What Makes Yale Medicines Approach To Treating Congestive Heart Failure Unique
Yale Medicines team comprises heart failure cardiologists and cardiac surgeons, dedicated advanced-practice, registered nurses and nurse coordinators, dietitians, exercise physiologists, financial counselors, immunologists specializing in transplants, psychologists, and specialists in palliative care.
With a multidisciplinary approach, Yale Medicine physicians include the patients desires as well as input from the family to develop a comprehensive treatment plan that’s right for them.
Outlook For Heart Failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities you’re able to do and is often eventually fatal.
But it’s very difficult to tell how the condition will progress on an individual basis.
It’s very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
About Congestive Heart Failure
Heart failure, sometimes called congestive cardiac failure , is a condition in which the heart muscle is weakened and cant pump as well as it usually does. The main pumping chambers of the heart can change size and thickness, and either cant contract or cant relax as well as they should. This triggers fluid retention, particularly in the lungs, legs and abdomen.
The major causes of heart failure include coronary heart disease and heart attack, high blood pressure, damage to the heart muscle , heart valve problems and abnormal heart rhythms. Of these, coronary heart disease and heart attack are the most common causes.
The major factors that contribute to coronary heart disease include:
- reduced emotional and social wellbeing
- physical inactivity.
Heart failure is more common in elderly people. The survival rate for people with this disorder depends on the severity of their condition.
Most common treatments for heart failure are medications and self-managed lifestyle changes. Some less-common treatments may require insertion of implantable cardiac devices or valve replacement.
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Can Heart Failure Be Prevented
You may be able to prevent or delay heart failure if you:
- Work with your provider to manage any health conditions that increase your risk of developing heart failure
- Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease
NIH: National Heart, Lung, and Blood Institute
Cardiac Rehabilitation And Physical Activity
Attending a cardiac rehabilitation program is one of the best things you can do for heart failure. Many people can benefit from cardiac rehabilitation – it can improve your quality of life, keep you out of hospital and have a positive impact on your mental health and wellbeing.
Cardiac rehabilitation combines exercise and education sessions to help you make healthy changes. This includes exercise to help increase your strength, fitness and confidence levels. Exercise includes activities that make you slightly out of breath, while still being able to hold a conversation. For example, walking or riding a stationary bike. It might also include exercises that use light weights or other equipment. Youll get a tailored exercise program to suit you and you will be able to go at your own pace. Many cardiac rehabilitation service now offer home-based services via telephone and/or over the internet.
Visit the Heart Foundations cardiac services directory to find a cardiac rehabilitation program near you.
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Chf Complications Related To Other Body Functions
CHF doesnt only affect the heart. In fact, some of the most prominent symptoms arise due to the effect of blood congestion in other organ systems. These include:
- Nausea and lack of appetite: Feeling sick, vomiting, and lack of hunger associated with CHF are due to affected blood supply to the liver and digestive system.
- Swelling: Swelling in the extremities arises as kidneys receiving insufficient blood emit hormones that retain salt and water.
- Weight gain:The rapid weight gain associated with CHF is also related to hormonal imbalances and retention of salt and water caused by insufficient circulation of blood.
- Confusion and impaired thinking:Impaired thinking, confusion, and other cognitive effects may arise from electrolyte imbalances and toxins in the bloodstream that result when the kidneys are not working optimally.
Can Surgery Be Used To Treat Heart Failure
In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:
- Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is . Although surgery is more risky for people with heart failure, new strategies before, during, and after surgery have reduced the risks and improved outcomes.
- Heart valve surgery. Diseased heart valves can be treated both surgically and non-surgically .
- Implantable left ventricular assist device . The LVAD is known as the “bridge to transplantation” for patients who haven’t responded to other treatments and are hospitalized with severe systolic heart failure. This device helps your heart pump blood throughout your body. It allows you to be mobile, sometimes returning home to await a heart transplant. It may also be used as destination therapy for long-term support in patients who are not eligible for transplant.
- Heart transplant. A heart transplant is considered when heart failure is so severe that it doesn’t respond to all other therapies, but the person’s health is otherwise good.
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Symptoms Of Heart Failure
The main symptoms of heart failure are:
- breathlessness after activity or at rest
- feeling tired most of the time and finding exercise exhausting
- feeling lightheaded or fainting
- swollen ankles and legs
Some people also experience other symptoms, such as a persistent cough, a fast heart rate and dizziness.
Symptoms can develop quickly or gradually over weeks or months .
Quality Of Patient Care
Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.
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What Are The Symptoms Of Heart Failure
The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.
Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling and other problems.
Symptoms of heart failure may include:
- Feeling short of breath when you do things like climbing stairs. This may be one of the first symptoms you notice.
- Fatigue or weakness even after rest.
When Should I Get Emergency Care
Go to the ER or call 911 if you have:
- New, unexplained, and severe chest pain that comes with shortness of breath, sweating, nausea, or weakness
- Fast heart rate , especially if you are short of breath
- Shortness of breath that doesn’t get better if you rest
- Sudden weakness, or you can’t move your arms or legs
- Sudden, severe headache
- Fainting spells
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Chf: Medical Abbreviation For Congestive Heart Failure
Signs, risks, and diagnosis of CHF
CHF is a medical abbreviation for congestive heart failure, sometimes simply referred to as heart failure. Despite this name, the heart doesn’t actually stop functioning altogether. Rather, its muscles fail to keep up with the bodys needs, meaning the heart is unable to properly circulate blood.
This typically chronic condition causes blood to pool in arteries and veins, leading to swelling , fluid buildup in the lungs, and kidney problems, among many other symptoms. CHF most often arises in those whove had or are having other heart problems like coronary artery disease , hypertension , and heart attack.
Life Expectancy With Congestive Heart Failure
The life expectancy of someone with congestive heart failure depends on the type of heart failure, the cause, the stage of the disease, and how effective treatment is.
When heart failure results from cardiomyopathy or coronary artery disease, a person typically has a less positive outlook than someone with heart failure in its earliest stage.
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Congestive Heart Failure Symptoms
Signs of heart failure can appear in anyone at any age, even in young children that may be born with heart defects. But it usually affects older people with weakened hearts from other diseases.
There may be no symptoms in the early stages, but people start having symptoms in stage II and they get progressively worse, especially without treatment.
Symptoms include:
- Feelings of anxiety, suffocation and restlessness
- Hacking, dry cough that happens more often when lying down
- Having to urinate more often at night
- Lung congestion and difficulty breathing from blood backing up into the lungs
- Nausea, abdominal swelling, tenderness or pain
- Swelling from fluid buildup, especially in the feet, ankles and legs
- Weight gain from fluid buildup or weight loss from poor nutrient absorption and decreased appetite
How Is Heart Failure Diagnosed
To find out if you have heart failure, your doctor will:
- Ask about your medical history, including your symptoms
- Ask about your family health history, including relatives who have had heart failure
- Do a physical exam
In some cases, your doctor may refer you to a cardiologist for tests, diagnosis, and care.
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How The Normal Heart Works
The normal healthy heart is a strong, muscular pump a little larger than a fist. It pumps blood continuously through the circulatory system.
The heart has four chambers, two on the right and two on the left:
- Two upper chambers called atria
- Two lower chambers called ventricles
The right atrium takes in oxygen-depleted blood from the rest of the body and sends it through the right ventricle where the blood becomes oxygenated in the lungs.
Oxygen-rich blood travels from the lungs to the left atrium, then on to the left ventricle, which pumps it to the rest of the body.
The heart pumps blood to the lungs and to all the bodys tissues through a sequence of highly organized contractions of the four chambers. For the heart to function properly, the four chambers must beat in an organized way.
What Are The 4 Stages Of Congestive Heart Failure
Years ago, the American Heart Association and the American College of Cardiology identified the stages of congestive heart failure. Those stages were updated and revised in 2005. Understanding these stages can help you recognize that congestive heart failure is a progressive disease that can worsen over time.
Here is a description of the 4 Stages of Congestive Heart Failure:
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Angiotensin Ii Receptor Blockers
These drugs work similarly to ACE inhibitors, but dry cough side effects are less severe.
Drugs in this class include Diovan and Cozaar . Like ACE inhibitors, these drugs may damage kidneys so tests for kidney functions are recommended. Common side effects include dizziness, changes in kidney function and increased potassium levels.
What Causes Heart Failure
Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.
Conditions that can cause heart failure include:
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Preventing And Living With Chf
Because heart failure is a serious, progressive condition, prevention is important. For people living with CHF, there are things they can do to stop or slow disease progression and improve their quality of life.
- Limit alcohol intake to 1 drink a day or avoid it
- Dont drink more than 4 cups of coffee a day
- Dont use illegal drugs
- Talk to your doctor about medications that may increase CHF risk
- Treat any existing conditions that may lead to CHF
What Is The Outlook For People With Heart Failure
With the right care, heart failure may not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.
Everyone with a long-term illness, such as heart failure, should discuss their desires for extended medical care with their doctor and family. An “advance directive” or “living will” is one way to let everyone know your wishes. A living will expresses your desires about the use of medical treatments to prolong your life. This document is prepared while you are fully competent in case you are unable to make these decisions at a later time.
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How Is Heart Failure Treated
Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle behaviors are part of every treatment plan. Your healthcare provider will talk to you about the best treatment plan for you. Treatment is the same, regardless of gender.
As heart failure gets worse, your heart muscle pumps less blood to your organs, and you move toward the next stage of heart failure. Since you cant move backward through the heart failure stages, the goal of treatment is to keep you from moving forward through the stages or to slow down the progression of your heart failure.
Stage A treatment
The usual treatment plan for people with Stage A heart failure includes:
- Regular exercise, being active, walking every day.
- Stopping the use of tobacco products.
- Treatment for high blood pressure .
- Treatment for high cholesterol.
- Not drinking alcohol or using recreational drugs.
- Angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
- Beta-blocker if you have high blood pressure.
Stage B treatment
The usual treatment plan for people with Stage B heart failure includes:
Stage C treatment
The usual treatment plan for people with Stage C HF-rEF includes:
If the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression to Stage D.
Stage D treatment
Deaths From Heart Failure Vary By Geography
Heart failure is more common in some areas of the United States than in others. Below is a map showing the rate of death from heart failure by county during 20142016.
The map shows that concentrations of counties with the highest heart disease death rates meaning the top quintile are located primarily in Mississippi, Louisiana, Arkansas, Oklahoma, Texas, Kentucky, Tennessee, Indiana, Illinois, and Wisconsin. Pockets of high-rate counties also were found in Oregon, Utah, Montana, South Dakota, and Nebraska.
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How Chf Is Diagnosed
Several tests are used to diagnose CHF:
- Physical evaluation:Your healthcare provider goes over your symptoms, medical history, and any medications and supplements youre taking. They listen to your heart using a stethoscope, check blood pressure and other vital measures, and test your blood.
- Chest X-ray: X-ray imaging of the chest lets practitioners see if the heart has become enlarged and if blood is pooling in the lungs.
- Electrocardiogram : Heart rhythm, rate, and electrical activity are recorded using electrodes placed on the chest to assess the effects of a previous heart attack as well as detect an irregular heartbeat.
- Echocardiography:Colloquially called echo, this test relies on ultrasound to examine the motion and structure of the heart.
- Cardiac stress test: Blood pressure, heart rate, and other important measures are monitored while walking on a treadmill and afterward.
- MUGA scan:Also known as radionuclide ventriculography , this test relies on injecting a radioactive dye into the bloodstream to examine the heart using nuclear imaging.
- Cardiac catheterization: Using a catheter , a contrast dye is injected into the arteries of the heart, and X-ray pictures are taken to assess if there are any blockages. The resulting images are called angiograms.
- Magnetic resonance imaging : This type of imaging relies on magnetic fields and radio waves to create accurate, interactive computer images of the heart.
Living Well With Heart Failure
The Heart Foundation has developed a range of resources for people living with heart failure, and their families and carers.
- Living well with heart failure booklet, which includes information about what to do when you feel sick, managing symptoms, and monitoring your fluid and salt intake.
- Living well with heart failure video series, which includes seven videos covering topics to help you manage your condition. The series is available in a range of languages.
- Heart failure fact sheet, which includes questions to ask your health professional and what changes you might need to make to your daily life.
- Heart failure action plan, which helps you to identify the most important parts of your heart failure management to focus on right now.
Access these resources on the Heart Foundation website.
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