Sunday, March 12, 2006

Heart Failure and High Blood Pressure

Over time, even a moderately raised blood pressure can greatly increase the workload of the left side of the heart. The heart is endeavouring to pump as much blood as it can into the aorta and the rest of the arterial system against an ever increasing resistance which is offered by the constricted and diseased arterioles.

Enlargement of the heart can be detected by different types of examinations which include a physical examination, chest x-ray and an ECG (Electrocardiogram).

Any type of muscle tends to become more bulky when it is used excessively, and the muscles of the heart are no exception. One of the earliest signs of heart failure is a thickening in the wall of the left ventricle. This is the lower left sided pumping compartment from which the aorta emerges.

Eventually the continued effort by the heart to continue pumping starts to falter, and the left side starts to show signs of failure. The blood supply to other organs and tissues in the body starts to dwindle with an associated weakness and lethargy in the person affected.

A build up of pressure occurs in the left ventricle which prevents the blood from draining from the lung veins into the atrium which is the upper compartment of the heart. The lung tissues then become congested which produces a cough and breathlessness.

The cough which is produced can be either dry or can produce a frothy blood stained phlegm. It can be especially worse at night and if an acute attack occurs, it can be very frightening to the person involved who will think they are choking to death.

This breathlessness is usually first noticed during a prolonged exercise period, but later as the heart failure becomes progressively worse, it will be apparent even with mild exercise or even at rest.

Unless urgent action is taken, the blood pressure reduced and the heart failure relieved, the right side of the heart will also become affected. The pressure will then build up in the right atrium which will in turn cause back pressure into the veins draining blood into it.

A characteristic outward sign that heart failure has reached this stage is enlargement of the external jugular veins on either side of a person's neck. These veins which carry blood flow from the scalp and face are often partially visible anyway due to their close proximity to the skin, however in the case of this stage of heart failure; they become much more noticeable and can become vulnerable to injury.

Other signs of right sided heart failure include " Swollen feet and ankles. " Enlarged liver, " Swollen abdomen " Reduced urine flow. " Loss of appetite

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