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Keep an eye out for a weakened heart
Being aware of the symptoms and early detection can help prevent poor quality of life or sudden death due to heart failure. Heart failure seems to be one of the leading causes of death despite the fact that a few definite steps can help in its prevention and control. While no conclusive studies have been done to determine the prevalence of heart failure in India, it is of roughly estimated to be between 1.3 - 4.6 million cases.
When a weak heart is not able to pump required amount of blood carrying oxygen and nutrients into the body, it puts more pressure on the muscles of the heart, eventually causing heart failure. But being alert to the symptoms can ensure that there is minimal damage to the organ.

According to Dr Rajpal Singh, Consultant Interventional Cardiologist and Device therapist, Fortis Hospitals, Bannerghatta road, Bangalore; some of the early symptoms of congestive heart failure to look out for are -- shortness of breath on exertion, which is relieved by rest and gets worse over time; fatigue; swelling of lower limbs; reduced urine output; need to use more pillows at night to sleep comfortably and in advanced cases, waking up in the middle of the night with difficulty in breathing.

Patients who are at higher risk of developing heart failure need to be screened early, typically patients who are over the age of 50-55 years, those who have angina or have suffered a heart attack in the past. Individuals with diabetes mellitus, history of hypertension, smokers and persons indulging in high alcohol intake are the high risk candidates for this condition, adds Dr Singh.

One of the early signs of heart failure is Ejection Fraction (EF), which is ameasure that reflects the pumping ability of the heart. “Normal EF is about 60 per cent. A ‘low EF’, typically less than 35 per cent, would imply that the patient is suffering from symptoms of heart failure, cardiac arrhythmias and if neglected, may even lead sudden death,” says Dr Singh.

Since low EF spells danger, a few simple steps by the patient can bring it to normal-
1. Stop smoking/ reducing alcohol intake
2. Reducing salt intake
3. Comply with prescribed medications.
4. Regular follow up
5. Maintain a weight chart and report unexplained weight gain.
6. Follow doctor’s instructions


Diagnostic tests such as ECG and Echocardiogram can point out if the heart muscles are weakened. A chest X-ray and a specific blood test called Beta naturetic Peptite levels helps in diagnosis and can also be used to identify high risk patients and monitor response to therapy. Coronary angiogram, cardiac MRI and ultrasound scans of kidneys and renal arteries may be done to find out the underlying reason for heart failure.

“After the initial examinations, medications which can improve the EF may be given by a cardiologist. Patients and their family will be educated about the nature of the problem and its implications. Symptomatic therapies are given to improve the symptoms and stabilise the patient. Advice about risk factors and diet is also given.”

For those patients who are found to be at high risk of sudden cardiac death, doctor may advise implantable cardiac defibrillators as a life saving technique.

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