Heart failure, it's a syndrome so it gives you
particular symptoms, you get breathless
you get tired, you get swollen ankles.
And it's due to the fact that the heart just
can't pump enough blood round the body.
Either at rest or when it's doing things so that,
that's what gives you heart failure.
It's very common over all it depends on
the age of the patients that we're
looking at but overall its prevalence in
the UK is anything anywhere between one
to two percent of the population.
Now at the end of the day all heart failure is
due to the heart failing as a pump but
it can really fail in two ways. One is
where the left ventricle which is the
main pumping chamber of the heart does
not pump properly and it's actual force
of contraction of pumping is reduced and
that's called left ventricular systolic dysfunction.
And that accounts for
about 70% of all heart failure in this
part of the world. The other part, the
other type of heart failure is where the
heart does not relax properly, it's
usually stiff or hypertrophied as a
result of years of high blood pressure
when the heart does not relax properly
it does not fill properly if it does not
fill properly it does not empty properly
and that accounts for about 30% of the
heart failure that we see.
So you have heart failure with a weak heart, that's where you
have a reduced ejection fraction that's
called heart failure with reduced
ejection fraction. So a normal heart pumps
about the 50 or 60 percent of its
blood in one beat. With this condition it
will be pumping out less than 40% of its
blood in one beat so the heart will be
bigger and weaker. And then an equal
number of people have something called
heart failure with preserved ejection
fraction that's where the heart still
can't pump enough blood round but it's
because the heart stiff rather than it's
big and weak so I think that's quite
important because the treatments for
those two conditions are very different actually.
Most of heart failure, most of
the time you're talking about a problem with
the left ventricle. Now sometimes you can
get weakness in the right ventricle, the
right pumping chamber, that pumps the blood
to the lungs and you often see that in
people sometimes where they have bad
lung disease and the pressures in the
artery to the lungs get raised
the right side of the heart then
struggles with that so you can have a
condition where the right side is weak
due to lung problems, clots on the lungs
occasionally again due to inherited heart problems.
And it's very important to understand all
of these different types once you have your
diagnosis because the treatment slightly
different but the symptoms are not but
the important thing is that once that
echo scan tells a doctor what's wrong
with you you can start on a good treatment plan.
The progression of heart
failure is quite unpredictable however
it is usually the case that there will
be a slow but steady progression in the
disease and then as that happens you
might on top of that have episodes where
you have acute heart failure that will
admit you to hospital.
Everyone is very different and no two cases are the same
but we do know that generally over time
the condition does get worse, but that can be
a long long period of time over many years.
Obviously when you first present
with heart failure the quicker you're
diagnosed, the sooner you're put on the
appropriate therapies and see a
specialist usually, then that is going to
impact probably on the trajectory of your condition .
So a lot of patients with
heart failure live for a long long
time their symptoms improve with a
medical therapy we give them and so it's
a very variable disease and it's a very
treatable disease so I think I would say
for a lot of people with heart failure
actually the outlook is good these days.