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Heart Failure: A Matter of The Heart


Medic-ALL (07:11:2014) by Kayode Kuku MB;BS


Each day of our lives almost 2,000 gallons of oxygen-rich blood is supplied to every living cell in our body to ensure their nourishment and continued living. This is made possible by a strategically located "pump of an organ" in the body called the Heart. The heart is truly an amazing organ, beating almost a 100,000 times every 24 hours, to deliver almost 65 million gallons in a lifetime.

The Heart provides the power needed for life. When it fails to pump blood at a rate sufficient to meet the body's requirements, the result is "heart failure". Heart failure does not mean that the heart has stopped working, it simply means that the heart is pumping less effective than normal. Hence, with heart failure, blood flows through the heart and body at a slower rate, there is an increase in pressure in the heart, the heart muscles stretch and/or thicken in order to accommodate more blood and the heart attempts to pump faster and blood vessels become narrow in order to meet up with the body's unmet demands. The heart muscles eventually weaken and are unable to pump as strongly.

Before the 1900s, very few people suffered from and even fewer died from heart failure. In the last decennia however, heart failure has become a huge burden all over the world, particularly in the Western world affecting millions and been the leading cause of hospitalization in persons over 65 years of age.

While the age of technology and importation of certain western "habits" have made life easier for millions all over the world, they have also made us prone to heart disease. Almost a lifetime ago, most people made their living through some sort of manual labor, walking was a major means of transportation and most daily tasks were done by hand. Statues were climbed (no elevators), carpets were swept and beat , laundry was scrubbed and butter was churned. Fresh foods consisting of mainly of fruits and vegetables, and home made delicacies were consumed. With the arrival of automation most manual labors were replaced or assisted by machinery. 

Modern conveniences made physical inactivity unneccessary and lifestyle "inconveniences" brought about changes in diet; Fried foods, like potato chips, hamburgers, and French fries became staples in many diets. The combination of a sedentary lifestyle and a seemingly "rich" diet led to an increase in clogged blood vessels, heart attacks and strokes, the heart failure and other heart diseases became a common occurrence. The rate of heart disease in fact increased sharply between 1940 and 1967, in what the World Health Organization described as the world's most serious epidemic. 

The field of Cardiology has grown tremendously over the years to meet the demands of heart failure. Various techniques and tools have also evolved to meet the increased need. Though, many causes of heart diseases are not always reversible, the signs and symptoms frequently can be treated with well established pharmacologic, dietary and therapeutic modalities.

The use of medications have proven consistently to not only improve the symptoms of heart failure, but also to reduce hospitalization and mortality. In addition, lifestyle and dietary modifications such as monitoring daily weight, reducing salt and fatty food intake, increasing functional activity , reducing alcohol intake, quitting smoking, regular medical check-ups and follow-ups.

Ref: WebMD

India Performs First Fetal Heart Surgery!

Medic-ALL (01:11:2014)
A team of 12 specialists  led by K. Nageshwar Rao, chief pediatric cardiologist at  Care Hospital in Hyderabad performed India’s first successful fetal heart surgery. The baby in the womb of a 25-year old Sirisha was diagnosed with  severe aortic valve obstruction that was causing failure of blood supply sue to interrupted pumping of left ventricle. It was also resulting in further damage in the form of leakage of mitral valve and shrinkage of left sided heart chambers.



The surgery was performed in the 27th week of pregnancy after a failed attempt at 26 weeks due to unfavourable fetal positioning. The blockage according to Dr. Rao , is said to have been reduced from 99percent to 60percent which is sufficient to allow normal development of the left ventricle.Further surgery such as balloon dilatation may however be carried out after birth.

The history of fetal heart surgery dates back to April 1981, when the  first human open fetal heart surgery was carried out in the University of California , San Francisco under the direction of Dr Michael Harrison following extensive research with animal models by him and his research colleagues.

Ref: The Healthsite
         Iseeindia website
          Wikipedia 


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