Heart Failure

How do we define heart failure?  Am I correct to say that it does not refer to an absolute state but more to the degree of inefficiency of the heart in performing its function? Is it true that when a person has heart failure, it doesn't mean that his/her heart is going to stop beating soon, and that death is imminent?

A cousin of mine has had chronic atrial fibrillation since 3 months ago. The cardiologist at a private medical centre was not able to help much to control the rate, and he was prescribed Herbesser 200mg (diltiazem), Propranolol 20mg (10mg x 2), Lasix, Slow K (potassium supplement), warfarin 2mg and rosuvastatin 10mg (for cholesterol). But his condition persists.  He gets breathless easily.

We have heard of ways to cure Afib, one of which is ablation, and have contacted the National Heart Institute. One of the procedures to get into the Heart Institute is to get a referral from a local government hospital, and this he has recently done so.  From the echo report, the doctor whom he is seeing now at the government hospital, says that his problem is not just to solve his Afib but more toward another problem that he has, that his left ventricle is not doing fine, and that CRT was mentioned.  The doctor prescribed a beta blocker  Bisoprolol (Concor) 2.5 mg a day, to replace Herbesser (diltiazem) and propranolol. He is still taking Lasix, Warfarin (blood thinner) and rosuvastatin.

Do you think the Bisoprolol is good enough to stabilise his condition?  Also, waiting time at the local government hospital is long, and so is it wise to wait for another 2 months for his next visit?  Will his heart condition deteriorate? Or that the warfarin is doing a good job (i.e. to prevent strokes) and that we do not have to worry about his heart as irregular heartbeats are not life-threatening?

Thanks.

Dino.

[BrokenPen]

Heart failure is a condition in which the heart’s ability to supply the body with the blood is impaired. It causes a variety of symptoms that worsens gradually, thus interfering with the daily activities.

Despite the deterioration of heart function and the seriousness of the condition, heart failure is not an irreversible condition. It can be treated if the patient provides enough compliance to his medicines.

Regarding your cousin’s condition, the Bisoprolol has stronger effect than Propranolol on heart rate and is cardiordiselective (acts only on heart cells) while Propranolol is non cardioselective. Irregular heart beats in themselves are not life threatening if controlled (not exceeding 100 beat per minute), and if your cousin’s pulse rate doesn’t frequently exceed 110-120 beats per minute, it’s ok to wait for 2 months. However, I guess that discussing these options with the doctor would be better.

I hope this was of some help. Let us hear from you soon.

[kenkeith]

Heart failure is medically classified as having an EF 30% or lower (percent of blood pumped with each heartbeat).  Sometimes a person can function well in heart failure mode....there is a statistic that estimates there a about 26% of heart patient population that do not know they have a weak heart as they function without symptoms.  And some have problems when the EF is below 40%.

Not successfully treated such as controlling blood pressure, proper diet to lower lipid profile, exercise, etc. the condition will eventually lead to the ability to meet demand for blood/oxygen...there will be severe respiratory problems (congested heart failure) and an enlarged heart could cause arrhythmia (irregular heartbeat).