

Weigh themselves every day: They should maintain a normal weight, as a large increase or decrease in weight over a short period of time isn’t a good sign.

See their doctors as soon as they have a cold: Nearly half of all heart failure recurrences are caused by colds. Therefore, if a patient has cold symptoms, he or she should see a doctor as soon as possible to avoid a recurrence of heart failure.

Restrict water and salt intake: Patients with heart failure are prone to edema due to poor water discharge. So they should consume less water and salt than the general population, and avoid eating too much stimulating food or becoming stuffed. When drinking water, these patients should avoid drinking too much at one go. They should take a sip, hold it for eight seconds and then swallow it. If they don’t feel thirsty after a couple of sips, it is recommended for them to stop drinking.

Do appropriate aerobic exercises: They can walk and bike, as long as it’s not too intense.

Since nearly one-third of the body’s blood is concentrated in the hips, thighs, and calves. People with heart failure tend to have lower limb edema and poor circulation, and they may even have venous thromboembolism. Leg exercises can increase the circulation in the lower body, which in turn drives the circulation of the entire body, and thus can also prevent venous thromboembolism and edema.

Dr. Liu emphasized that it is important for the heart to keep the body’s circulation constant. Therefore, it is important for heart failure patients to follow the aforementioned advice to prevent recurrences.