Matters of The Heart: Cardiovascular Diseases
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What are Heart Failure and Valvular Diseases?

Heart failure is a chronic medical condition in which the heart is unable to pump enough blood to meet the body’s needs. It occurs when the heart’s ability to contract and relax, or its pumping function, is compromised. This can lead to a variety of symptoms and complications.

Heart failure is typically classified into two main types based on the function of the heart and the side of the heart affected:

Systolic Heart Failure. Also known as reduced ejection fraction heart failure, systolic heart failure occurs when the left ventricle, the main pumping chamber of the heart, becomes weak and cannot contract effectively. As a result, the heart is unable to pump out a sufficient amount of blood with each beat. This leads to a decrease in the overall pumping ability of the heart.

Diastolic Heart Failure. Also referred to as preserved ejection fraction heart failure, diastolic heart failure occurs when the left ventricle loses its ability to relax and fill with blood properly during the resting phase (diastole). The heart’s pumping function may still be normal, but the reduced capacity to relax and fill results in inadequate blood supply to meet the body’s demands.

Heart failure can also be classified based on the side of the heart primarily affected:

Left-Sided Heart Failure. This occurs when the left ventricle is unable to pump blood effectively to the rest of the body. It can lead to symptoms such as fatigue, shortness of breath, and fluid accumulation in the lungs.

Right-Sided Heart Failure. This happens when the right ventricle fails to effectively pump blood to the lungs for oxygenation. It can result in symptoms like swollen legs, ankles, and abdomen, as well as fluid accumulation in other parts of the body.

Heart failure in Singapore is often classified based on the severity of symptoms and the patient’s functional status. The most commonly used classification system is the New York Heart Association (NYHA) functional classification, which helps healthcare professionals assess the impact of heart failure on an individual’s daily activities. The NYHA classification includes the following categories:

  • Class I. Patients with no limitation of physical activity. They experience no symptoms during normal physical activity.

  • Class II. Patients with slight limitation of physical activity. They may experience symptoms, such as fatigue or shortness of breath, during moderate physical exertion.

  • Class III. Patients with marked limitation of physical activity. They may experience symptoms with minimal physical exertion and may be comfortable only at rest.

  • Class IV. Patients who are unable to carry out any physical activity without experiencing symptoms. They may have symptoms even at rest and their discomfort increases with any physical activity.

Understanding the classification of heart failure helps healthcare professionals determine appropriate treatment strategies and management plans tailored to the individual needs of patients. It is important for individuals with heart failure to work closely with their healthcare team to monitor their condition, manage symptoms, and improve their overall quality of life.