Dr. Philip Strike
Consultant Interventional Cardiologist
Mediclinic Parkview Hospital
Heart Failure
Heart Failure is becoming more and more common every year. Simply put, heart failure is an inability of the heart to do its job properly i.e. pump blood around the body. There are two main reasons that this might happen, either because the heart cannot pump strongly enough (systolic heart failure) or because the heart is too stiff to allow blood back into the heart properly (diastolic heart failure or heart failure with preserved ejection fraction HFPEF).
Heart failure is now one of the leading causes of disability in the world. The main symptoms are shortness of breath and ankle swelling, but it can also be associated with tiredness, lethargy and palpitations.
Systolic heart failure is most commonly caused by heart attacks or a weakness of the heart muscle called a cardiomyopathy. Some forms of cardiomyopathy (such as dilated cardiomyopathy or hypertrophic cardiomyopathy) can run in families. Diastolic heart failure is often due to a combination of things including age, obesity, high blood pressure, diabetes and lack of fitness. Heart valve problems can also cause heart failure. Other causes such as excess alcohol consumption or thyroid disease are less common.
An early diagnosis is important. Most cardiologists are comfortable diagnosing and treating heart failure. Investigations might include simple tests such as a heart tracing (ECG), and ultrasound (echocardiogram), or more complex tests like angiograms or magnetic resonance imaging (MRI).
Mostly heart failure can be treated with medications. Occasionally more complicated treatments can be suggested such as special pacemakers to re-synchronise the heart.
In most people, heart failure symptoms can be improved a great deal, but anyone with breathlessness or ankle swelling should make an appointment to see a doctor.
