Heart failure progression varies, with some managing symptoms for years while others see them worsen, prompting potential heart transplant evaluations. Recognizing signs like increased breathlessness, fluid retention, fatigue, and repeated hospital stays is crucial for timely intervention and treatment planning. These indicators suggest the heart may no longer adequately supply the body's needs, leading to a specialist evaluation for conditions like end-stage heart failure.

Heart failure progression varies, with some managing symptoms for years while others see them worsen, prompting potential heart transplant evaluations. Recognizing signs like increased breathlessness, fluid retention, fatigue, and repeated hospital stays is crucial for timely intervention and treatment planning. These indicators suggest the heart may no longer adequately supply the body's needs, leading to a specialist evaluation for conditions like end-stage heart failure.

Heart failure progression varies, with some managing symptoms for years while others see them worsen, prompting potential heart transplant evaluations. Recognizing signs like increased breathlessness, fluid retention, fatigue, and repeated hospital stays is crucial for timely intervention and treatment planning. These indicators suggest the heart may no longer adequately supply the body's needs, leading to a specialist evaluation for conditions like end-stage heart failure.

Heart failure does not follow the same path for everyone. Some people remain stable for years with medicines and cardiac devices. Others find that symptoms slowly worsen, even when they follow treatment carefully. If this happens, your cardiologist may begin discussing a heart transplant evaluation. That does not mean you need a transplant immediately. It means your heart may no longer be meeting your body's demands as well as before.

Symptoms to look out for

Increased breathlessness is one of the first symptoms of heart failure. Simple tasks like walking to the mailbox, going up a few stairs, or carrying groceries can leave you breathless. As heart failure progresses, the breathlessness can occur even while lying down or in the middle of the night when sleep becomes disrupted and tossing around the extra pillows does not seem sufficient to help.

Repeated hospital stays are another sign that deserves attention. If you are admitted several times for breathlessness, fluid build-up, or low blood pressure despite taking the right medications, your heart failure may be progressing.

Activities you once completed without thinking, such as cooking, bathing, shopping, or walking, may leave you unusually tired. Many people describe a steady loss of energy rather than sudden exhaustion.

Fluid retention can become harder to control. Swelling in your feet, ankles, legs, or abdomen, gaining a few kilograms over several days, or needing higher doses of water tablets often suggests that your heart is struggling to keep up.

As blood flow falls, other organs can begin to feel the effects. You may notice dizziness, low blood pressure, cold hands and feet, or reduced urine output. Blood tests may show rising BNP or NT-pro BNP levels, while kidney or liver function may begin to decline. Heart scans may show a severely reduced ejection fraction.

Some people develop dangerous heart rhythm problems that require repeated ICD shocks. Others reach a stage where intravenous medicines are needed to keep the heart pumping well enough to maintain circulation.

A heart transplant evaluation is designed to identify the right treatment at the right time. A specialist heart failure team reviews your symptoms, test results, overall health, and treatment response before deciding whether transplantation is appropriate.

For carefully selected people with end-stage heart failure, a heart transplant can improve survival and make everyday activities possible again. Recognising these signs early gives you and your care team more time to plan the next step.

(The author is a consultant CTVS, Manipal Hospital, Vijayawada)

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.

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