Heart Failure



Heart failure is particularly common in older people with heart disorders. It’s not common in children, but may occur as a follow on from congenital heart defects, rheumatic fever and various viral cardiac infections.

Many people go through life maintaining their hearts in good working order. However, with a workload of this size, it is inevitable that many instances will occur where the heart simply cannot cope nonstop.



Heart failure may be aggravated by outside causes not directly related to the capacity of the heart. If additional obstructions are placed in its way, and it has to work against increasing forces, then there is a greater likelihood of its breaking down (fully or partially) at some time. When this happens, the condition is generally referred to as heart failure. In short, the heart fails to accomplish its appointed task with its usual efficiency. When this starts to happen, a large number of symptoms set in. some of them serious.

The heart maintains two separate circulations: the right-hand side, which pumps blood through the king system, and the left-hand side, which pumps blood through the general circulation of the body. Either of these sides may be affected if the heart becomes inefficient as a pumping machine.



However, it is much more common for these two to occur together, for the heart is a single organ, and as it becomes less effective, both sides tend to become involved simultaneously.

Doctors often talk about right-sided heart failure, and left-sided heart failure. But, generally, if evidence of both is present, the more common term “congestive cardiac failure” or “congestive heart failure” is used.



Under normal conditions, the heart responds automatically to increased demands made upon it. If exercise is being undertaken and the various muscles and organs require extra oxygen and food supplies, this is automatically reflected back by the heart beating faster and performing additional work. Its capacity for varying its output is incredible. A heart in good order and in a healthy body is capable of expanding its output to huge levels. Athletes in good training bear testimony to the efficiency of a healthy heart.

Not only does the heart rate increase with extra demands, but its output increases. The muscle fibers that comprise the organ stretch further as blood is delivered to its chambers. The increased stretching automatically liberates more energy with the subsequent contraction, so a greater volume of blood is delivered with each stroke.



However, all this occurs up to a certain critical point. Beyond this point, the reverse commences. Instead of greater efficiency resulting, a reduced response occurs. In normal good health, this critical point is never reached.

But under certain situations of cardiac disease, this point is reached fairly early. In heart failure, it is quickly reached, and the situation deteriorates rapidly beyond this point. Each heartbeat subsequently becomes weaker and less effective. To try to compensate for this, the chambers of the heart start to enlarge in size or dilate.



In this way, a condition called cardiac hypertrophy occurs. The heart, as a muscle organ, becomes large, over distended, and reduced in efficiency. At this juncture, its efficiency as a pump is markedly impaired.

As this situation gradually develops, symptoms evolve along with the mechanical deterioration, presenting a typical picture. Heart failure is an extremely common disease. It is seldom dramatic (as compared to angina and coronary infarcts), but tends to linger on, progressively worsening.

Heart Failure Causes

The causes of heart failure are usually outside factors that increase the workload of the heart. It may be a basic disease of the heart muscle itself, such as inflammation, or a poor blood supply to the myocardium. There may be an increased resistance to each heartbeat, such as occurs in elevated blood pressure. In this case, each time the heart beats; it must first overcome the pressure in the vessels before the blood can be pushed out into the body circulation. Commonly, the various valves of the heart are damaged, and this means greater force is needed with each stroke of the heart to overcome this increased resistance. At other times, there may be irregularities of the heartbeat itself, and this can produce inefficiency of each heartbeat.

But whatever the primary cause, the result is the same. It means the heart is unable to deliver an adequate blood supply to the tissues. Its primary function is to accomplish this, and every effort is made to succeed.



So, as it makes super efforts to compensate for its own inherent disability, the heart virtually destroys itself, slowly and insidiously

At this stage it is well to recognize several factors:

  1. In the overall picture of the Western world, the incidence of coronary heart disease is gradually decreasing, especially in men. But this does not leave room liar complacency, for more, younger people suffer from heart disease, often leading to sudden death. The combined effect of constant patient education, the mass media, and National Heart Foundations have collectively played a part.
  2. Many features of so-called modern living tend to increase the risk of developing premature heart attack.
  3. Some of these features may be overcome. A person does not necessarily have to have a heart attack because it happens to lots of other people. Knowledge of the causes can allow a commonsense approach that will reduce the risks to any particular person. This is now very well established.
  4. Even though these features are well documented, and most are fairly easy to follow, the majority of people can’t be bothered rearranging their lives and habits so that they will benefit from current knowledge.
  5. Most of the methods of reducing the incidence of heart attack are easy to follow, and cost virtually nothing except a little time and personal effort.
  6. The affluence of the Western world is increasing rapidly while the poverty of the underdeveloped areas is escalating. Nevertheless, many factors that keep the latter free from heart attack are an object lesson of prime value. It is worth looking into some of the reasons for this, and incorporating them into our way of living where practical.
  7. Greater wealth does not always mean better food. The modern method of removing fiber from grain also removes a key item of inestimable value for better health, as the underdeveloped nations have proved. Processed starches in all forms are among the giant hazards of modern living. The sooner more people recognize this and return to foods that are less refined, the better the health of the nation will be.
  8. Wealth and riches do not necessarily mean better health. Commonsense plays a major part. Often the best things in life are free.
  9. To end on a note of good cheer, however, the most recent figures indicate that several of the larger Western nations have at last managed to control their death toll from heart disease. Australia and Britain lead the field; there is little similar evidence in the United States at this moment. People coming to grips with the known causes and making an effort (often small, but nevertheless some effort) is at last paying off as national figures for heart attacks are slowly starting to tumble. It is to be hoped that this trend will continue.

Heart Failure Symptoms

There may be sighing, breathlessness, weakness, reduced desire for food. The child may be pale or have a bluish cyanotic complexion. With heart disorders generally, or those suspected of being cardiac in nature, medical attention is necessary.

Under normal conditions, it will beat with unfailing regularity 70 times a minute. 100,000 times a day, 2500 million times in a lifetime. Work on this scale is incredible. But apart from beating regularly, it is actively working, receiving blood at one end and pumping this through two intricate systems.