Treatment And Medication Options For Congestive Heart Failure
Heart failure is a chronic condition, and there is no cure. However, once youve been diagnosed, there are several things you can do to treat the condition and manage it so that it does not progress. Chief among them are lifestyle changes. That includes exercising and maintaining a heart-healthy diet thats low in saturated fat, trans fats, and cholesterol.
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
What Is The Prognosis And Life Expectancy For Congestive Heart Failure
- The degree to which other organ systems are involved and the severity of other accompanying conditions
- The person’s symptoms and degree of impairment
- Other factors that remain poorly understood
With the availability of newer drugs to potentially favorably affect the progression of the disease, the prognosis in congestive heart failure is generally more favorable than that observed just 10 years ago. In some cases, especially when the heart muscle dysfunction has recently developed, a significant spontaneous improvement is not uncommonly observed, even to the point where heart function becomes normal.
Heart failure is often graded on a scale of I to IV based on the patient’s ability to function.
The prognosis of heart failure patients is very closely associated with the functional class.
An important issue in congestive heart failure is the risk of heart rhythm disturbances . Of those deaths that occur in individuals with congestive heart failure, approximately 50% are related to progressive heart failure. Importantly, the other half are thought to be related to serious arrhythmias.
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Treatments For Heart Failure
Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.
How you’re treated will depend on what is causing your heart failure.
Common treatments include:
- lifestyle changes including eating a healthy diet, exercising regularly and stopping smoking
- medicine a range of medicines can help many people need to take 2 or 3 different types
- devices implanted in your chest these can help control your heart rhythm
- surgery such as a or a heart transplant
Treatment will usually be needed for life.
A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.
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.
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How Is Chf Diagnosed
After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist.
The cardiologist will perform a physical exam, which will involve listening to your heart with a stethoscope to detect abnormal heart rhythms.
To confirm an initial diagnosis, a cardiologist might order certain diagnostic tests to examine your hearts valves, blood vessels, and chambers.
There are a variety of tests used to diagnose heart conditions. Because these tests measure different things, your doctor may recommend a few to get a full picture of your current condition.
What You Can Do
Some risk factors of heart failure, like age, cant be modified. Still, people with CHF can take steps to improve the long-term prognosis. The first thing to do is to be familiar with any family history of heart disease. You’ll also want to learn about all the possible symptoms. Don’t ignore any symptom that you think is cause for concern. Tell your healthcare provider about them right away.
Regular exercise, along with managing any other health issues you may have, can also help to keep CHF under control.
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What Are Risk Factors For Congestive Heart Failure
While a single risk factor may cause congestive heart failure, having a combination of different risk factors significantly increases a persons risk of developing heart failure. Risk factors for heart failure include:
- Coronary Artery Disease Coronary artery disease, also known as heart disease occurs when the blood vessels that supply the hearts muscles with oxygen and nutrients become diseased and narrowed. The hearts muscles, starved of adequate oxygen and nutrients become weakened. Weakened, the heart is then unable to adequately pump and to move blood throughout the body.
- High Blood Pressure High blood pressure forces the heart to work harder as it tries to pump blood through blood vessels against the high pressure in those blood vessels. This forces the hearts pumping muscles to work harder. Over time, this can damage these pumping muscles making them unable to properly pump blood.
- Diabetes Diabetes increases a persons risk of developing coronary artery disease. Coronary artery disease can damage the hearts pumping muscles.
- Heart Attack A Heart Attacks occurs when some of the hearts pumping muscles die after being starved of oxygen for too long. Once dead, these pumping muscles can no longer pump blood. If a heart attack is severe enough to damage a large amount of the hearts pumping muscles, the heart is unable to properly pump blood after this heart attack. This leads to heart failure.
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.
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How Is Congestive Heart Failure Diagnosed
Patients will typically have an intake visit with a heart specialist and nurse or physicians assistant. During this visit, the doctor will review the patients prior records and his or her current health status. This allows the doctor to establish a picture of where the patient is along the spectrum, and make a plan for prognosis and treatment.
The process often takes more than one meeting and involves both the patients local cardiologist or referring physician.
How Can I Improve My Quality Of Life With Heart Failure
There are several things you can do to improve your quality of life if you have heart failure. Among them:
- Eat a healthy diet. Limit your consumption of sodium to less than 1,500 milligrams each day. Eat foods high in fiber. Limit foods high in trans fat, cholesterol, and sugar. Reduce total daily intake of calories to lose weight if necessary.
- Exercise regularly. A regular cardiovascular exercise program, prescribed by your doctor, will help improve your strength and make you feel better. It may also decrease heart failure progression.
- Don’t overdo it. Plan your activities and include rest periods during the day. Certain activities, such as pushing or pulling heavy objects and shoveling may worsen heart failure and its symptoms.
- Prevent respiratory infections. Ask your doctor about flu and pneumonia vaccines.
- Take your medications as prescribed. Do not stop taking them without first contacting your doctor.
- Get emotional or psychological support if needed. Heart failure can be difficult for your whole family. If you have questions, ask your doctor or nurse. If you need emotional support, social workers, psychologists, clergy, and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.
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Factors That Can Worsen Symptoms Of Heart Failure
The symptoms of heart failure can be worsened by a number of factors, including:
- too much salt, fluid, or alcohol in the diet
- some viral and bacterial infections
- kidney diseases
Treatment for heart failure may include:
- medicines, such as
- diuretics to remove excess fluid and improve symptoms of heart failure
- mineralcortiocoid receptor antagonists are also recommended and used in most patients with heart failure to reduce mortality and hospitalisation
- ACE inhibitors to open up blood vessels, reduce blood pressure and reduce sodium retention and water retention
- certain beta-blockers to slow the heart rate and reduce its work
- aldosterone blockers to reduce blood pressure and reduce the effects of damage to the heart muscle
- ACE inhibitors, beta blockers and aldosterone blockers can increase survival and reduce the likelihood of hospitalisation.
Why Is Congestive Heart Failure Dangerous
Congestive Heart Failure, when untreated, can lead to a number of different complications. Many of these complications result from the fact that vital organs become congested with excess fluid. This can cause them to become water logged and to function improperly. Additionally, because Congestive Heart Failure results in the heart being unable to provide adequate oxygen and nutrients to vital organs, this causes these congested water-logged organs to malfunction even further. As a result, Congestive Heart Failure can cause the following:
- Kidney damage, sometimes leading to the need for dialysis.
- Liver damage, because one of the livers primary jobs is to remove toxins from the blood, liver damage can then lead to a build-up of toxins in the blood.
- An enlarged heart.
- Damaged heart valves.
- An irregular heartbeat.
- Death, while many people with CHF will see improvement of their condition if it is properly treated, Congestive Heart Failure, when untreated can be life-threatening.
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Facts About Heart Failure In The United States
- About 6.2 million adults in the United States have heart failure.1
- In 2018, heart failure was mentioned on 379,800 death certificates .1
- Heart failure costs the nation an estimated $30.7 billion in 2012.2 This total includes the cost of health care services, medicines to treat heart failure, and missed days of work.
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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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
Health Teaching And Health Promotion
Nursing care plans for patients with HF must include patient education to improve clinical outcomes and reduce hospital readmissions. Patients need education and guidance on self-monitoring of symptoms at home, medication compliance, daily weight monitoring, dietary sodium restriction to 2 to 3 g/day, and daily fluid restriction to 2 L/day. In addition, patients with HF need aggressive treatment for underlying risk factors and the potential triggers for HF exacerbations. Modifiable risk factors include diabetes mellitus, hypertension, obesity, nicotine use, alcohol use disorder, and recreational drug use, especially cocaine. Patients with sleep apnea and HF should be encouraged to use continuous positive airway pressure therapy as uncontrolled sleep apnea can also increase HF-associated morbidity and mortality.
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History And Physical Exam
A clinician listens to your heart and lungs and measures your blood pressure and weight. They will also ask about your:
- Familys medical history, especially previous cardiac problems
- Medications, including prescriptions, over-the-counter drugs and supplements
- Personal medical history
Blood tests can measure several things related to heart failure:
- Sodium and potassium levels
- Creatinine, which helps measure how well your kidneys are working
- B-type natriuretic peptide , a hormone released from the ventricles in response to increased wall tension that occurs with heart failure
Stage C Treatment Options
Treatment at this stage focuses on managing your symptoms, optimizing your heart function, and preventing worsening of your condition.
Medications to treat stage C heart failure include:
- Diuretics to reduce fluid retention
- Beta blockers to help make your heart work less hard
- SGLT2 inhibitors to reduce the risk of cardiovascular death and hospitalization for heart failure
- Angiotensin-converting enzyme inhibitors
- Angiotensin II receptor blockers
- Entresto , which reduces the risk of death and hospitalization among patients with chronic heart failure
- Aldosterone antagonists
- Digoxin to help the heart beat stronger and more regularly
- Possible cardiac resynchronization therapy
- Possible implantable cardiac defibrillator therapy
In addition to the lifestyle changes for stages A and B, you may need to make the following changes:
- Reduce your sodium intake
- Restrict fluid intake
- Keep track of your weight daily
Remember that even if the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression of your condition to stage D.
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How Is Heart Failure Diagnosed
Your doctor will ask you many questions about your symptoms and medical history. Youâll be asked about any conditions you have that may cause heart failure . Youâll be asked if you smoke, take drugs, drink alcohol , and about what drugs you take.
Youâll also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.
Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:
Other tests may be ordered, depending on your condition.
Surgery And Percutaneous Procedures
Surgery may be appropriate when certain underlying disorders are present. Surgery in patients with advanced HF should be done in a specialized center.
Surgical closure of congenital or acquired intracardiac shunts can be curative.
If HF is primarily due to a valvular disorder Overview of Cardiac Valvular Disorders Any heart valve can become stenotic or insufficient , causing hemodynamic changes long before symptoms. Most often, valvular stenosis or insufficiency… read more , valve repair or replacement should be considered. Patients with primary mitral regurgitation are more likely to benefit than patients with mitral regurgitation secondary to LV dilation, in whom poor myocardial function is likely to continue postoperatively. Surgery is preferably done before myocardial dilation and damage become irreversible. More recently, percutaneous mitral valve repair procedure, in which a clip is applied to approximate the anterior and posterior mitral leaflets, has been shown to reduce death and HF hospitalization in carefully selected patients with symptomatic HF despite optimal medical management and moderate to severe or severe mitral regurgitation with preserved LV size is a syndrome of ventricular dysfunction. Left ventricular failure causes shortness of breath and fatigue, and right ventricular failure causes peripheral and abdominal fluid… read more ).
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Our Favorite Apps And Gadgets
This app can help you to keep track of your liquid intake to avoid excess fluid buildup, which can lead to complications. You can also track your weight, since sudden increases in weight can be due to water retention. Another great thing about this app is that it alerts you if your blood pressure or weight gets high enough that you should tell your doctor. It also allows you to send reports on your fluid intake and weight to your healthcare provider.
This app, developed in partnership with the Heart Failure Society of America, is your one-stop shop for recording symptoms, vital signs, and medications to help you manage congestive heart failure. You can also track your information and keep a journal to maintain wellness and emotional health.