What are the symptoms of this disease?
The signs and symptoms of HF derive mainly from a peculiar feature of this disease, which is the tendency of the body to retain water and salt. The symptoms and their severity differ from one person to another according to the degree of evolution of the disease, but the most frequent are fatigue or asthenia, difficulty in breathing with low levels of effort or even without effort (dyspnea) and the signs derived from the tendency to retain water and salt, such as swelling of the extremities or edema. Characteristically this swelling is not accompanied by signs of inflammation or pain. Sometimes dyspnea is so severe that it appears even at rest and characteristically when lying down.
In more advanced cases of the disease, complications often arise from inadequate blood supply to vital organs, particularly the kidney, which only aggravates water and salt retention.
What care should a patient with this disease follow?
The care that patients should follow is based on 5 fundamental pillars.
1.- Diet low in salt: Chronic HF is a disease characterized because the body has a permanent tendency to retain water and salt and this has serious consequences on the distribution of water in our body, which tends to accumulate in the tissues and viscera, and in particular in the lung with the consequent risk of developing a serious complication which is “wet lung” or pulmonary edema. Therefore, patients should become accustomed to a low-salt diet.
2.- Mobilization: The patient with chronic HF who is in a stable situation should try to perform gentle physical exercise, such as walking on level ground, because this contributes to improving his functional situation and minimizes the risk of loss of muscle mass which is a complication associated with HF.
3.- Weight: HF patients should try to bring their weight closer to their ideal weight. Excess weight will worsen their functional status. On the other hand, the HF patient should get used to monitor his or her weight on a daily basis. In the event of an unexpected weight gain not attributable to excess intake, he/she should think that he/she is beginning to accumulate excess water, which weighs one kg per liter, something that should be reported immediately to his/her physician.
Control of the underlying disease: Periodic check-ups by your primary care physician and/or cardiologist will give you information about the course of your underlying disease and will allow you to make adjustments in your drug treatment.
Drugs: In the last 4 decades we have witnessed spectacular advances in the treatment of HF through the application of new drugs that have reduced mortality from this cause and that many patients have experienced a reduction in their morbidity, have improved their functional capacity and their quality of life. Patients should know that each of the drugs they are prescribed fights this powerful enemy that is HF, but that they fight it from different flanks and that they act synergistically with each other. Hence the importance of the patient taking the prescribed medication properly. Nevertheless, despite the great advances made, there is still a long way to go, especially because the mechanisms of the disease, what we call the pathophysiology, are still far from being clarified in almost half of the cases of patients with this disease.
In the meantime, new treatment alternatives continue to be developed, such as surgical procedures or electronic devices to resynchronize the heart or to assist the heart, but these are applicable to a small number of patients.