Causes, Symptoms and Treatment of Heart Failure
When the heart cannot pump enough blood to meet your body’s needs, this is known as heart failure (also known as congestive heart failure). Sometimes the heart cannot fill with enough blood, sometimes the heart cannot pump the blood with enough force to reach the entire body and sometimes people with heart failure have both problems.
It should be noted that heart failure does not mean that your heart has stopped working or is going to stop working soon.
Fast Facts about Heart Failure
- Heart failure does not mean that your heart is about to stop working. Your heart just needs support to do the job properly and this support usually comes in the form of medicines. It is a serious medical condition that requires medical intervention.
- It is a condition that causes the heart not to be able to pump enough blood to meet your body’s needs. Sometimes the heart cannot pump blood to the entire body. Other times the heart cannot fill with enough blood and sometimes the patient has both problems.
- The condition is common and more men have it than women.
- The most common symptoms of heart failure are due to the build-up of fluid. The symptoms are swelling of the abdomen, veins in the neck, feet, ankles and legs. Other symptoms of heart failure are feeling tired, trouble breathing and shortness of breath.
- Diagnosis of heart failure is based on medical and family history, diagnostic tests and a physical exam.
- Early diagnosis can lead to a longer and more active life.
- The treatment for heart failure includes medicine, ongoing care, medical procedures and surgery and lifestyle changes.
- Leading a healthy lifestyle can help prevent heart failure.
- There is no cure for heart failure at this time. You will have to follow your treatment plans and take your medication for the rest of your life.
- There is research being done to find new treatments for heart failure. You can discuss which studies might benefit you with your doctor.
Types of Heart Failure
Heart failure can affect either one side of the heart or both. When it affects the right side the heart does not fill with enough blood and cannot pump enough blood to the lungs. When the heart failure is on the left side the heart cannot pump enough blood to the body.
Common Causes of Heart Failure
There are three main causes of heart failure. They are diabetes, high blood pressure and coronary heart disease. These diseases either damage or overwork the heart. As these conditions weaken the heart, proteins and other substances are released into the blood. The toxic effect that these substances have on the heart will worsen heart failure.
Other causes of heart failure are:
- Congenital heart defects
- Heart valve disease
- Excessive vitamin E levels
- Chemotherapy and radiation treatment for cancer
- Too little or too much thyroid hormone
- Illegal drug and/or alcohol abuse
- Obstructive sleep apnea
Risk Factors for Heart Failure
There are certain factors that make a person more likely to have heart failure:
- African Americans are more likely to have heart failure than those of other races.
- People who are overweight are more likely to have heart failure because carrying excess weight puts strain on the heart. It also puts you at risk of type 2 diabetes which is a risk factor for heart failure.
- Men are more likely than women to suffer from heart failure.
- Since age weakens the muscle in the heart, being over 65 puts a person at a higher risk of heart failure.
Symptoms of Heart Failure
There are a few signs of heart failure that are common:
- Trouble breathing or shortness of breath
- Tiredness (fatigue)
- Swelling in the legs, feet, ankles, abdomen and veins of the neck
These symptoms are cause by a build-up of fluid in your body. The symptoms will get worse as your heart gets weaker. You may also experience more frequent urination, weight gain and coughing that is made worse by lying down and at night.
Diagnosing Heart Failure
There are many factors that go into the diagnosis of heart failure. Your doctor will order tests, do a physical exam and take a medical history for yourself and your family. Other conditions have similar symptoms to heart failure, so your doctor will need to rule out other possible conditions that can also cause your symptoms. Your doctor will also need to determine if you have a condition or disease that causes heart failure. Some of these conditions are diabetes, high blood pressure and heart disease. It will also need to be determined how well your heart can pump blood and if your heart has any damage.
Taking a medial and family history involves your doctor asking whether you or members of your family have had a condition or disease that causes heart failure. Then your doctor will ask about your symptoms. The doctor will want to know which symptoms you have, when they occur and how long you have been experiencing them. The doctor will need to know how severe your symptoms are and your answers will help determine how much your symptoms limit your daily activities.
There is no one test that can give a diagnosis of heart failure. If you are showing symptoms of heart failure there are many tests that can be carried out. Your doctor may order one or more of these tests. They may also refer you to a cardiologist, a doctor that specializes in treating the heart.
Treatment Options for Heart Failure
The treatment for heart failure is decided by the severity and type of the disease. The goals of treatment are the same, though, no matter how severe the patient’s heart disease. These goals are:
- Stopping the heart failure from worsening
- Improving quality of life and increasing a patient’s potential lifespan
- Symptom reduction
- Treating any underlying causes of the heart failure
Some of the easiest and least invasive treatments are lifestyle changes. A healthy diet that lowers sodium is a good place to start. A diet that provides your body with a variety of nutrients will help your heart work better. This diet should be low in added sugar and include a wide variety of fruits and vegetables. Your doctor will tell you how much fluid you need each day. Alcohol should be avoided.
If you are overweight then you should work to lose any excess weight. Patients with heart failure should also keep up the level of exercise that their doctor recommends to stay as fit and active as possible. You should stop smoking and avoid any second hand smoke. Getting enough rest is essential to staying healthy as well.
There are several medications that can be prescribed by your doctor to treat your heart failure. Which of these medications your doctor will prescribe will depend on the severity and type of heart failure.
- Digoxin – makes the heart pump more blood and makes the heart beat stronger
- Isosorbide dinitrate/hydralazine hydrochloride – makes the heart’s job easier by relaxing the blood vessels
- Diuretics – “water pills” reduce the swelling in your ankles and feet and reduces the fluid build-up in the lungs
- Aldosterone antagonists – lowers the amount of blood that the heart hast to pump by reducing the salt and water present in the body through urine
- Beta blockers – lower blood pressure and slow heart rate to decrease the heart’s workload
- ACE inhibitors – reduce strain on the heart by lowering blood pressure and can reduce the chance for a future heart attack
- Angiotensin receptor blockers – lower blood pressure by relaxing blood vessels
When heart failure worsens more medical intervention may be needed to control a patient’s symptoms. When the damage or heart failure is severe a patient may need cardiac resynchronization therapy (CRT). A pacemaker type device could be implanted near your heart to make both sides of the heart contract at the same time.
Patients may also need an implantable cardioverter defibrillator (ICD). This device checks the patient’s heart rate and uses electrical impulses to correct an irregular heartbeat. These are needed because some patients with heart failure have very fast and irregular heartbeats that can lead to a sudden cardiac arrest.
When heart failure symptoms are severe, even when the patient is at rest, a left ventricular assist device may be needed to help the heart pump blood to the rest of the body. These devices can be used either while a patient is waiting for surgery or as a long term treatment. When less drastic treatments have failed a patient may need a heart transplant to save their life. A donor heart is taken from a deceased donor and is used to replace the patient’s heart. Open heart surgery and angioplasty are experimental treatments for heart failure at this time.
Prevention of Heart Failure
Steps to prevent heart failure should be taken sooner rather than later. The sooner your prevention starts, the greater your odds are of delaying or preventing this disease. There are steps that you can take either while you are still healthy or if you are already at high risk for heart failure.
Healthy people should follow a healthy diet that is rich in fruits and vegetables and low in sodium and sugar. In addition to quitting smoking, you should avoid second hand smoke. If you are overweight or obese you should take steps to lose the excess weight. Getting at least 60 minutes of moderate intensity aerobic activity each week is recommended. The more activity you do the better. Illegal drugs should be avoided.
If you already have coronary heart disease, diabetes or high blood pressure there are additional steps you should take in addition to the ones above. You should consult with your doctor about what level of physical activity is safe for you and continue to see your doctor for ongoing care. Patients should also avoid alcohol and take all of their medications as prescribed by their physician.
Coping with Heart Failure
There is no cure for heart failure currently. It is most likely that you will have to take your medications and follow your treatment plan for the rest of your life. Despite receiving treatment there is a chance that your symptoms will get worse. You can stay healthier longer if you follow your doctor’s recommendations. Properly following treatment can reduce the amount of time you have to spend in the hospital and make daily life easier.
- Follow your doctor’s instructions about lifestyle changes
- Take your medications in the manner in which your doctor prescribes them. If side effects are a problem then discuss them with your doctor.
- You should attend all of your medical appointments including lab work, tests and doctor appointments.
- Follow your doctor’s advice about how active you can be. This includes exercise, daily activities, sex, and work and leisure time.