Heart Failure Management Insights by Dr Bhagirath Raghuraman Heart failure is a serious condition where the heart can't pump ...

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Heart Failure Management Insights by Dr Bhagirath Raghuraman

hello everybody I am Dr bagat raguraman working as senior consultant cardiologist and program director of heart transplant at Nar Health city bangaluru today we will discuss regarding the topic of heart failure basically heart failure is a condition wherein the heart is unable to pump blood at a rate required for the body's circulatory needs there are many types of heart heart failure and there are many conditions that cause heart failure so first of all let's look at what are the signs and symptoms of heart failure so the patient presents to us with a history of breathlessness swelling of the feet distension of abdomen puffiness of face extreme tiredness exhaustion unable to do the daily routine of life when we look at the evaluation of the patient the B patient basically has extensive reputations that is fluid buildup in the lungs there is elevated Venus pressure there is enlargement of the liver due to the edima that that builds up in the liver there is also collection of fluid in the abdomen and there is collection of fluid in the feet the ways to investigate a patient with heart failure we start off with a routine ECG and echocardiogram is a very useful test to diagnose heart failure changing gears you can also add on other test like a cardiac MRI which will give us an in detail assessment of the anatomy of the patient the overall heart function the possible causes or pointers which will guide us regarding the direction how to investigate the patient we do a CT scan of the patient both for the cardiac function as well as the coronary anatomy and we can do a mardial perfusion scan which will tell us what is the blood supply and whether this heart failure of the patient is related to a decreased blood supply what we call as mardial lemia the broad ways in which you can treat heart failure are first of all lifestyle modification measures wherein you restrict fluids uh the guideline recommendation is 1.2 L in 24 hours you also do a salt restricted diet for these patients medical management is basically anti-failure medications which is the broad four pillars for the management of heart failure plus the add-on guideline recommended medical management next up you have device therapy here again it is divided into those who have a left bundle branch block on ECG which we use a device called as a cardiac res synchronization therapy with a defibrillator crtd device and for those who don't have a left bundle branch block we use an ICD that is an automated internal cardiov defibrillator device this device helps to shock the patient out of dangerous arthas and save the patients life the next level of devices include a left ventricular or a right ventricular or a B ventricular assist device which is a mechanical circulatory pump which is fitted into the Chamber of failure and is has got a battery operated support wherein the battery has to be charged every 10 to 11 hours to keep the machine running and of course the ultimate in terms of heart failure management is a cardiac transplantation here after the tests are analyzed we enlist this patient for a heart transplant surgery and when a suitable donor is available this patient undergoes a heart transplant and we follow up with again a new set of medications and periodic tests to look for rejection and monitor the graft [Music] survival

Dr.

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