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legs, disturbed heartbeat, persistent cough, and dizziness and the like. Symptoms can develop rapidly (acute HF) or gradually over weeks (chronic HF).

      With early intervention for HF, it will be possible for patients to live longer. Some measures such as losing weight, reducing stress, and reducing the amount of salt used will positively affect the quality of life of patients. One way to prevent HF is to prevent and control conditions such as CAD, high blood pressure, diabetes, and obesity.

      The activity that will benefit most is diagnosing the disease and conducting studies according to the symptoms. Thus, as in many other diseases, early diagnosis will have a life-saving effect in HF, as will correct diagnosis and determining the type and real cause of the ailment.

      1.2.2 Causes of HF

As mentioned, the causes of HF are CAD, high blood pressure, and other heart diseases, and it occurs because of the damage to the heart muscle brought about by these and similar conditions. While oxygen is regularly carried to a normal heart, it is not possible to carry enough oxygen in the case of a damaged heart. Although HF usually occurs on the left side of the heart, it can develop on the right or both sides. Table 1.1 lists multiple HF types and their results.

Table 1.1 HF types and their outcomes.

HF Type	Outcome
Left-sided HF	This causes fluid to accumulate in the lungs, which causes shortness of breath in people.
Right-sided HF	Fluid builds up in the abdomen, legs, and feet, which causes swelling in the abdomen and legs.
Systolic HF	This occurs when the heart muscle cannot contract strongly as it should; as a result, blood is not pumped in the normal way.
Diastolic HF	There is insufficient blood filling the area due to the inability of the heart to relax sufficiently.

      Some of the prominent causes of HF are:

       CAD and heart attack: CAD is the most prominent heart disease and the most common cause of HF. The disease occurs when blood circulation is not normal due to fat deposits, called plaques, in the blood vessels. Heart attacks are divided into mild heart attack and major heart attack. Mild heart attacks occur in a small portion of the heart muscle. However, a mild heart attack should be taken seriously because it can cause a second attack. Major heart attack affects a large part of the heart muscle. The blood flow to the heart is completely blocked or there is no blood flow for a long time. Major heart attack can cause cardiac arrest and death.

       High blood pressure (hypertension): High blood pressure is one of the factors that makes it difficult for the heart to pump blood to the body. This strain causes the heart muscle to work more than normal, damaging it.

       Faulty heart valves: The function of the heart valves is to keep the blood flowing in the right direction. Failure of heart valves to function is known as heart valve malfunction. Heart valve malfunctions can be caused by genetic factors, old age, and infection. A faulty valve tires the heart, forcing it to work harder and causing it to weaken over time.

       Damage to the heart muscle (cardiomyopathy): Cardiomyopathy can have many causes, such as various diseases, infections, alcohol use, and the toxic effect of drugs like cocaine or chemotherapy drugs. Sometimes it can be due to genetic factors.

       Heart muscle inflammation: This is caused by viruses and can lead to left-sided HF.

       Congenital heart defects: If the heart and chambers or valves aren’t formed correctly, the healthy parts of the heart have to work harder to pump blood, which can lead to HF.

       Heart arrhythmias: Abnormal heart rhythms will show heart-damaging output in both fast heartbeat and slow heartbeat. Its rapid beating will tire the heart, and its slow beating will cause problems in circulation.

       Other diseases: Diabetes, HIV, hyperthyroid and similar diseases can also cause HF.

Heart diseases and the factors that affect the HF that occur as a result may be genetic, sometimes congenital abnormalities, and sometimes related to our lifestyle. Overweight, having a sedentary life, smoking, and stressful work life are also harmful factors for the heart [1].

      1.2.3 What are the Symptoms of HF?

HF may be faced if one or more of the following symptoms are present. For example, if someone is tired earlier than before even though they are doing the same activity, this might be a symptom. This symptom should not be confused with early fatigue due to old age – a 55-year-old person should compare and interpret their symptoms according to their current age, not to what it was at the age of 45 or younger.

      Another symptom of HF is loss of appetite, which can be related to other ailments. Therefore, the loss of appetite that occurs without any external cause should be evaluated. Another symptom associated with loss of appetite may be nausea, which can also occur with extreme sensitivity to some foods and certain odors. Due to HF, blood accumulates in the abdomen and presses on the intestinal wall and stomach. This pressure causes loss of appetite and nausea.

      HF can also cause shortness of breath, but is not, of course, the only cause of this; severe shortness of breath is possible in the case of advanced bronchitis and asthma, which includes narrowing of the airways and chest, and a wheezing sound from the lungs. Shortness of breath caused by HF occurs due to pulmonary edema. It is accompanied by fatigue and weakness, caused by heart-induced constriction; shortness of breath is caused by bronchitis or asthma and, similarly, often by overweight and obesity. Shortness of breath experienced without an external cause should be taken seriously.

      Everyone has a certain gradual transition in weight gain and weight loss. Under normal conditions, this situation does not develop suddenly, so sudden weight gain might be associated with HF. The relationship between HF and weight gain is related to the weakness of some organs in performing their duties due to the inability of the heart. When the calories taken into the body through food are more than the calories consumed by the body, this excess is stored as fat. Insulin resistance develops due to excess fat in the body and one of the diseases caused by insulin resistance is HF. The measurement of excess fat is carried out with the help of the body weight index (BMI). Those with a BMI of 25–29.9 are considered overweight and those with a BMI over 30 are considered obese. In addition, these values change depending on age. While the normal BMI values for 25–35-year-olds are 20–25, this BMI value is 24–29 for those over 65 years old.

      One of the most important indicators of possible heart disease is chest pain. Sometimes people may panic due to the sensitivity of the subject. Some problems in the digestive system, such as bloating in the stomach, can cause chest pain and tightness in the chest area. However, it is best not to leave it to chance.

      Coughing and related sputum production of pink or white color may also be a harbinger of HF. As will be appreciated, heart disease is not the only cause of a cough, but it is one of its causes.

      Interrelated heart palpitations and pulse irregularities are also associated with HF. In addition, swelling of the ankles, legs, and abdomen due to edema can occur as a result of right-sided heart problems. Seeing one or more of these problems can also be viewed as a symptom.

      People often find themselves in a state of indolence when they are low in morale. They want to sleep all the time and cannot easily concentrate on any task. The condition that manifests itself as in the body may sometimes indicate a heart problem.

Two other problems with HF are frequent urination at night and the prominence of blood vessels in the neck. The accumulated

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