Pathophysiology refers to the abnormal functioning of a body organ or system due to disease, and the most common pathophysiology causing heart failure is probably the process of atherosclerosis, or furring of the arteries. Atherosclerotic changes involved in heart failure pathophysiology may begin as early as childhood but increase with age, causing progressive narrowing of the arteries which can prevent normal functioning of the heart muscle. Sometimes pain in the heart, known as angina, may be felt during exertion and general symptoms of heart failure such as breathlessness, tiredness and swollen ankles may eventually occur. Medication and surgery are treatment options, but healthier lifestyle choices can also be effective for some people.
When heart failure pathophysiology is a result of atherosclerosis, changes take place gradually over a long period and affect arteries throughout the circulation, as well as causing coronary artery disease, often known simply as heart disease. Narrowing of the coronary arteries, which supply the heart muscles, may mean blood flow becomes insufficient, leading to the pain of angina felt in the heart muscles during exercise. If the blood supply becomes extremely low, parts of the heart muscle may even die in what is known as a myocardial infarction, or heart attack.
Narrowing of the coronary arteries and destruction of heart muscle following a heart attack can leave the heart unable to pump blood normally, a condition known as congestive heart failure. There are other, less common, diseases associated with heart failure pathophysiology, including abnormalities of the heart valves and illnesses which weaken heart muscle. Sometimes heart failure pathophysiology ends up affecting both sides of the heart, or occasionally only the right or the left. Problems with the heart's pumping action can be due to failure of the heart to fill up properly or difficulties in ejecting blood after filling. In any case, the heart's failure to pump blood around the body results in blood backing up, and organs such as the liver and lungs may become congested and damaged.
The outcome of heart failure depends on its severity and, while the most serious cases can be fatal, milder cases can often be treated to reduce symptoms and increase life expectancy. Beneficial lifestyle changes include: eating healthily and losing weight, taking regular exercise, giving up smoking, and reducing alcohol consumption. Drugs such as diuretics can regulate body fluids, while ACE inhibitors and beta-blockers can help take the pressure off the heart. Treating high cholesterol and hypertension, or high blood pressure, may decrease the risk of further damage to the arteries. Occasionally surgery is used to bypass diseased coronary arteries or the heart may even be replaced with a transplant.
