What are Structural Heart Issues?
Structural heart issues refer to conditions that affect the physical structure of the heart, including the heart muscle, chambers, and valves. These problems can alter how blood flows through the heart or how effectively the heart pumps. Structural abnormalities may be present from birth (congenital) or develop later in life due to conditions such as high blood pressure, infection, or coronary artery disease. Symptoms can include shortness of breath, fatigue, chest discomfort, and swelling in the legs. Diagnosis is usually made through imaging such as echocardiography, and treatment depends on the underlying cause, ranging from medication to procedures or surgery to improve heart function. ​
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Heart Failure
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Heart failure is a condition where the heart is unable to pump blood around the body effectively. This does not mean that the heart has stopped working, but rather that it is not functioning as efficiently as it should. This can lead to reduced oxygen and nutrient delivery to vital organs and tissues.
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Heart failure can develop due to a number of underlying conditions, most commonly coronary artery disease, previous heart attacks, high blood pressure, or structural abnormalities of the heart muscle. Over time, the heart may become weakened or stiff, making it harder to fill with or pump blood.
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Common symptoms of heart failure include shortness of breath, fatigue, swelling in the legs or ankles, and reduced exercise tolerance. Some patients may also experience persistent coughing or a feeling of fullness due to fluid retention.
Diagnosis is usually made through a combination of clinical assessment, blood tests, ECG, echocardiography, and sometimes further imaging. Treatment focuses on improving symptoms, slowing progression, and reducing hospital admissions.
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Management often includes medications such as diuretics to remove excess fluid, ACE inhibitors or ARBs to support heart function, and beta-blockers to control heart rate and reduce strain on the heart. In some cases, devices such as pacemakers or cardiac resynchronisation therapy (CRT) may be required to improve heart function. Lifestyle changes are also important in managing heart failure. These include reducing salt intake, maintaining a healthy weight, regular physical activity where appropriate, and careful monitoring of symptoms.
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Cardiomyopathy
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Cardiomyopathy refers to diseases of the heart muscle that affect its size, shape, or function. These conditions can impair the heart’s ability to pump blood effectively and may lead to heart failure or arrhythmias.
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There are several types of cardiomyopathy:
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Dilated Cardiomyopathy – This is the most common type and occurs when the heart chambers become enlarged and weakened. The heart muscle becomes stretched, reducing its ability to pump blood efficiently.
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Hypertrophic Cardiomyopathy – This condition involves thickening of the heart muscle, particularly in the ventricles. The thickened muscle can restrict blood flow and may interfere with the heart’s electrical system.
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Restrictive Cardiomyopathy – In this type, the heart muscle becomes stiff and less able to relax between beats, which affects the heart’s ability to fill with blood.
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Cardiomyopathy can be caused by genetic factors, long-term high blood pressure, infections, excessive alcohol intake, or other medical conditions. In some cases, no clear cause is identified. Symptoms can vary depending on the type and severity but commonly include breathlessness, fatigue, palpitations, chest discomfort, and dizziness. Some patients may remain asymptomatic for long periods.
Diagnosis is typically made using imaging such as echocardiography or cardiac MRI, alongside ECG and blood tests. Treatment depends on the type of cardiomyopathy and the symptoms present.
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Management may include medications to improve heart function, control heart rhythm, and reduce symptoms. In some cases, implantable devices such as defibrillators or pacemakers may be required. Lifestyle advice, including reducing alcohol intake and managing risk factors, also plays an important role