Heart Failure

Heart failure, sometimes called congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.

Heart failure doesn't mean your heart has stopped working. It means your heart isn't pumping as well as it should to meet your body's needs for blood and oxygen. The heart keeps working, but the body's need for blood and oxygen isn't being met.

Heart failure is a serious condition, but with proper treatment and lifestyle changes, many people with heart failure can lead active, fulfilling lives. Early diagnosis and treatment can improve symptoms and quality of life.

Heart failure can be ongoing (chronic), or your condition may start suddenly (acute). Symptoms may include:

Common Symptoms:

• Shortness of breath (dyspnea) when you exert yourself or when you lie down
• Fatigue and weakness
• Swelling (edema) in your legs, ankles and feet
• Rapid or irregular heartbeat
• Reduced ability to exercise
• Persistent cough or wheezing with white or pink blood-tinged phlegm
• Increased need to urinate at night
• Swelling of your abdomen (ascites)
• Rapid weight gain from fluid retention
• Lack of appetite and nausea
• Difficulty concentrating or decreased alertness
• Chest pain if heart failure was caused by a heart attack

Symptoms may be mild or severe and may come and go.

Seek emergency care if:

• Chest pain
• Severe shortness of breath
• Fainting or severe weakness
• Rapid or irregular heartbeat with chest pain, shortness of breath, or fainting
• Severe difficulty breathing
• Coughing up pink, foamy mucus

Lifestyle changes are crucial for managing heart failure:

1. Monitor Weight Daily:

   • Weigh yourself at the same time each day
   • Rapid weight gain (2-3 pounds in a day) may indicate fluid retention
   • Contact doctor if sudden weight gain

2. Limit Salt (Sodium):

   • Reduce sodium intake to less than 2,000 mg per day
   • Read food labels
   • Avoid processed foods
   • Don't add salt to food

3. Limit Fluids (if recommended by doctor):

   • May need to restrict fluid intake
   • Follow doctor's recommendations
   • Count all fluids (water, juice, soup, etc.)

4. Take Medications as Prescribed:

   • Don't skip doses
   • Don't stop medications without doctor's approval
   • Report side effects
   • Keep list of all medications

5. Monitor Symptoms:

   • Track daily weight
   • Note any new or worsening symptoms
   • Keep symptom diary

6. Stay Active (as recommended):

   • Regular, moderate exercise (if approved by doctor)
   • Don't overexert
   • Rest when needed

7. Get Adequate Rest:

   • Ensure good sleep
   • Elevate head when sleeping (if recommended)
   • Take breaks during the day

• New or worsening symptoms
• Sudden weight gain (2-3 pounds in a day)
• Increased shortness of breath
• Swelling that's getting worse
• Difficulty sleeping due to breathing problems
• Persistent cough
• Fatigue that's getting worse
• Need to adjust medications

• Following treatment plan
• Symptoms stable
• No new or worsening symptoms
• Regular follow-up appointments scheduled

Diagnosing heart failure involves:

1. Physical Examination:

   • Listen to heart and lungs
   • Check for swelling
   • Check blood pressure
   • Assess heart rate and rhythm

2. Blood Tests:

   • BNP or NT-proBNP (heart failure markers)
   • Complete blood count
   • Kidney and liver function
   • Thyroid function

3. Chest X-Ray:

   • Shows heart size
   • Shows fluid in lungs
   • Checks for other lung problems

4. Electrocardiogram (ECG/EKG):

   • Records heart's electrical activity
   • Shows heart rhythm problems
   • May show heart damage

5. Echocardiogram:

   • Ultrasound of heart
   • Shows heart function
   • Measures ejection fraction (pumping ability)

6. Other Tests (if needed):

   • Stress test
   • Cardiac catheterization
   • MRI or CT scan

Treatment aims to improve symptoms and prevent worsening:

1. Medications:

   • ACE inhibitors or ARBs: Help heart work more efficiently
   • Beta-blockers: Slow heart rate, reduce blood pressure
   • Diuretics: Help remove excess fluid
   • Digoxin: Helps heart pump more effectively
   • Other medications as needed

2. Lifestyle Changes:

   • Low-sodium diet
   • Fluid restriction (if needed)
   • Regular exercise (as approved)
   • Weight management
   • Limit alcohol
   • Don't smoke

3. Devices (if needed):

   • Pacemaker
   • Implantable cardioverter-defibrillator (ICD)
   • Cardiac resynchronization therapy (CRT)

4. Surgery (in some cases):

   • Coronary bypass surgery
   • Heart valve repair or replacement
   • Heart transplant (severe cases)

5. Monitoring:

   • Regular follow-up appointments
   • Daily weight monitoring
   • Symptom tracking

Prevent heart failure by:

• Control High Blood Pressure: Take medications as prescribed
• Manage Diabetes: Keep blood sugar controlled
• Treat Heart Disease: Follow treatment for coronary artery disease
• Don't Smoke: Quit if you smoke
• Maintain Healthy Weight: Obesity increases risk
• Exercise Regularly: As approved by doctor
• Eat Healthy Diet: Low sodium, heart-healthy foods
• Limit Alcohol: Excessive alcohol damages heart
• Manage Stress: Find healthy ways to cope
• Get Regular Check-ups: Early detection and treatment

In heart failure:

1. Heart Weakness: Heart muscle becomes weak or stiff
2. Reduced Pumping: Heart can't pump blood effectively
3. Fluid Backup: Blood backs up into lungs and other tissues
4. Symptoms: Shortness of breath, swelling, fatigue
5. Compensation: Body tries to compensate (faster heart rate, fluid retention)

The heart tries to compensate, but over time, this makes the condition worse.

• More common in older adults
• May have multiple contributing conditions
• May need careful medication management
• Higher risk of complications

• Diabetes, high blood pressure, coronary artery disease increase risk
• Managing these conditions is crucial
• May need coordination of multiple treatments

Heart failure is usually a chronic condition that can be managed but not cured. However, with proper treatment, many people live active, fulfilling lives.

Many factors affect life expectancy. With proper treatment and lifestyle changes, many people live for many years with heart failure. Early diagnosis and treatment improve outcomes.

Yes, but it depends on your condition. Your doctor will recommend appropriate exercise. Regular, moderate exercise can actually help improve heart function.

Most people with heart failure don't need a transplant. It's only considered for severe cases when other treatments haven't worked.

Many cases can be prevented or delayed by controlling risk factors like high blood pressure, diabetes, and coronary artery disease, and by living a heart-healthy lifestyle.