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💔 Men's Health

Heart Failure in Nigeria

When the heart can't pump enough — understanding and managing heart failure

Heart failure does not mean the heart has stopped — it means the heart cannot pump blood efficiently enough to meet the body's needs. It is one of the commonest reasons for hospital admission in Nigeria and a leading cause of death. Hypertension is by far the most common cause in Nigerians. Most heart failure is treatable, and many people live active lives for decades with the right management.

Signs and Symptoms

✓ Breathlessness — especially on exertion, lying flat, or waking at night (orthopnoea/PND)
✓ Leg swelling (oedema) — pitting, worse by evening
✓ Fatigue and exercise intolerance
✓ Persistent cough — especially lying down, sometimes with frothy or pink-tinged sputum
✓ Rapid or irregular heartbeat (palpitations)
✓ Abdominal bloating and reduced appetite
✓ Dizziness or lightheadedness
✓ Rapid weight gain from fluid retention (1–2 kg in 24–48 hours)

Risk Factors

When to Seek Help

Sudden severe breathlessness at restAcute pulmonary oedema — go to hospital immediately by the fastest means available.
Leg swelling getting worse over daysWorsening heart failure — arrange urgent doctor review within 24–48 hours.
Rapid weight gain (2 kg in 2 days)Fluid accumulation — contact your cardiologist or heart failure nurse.
Chest pain with breathlessnessPossible heart attack causing acute heart failure — emergency.

Tests & Diagnosis

🧪 Echocardiogram (Echo)
The most important test — shows heart chamber size, wall motion, and ejection fraction (EF). EF below 40% confirms reduced ejection fraction heart failure (HFrEF).
🧪 Chest X-ray
Shows heart size and pulmonary congestion (fluid in lung vessels). Rapid bedside test.
🧪 BNP or NT-proBNP
Elevated natriuretic peptides confirm heart failure diagnosis. Levels correlate with severity. Useful in distinguishing cardiac from pulmonary causes of breathlessness.
🧪 ECG
Identifies arrhythmias, previous heart attack, left ventricular hypertrophy from hypertension.
🧪 Full blood count, kidney function, electrolytes, thyroid
Anaemia, renal impairment, and thyroid disease all affect heart failure management.

Treatment Options

1
ACE inhibitor or ARB (foundational)
Lisinopril, ramipril, enalapril, or losartan — reduce cardiac workload and reverse cardiac remodelling. Proven to prolong life. Start at low dose, titrate up.
2
Beta-blocker (after stabilisation)
Carvedilol, bisoprolol, or metoprolol — reduce heart rate, improve pump function, and prevent arrhythmia. Start only when fluid overload is controlled.
3
Diuretic (for congestion)
Furosemide — removes excess fluid. Dose guided by symptoms, weight, and kidney function. Too much causes electrolyte imbalance; too little causes fluid overload.
4
Spironolactone or eplerenone
Aldosterone antagonists — added to ACE inhibitor + beta-blocker for HFrEF. Further reduce mortality.
5
SGLT2 inhibitor (dapagliflozin, empagliflozin)
Now part of the foundational quadruple therapy for HFrEF — reduces hospitalisations and death in heart failure regardless of diabetes status.
6
Salt restriction
Limit salt to less than 5g daily. Avoid added salt, stock cubes, processed foods. This directly reduces fluid retention.
7
Daily weighing
Weigh every morning after voiding, before eating. A rise of more than 1 kg in 24 hours or 2 kg in 48 hours = contact your doctor and increase diuretic dose as instructed.
8
Device therapy (ICD/CRT)
For selected patients with severe HFrEF — implantable defibrillator (ICD) prevents sudden cardiac death; cardiac resynchronisation therapy (CRT) improves pump function. Available at specialist cardiology centres in Lagos and Abuja.

Frequently Asked Questions

Can heart failure be cured?
In some specific causes (peripartum cardiomyopathy, alcohol cardiomyopathy, tachycardia-induced) the heart can partially or fully recover with treatment. In most chronic HFrEF, the condition is managed rather than cured — but many people live 10–20+ years with good quality of life. Heart transplant is the only cure for end-stage disease.
What is the ejection fraction and what does mine mean?
Ejection fraction (EF) is the percentage of blood pumped out of the heart with each beat. Normal is above 55%. HFrEF (reduced EF) is below 40% and responds best to medical therapy. HFpEF (preserved EF) is 50%+ with symptoms — a different condition managed differently. Your cardiologist will explain what your EF means for your treatment.
Can I exercise with heart failure?
Yes — cardiac rehabilitation and regular, supervised exercise significantly improve symptoms, exercise capacity, and quality of life in stable heart failure. Start with gentle walking and increase gradually. Do not rest excessively. Avoid vigorous exertion during decompensation (when you have significant symptoms).
Why does heart failure cause leg swelling?
The failing heart pumps less effectively, leading to a back-pressure of fluid into the venous system. Fluid leaks out of capillaries and accumulates in the tissues, particularly in the legs (gravity-dependent oedema). Diuretics and salt restriction reverse this.
Why is hypertension the main cause of heart failure in Nigerians?
Chronically elevated blood pressure forces the heart to work harder, causing the left ventricle to hypertrophy (thicken) and eventually dilate and weaken. Nigerian hypertension is often: diagnosed late, poorly controlled, associated with high salt intake, and more severe than in Western populations. This explains why hypertensive heart disease is proportionally much more common in Nigerian heart failure than in Europe.

Related Pages

Hypertension: Reduce BP NaturallyStroke Prevention NigeriaChest Pain: What Does It Mean?What is Furosemide?

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