Heart failure (HF) Causes, Epidemiology, Symptoms and warning signs, Emergency aid.

Heart failure (HF)
Causes
HF describes a usually gradual weakening in heart tissue and a decline in its ability to perform its function to pump blood around the body.
There are several causes:
reduced ventricular contractility, as result of myocarditis (infl  ammation of the myocardium), cardiomyopathy (hypertrophy of heart tissue) or MI
ventricular outfl ow obstruction, caused by hypertension, narrowing of the aorta (aortic stenosis), pulmonary hypertension or pulmonary valve stenosis
ventricular infl ow obstruction, as a result of stenosis of the mitral and tricuspid valves, among other causes
ventricular volume overload, due to failure of the mitral valve regulating the fl ow of blood into the left ventricle and the septa separating the heart chambers
arrhythmias.
Epidemiology
HF is a disease of the elderly  – average age at fi rst diagnosis is 76 years.
Incidence is increasing with increasing life expectancy and higher survival rates following MI.
About 1 in 35 people aged 65–74 years have HF, increasing to about 1 in 15 of those aged 75–84 years, and to 1 in 7 in those over 85.
Symptoms and warning signs
fatigue and shortness of breath after mild exertion
a dry, wheezy, hacking cough occurring a few hours after lying down but stopping after sitting up
when there is pulmonary oedema, there may be a cough producing a pinkish froth
accumulation of fl  uid in the feet, ankles, legs and abdomen
weight loss.
Emergency aid
Pharmacists would not normally encounter situations of acute HF, which often occur at night. Symptoms include severe breathlessness, often accompanied by MI symptoms.
Emergency aid is as for MI.