The heart works throughout life. It doesn’t sleep, it neither takes breaks nor retires, and there is no lazy bone in this muscle. An intensive “workout” from exercise makes the heart stronger.

But the heart demands fair play. If the workload is consistently excessive or the heart is damaged, this tireless worker can become overwhelmed. In heart failure, the overwhelmed heart is unable to fully perform its task of receiving and pumping out blood.

Most people with heart failure do not seek medical help until advanced stages; survival and quality of life can be improved by early diagnosis and proper treatment.

The heart asks for little in exchange for lifelong work

To put it simply, the heart only needs well-preserved muscle strength, good valves to control the direction of blood flow, and normal blood pressure to keep giving.

Most cases of heart failure in Africa occur after the heart succumbs to high blood pressure or when chunks of the heart muscle have become damaged, such as after a heart attack. Other heart failure diagnoses are linked to congenitally defective heart valves or acquired infections, among many possible causes. Sometimes the cause is unknown.

Increased awareness of the window of opportunity called “pre-heart failure” will help. Pre-heart failure is when someone has not developed heart failure but has risk factors for developing the condition. Correction of such risk factors may prevent progression to heart failure which initially has no symptoms then progresses to a symptomatic phase and finally to advanced or full-blown heart failure. Close follow-up of those with pre-heart failure may also help doctors catch symptoms earlier. The earlier treatment starts, the greater the chance of survival with a good quality of life.

Making lemonade from lemons

Those with heart failure do not have to endure a life plagued by activity-limiting breathing problems, low energy, restricted social engagement, low economic productivity, and so on.  There are ways to give a failing heart some boost.

The first piece of advice is one of the hardest to follow: consume less salt.  Low salt intake lowers blood pressure; hence it lowers the offensive workload.

  • The average person consumes 9–12 grams of salt daily, which is around twice the recommended maximum intake.   
  • Exercise, maintenance of normal blood sugar, regular physical activity, a healthy diet also help prevent and manage heart failure

Proper treatment depends on the cause

Certain classes of medications(angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB), beta-blockers, and diuretics commonly called “water pills”) have been shown to improve survival and/or quality of life in heart failure. These medications reduce the workload of the heart or help the heart carry some of the load.

  • Africa needs more heart specialists. There are approximately 2,000 cardiologists for a population of 1.2 billion.
  • The World Health Organization has targeted that key heart medicines be available in 80% of African communities and used by 50% of eligible individuals by 2025.   

Skilled doctors use special tests to select the right medication(s)as one size does not fit all. The combination of medications for a heart that is too flabby to pump blood efficiently is different from the treatment needed for heart muscle that is too stiff to easily receive in-flowing blood.  Sometimes a diseased valve must be replaced, or clogged blood vessels opened to get the heart muscle needed nutrients.

Our hearts demand little in return for a lifetime of work. Heart failure is a sign of an overwhelmed heart; a productive life is possible despite heart failure. One thing is clear, our tirelessly working hearts will have the final say.