Treating Advanced Heart Failure During A Pandemic

Heart failure is a chronic condition which occurs when the heart is unable to pump blood sufficiently to meet the metabolic demands of the tissues in the body. A weakened heart results in inadequate blood supply to the cells leading to fatigue, shortness of breath and other symptoms of heart failure. This does not mean that the heart has actually 'failed' but that one or more chambers of the heart have failed to keep up with the volume of blood flowing through them.

Heart failure symptoms

Initially, when one experiences any of the symptoms that can indicate an underlying heart problem, it is recommended to visit a cardiologist or even a general physician. However, if the condition worsens, your physician or cardiologist may suggest you consult a cardiothoracic surgeon, heart failure or heart transplant expert so that they can recommend the way forward for you.

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How can heart failure be treated or managed across stages and what are some of the treatment options?

Making simple changes to your lifestyle can help relieve symptoms of heart failure and prevent the disease from worsening. Precautionary measures such as monitoring your weight, leading an active life, eating a well-balanced and nutritious diet and avoiding stress can go a long way to keep your heart healthy.

While in the initial stages of heart failure, lifestyle changes along with medication can help manage the condition, in case of advanced heart failure, treatment options such as LVAD procedure or a heart transplant along with medications and therapy are necessary for the patient. An LVAD (left ventricular assist device) helps the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body. It is a feasible and safe option for management of the condition.

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Case study:

I would like to share a patient I operated on sometime back who was struggling with a cardiac disease since the past few years.

This patient was initially facing breathlessness on multiple occasions, which is a typical sign that many tend to overlook. Even while resting or laying down, he would be short of breath. After his situation worsened, he visited some doctors, who then revealed that his heart's pumping efficiency had gone down drastically and is only functioning on 15% efficiency. The doctor also told him that they did not have any solution for his particular case. In that moment, he was told that they could not tell him how long his heart would be able to function.

After this a relative of his recommended the LVAD implantation procedure to him. It was the patients only choice. After much deliberation, he had the LVAD machine implanted to his heart. Now, it has almost been 3 years to the procedure, and he has not faced any restriction or hesitation. He is happy to share that now he is an active member of the society and is able to walk a free life.

Lifestyle changes one must make after a left ventricular assist device (LVAD) implant

Post treatment, a patient must make a few lifestyle changes such as monitoring one's weight, eating a healthy diet, leading an active life and avoiding stress and excessive physical strain. They must also seek medical consultations with their doctor and stay alert for any symptoms.

(Dr Z S Meharwal Cardiac Surgery/ Cardio Thoracic Vascular Surgery Executive Director and HOD, Fortis Escorts Heart Institute)

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