Sudden death from heart failure - what does this mean?

[Lemons1571]

My DDad died suddenly last week. He had all the symptoms of heart failure, was on heart medication, and had only just been discharged from hospital for an unrelated non-fatal matter. I know he had aortic stenosis (calcium affecting a valve) but that was being monitored.

Does anyone know if heart failure means he died of a heart attack? He was found in his chair, but didn’t have time to press his wrist alarm button (or maybe he forgot it was there?). Or is heart failure something where he just passed out and never woke up? I can’t find any info on this at all.

The paramedic said there was a little electrical activity when he was found? But he flatlined soon after.

Just want to understand what happened a bit better.

Heart failure is not the same as a heart attack.

Heart failure is when the heart muscle becomes too weak to pump the blood efficiently around the body.

An electrical activity means that the electric pulse triggering the heart contractions was still there, but that the heart muscle was no longer strong enough to respond properly.

With poor blood circulation to the brain he would likely have lost consciousness fairly quickly and then his heart gradually wound down and stopped.

I'm sorry for your loss 💐

@vitaminC thabk you so much for explaining this. It’s so helpful to understand a bit more, what he might have experienced that morning, and why he couldn’t press the button.
I find it more scary, not knowing how it happened. But I couldn’t find any info on the internet about how the final moments of heart failure actually manifest in someone.

Sorry for your bereavement.

With the ex FIL, they described it to his widow as 'he probably thought 'oh, I feel a bit -' and was gone'. Very, very quick and pain free.

A cardiac arrest isn’t necessarily a heart attack.

For what it’s worth I had a cardiac arrest 3 years ago. I sat up, felt really really dizzy, I was in hospital so I did press the bell and the crash team came, and I remember that, and then I woke up the next morning. Had I not been resuscitated it would literally just have been not feeling well to oblivion. It really is that quick.

I am sorry for your loss.

My husband died suddenly like this at 52, what's on your dad's death certificate?

@Ladyofthelake53 no certificate yet, he doesn’t even have heart failure on his medical records as far as I can tell. He had been suffering from bilateral leg oedema, and was given tablets for water retention. He also had worsening breathlessness which none of the doctors seemed to worry about. He was discharged two days prior to death, as “medically fit for discharge”. A bad episode of fainting was put down as a fall.

So I asked for a post mortem and his GP agreed (she said she didn’t have much to go on from the discharge letter so could I help her out with more info to start establishing a cause).

I don't know if this will help op but my grandad died of heart failure and I was with him. He felt unwell and then became unconscious - we were called by the home - and his passing was very very peaceful. He literally slipped away while I held his hand.

My auntie died of heart failure, she died when she was having a bath, the doctors said she would have just drifted off as if she was going to sleep.

Same for my mum, she told her morning carer she didn’t feel right and didn’t really want to get out of bed, she peacefully died minutes later. Heart failure on the certificate.

so sorry for your loss.

have had quite a few heart attacks, and one instance of heart failure, sorry for your loss.

heart attack tends to be blocked arteries, bad blood flow to heart muscles, and then heart being unable to function as muscle in heart is denied oxygen, its painful, and you can feel the heart struggle to function. Heart failure is where the heart weakens over time and simply cannot pump the required amount of blood to the body, blood pressure falls, and you basically fall into a deep sleep and never wake up, there is no pain, just a sense of slipping away,

Sorry for your loss OP. My DDad passed due to heart failure. I was with him that morning, chatting and laughing, he went outside to get something and was gone in seconds. I take comfort that he didn’t know what was about to come and didn’t suffer for any significant time.

Heart failure cannot be 'one instance' heart failure is a condition

Someone I knew died like this. She coughed while holding her gd in the car and then was slumped over her. It was very, very quick and noiseless - nobody in the car even knew she’d died until the baby almost fell out of her arms.

Bilateral leg oedema, being on diuretics for it and breathless, they are all symptoms of heart failure, he probably had bloods called a BNP done recently and also if he had aortic stenosis, he would have had an echo done which would show his heart function. I'm surprised the GP didn't know he had heart failure with the information there. A loss is painful at any point, but I imagine all the more so when you feel you have unanswered questions.

Aortic stenosis means the aortic valve is constricted, so the heart has to work extra hard to try and pump blood out through the narrowed valve to supply the body.
The heart will cope with it for a while - even for years, if the stenosis is mild - but then it finally decompensates and goes into failure. The only way to prevent that is a valve replacement operation, but your father may have been too frail or old to cope with the op, or the valve may have deteriorated too rapidly for referral.
I am sorry that you are grieving, but I hope there is some comfort in knowing that heart failure is not a painful death, and that you and your father had some good years together before this.

My mum was dying of heart failure until she had open heart surgery a few days ago and definitely not out if the woods yet so it’s not an easy fix or anything - the operation has been really traumatic for her and we don’t know how she will fate
mentally or physically. she’s not really awake and this was two days ago so it’s concerning. Anyway he replaced a valve. . she has been breathless and fatigued for months.

In fact everybody medical thought she had a cancer somewhere but no pain. She was diagnosed via echocardiogram. Symptoms of heart failure can be very vague. In my
mum case, persistent heartburn which is common in women, fatigue, anaemia and constant tachycardia episodes. .

@ChangeNameagain2 yes he had a BNP before discharge. I’ve looked it up - levels indicating acute heart failure would be >1,800. His level was >9,000. They discharged him with an outpatient appointment for an echo, so maybe 9,000 is not critically high.

Apparently the ecg that the paramedics did a couple of weeks earlier, after his first fainting/collapse episode, was fine. His last echo was 15 months ago - the aortic stenosis was then moderate/severe.

@Babdoc i suspect if he’d had a valve replacement a couple of years ago when the aortic stenosis was mild/moderate, he might have fared better. Maybe it never got that bad for him to be a priority for surgery.

@SeasonaIVag yes he had heartburn for the past couple of years and was on omeprazole.

I do suspect perhaps there’s been a lack of joined up thinking somewhere along the line. He didn’t have and was never asked for a DNR, all his notes say For Resuscitation. The paramedics tried heroic measures for a long time.

i’m beginning to think that the time to act to prevent/delay this was many months/years ago. Or at his age, perhaps this was inevitably the outcome. I am comforted that he made it home from hospital for a few good days.

My Grandma died of heart failure recently after 6 months of deterioration. She wasn't a candidate for surgery as hers was due to stiffening muscles of the heart rather than a valve problem. She just slipped away in her sleep, it was peaceful and quick at the end, we knew she would die in the medium term but hadn't expected it to be imminent

It is different in different people.

The first reply is a good explanation.

Heart failure is when the heart is not pumping the blood to the body as it should. This can be for a number of reasons, a valve that is too narrow or a heart that has enlarged so can't pump properly.

Thing about some old tights. They start of very elastic and fitting round your legs but the more you wear them the more the elasticity is lost.

How it contributes to a death can depend on what is causing the failure.

The main artery from the heart is the aorta, this is the start of the oxygenated blood's trip around the body. So this can show in things like leg edema, ie the blood isn't pumping through the arteries as it should so liquid pools.

If it was pulmonary stenosis then the effect of the heart failure would be on the lungs.

An ECG shows the electrical activity of the heart. It CAN show some things about the structure from the way the ECG changes but it can't tell you anything about the valves, you need an echo to accurately look at the structure of the heart.

I'm sorry for your loss.

I don't know what the PM will show, obviously, but if he was just sitting and his heart stopped than it would have been peaceful.

My husband died of congestive heart failure earlier this year. I hope it helps you to hear what my GP told me. He said this ' When you go to sleep at night you don't feel the process of going to sleep. One second you are awake the next asleep. That is what it was like for your husband, one second he was here the next he had died. He would have known nothing, and it is just about the most peaceful way to die.'
I hope that gives you some comfort, your DD would not have felt pain, and it would have been very peaceful.
I am so sorry for your loss.

You can indeed have ‘one instance’ of heart failure where the heart function is transiently impaired by some sort of acute insult that is reversible (a common example in hospital being transient heart failure secondary to an acute abnormal rhythm where everything recovers on fixing the rhythm problem). HTH.

I was lucky, they managed to get me back again, however, just mentioning my experience to reassure the OP that her father probably did not suffer any pain or possibly even awareness of his passing.

No one said anything about a cardiac arrest.

A cardiac arrest is NEVER a heart attack.

Someone having an acute MI (the actual attack part) can go in to cardiac arrest but they are different things.

I am 51 years old, was in hospital last year for kidney stone. To my surprise ECG showed something wrong and eventually Doctor found 100% blockage in LAD and had a mild heart attack which i never knew. But I had not symptoms related to heart. But Doctor suggested to go for Bypass surgery and instead of taking multiple opinions i just went ahead and got by pass done. (Infact i had good collaterals and hence there was no need for surgery as i understood from other doctors post surgery). Soon after surgery i developed heart failure and every day has been a nightmare with breathlessness and stiffness in heart. Unable to tolerate heart failure medications. I only pray to have cardiac arrest so that i can die peacefully. I can't do even small activities. Last year at this time I was paniced that I might die due to blockage but I am praying for sudden death now, what an irony :-(.