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