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Showing posts with label Heart Failure. Show all posts
Showing posts with label Heart Failure. Show all posts

Heart Failure

 What is heart failure?

Heart failure is characterized by the heart’s inability to pump an adequate supply of blood to the body. Without sufficient blood flow, all major body functions are disrupted. Heart failure is a condition or a collection of symptoms that weaken your heart.

In some people with heart failure, the heart has difficulty pumping enough blood to support other organs in the body. Other people may have a hardening and stiffening of the heart muscle itself, which blocks or reduces blood flow to the heart.

Heart failure can affect the right or left side of your heart or both at the same time. It can be either an acute (short-term) or chronic (ongoing) condition.

In acute heart failure, the symptoms appear suddenly but go away fairly quickly. This condition often occurs after a heart attack. It may also be a result of a problem with the heart valves that control the flow of blood in the heart.

In chronic heart failure, however, symptoms are continuous and don’t improve over time. The vast majority of heart failure cases are chronic.

About 6.2 million AmericansTrusted Source have heart failure, according to the Centers for Disease Control and Prevention (CDC). Most of these people are male. However, females are more likely to die from heart failure when the condition goes untreated.

Heart failure is a serious medical condition that requires treatment. Early treatment increases your chances of long-term recovery with fewer complications. Call your doctor right away if you’re having any symptoms of heart failure.

The symptoms of heart failure may include:

  • fatigue
  • sudden weight gain
  • a loss of appetite
  • persistent coughing
  • irregular heart rate
  • heart palpitations
  • abdominal swelling
  • shortness of breath
  • leg and ankle swelling
  • protruding neck veins

Heart failure is most often related to another condition. The most common cause of heart failure is coronary artery disease (CAD), a disorder that causes narrowing of the arteries that supply blood and oxygen to the heart. Other conditions that may increase your risk for developing heart failure include:

  • cardiomyopathy, a disorder of the heart muscle that causes the heart to become weak
  • congenital heart disease
  • heart attack
  • heart valve disease
  • certain types of arrhythmias, or irregular heart rhythms
  • high blood pressure
  • emphysema, a disease of the lung
  • diabetes
  • an overactive or underactive thyroid
  • HIV
  • severe forms of anemia
  • certain cancer treatments, such as chemotherapy
  • substance or alcohol misuse

Heart failure can occur in either the left or right side of your heart. It’s also possible for both sides of your heart to fail at the same time.

Heart failure is also classified as either diastolic or systolic.

Left-sided heart failure

Left-sided heart failure is the most common type of heart failure.

The left heart ventricle is located in the bottom left side of your heart. This area pumps oxygen-rich blood to the rest of your body.

Left-sided heart failure occurs when the left ventricle doesn’t pump efficiently. This prevents your body from getting enough oxygen-rich blood. The blood backs up into your lungs instead, which causes shortness of breath and a buildup of fluid.

Right-sided heart failure

The right heart ventricle is responsible for pumping blood to your lungs to collect oxygen. Right-sided heart failure occurs when the right side of your heart can’t perform its job effectively.

It’s usually triggered by left-sided heart failure. The accumulation of blood in the lungs caused by left-sided heart failure makes the right ventricle work harder. This can stress the right side of the heart and cause it to fail.

Right-sided heart failure can also occur as a result of other conditions, such as lung disease. Right-sided heart failure is marked by swelling of the lower extremities. This swelling is caused by fluid backup in the legs, feet, and abdomen.

Diastolic heart failure

Diastolic heart failure occurs when the heart muscle becomes stiffer than normal. The stiffness, which is usually due to heart disease, means that your heart doesn’t fill with blood easily. This is known as diastolic dysfunction. It leads to a lack of blood flow to the rest of the organs in your body.

Diastolic heart failure is more common in females than in males.

Systolic heart failure

Systolic heart failure occurs when the heart muscle loses its ability to contract. The contractions of the heart are necessary to pump oxygen-rich blood out to the body. This problem is known as systolic dysfunction, and it usually develops when your heart is weak and enlarged.

Systolic heart failure is more common in males than in females.

Both diastolic and systolic heart failure can occur on the left or right sides of the heart. You may have either condition on both sides of the heart.

Heart failure can happen to anyone. However, certain factors may increase your risk of developing this condition.

There is a higher incidenceTrusted Source of heart failure in males compared with females, though the prevalence is about the same for all sexes.

People with diseases that damage the heart are also at an increased risk. These diseases include:

  • anemia
  • hyperthyroidism
  • hypothyroidism
  • emphysema

Certain behaviors can also increase your risk of developing heart failure, including:

  • smoking
  • eating foods high in fat or cholesterol
  • not getting enough exercise
  • not managing weight

Physical exam

Your doctor may perform a physical exam to check for signs of heart failure. For instance, leg swelling, irregular heart rate, and bulging neck veins may lead your doctor to diagnose heart failure.

Echocardiogram

An echocardiogram is the most effective way to diagnose heart failure. It uses sound waves to create detailed pictures of your heart, which help your doctor evaluate the damage to your heart and determine the underlying causes of your condition. Your doctor may use an echocardiogram along with other tests.

Other tests

chest X-rayThis test can provide images of the heart and the surrounding organs.
heart MRIAn MRI produces images of the heart without the use of radiation.
nuclear scanA very small dose of radioactive material is injected into your body to create images of the chambers of your heart.
catheterization or coronary angiogramIn this type of X-ray exam, the doctor inserts a catheter into your blood vessel, usually in the groin or arm. They then guide it into the heart. This test can show how much blood is currently flowing through the heart.
stress examDuring a stress exam, an EKG machine monitors your heart function while you run on a treadmill or perform another type of exercise.
Holter monitoringElectrode patches are placed on your chest and attached to a small machine called a Holter monitor for this test. The machine records the electrical activity of your heart for at least 24 to 48 hours.

Treating heart failure depends on the severity of your condition. Early treatment can improve symptoms fairly quickly, but you should still get regular testing every 3 to 6 months. The main goal of treatment is to increase your lifespan.

Medication

Early stages of heart failure may be treated with medications to help relieve your symptoms and prevent your condition from getting worse. Certain medications are prescribed to:

  • improve your heart’s ability to pump blood
  • reduce blood clots
  • reduce your heart rate, when necessary
  • remove excess sodium and replenish potassium levels
  • reduce cholesterol levels

These medications can include:

  • blood thinners
  • angiotensin converting enzyme (ACE) inhibitors
  • angiotensin II receptor blockers (ARBs)
  • beta-blockers
  • calcium channel blockers
  • cholesterol-lowering medications
  • nitrates

Always speak with your doctor before taking new medications. Some medications are completely off-limits to people with heart failure, including naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Midol).

Surgery

Bypass surgery

Some people with heart failure will need surgery, such as coronary bypass surgery. During this surgery, your surgeon will take a healthy piece of an artery and attach it to the blocked coronary artery. This allows the blood to bypass the blocked, damaged artery and flow through the new one.

Angioplasty

Your doctor may also suggest an angioplasty. In this procedure, a catheter with a small balloon attached is inserted into the blocked or narrowed artery. Once the catheter reaches the damaged artery, your surgeon inflates a balloon to open the artery.

Your surgeon may need to place a permanent stent, or wire mesh tube, into the blocked or narrowed artery. A stent permanently holds your artery open and can help prevent further narrowing of the artery.

Pacemakers

Other people with heart failure will need pacemakers to help control heart rhythms. These small devices are placed into the chest. They can slow your heart rate when the heart is beating too quickly or increase your heart rate if the heart is beating too slowly. Pacemakers are often used along with bypass surgery as well as medications.

Implantable cardioverter defibrillator (ICD)

An ICD is a battery-powered device that keeps track of your heart rate and will shock your heart if it detects an abnormal heart rhythm. This shock restores the heart rate back to a normal rhythm. An ICD is suggested for people with an ejection fraction (how much blood your heart pumps out with each contraction) less than 35 percent.

Transplant surgery

Heart transplants are used in the final stages of heart failure when all other treatments have failed. During a transplant, your surgeon removes all or part of your heart and replaces it with a heart from a donor.

Some lifestyle measures can help treat heart failure and prevent the condition from developing. Managing weight and exercising regularly can significantly decrease your risk of heart failure. Reducing the amount of salt in your diet can also lower your risk.

Other habits that may prevent heart failure include:

  • limiting alcohol intake
  • not smoking
  • avoiding foods high in fat
  • getting the right amount of sleep

Untreated heart failure can eventually lead to congestive heart failure (CHF), a condition in which blood builds up in other areas of your body. In this potentially life threatening condition, you may experience fluid retention in your limbs as well as in your organs, such as the liver and lungs.

Additional complications of heart failure can include:

  • stroke
  • thromboembolism
  • arrhythmias, like atrial fibrillation

Heart attack

A heart attack may also occur as a result of a complication related to heart failure.

Call 911 or your local emergency services right away if you have these symptoms:

  • crushing chest pain
  • discomfort in the chest, such as squeezing or tightness
  • discomfort in the upper body, including numbness or a coldness
  • fatigue
  • dizziness
  • rapid heart rate
  • vomiting
  • nausea
  • cold sweats

Heart failure is usually a long-term condition that requires ongoing treatment to prevent complications. When heart failure is left untreated, the heart can weaken so severely that it causes a life threatening complication.

It’s important to recognize that heart failure can happen to anyone. You should take lifelong preventive measures for your heart health. Always contact your doctor if you suddenly have any new or unexplained symptoms that may indicate a problem with your heart.

Because heart failure is most often a chronic condition, your symptoms will likely get worse over time. Medications and surgeries can help relieve your symptoms, but such treatments may not help if you have a severe case of heart failure. In some cases, heart failure can be life threatening.

Early treatment is key in preventing the most serious cases of heart failure. Call your doctor right away if you’re showing signs of heart failure or if you believe you have the condition.

JPeei Clinic

What Are My Medication Options for Systolic Heart Failure? Talk to Your Doctor


Overview

Systolic heart failure is a condition in which the heart doesn’t pump normally. If your left ventricle doesn’t contract well enough, you may have systolic heart failure.

Symptoms of systolic heart failure include fatigue, shortness of breath, weight gain, and coughing.

There are a few other types of heart failure. Diastolic heart failure is when the left ventricle doesn’t relax normally. Right ventricular heart failure is when the deoxygenated side doesn’t contract normally.

If you’ve been diagnosed with systolic heart failure, you likely have a lot of questions about the condition and how it’s treated. Read on for answers to commonly asked questions, and consider using these points as a guide to start discussions with your doctor.

Systolic heart failure needs to be treated with several types of medication. The goal of therapy for this type of heart failure is to reduce the burden on the heart and interrupt the chemicals that can lead to weakening of the heart over time. In turn, your heart should work more efficiently and improve your quality of life.

Medications include:

Beta-blockers

This type of medication is useful for slowing heart rate, reducing blood pressure, decreasing the force with which the heart contracts, and even reversing heart damage. These medications work by blocking beta receptors, which can be stimulated by epinephrine or norepinephrine.

Angiotensin converting enzyme (ACE) inhibitors

Angiotensin is a hormone produced by your body. It stabilizes circulation by narrowing blood vessels. This raises your blood pressure.

When you have a healthy heart, angiotensin helps to make sure your blood pressure doesn’t get too low. When you have heart failure, angiotensin regulation is disturbed and levels can be excessive.

With systolic heart failure, lowering your blood pressure can reduce the burden on your heart. ACE inhibitors interrupt angiotensin converting enzyme, which relaxes blood vessels and reduces fluid retention. This lowers your blood pressure and rests your heart, so your heart doesn’t have to work as hard to circulate your blood.

Angiotensin II receptor blockers

This medication, often shortened to “ARB,” has very similar benefits to ACE inhibitors as it works on the same pathway. If you can’t tolerate ACE inhibitors because of a reaction such as a cough or swelling, your doctor may prescribe angiotensin II receptor blockers instead. ACE inhibitors and angiotensin II receptor blockers are not used together.

Angiotensin receptor-neprilysin inhibitors

This type of combination medication, referred to as “ARNi” for short, pairs an angiotensin receptor blocker with a neprilysin inhibitor. In some people, this kind of combination treatment can be the most effective option.

An example of this type of medication is a treatment that combines valsartan and sacubitril (Entresto). It works to widen blood vessels, while also reducing excess fluid in the body.

Diuretics

Commonly known as water pills, this medication helps to prevent excess fluid buildup in your body. You may have increased thirst and urination.

Potential benefits include easier breathing and reduced bloating or swelling. These medications are given for symptom relief only and do not help you live longer or change the course of the disease.

Aldosterone antagonists

This medication also works on the stress hormone system that is activated in heart failure. It’s usually part of the combination of medications used to treat systolic heart failure.

In addition, this medication can cause high potassium levels. You may need to pay close attention to your diet so that you don’t accumulate too much potassium.

Digoxin

Also called digitalis, this medication slows your heartrate while increasing the strength of your heart muscle contraction. Your doctor may prescribe this medication if you have a heart rhythm issue such as atrial fibrillation.

This medication has been linked to some adverse outcomes and toxicity, so it should be used carefully.

Inotropes

These are a class of intravenous medications usually given in a hospital setting. They help to maintain blood pressure and improve the pumping action of the heart. These drugs are only recommend for short-term use.

Vasodilators

Another important type of cardiac medication is vasodilators, such as hydralazine and nitrates. These treatments help dilate, or relax, blood vessels. When blood vessels are relaxed, your blood pressure will lower. This helps your heart more easily pump blood.

Your doctor may also prescribe a blood thinner to reduce your risk of clotting, especially if you have cardiac rhythm issues, such as atrial fibrillation.

Your treatment will also likely focus on addressing related health conditions, such as high blood pressure, diabetes, and high cholesterol. For example, your doctor may recommend statins to treat cholesterol.

Systolic heart failure is also known as heart failure with reduced ejection fraction (HFrEF). Ejection fraction measures how much of the blood that flowed into your left ventricle is pumped out with each heartbeat.

Normal ejection fraction is usually greater than 55 percent. With systolic heart failure, your heart can’t pump as much blood out of the left ventricle as it should. Mild systolic dysfunction means a left ventricle ejection fraction of 40 to 50 percent. The condition is considered moderate at 30 to 40 percent, and severe at less than 30 percent.

The other type of left ventricle heart failure is called diastolic heart failure, also known as heart failure with preserved ejection fraction (HFpEF). In this case, the left ventricle can pump properly but is unable to relax normally between beats.

Unlike treatment for systolic heart failure, treatment for diastolic heart failure tends to focus on treating related conditions. This can include high blood pressure, sleep apnea, diabetes, salt retention, and obesity. All of these conditions contribute to heart failure.

For this reason, it’s helpful to know your specific diagnosis. Your doctor can tell you if you have left ventricle heart failure, and if it is systolic or diastolic.

When you experience systolic heart failure, your body can’t circulate blood properly. Without medication, your body tries to compensate and restore this circulation. Your sympathetic nervous system activatesTrusted Source and increases your cardiac output by making your heart beat faster and harder.

This compensation response isn’t meant to be continuously activated. This causes the receptors in your heart that activate the sympathetic nervous system to down-regulate. Your heart can’t keep up with the ongoing demand, and compensation changes to decompensation. Heart failure gets worse and the cycle continues.

Medication slows down the progression of heart failure by interrupting the sympathetic nervous system response. It helps to reduce the burden on your heart. It also plays a role in regulating cardiac output and stabilizing circulation.

Healthline on Call: Heart Failure with Dr. Kholi
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Most medications have side effects, so ask your doctor what to expect from the medication you’re taking.

Common side effects from heart failure medications include dizziness, nausea, headache, and changes in appetite. Some side effects are harmless while others require prompt medical attention. Your doctor can explain which side effects are a concern and when to have them medically assessed.

An effective treatment approach for heart failure involves taking more than one medication, usually a combination of medications.

For example, tTrusted SourcerialsTrusted Source have shown that ACE inhibitors reduce the risk of dying from heart failure by 17 percent. But adding a beta-blocker medication improves that risk reduction to as much as 35 percent. Including the aldosterone antagonist spironolactone improves the outcome even more.

A combined medication therapy can lower the risk of dying from heart failure over the next two years by as much as 50 percentTrusted Source.

To help your medications work well, take them as prescribed. Take the amount recommended by your doctor, at the proper times.

Pay attention to additional instructions from your doctor or pharmacist. For example, note if you can take your medication with food, and if certain foods, beverages, or vitamin supplements can interfere with how the medication works. Always ask your doctor first before taking supplements.

Write down all the medications that you take and keep the list with you. If you have any questions write those down too, and make sure to ask your doctor.

Systolic heart failure, or heart failure with reduced ejection fraction, is treatable with medication. Without medication, heart failure tends to get worse. The goal of treatment is to improve the quality of your life, reduce your risk of being hospitalized, reduce your symptoms, and improve the function of your heart.

Always take your medication as prescribed. Your doctor can tell you more about how your medication works and why they recommend it for you.

JPeei Clinic

5 Ways to Reduce Your Risk of Complications with Left-Side Heart Failure


Complications and heart failure

Heart failure increases the risk of a number of other health issues, including kidney and liver damage. It can also increase the risk of developing an irregular heartbeat or heart valve problems.

If you’ve been diagnosed with heart failure, it means that your heart is no longer pumping blood as strongly throughout your body. Heart failure may begin on the left or right side of the heart.

There are a few types of heart failure. Left-sided heart failure is more common, and includes systolic and diastolic. Both types increase the risk of the same kinds of complications. For example, a common complication of left-sided heart failure is right-sided heart failure.

If you’re living with heart failure, you can take steps to reduce your risk of related complications. Sticking with your treatment plan and making healthy lifestyle changes are good places to start.

Read on to learn more about lowering your chances of experiencing complications and simple tips for managing heart failure.

One of the most important things you can do to reduce your risk of heart failure complications is to get started on your doctor’s recommended treatment plan — and stick with it.

When your condition is well-managed, it’s less likely to worsen. You’ll also likely feel better when you’re taking your medications as prescribed and following your doctor’s guidance.

It can be a challenge to remember to take your medications every day or to manage the costs of treatment. In fact, a 2013 studyTrusted Source published in JAMA Internal Medicine found that among 178,102 heart failure patients in the United States, just 52 percent took their medications regularly.

If you’re facing financial barriers to treatment, let your doctor know. They may be able to offer a comparable treatment that’s less expensive. If you have trouble remembering to take your medications, try to set a daily alarm or ask family or friends to help you remember.

Fast Facts: Heart Failure
Heart failure is a complex condition that involves more than just the heart.
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When you have heart failure, managing your condition and health can feel like a lot of work. A smartphone app can help you keep track of your medications, appointments, symptoms, and your state of mind. The Heart Failure Society of America has a free app called Heart Failure Storylines, and there are many others too.

2018 study reviewed 18 previous reports on mobile health apps for heart failure. The study authors noted a general trend that suggested the apps made a difference to people who used them. They also reported that the apps were cost-effective and promoted people being engaged in their own care.

Making heart-healthy food choices is an important aspect of managing heart failure. Your doctor may recommend that you see a dietitian to help you find a meal plan that works for you.

Two widely recommended diets for people living with heart failure are the Dietary Approaches to Stop Hypertension (DASH) planTrusted Source and the Mediterranean diet.

2017 reviewTrusted Source indicated that both diets, and especially the DASH plan, might be helpful for people with heart failure. The authors recommended further research on the Mediterranean diet, and noted that the DASH plan may provide benefits such as improved cardiac function.

If you don’t want to stick to a specific diet, another option is to focus on making heart-healthy choices on a regular basis. The American Heart Association (AHA) advises people to follow a couple key principles.

In general, you’ll want to focus on:

  • Limiting certain foods and items. Make an effort to cut back on sodium, saturated fat, cholesterol, and sugar. It’s best to avoid trans fats altogether.
  • Choose highly nutritious foods. Aim to include simple, wholesome foods in your meals, such as vegetables, fruits, lean proteins, and whole grains. Stick to low-fat or no-fat dairy products.

Your doctor may advise you to treat exercise as part of your overall plan to manage heart failure. Talk to your doctor about the right level of exercise for you, and how you can get started. Depending on your condition, they may recommend a cardiac rehabilitation program.

For many people, a great exercise for getting started is simply walking. You can build up gradually, walking for longer periods of time and at a quicker pace as your fitness level improves. If you’re finding moderate activity difficult, let your doctor know and see what they suggest.

Surprisingly, some programs might use high intensity interval training (HIIT). This form of exercise alternates very intense cardio exercise with short breaks.

2018 studyTrusted Source found HIIT does help heart failure patients, and it’s best when combined with more traditional exercise approaches. Don’t try this approach without discussing it with your doctor first.

With heart failure, being in emotional distress can make it harder to stay healthy. The Cleveland Clinic notes that stress and depression may increase your risk of cardiac events, such as chest pain and heart attack. But having heart failure can be stressful in itself, and may actually lead people to feel depressed.

If you’ve been experiencing difficult emotions, anxiety, or stress, talk to your doctor. They may be able to advise you about mental health services in your area. You can also look for a therapist or other mental health professional on your own.

Seeking emotional support from the people in your life is important, too. Reach out to friends and family, and let them know you’d like to talk. You might also consider looking for a support group. The AHA offers a place to start with their online support network.

The complications of heart failure can be serious, and some are life-threatening. That’s why it’s so important to take steps to reduce your risk of experiencing them.

Some of the most common complications include:

  • Irregular heartbeat. An irregular heartbeat, also known as an arrhythmia, can cause your heart to beat faster or at a less efficient rhythm. In turn, this can lead your blood to pool and form blood clots. This can be life-threatening if they lead to stroke, heart attack, or pulmonary embolism.
  • Heart valve issues. Heart failure can change the size of your heart and place pressure on the four valves that move blood in and out of it. These changes can impact how well the valves work.
  • Kidney damage. Reduced blood flow to your kidneys can damage them and even cause them to fail. In the most serious cases, people may need dialysis.
  • Liver damage. Heart failure puts more pressure on the liver, which can cause scarring and affect how it functions.

Taking action to reduce your risk of complications from heart failure is an important part of managing your health. Sticking with your treatment plan, following a heart-healthy diet, getting exercise, and caring for your emotional health can all make a difference. If you’re concerned about heart failure complications, talk to your doctor to learn more about what you can do to reduce your risk.

JPeei Clinic