How Is Heart Failure Treated
Your healthcare providers will help you manage any other health conditions that may be causing your heart failure. The goals of treatment are to manage, slow, or reverse heart damage. Treatment may include the following:
- Medicines may be given to help regulate your heart rhythm and lower your blood pressure. You may also need medicines to help decrease extra fluid. Medicines, such as NSAIDs, may be stopped if they are making your heart failure worse. Do not stop any of your medicines on your own.
- Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. In the program you will learn about exercise, relaxation, stress management, and heart-healthy nutrition. Cardiac rehab may be recommended if your heart failure is not severe.
- Oxygen may help you breathe easier if your oxygen level is lower than normal. A CPAP machine may be used to keep your airway open while you sleep.
- Surgery can be done to implant a pacemaker or another device in your chest to regulate your heart rhythm. Other types of surgery can open blocked heart vessels, replace a damaged heart valve, or remove scar tissue.
Medical History And Physical Exam
Bring a list of your symptoms to your doctors appointment, including how often they happen and when they started. Also, bring a list of any prescription and over-the-counter medicines you take. Let your doctor know if you have any risk factors for heart failure.
During your physical exam, your doctor will:
- Measure your heart rate, blood pressure, and body weight.
- Listen to your heart with a stethoscope for sounds that suggest that your heart is not working properly.
- Listen to your lungs for the sounds of fluid buildup.
- Look for swelling in your ankles, feet, legs, liver, and veins in your neck.
What Are The Types Of Left
There are two types of left-sided heart failure: systolic heart failure and diastolic heart failure.
- Systolic heart failure: Also called reduced ejection fraction , it happens when the left ventricle cant contract forcefully. Less oxygen-rich blood gets pumped out to the body when you have systolic heart failure. Instead, it flows back into the organs, leading to fluid build-up in the lungs as well as swelling in certain parts of the body.
- Diastolic heart failure: Also referred to as preserved ejection fraction , this is when the heart muscle actually contracts normally but the ventricles are stiff or thick and dont relax, so the amount of blood pumped out to the body is reduced.
Ejection fraction is the term thats used to measure the amount of blood that pumps through the ventricles. A hearts normal ejection fraction is between 50 and 70 percent. A measurement of 40 percent or under is usually a sign of heart failure. Sometimes, people can have a normal ejection fraction reading and still have heart failure. An echocardiogram is the most common test used for measuring EF.
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Whats The Outlook For People With Right
For many people, the right combination of therapies and lifestyle changes can slow or stop the disease and improve symptoms. They can lead full, active lives.
About 1 in 10 American adults who live with heart failure have advanced heart failure. That means treatments arent working, and symptoms are getting worse. You may feel symptoms, such as shortness of breath, even when youre sitting. If you have advanced heart failure, talk with your care team about important care decisions and next steps.
Enhancing Healthcare Team Outcomes
Right heart failure is a systemic disorder that can affect many organs and hence is best managed by an interprofessional team. The outcomes of patients with RVF is worse than those with LVF, but it does depend on the cause and other comorbidities. Patients with persistently elevated pulmonary artery pressures have the worst outcomes. Many of these patients require repeat admissions and also have prolonged stays. Despite the various therapies for RVF, the outcomes have not greatly improved over the past two decades. While heart transplant is the ideal treatment for patients with no lung pathology, the shortage of donors is a limiting factor.
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Risk Factors Associated With Left
As you may have guessed, there are people who are more prone to left-sided heart failure than others. Some of the left-sided heart failure risk factors are out of our control, while others are an indication of how important it is to pay attention to our overall health since we can have influence over it.
Here are some of the common risk factors:
- Blood clots: Clots in the lungs are known to lead to left-sided heart failure
- Chronic diseases: HIV, hyperthyroidism, hypothyroidism, diabetes, or a build-up of protein or iron can lead to left-sided heart failure.
- Congenital heart defects: These can prevent proper blood flow from the heart.
- Aortic stenosis: Blood flow slows and then the heart weakens when the aortic valve opening narrows.
- Cardiomyopathy: This is a hereditary condition that can lead to heart damage.
- Irregular heartbeats: Abnormal heart rhythms can weaken the heart muscle.
- Myocarditis: This is a condition that is caused by inflammation of the heart
- Pericardial constriction: This is inflammation that creates a sac covering the heart, which can scar and tighten the heart muscle.
- Previous heart attack: In some cases, this can impact the pumping of blood
- Medications: Some chemotherapy and diabetes medications may increase risk.
- Valvular heart disease: Damage to one of the four heart valves can prevent the heart from pumping blood properly.
- Viral infection: Some viral infections have the potential to damage heart muscle.
What Are The Symptoms Of Right
The main sign of right-sided heart failure is fluid buildup. This buildup leads to swelling in your:
- Feet, ankles and legs.
- Gastrointestinal tract and liver .
Other signs include:
Where you accumulate fluid depends on how much extra fluid and your position. If youre standing, fluid typically builds up in your legs and feet. If youre lying down, it may build up in your lower back. And if you have a lot of excess fluid, it may even build up in your belly.
Fluid build up in your liver or stomach may cause:
- Appetite loss.
Once right-sided heart failure becomes advanced, you can also lose weight and muscle mass. Healthcare providers call these effects cardiac cachexia.
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Treatments For Congestive Heart Failure
Heart failure has no known remedy. The goal of treatment is to alleviate symptoms while also slowing the progression of the disease to avoid life-threatening conditions. The stage and type of heart failure determine the treatment plan, as well as the patients underlying diseases. Although the treatments vary in terms of medications, lifestyle changes are crucial to prevent heart failure. Due to fluid retention, patients may be advised to avoid salt. Caffeine consumption may also be reduced due to irregular heartbeats. Lastly, a physician will tell you how much and what kind of liquids to drink, as fluid consumption may need to be restricted at times.
Energetic Aspects In Heart Failure
The contractile machinery is dependent on a substrate utilization , oxidative phosphorylation , and high-energy phosphate metabolism . Each of these components or a combination of these may be affected in heart failure and lead to energy starvation and in consequence affect contractile function . Mitochondrial high-energy phosphate production is the predominant energy source for cardiomyocytes. Alterations in the mitochondrial energy support lead to myocyte dysfunction , promote apoptosis and thus may favor heart failure further . Thus, reduced energy levels inhibit Ca2+ influx via the sarcolemmal L-Type calcium channel and reduce sarcoplasmatic Ca2+-re-uptake via reduced phosphorylation of phospholamban. These mechanisms reduce contractility and slower relaxation and may also be the target for treatment options . In patients with heart failure treatments targeting substrate utilization and/or oxidative stress in mitochondria will be tested in addition to the well defined neuroendocrine inhibition .
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Classification Based On Pumping Ability
Nowadays, heart failure is increasingly being classified based on the pumping ability of the heart. This is because the pumping ability plays an important role when choosing the most suitable medication. There are two types of heart failure here:
- Heart failure with reduced pumping ability: The heart muscle has become weaker, and no longer pumps enough blood around the body when it contracts . As a result, the organs in the body dont get enough oxygen. The medical term for this is heart failure with reduced ejection fraction.
- Heart failure with preserved pumping ability: Although the heart muscle is still strong, it can no longer relax and widen enough after it has squeezed blood out, so it doesnt fill up with blood properly. Despite pumping strongly enough, not enough blood is pumped out into the body as a result, especially during physically strenuous activities. Doctors call this heart failure with preserved ejection fraction.
Heart failure with reduced pumping ability is sometimes referred to as systolic heart failure, and heart failure with preserved pumping ability is also known as diastolic heart failure. The systolic phase of the cardiac cycle is the phase when the heart contracts , and the diastolic phase is when the heart relaxes and widens.
What Are The Complications Of Heart Failure
Untreated heart failure can eventually lead to congestive heart failure , 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:
- arrhythmias, like atrial fibrillation
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Atrial Natriuretic Peptide And B
ANP and BNP are endogenously generated peptides activated in response to atrial and ventricular volume/pressure expansion. ANP and BNP are released from the atria and ventricles, respectively, and both promote vasodilation and natriuresis. Their hemodynamic effects are mediated by decreases in ventricular filling pressures, owing to reductions in cardiac preload and afterload. BNP, in particular, produces selective afferent arteriolar vasodilation and inhibits sodium reabsorption in the proximal convoluted tubule. It also inhibits renin and aldosterone release and, therefore, adrenergic activation. ANP and BNP are elevated in chronic heart failure. BNP especially has potentially important diagnostic, therapeutic, and prognostic implications.
For more information, see the Medscape Drugs & Diseases article Natriuretic Peptides in Congestive Heart Failure.
What Are The Symptoms Of Diastolic Heart Failure
In the earliest stages of diastolic heart failure, you may not notice any symptoms. But as the condition progresses, some of the following symptoms will likely develop:
- shortness of breath when lying down or when doing activities that you used to do with no problem
2016 study notes that diastolic heart failure is now the most common form of heart failure. It also suggests that the key to successful treatment is aggressive management of contributing factors. That means treating diastolic heart failure also involves proper treatment of any other conditions you may have, as listed above.
More specifically, treating diastolic heart failure usually involves some combination of the following therapies:
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The Ticker Tapes Podcast
Claire Berouche’s life changed in ways she could never have imagined following a family afternoon at the cinema. Claire was given the shock news that she had suffered a heart attack and subsequently heart failure which is irreversible. Hear her story and other real experiences from people living with heart and circulatory diseases.
Is There A Treatment For Heart Failure
There are more treatment options available for heart failure than ever before. Tight control over your medications and lifestyle, coupled with careful monitoring, are the first steps. As the condition progresses, doctors specializing in the treatment of heart failure can offer more advanced treatment options.
The goals of treating heart failure are to try to keep it from getting worse , to ease symptoms, and to improve quality of life.
Some common types of medicines used to treat it are:
- ACE inhibitors
- Aldosterone antagonists
- Selective sinus node inhibitors
- Soluble guanylate cyclase stimulator
Your doctor may also recommend a program called cardiac rehabilitation to help you exercise safely and keep up a heart-healthy lifestyle. It usually includes workouts that are designed just for you, education, and tips to lower your chance of heart trouble, like quitting smoking or changing your diet.
Cardiac rehab also offers emotional support. You can meet people like you who can help you stay on track.
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What Happens If Left Side Of Heart Fails
When the left side of the heart is failing, it cant handle the blood it is getting from the lungs. Pressure then builds up in the veins of the lungs, causing fluid to leak into the lung tissues. This may be referred to as congestive heart failure. This causes you to feel short of breath, weak, or dizzy.
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Surgery For Heart Failure
Your doctor may recommend surgery to implant a medical device that helps the heart function more effectively:
- Pacemaker, which maintains a steady heart beat in people with a slow or irregular heartbeat
- Implantable cardioverter defibrillator , which monitors the heart for fast rhythm and delivers an electrical shock to reset normal rhythm
- Left ventricular assist device , which takes over the pumping action of the heart
People with advanced heart failure may be candidates for heart transplantation. A heart transplant replaces the diseased heart with a donated heart from a person who has died.
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Left Ventricular Assist Device
A left ventricular assist device is a mechanical pump operated by a battery that’s implanted via open-heart surgery. There are different types, but they all have four parts, including:
Heart Failure Treatment Is A Team Effort
Heart failure management is a team effort, and you are the key player on the team. Your heart doctor will prescribe your medications and manage other medical problems. Other team members — including nurses, dietitians, pharmacists, exercise specialists, and social workers — will help you achieve success. But it is up to YOU to take your medications, make dietary changes, live a healthy lifestyle, keep your follow-up appointments, and be an active member of the team.
If you notice anything unusual, don’t wait until your next appointment to discuss it with your doctor. Call them right away if you have:
- Unexplained weight gain
- Swelling in your ankles, feet, legs, or belly that gets worse
- Shortness of breath that gets worse or happens more often, especially if you wake up feeling that way
- Bloating with a loss of appetite or nausea
- Extreme fatigue or more trouble finishing your daily activities
- A lung infection or a cough that gets worse
- Fast heart rate
- New irregular heartbeat
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Heart Failuresigns And Symptoms
Heart failure is a condition in which the heart fails to function properly. The terms heart failure and congestive heart failure dont mean that the heart has actually failed or stopped but mean one or more chambers of the heart fail to keep up with the volume of blood flowing through them.
Heart failure is brought on by a variety of underlying diseases and health problems.
Your condition may involve the left side, the right side or both sides of the heart. Each side has two chambers:
- An atrium or upper chamber
- A ventricle or lower chamber
Any one of these four chambers may not be able to keep up with the volume of blood flowing through it.
Two types of heart dysfunction can lead to heart failure, including:
- Systolic Heart Failure This is the most common cause of heart failure and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs.
- Diastolic Failure The muscle becomes stiff and loses some of its ability to relax. As a result, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.
What Type Of Heart Failure Is Associated With Left
There are two types of left-sided heart failure. Drug treatments are different for the two types. Heart failure with reduced ejection fraction , also called systolic failure: The left ventricle loses its ability to contract normally. The heart cant pump with enough force to push enough blood into circulation.
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Mood And Heart Failure
Its normal to feel low or sad from time to time. You may feel down about your symptoms and new limitations, or feel that you have a lack of control over your life.Some people find it very difficult to live with the uncertainty of having heart failure. But learning about your condition and being involved in making decisions about your treatment will all help you to feel more in control and may help to relieve anxiety. Its also important to discuss your worries with your family and close friends so they can support you.
Stress affects different people in different ways. People who dont manage their stress well may turn to unhealthy habits such as smoking, drinking alcohol, or snacking on unhealthy foods. Knowing what triggers the stress can help you to tackle the problem. Finding healthy ways of coping with stress and learning to relax can help you manage your heart failure. Read more about coping with stress.