viral fevers rheumatic disorders or valvular disorders the most common cause occurs when the hearts blood supply is compromised due to blockages it causes the heart to activate a compensatory mechanism where it starts beating slowly to preserve its muscle and not die the heart is a muscle and muscle is life when a person has a heart attack a part of the muscle dies if the arteries close for a long time therefore it is necessary that emergent opening of the vessels during the attack preserves the heart muscle the best and prevents heart failure and subsequently the whole outcome of the patient it is the golden hour after the cardiac attack that will determine the entire prognosis of the patient whether he lives a crippled life or an active life if not managed on time it will gradually weaken the heart and progress heart failure dr ramji malhotra elaborated furtherit is necessary to know how much the muscle functions to understand whether heart failure is reversible and if the person can lead an everyday life after a heart attack the doctor does an angioplasty and an assessment of the functioning of the heart by an investigation called echocardiography ecg it will reveal the ventricular function of the heart and calculate ejection fraction the efficacy of blood pumped by the heartan ordinary person does not understand the reason behind their symptoms and whether they should consult a doctor some of the signs and symptoms are1 exertionrelated breathing difficulty which aggravates in advanced stages or at night the person requires more than one pillow or lies on one side the person cant lie straight on their back2 patient suddenly wakes up in the middle of the night gasping for breath suffocative feeling while sleeping it is a sign that tells the cardiologist that the patient may end up in an emergency3 increasing fatigue and difficulty doing daily activities such as climbing stairs gardening sexual activity4 swelling of feet or compensatory weight gain as the body tries to conserve fluid to increase the hearts efficiencyafter a person is diagnosed with heart failure they must contact their cardiologist regularly there has been tremendous advancement in the treatment compared to twothree decades back the mortality rate due to cardiac involvement has reduced by 50 this progress has also improved the quality of life cardiologists suggest regular echocardiography the cardiologist checks the ejection fraction and accordingly proposes further management that whether the symptom management requires medications or surgery planned treatment depends on the causes and extent of heart failure the doctor suggests having an emergency kit at home for patients with low ejection fractionsthese days younger patients are seen more frequently in emergency wards with cardiac disorders the pandemic has seen worsening heart health and increased cardiac deaths multiple external factors have precipitated this crisis further patients who have heart disease and recover from covid are more prone to cardiac death various studies have shown that covid19 increases blood coagulability blood thickening pulmonary embolism