What Is
Heart Failure?
Heart failure is a condition in which the heart muscle cannot pump or fill with blood well enough to meet the body’s needs. Fluid then builds up in the lungs and legs, causing breathlessness and swelling. It does not mean the heart has stopped, and with medicines, devices such as CRT and lifestyle changes, many people live active lives for years.
Doctors describe heart failure by the ejection fraction (EF) — the percentage of blood the main pumping chamber pushes out with each beat, measured on an echocardiogram. A normal EF is about 55–70%.
International guidelines group heart failure into three types: reduced EF (40% or less), mildly reduced EF (41–49%) and preserved EF (50% or more, where the heart is stiff and does not fill well). The type guides which medicines and devices help most.
At KG Heart Center, heart failure is managed in a dedicated Advanced Heart Failure Clinic where cardiologists, cardiac surgeons, electrophysiologists, physiotherapists, dieticians and clinical psychologists work together around each patient.
- Long-term, treatable condition
- Measured by ejection fraction
- Medicines are the foundation
- CRT & ICD for selected patients
- LVAD for advanced failure
- Transplant evaluation on site
Symptoms & Causes
of Heart Failure
What causes heart failure?
How Heart Failure Is
Diagnosed & Staged
Diagnosis combines your symptoms and examination with tests that show how well the heart pumps and why it is weak. Finding the cause matters, because some causes — such as blocked arteries, a narrowed valve or a fast rhythm — can be treated directly.
| NYHA class | What it means |
|---|---|
| Class I | No symptoms in ordinary activity |
| Class II | Breathless or tired with ordinary activity |
| Class III | Symptoms with less than ordinary activity |
| Class IV | Symptoms even at rest |
The New York Heart Association (NYHA) class describes how symptoms limit daily life and helps decide when devices such as CRT are needed.
Heart Failure Treatment
at KG Hospital
Treatment is built step by step around your heart’s function, symptoms and the cause of the weakness. Most patients need a combination of the options below.
Guideline-Directed Medicines
For reduced EF, four medicine groups — ARNI/ACE inhibitor/ARB, beta-blockers, MRAs and SGLT2 inhibitors — reduce hospital admissions and improve survival. Diuretics (water tablets) relieve fluid build-up.
FoundationTreat the Underlying Cause
Opening blocked arteries with angioplasty or bypass, repairing valves, and controlling rhythm problems can improve heart function.
CauseCRT — Resynchronisation
A special pacemaker with three leads that makes both lower chambers beat together, for patients with low EF and a wide QRS on ECG despite medicines.
DeviceICD — Sudden Death Protection
A weak heart can develop dangerous fast rhythms. An ICD treats them automatically; it can be combined with CRT as a CRT-D device.
DeviceCardiac Rehabilitation
Supervised exercise, dietician-led nutrition and fluid advice, and psychological support help you regain strength and confidence and stay out of hospital.
RecoveryLVAD & Heart Transplant
For end-stage heart failure despite all other treatment, a left ventricular assist device or a heart transplant can be considered after careful evaluation.
AdvancedCRT — Cardiac Resynchronisation
Therapy Explained
Cardiac resynchronisation therapy (CRT) is a pacemaker-type device with three leads — one in the right atrium, one in the right ventricle and one placed on the left ventricle through a vein called the coronary sinus. It times both lower chambers to contract together, which can strengthen the heartbeat, ease breathlessness and reduce hospital admissions.
Who benefits? CRT is usually advised for people with heart failure symptoms despite optimal medicines, an ejection fraction of 35% or less and a wide QRS on ECG — especially left bundle branch block. Your electrophysiologist confirms suitability with an ECG and echocardiogram.
CRT-P or CRT-D? A CRT-P is a resynchronisation pacemaker. A CRT-D adds a defibrillator (ICD) to protect against sudden cardiac death. The choice depends on your risk profile and guidelines.
Alternatives: in selected patients, conduction system pacing (HIS bundle or left bundle branch area pacing) can achieve similar synchrony through the heart’s own wiring.
LVAD, Heart Transplant
& Critical Care
| Therapy | What it does | When it is used |
|---|---|---|
| LVAD | A surgically implanted pump that helps the left ventricle move blood | Bridge to transplant, or long-term (destination) therapy |
| Heart transplant | Replaces the failing heart with a donor heart | End-stage heart failure in suitable patients |
| IABP | A balloon pump in the aorta that supports a failing heart short term | Cardiogenic shock, high-risk procedures |
| ECMO | A temporary heart-lung machine at the bedside | Severe heart or lung failure not responding to other treatment |
KG Hospital is authorised by NOTTO and registered under THOA 1994 for heart transplantation, with pre-transplant evaluation, surgery and lifelong follow-up through the cardiac surgery and transplant programmes. Acute and critically ill patients are cared for in the 24/7 Cardiac ICU, with IABP and a dedicated ECMO team.
Living Well With
Heart Failure
Small daily habits make a big difference. Weigh yourself every morning after using the toilet and before breakfast: a gain of more than about 2 kg in three days can mean fluid is building up and your medicines may need adjusting.
Limit salt, follow the fluid advice your doctor gives you, stay active with a programme from your cardiac rehabilitation team, stop smoking and avoid alcohol. Keep vaccinations against influenza and pneumonia up to date, and never stop heart failure medicines without advice — even if you feel well.
If travelling to the hospital is difficult, KG Home Care can arrange nursing and physiotherapy at home in Coimbatore, and tele-consultations help with follow-up.
Heart Failure & CRT Cost
in Coimbatore
Heart failure care ranges from outpatient medicines to advanced therapies, so costs vary widely. For CRT, the main factor is the device — CRT-P or CRT-D — and its features, plus tests and hospital stay. KG Hospital gives a written estimate once your treatment plan is decided.
KG Hospital is empanelled with 50+ insurers and TPAs and with CMCHIS, PM-JAY, ESI, CGHS and ECHS. Cover for devices and advanced therapies depends on your policy or scheme, so the insurance desk checks eligibility and sends pre-authorisation, usually within 1–4 hours. Call 0422-4042121, Extn 205. Insurance & cashless details →
Coming from another city or country? Our International Patient Care team shares a free estimate within 48 hours of receiving your reports.
The Heart Failure Team
at KG Heart Center
KG Heart Center is part of KG Hospital, founded in 1974 by Padma Shri awardee Dr G. Bakthavathsalam, and accredited by NABH.
About this page. Written by the KG Heart Center Advanced Heart Failure Clinic team, KG Hospital, Coimbatore. Clinical information is consistent with the international guidelines listed below. Last updated: .
References
- 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure — European Society of Cardiology (key points summary).
- 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure — American Heart Association / American College of Cardiology / Heart Failure Society of America.
- 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy — European Society of Cardiology.