SN: Before we proceed as to your placement, let me first check with you your knowledge about heart failure. Do you know what it is exactly?

TN: Well, I guess it refers to the inability of the heart muscle to normally propel enough blood through the body to provide the oxygen and nutrients necessary for the proper functioning of the organs. This progressive inability is most often secondary to a pre-existing heart condition.

SN: Ok. Now when is heart failure considered acute?

TN: It’s that when the heart is suddenly unable to pump blood. This is the case of a myocardial infarction. Acute heart failure can also be due to the aggravation of chronic heart failure that becomes too severe.

SN: And what’s the difference between “systolic” and “diastolic” heart failure?

TN: Heart failure is said to be “systolic” when the heart pump has less force and therefore the amount of blood emitted by the ventricle is reduced. It is said to be “diastolic” when the heart fills less well because it has difficulty relaxing. However, my knowledge on the subject is still theoretical. Therefore, I’d like to ask you what the main causes of heart failure are?

SN: There are three main causes of heart failure. The first is an ischemic heart disease, which is the narrowing of the coronary arteries caused by insufficient oxygenation of the heart leading to a myocardial infarction or to angina pectoris. The second is high blood pressure, in that when poorly controlled high blood pressure tires the heart muscle, which must strain to send blood through the arteries. After having thickened to remain efficient at first, the heart muscle becomes tired and loses its strength, which leads to heart failure. And the third is the cardiomyopathies, which are diseases that directly affect the heart muscle and its functioning. They are characterized by a progressive alteration of the structure and function of the heart muscle walls. Cardiomyopathies can be caused by infection (e.g. HIV/AIDS), drugs (e.g. cancer chemotherapy), chest radiotherapy (e.g. breast cancer), or excessive consumption of alcohol or drugs, among other causes, of course.

TN : Are there any warning signs that would foretell heart failure?

SN: Yes. Four symptoms should warn us and suggest heart failure, namely shortness of breath, weight gain, edema, and fatigue. The presence of one or more of these symptoms justifies a consultation.

TN: Ok. Now let’s say that the diagnosis has been made. So, how can we manage heart failure?

SN: Once the diagnosis is made, the management of heart failure aims to slow its progression, improve symptoms and quality of life, reduce complications, hospitalizations or death. Also, lifetime treatment is based on an adaptation of hygienic and dietary habits to the disease, drug treatment and the use of a cardiac implantable device in case treatments won’t do as expected.