Treatment for Chronic Cardiac Failure

Chronic Cardiac Failure (CCF) is a common clinical condition resulting from any structural or functional cardiac disorder that impairs the ability of the heart to pump blood efficiently.

Common causes of heart failure include coronary artery disease (including a previous heart attack), high blood pressure, excess alcohol use, tobacco, atrial fibrillation, valvular heart disease, infection, and cardiomyopathy of an unknown cause. These causes bring changes either in the structure or the functioning of the heart. There are two main types of heart failure: heart failure due to left ventricular dysfunction with normal ejection fraction or with low ejection fraction.

Common Symptoms are:

• Breathless on minimal exertion or at rest
• Swollen ankles, legs or stomach discomfort
• Weight gain
• Loss of appetite
• Dizziness
• Coughing

The condition is diagnosed based on the history of the symptoms and a physical examination with confirmation by

• Echocardiogram
• Electrocardiogram (ECG)
• Pro BNP level
• Coronary angiogram
• Chest X-ray.

The goals of therapy of heart failure with reduced ejection fraction are to reduce morbidity (i.e. reducing symptoms, improving health-related quality of life and functional status, decreasing the rate of hospitalization), and to reduce mortality.

• Management of CCF includes management of contributing and associated conditions, lifestyle modification, drug therapy, cardiac rehabilitation, and preventive care.

• Treatment of CCF includes management of contributing and associated conditions such as hypertension, ischemic heart disease, anaemia, valvular heart disease, diabetes, thyroid dysfunction, and infection.

• Recommended lifestyle modifications for patients with CCF include smoking cessation, restriction of alcohol consumption, fluid and salt restriction, weight reduction in obese patients, as well as daily weight monitoring to detect fluid accumulation before it becomes symptomatic.

• The goals of pharmacologic therapy of CCF are to improve symptoms (including the risk of hospitalization), slow or reverse the deterioration in myocardial function due to pathologic remodelling, and reduce mortality.