Demystifying Heart Failure

Heart failure does not mean the heart has stopped working, but rather that it is unable to pump blood as effectively as the body requires . Left-sided heart failure specifically affects the left ventricle, which is the heart's primary chamber responsible for pumping oxygen-rich blood to the rest of the body . This condition is typically categorised by how well the heart's "pump" is working: Heart Failure with Reduced Ejection Fraction (HFrEF) occurs when the muscle is too weak to squeeze effectively, while Heart Failure with Preserved Ejection Fraction (HFpEF) happens when the heart muscle is too stiff to relax and fill with enough blood properly . Physiologically, because blood cannot move forward efficiently from the left side of the heart, it begins to "back up" into the blood vessels of the lungs, leading to congestion and fluid build-up . This backup is what causes common symptoms like shortness of breath, a persistent cough, or a feeling of being smothered when lying flat (known as orthopnoea) . The most frequent causes of left-sided failure include coronary heart disease, where narrowed arteries starve the heart muscle of oxygen, and high blood pressure (hypertension), which forces the heart to pump against much higher resistance . Long-term conditions such as diabetes, obesity, and heart valve problems like aortic stenosis also place significant stress on the heart, eventually leading to muscle thickening or damage . Additionally, an irregular heart rhythm like atrial fibrillation can further reduce the heart's efficiency and contribute to the progression of the disease