Wednesday, May 22, 2024

Diagnosing Congestive Heart Failure

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Blood Tests For Heart Disease

Congestive Heart Failure Diagnosis and Treatment
  • LDL , the so-called “bad” cholesterol
  • HDL , the so-called “good” cholesterol
  • C-reactive protein Your liver produces C-reactive protein as part of your body’s response to injury or infection. Inflammation plays a central role in the process of atherosclerosis, in which fatty deposits clog your arteries. CRP test results combined with other blood test results and risk factors for heart disease help create an overall picture of your heart health.
  • Homocysteine Your body uses homocysteine to make protein and to build and maintain tissue. However, too much homocysteine may increase your risk of heart disease and stroke. Homocysteine is usually ordered for people who have a high risk for developing heart disease or have a known history of heart disease. It is also used for people with a family history of heart disease but no other known risk factors.
  • CBC is a series of tests that measures your red blood cells, white blood cells and platelets.
  • Sodium and potassium levels
  • TSH is measured to check thyroid function.
  • Other Descriptive Terms In Heart Failure

    Right and left heart failure refer to syndromes presenting predominantly with congestion of the systemic or pulmonary veins. The terms do not necessarily indicate which ventricle is most severely damaged. High- and low-output, forward and backward, overt, treated, and congestive are other descriptive terms still in occasional use the clinical utility of these terms is descriptive without etiological information and therefore of little use in determining modern treatment for heart failure.

    Mild, moderate, or severe heart failure is used as a clinical symptomatic description, where mild is used for patients who can move around with no important limitations of dyspnea or fatigue, severe for patients who are markedly symptomatic and need frequent medical attention and moderate for the remaining patient cohort.

    What Are The Types Of Heart Failure

    There are many causes of heart failure, but the condition is generally broken down into these types:

    Left-sided heart failure

    Heart failure with reduced left ventricular function The lower left chamber of your heart gets bigger and cannot squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of your body.

    Heart failure with preserved left ventricular function Your heart contracts and pumps normally, but the bottom chambers of your heart are thicker and stiffer than normal. Because of this, your ventricles can’t relax properly and fill up all the way. Because there’s less blood in your ventricles, your heart pumps out less blood to the rest of your body when it contracts.

    Right-sided heart failure

    Heart failure can also affect the right side of your heart. Left-sided heart failure is the most common cause of this. Other causes include certain lung problems and issues in other organs.

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    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.

    Aspects Of The Pathophysiology Of The Symptoms Of Heart Failure Relevant To Diagnosis

    Congestive Heart failure: Causes and Types

    The origin of the symptoms of heart failure is not fully understood. Increased pulmonary capillary pressure is undoubtedly responsible for pulmonary oedema in part, but studies conducted during exercise in patients with CHF demonstrate only a weak relationship between capillary pressure and exercise performance., This suggests either that raised pulmonary capillary pressure is not the only factor responsible for exertional breathlessness or that current techniques to measure true pulmonary capillary pressure may not be adequate. Variation in the degree of mitral regurgitation will also influence breathlessness.

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    Tests For Heart Failure

    The doctor may suggest you get some tests to find the cause of your heart failure and see how severe it is.

    Blood tests. They look at your kidney and thyroid gland health and measure your cholesterol levels. They also check if you have anemia, which happens when you don’t have enough healthy red blood cells.

    B-type natriuretic peptide blood test. Brain natriuretic peptide is a substance your body makes. Your heart releases it when heart failure develops. It is turned into N-terminal pro-brain natriuretic peptide . Levels of both can be higher in people with heart failure. These tests can be used to help figure out if a patientâs shortness of breath is caused by heart failure.

    Chest X-ray. This shows the size of your heart. It also lets your doctor know if there’s a buildup of fluid around your heart and lungs.

    Echocardiogram. This test, often called an “echo,” shows your heart’s movement. During this exam, your doctor places a wand on the surface of your chest. It sends ultrasound waves that show pictures of your heart’s valves and chambers. Those images let your doctor look at how well your ticker is pumping.

    Your doctor may combine an echocardiogram with tests called Doppler ultrasound and color Doppler to check blood flow across your heart’s valves.

    Cardiac catheterization. This measures whether you have clogged heart arteries . Your doctor may also call it coronary angiogram.

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    Diagnostic Tests And Procedures

    This animation discusses some of the tests used to diagnose heart failure. These tests may include an electrocardiogram to look at your hearts electrical activity, an echocardiogram to measure how well your heart is working and look at the structure, and a chest X-ray to see if your heart is enlarged or there is fluid in your lungs. Other tests may include blood tests and an exercise, or stress test. .

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    Point Of Maximal Impulse

    The point of maximal impulse of the left ventricle is usually located in the midclavicular line at the fifth intercostal space. With the patient in a sitting position, the physician uses fingertips to identify this point. Cardiomegaly usually displaces the cardiac impulse laterally and downward.

    At times, the point of maximal impulse may be difficult to locate and therefore loses sensitivity . Yet the location of this point remains a specific indicator for evaluating the size of the heart.14

    Coronary Catheterization And Angiogram

    BNP Blood Test and its use diagnosing Congestive Heart Failure

    In coronary catheterization and angiogram, your doctor uses X-ray images taken in real time to create cross-sectional images of the heart. This enables the doctor to determine how well the heart is pumping blood to the rest of the body and to view any blockages in the blood vessels.

    After you are given local anesthesia and a sedative, your doctor guides a small, hollow tube called a catheter into a puncture in a vein in the arm or groin. He or she advances it through the aorta, the bodys largest artery, to the heart.

    An X-ray instrument called a fluoroscope is inserted into the catheter and led to the heart to provide live X-rays of the hearts chambers. Your doctor also injects a contrast agent into the catheter to highlight any blockages.

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    Physical Exam For Heart Failure

    First, your doctor will want to know if you:

    Your doctor will also do a physical exam. They’ll look for signs of heart failure as well as other illnesses that may have weakened your heart.

    During your visit, your doctor will:

    Theyâll also look at your appearance while you sit, do mild activity, and lie flat. People with mild or moderate heart failure may appear comfortable at rest, but when active, they often become short of breath. Those with heart failure may be uncomfortable if they lie flat for a few minutes.

    Your doctor may check for fluid in your lungs with a stethoscope. People with heart failure may also have neck veins that are larger than normal, swelling of the legs or abdomen, or an enlarged liver.

    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.

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    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:

    • Aldosterone antagonists
    • Selective sinus node inhibitors
    • SGLT2 inhibitor

    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.

    Symptomatic Systolic Left Ventricular Dysfunction And Concomitant Angina Or Hypertension


    Specific recommendations in addition to general treatment for heart failure because of systolic left ventricular dysfunction. If angina is present

  • optimize existing therapy, e.g. beta-blockade

  • add long-acting nitrates

  • if not successful, add amlodipine or felodipine

  • consider coronary revascularization.

    • optimize the dose of ACE-inhibitors, beta-blocking agents, and diuretics.

    • add spironolactone or ARBs if not present already

    • if not successful, try second generation dihydropyridine derivatives.

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    Stages Of Heart Failure

    When you’re diagnosed with heart failure, your doctor will usually be able to tell you what stage it is.

    The stage describes how severe your heart failure is.

    It’s usually given as a class from 1 to 4, with 1 being the least severe and 4 being the most severe:

    • class 1 you don’t have any symptoms during normal physical activity
    • class 2 you’re comfortable at rest, but normal physical activity triggers symptoms
    • class 3 you’re comfortable at rest, but minor physical activity triggers symptoms
    • class 4 you’re unable to carry out any physical activity without discomfort and may have symptoms even when resting

    Knowing the stage of your heart failure will help your doctors decide which treatments they think are best for you.

    Page last reviewed: 19 May 2022 Next review due: 19 May 2025

    How To Treat Congestive Heart Failure In Dogs

    Treating congestive heart failure depends on the type and severity of your dog’s underlying heart disease and whether the CHF is left- or right-sided. CHF treatment goals are to maximize the heart’s pumping ability and minimize fluid buildup.

    Various medications are available to treat CHF in dogs, including:

    • Diuretics: Diuretics are the mainstay of CHF treatment in dogs. They help flush excess fluid out of the system
    • ACE inhibitors: ACE inhibitors make it easier for the heart to pump blood
    • Positive inotropes: Positive inotropes promote heart muscle strength, improving pumping ability

    Other treatment methods may be needed, including:

    • Fluid removal: Severe fluid buildup may require periodic manual fluid removal from the lungs or abdomen
    • Oxygen supplementation: Dogs with severe respiratory distress may need oxygen supplementation

    A high-quality diet can improve your dog’s heart health, thus improving heart function and reducing CHF symptoms. Your veterinarian can provide guidance on dietary changes, such as omega fatty acid supplementation. Follow-up appointments are needed to re-evaluate the heart and assess fluid buildup. These appointments will include chest X-rays, blood work, and an echocardiogram.

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    What Are The Most Common Symptoms Of Congestive Heart Failure

    Swelling is the most common symptom of congestive heart failure. Often, swelling is most apparent in the extremities, especially in the legs and ankles, but it can occur in other parts of the body as well. Fluid collection in and around the lungs can cause shortness of breath , especially during physical activity or when lying down. Other common symptoms of heart failure include fatigue, loss of appetite, and weight gain.

    Symptoms And Signs In The Diagnosis Of Heart Failure

    Congestive Heart Failure (CHF) Treatment, Management, Nursing Interventions & Medications Part 2

    Breathlessness, ankle swelling, and fatigue are the characteristic symptoms and signs of heart failure but may be difficult to interpret, particularly in elderly patients, in obese, and in women. It should be interpreted carefully and different modes should be assessed.

    • Symptoms and signs are important as they alert the observer to the possibility that heart failure exists. The clinical suspicion of heart failure must be confirmed by more objective tests particularly aimed at assessing cardiac function .

    Fatigue is also an essential symptom in heart failure. The origins of fatigue are complex including low cardiac output, peripheral hypoperfusion, skeletal muscle deconditioning, and confounded by difficulties in quantifying this symptom.

    Peripheral oedema, raised venous pressure, and hepatomegaly are the characteristic signs of congestion of systemic veins., Clinical signs of heart failure should be assessed in a careful clinical examination, including observing, palpating, and auscultating the patient.

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    Stress Ekg Or Echocardiogram

    Stress tests are performed to see how the heart performs under physical stress. The heart can be stressed with exercise on a treadmill or in a few instances, a bicycle. If a person cannot exercise on a treadmill or bicycle, medications can be used to cause the heart rate to increase, simulating normal reactions of the heart to exercise.

    During the stress test, you will wear EKG leads and wires while exercising so that the electrical signals of your heart can be recorded at the same time. Your blood pressure is monitored throughout the test. The stress test can be performed together with the echocardiogram, described above.

    Recognized By Us News & World Report

    UT Southwestern Medical Center has earned High Performing recognition from U.S. News & World Report for treatment of heart failure, placing us among the countrys leading hospitals in this area of care.

    UT Southwestern Medical Centers heart failure specialists have the expertise and state-of-the-art technologies and techniques to properly diagnose and treat all severities of heart failure.

    Using advanced diagnostic tools and evidence-based therapies, our heart failure team improves the lives of people who suffer from this condition.

    Leaders in Heart and Vascular Care

    Combining attentive, compassionate care with our extensive clinical and research resources, UT Southwestern’s cardiology experts and vascular specialists deliver individualized care within pre-eminent health care facilities.

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    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

    What Is The Importance Of Ejection Fraction

    Is your Friend looking for Stem Cell Therapy For Congestive Heart ...

    Your ejection fraction is one way to measure the severity of your condition. If its below normal, it can mean that you have heart failure. Your ejection fraction tells your healthcare provider how good of a job your left or right ventricle is doing at pumping blood. Usually, your EF number is talking about how much blood your left ventricle is pumping out because its your heart’s main pumping chamber.

    Several non-invasive tests can measure your EF. With this information, your healthcare provider can decide how to treat you or find out if a treatment is working as it should.

    A normal left ventricular ejection fraction is 53% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in your left ventricle is pumped out with each heartbeat. Your EF can go up and down, based on your heart condition and how well your treatment works.

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