Heart Failure is one of the end-organ complications of hypertension. It is however important to note here that “heart failure”does not literally mean that the heart is no longer working at its full capacity, which however could lead to complete stoppage of the heart, if not, promptly treated.
How Hypertension Gives Rise to Heart Failure
As earlier mentioned, the blood pressure is increased when there is narrowing of blood vessels supplying blood to different organs; a phenomenon known as Peripheral Resistance. As expected, if the pipes from an overhead tank are partially or completely blocked, more water would be pulled back into the tank. If the tank has elastic property, it expands or becomes tense.
This same phenomenon occurs when the blood vessels are narrowed. At first, the part of the blood vessel before the narrowed point gets filled with blood and expands to accommodate the back flow. Since the heart is the source and the pumping machine, more blood is retained in the heart. In attempt to pump the blood against resistance (the narrowed blood vessels), more labour is placed on the muscles of the heart.
Generally, the muscles of the body enlarge when subjected to work, for example extreme exercise, gymnastics etc. In the same way, the muscles of the heart begin to increase in size when overloaded; a condition known as Cardiomegaly. Initially, this structural enlargement appears compensatory in nature but with time, the heart begins to perform below its optimal potential. In a state of poor pumping performance, the heart is said to be in failure; Hypertensive Heart Failure.
Signs and Symptoms of Heart Failure
Heart failure manifest with the following symptoms and signs.
Effort Intolerance: This is condition that is characterized by weakness and fatigue. A person with heart failure may complain of the following;
– Inability to walk a long distance due to unusual tiredness.
– Inability to climb staircase without panting.
– Unusual weakness and inability to carry out routine jobs.
– There could be complains of decreased sexual performance and/or unusual exhaustion after an episode of sexual exercise.
Pedal Edema: This is a medical condition characterized by leg swelling usually affecting both legs. Most times, when a finger is pressed on the leg, it leaves a depression on the skin i.e Pitting Edema. Such Swelling can occur in other disease condition like kidney and liver failure. It can also be seen in pregnant women. However, such swelling with weakness and other signs the doctor would detect point towards a heart that might be in problem.
Orthopnia: In this condition. the affected person may not be able to sleep freely without a pillow. Most times, such persons have choking or fainting experience while lying flat on the bed without pillow. Occasionally, amidst a deep sleep, such persons may suddenly wake up in search of air due to the feeling of suffocation or breathlessness. The latter state is called Paraxysmal Nocturna Dyspnia (PND).
Tender Hepatomegaly: This simply means enlarged and painful liver. In this case, the affected persons may complain of right sided chest/abdominal pains. Hear failure is one of such condition. Other signs of heart failure including difficulty in breathing, cough etc. The other diagnostic findings require professional’s (doctors) assessment.
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