Any of the heart diseases can make a heart very weak and make it weak enough to lose its ability to pump enough blood to the body. Many people don’t even get to know that they have a weak heart till late because the symptoms are slow in onset and the person keeps adjusting his or her lifestyle to the limits imposed be the failing heart. For example one of my patients and her husband were keen walkers, over time the lady couldn’t keep up with her husbands pace so he would slow down, then she started missing the walks and slowed down further. It was over 6 months later that they realised something was wrong when she sat panting for breath one night. She was lucky her heart was failing due to a leaky Mitral Valve, this was readily repaired and she is now able to enjoy her walks accompanied by the husband.
However, there are a large number of patients who cannot have curative surgery for their heart ailments. It is possible to help a lot of these patients by appropriately tailored medical therapy, appropriately supervised exercises and lifestyle modifications.
When the heart disease progresses to end stage heart failure, patients require hospitalisation quite often. The feet, legs and later the whole body swells and breathing becomes difficult especially at night. Patients sometimes feel suffocated a few hours after going to bed, wake up and walk about for sometime before feeling better. Congestion of the liver and stomach can cause nausea, vomiting and lack of appetite. Over time organs like the liver and kidneys also get affected by hormonal changes of heart failure.
End stage heart failure is a bad disease. Patients cannot expect to live very long. Some forms of heart failure can be worse than lung cancer, which undoubtedly is the worst cancer.
At that stage Heart Transplantation offers hope. Mechanical alternatives are being developed and permanently implanted Ventricular Assist Devices offer a reasonable chance at life to those patients who cannot receive a heart transplant due to additional illnesses, old age or general debility or for those who are very sick and wouldn’t be able to wait for a transplant.