Heart Failure — Symptoms, Causes and Treatment in Hyderabad
Heart failure does not mean the heart has stopped — it means the heart cannot pump blood efficiently enough to meet the body's needs. It is a chronic condition affecting millions of Indians, and increasingly younger patients. With the right treatment, most patients with heart failure can live well and manage their symptoms effectively.
What is heart failure?
When the heart muscle weakens — from a prior heart attack, long-standing high blood pressure, valve disease, or other causes — its pumping efficiency falls. The body compensates for a time by retaining fluid and increasing heart rate, but eventually these mechanisms fail and symptoms appear. The result is a cycle of fluid overload, reduced output, and progressive organ strain.
Heart failure is classified by whether the heart's pumping function — measured as the ejection fraction (EF) — is reduced or preserved:
| HFrEF (EF below 40%) | The heart muscle is weak and contracts poorly. The ventricle is enlarged. Classic heart failure. Responds well to GDMT drug therapy, CRT devices, and revascularisation when coronary disease is the cause. |
| HFpEF (EF above 50%) | The heart contracts normally but is stiff — it cannot relax and fill properly. Common in elderly patients, women, diabetics, and those with hypertension. Symptoms identical to HFrEF. Treatment focuses on congestion relief and risk factor control. |
| HFmrEF (EF 40–49%) | Mid-range ejection fraction — a distinct group that may share features of both. Treatment increasingly follows HFrEF guidelines. |
Symptoms of heart failure
Heart failure produces symptoms from two mechanisms — the heart not pushing enough blood forward, and fluid backing up because it cannot be cleared:
- Breathlessness — Initially occurs during exertion and may progress to breathlessness at rest or during sleep. Orthopnoea refers to needing multiple pillows to breathe comfortably at night.
- Swollen ankles and legs — Pitting oedema caused by retained fluid accumulating in dependent tissues.
- Extreme fatigue and weakness — Often disproportionate to the level of physical activity.
- Abdominal bloating and reduced appetite — Caused by fluid accumulation within the abdomen.
- Rapid or irregular heartbeat — Experienced as palpitations or awareness of the heartbeat.
- Reduced urine output during the day — Often accompanied by frequent urination at night (nocturia).
- Persistent cough or wheeze — Results from fluid accumulation within the lungs.
When to seek urgent help
Sudden worsening breathlessness, inability to lie flat, coughing pink frothy sputum, or rapid weight gain of more than 2 kg in 48 hours are signs of acute decompensated heart failure requiring emergency assessment. Call +91-9000352998 immediately.