There is one body part that has the most exhausting job – the heart. It has to continuously pump blood across about sixty thousand miles of blood vessels in our body. That too non-stop and without any break. Any obstacle that occurs in its functioning can lead to the failure of the heart. This is a lifelong non communicable disease. It becomes more important to talk about heart failure as the mortality rate is more than 20 per cent. Also, patients in India are ten years younger than the global average.
Beat Heart Failure, an initiative by The Times of India in partnership with Novartis, is trying to spread awareness about heart failure and its management and treatment. The initiative is in its fourth leg during which multiple panel discussions with senior doctors from India’s best hospitals were held. In one such discussion, doctors from the PSG Institute of Medical Science and Research spoke about heart failure and how regular treatment can help lead a quality life for adults as well as children with heart failure.
“Heart failure is very much treatable. Of course, curable with transplantation in deserving patients.” These are the encouraging words said by Dr J S Bhuvaneswaran – Director PSG Super Specialty Hospitals Peelamedu, Coimbatore for heart failure patients.
Dr K Tamil Arasu said that many people believe that heart failure is a death sentence, instead, they should understand that it is a gradual weakening of heart muscle and due to that heart is working at a reduced capacity.
“When the heart pumps blood, it contracts (called Systole) and relaxes (called Diastole). When anything affects the two then gradually heart failure ensues. The common causes of heart failure in adults are hypertension, diabetes and ischemic heart disease. During a heart attack when a patient delays in reaching the hospital, the heart muscles get damaged and resulting in heart failure. The natural course of the disease can be modified with the available treatment, if not completely reversed,” Dr Arasu said.
According to Dr Prem Krishna Anandan, the problem begins as most patients complain about breathing difficulties but instead of visiting a cardiologist, they prefer to go to a pharmacy and self-prescribe medication. “By the time patient realizes that symptoms are not relieved, the disease has progressed, and heart failure is set in. The other symptoms which are difficult to manage because the heart is in decompensated stage are – fatigue, oedema of lower limbs, abdomen, deranged renal function and low blood pressure,” he added.
Talking about heart failure in children, Dr Vinoth Doraiswami said that it occurs in almost two to three percent and the mechanism of development of heart failure is the same as adults, but the cause is different. According to the doctor, congenital heart disease or CHD is a condition that is present since birth and is the primary cause of heart failure in children. CHD is correctable and the child can live a normal life if the surgery is done on time.
Some of the common symptoms of heart problems in children:
- Growth not in line with their age or stunted growth
- Easy fatigability compared to children of their age group
- Swelling of lower limbs
If the congenital defects are repaired on time, then heart failure comes back to normal and eventually medicines can be stopped. Viral myocarditis is the second most common cause which can be managed by medicines but, difficult to bring the heart back to normal. In the first two stages of heart failure children can go to school but not allowed to participate in active sports. In the last two stages the children are unable to do any strenuous activity and if the symptoms are progressing then they are advised home schooling.
It is difficult to restrict fluid in young children. The only management is to increase the dosage of the medicines. A child around fifteen sixteen years can be taught to restrict fluid depending upon their weight.
The parents should be alerted about the danger signs of heart failure in children such as an increasing swelling, fatigability, increased respiratory rate etc. One of the major symptoms is when child stops taking the feed. This shows that the child’s heart is becoming decompensated. A calorie regulated scientific diet plan can be followed in children for dietary management.