How can one treat irreversible damage to the heart?

Heart failure happens when the heart has trouble sufficiently pumping blood. Shortness of breath, exhaustion, and, in severe cases, heart failure can all result from a weak heart’s reduced blood flow to the cells.

1.Understanding heart failure and common causes of the disease
Heart failure is a chronic condition which occurs when the heart is unable to pump blood sufficiently to meet the metabolic demands of the tissues in the body. A weakened heart results in inadequate blood supply to the cells leading to fatigue, shortness of breath and other symptoms of heart failure. Some common causes for heart failure include diabetes, valve disease, congenital heart disease, hypertension, heart attack or coronary artery disease, family history of the disease, an enlarged or infected heart.

2.Seeking medical advice for heart failure
A patient should consult a doctor when they start experiencing chest pains that are sudden, severe, unexpected, and come with shortness of breath, sweating, nausea, or weakness. One should also monitor their heart rhythm and be aware of abnormally fast heart beats, especially if you are short of breath that it is not relieved by rest. Sudden weakness or inability to move your arms or legs, severe headaches and sudden fainting spells are also major warning signs.

3.Stages of heart failure and treatment options
Heart failure develops over time as the heart’s pumping action grows weaker the body tries to compensate for this with hormonal and other mechanisms. The New York Heart Association classifies this into 4 stages (NYHA Class 1-4), and the treatment varies at each stage. This is because once a patient has progressed to the next stage, it cannot be reversed i.e. once they progress to Stage C, they cannot go back to Stage B or A. While in the initial stages of heart failure, lifestyle changes along with medication can help manage the condition, in case of advanced heart failure, treatment options such an LVAD procedure or a heart transplant along with therapy are necessary for the patient. LVAD (left ventricular assist device) helps the left ventricle (main pumping chamber of the heart) pump blood to the rest of the body. It is a feasible and safe option for management of the condition.

4.LVAD being a more lucrative option for patients with advanced heart failure compared to a heart transplant. An LVAD is a more safe and accessible option for patients with advanced heart failure. And due to persistent shortage of donors, LVADs can be used as both bridge to transplant and as destination therapy. An LVAD also requires fewer consultations post treatment compared to a heart transplant. Further, a study conducted by the NCBI has shown that there are no differences between a heart transplant and LVAD for patients with regards to late mortality. The two-year outcome of an LVAD is comparable to that of a heart transplant.

5.Are patients above 65yrs advised to get an LVAD?
As per guidelines patients above 65 years are not given priority for Heart Transplant. Availability of Donor Hearts is another issue. Hence LVAD is viable option for such group of patients.
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6.Living with an LVAD
An LVAD device helps a patient lead a more active life. It becomes a new way of life, a “new normal”. While it may take some time to get used to having an LVAD, it also improves the patient’s strength and ability to participate in activities they were not able to previously. Post treatment, a patient must follow the below mentioned precautions:
1.Monitor your weight
2.Eat a healthy and well-balanced diet
3.Lead an active life
4.Avoid stress
5.Get plenty of sleep
6.Seek medical consultation regularly and be on the lookout for symptoms
7.Avoid excessive physical strain
The author is a the Director of Interventional Cardiology at Fortis Escorts Heart Institute