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Heart Failure Congestive

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How Does Pulmonary Hypertension Affect My Body

Congestive Heart Failure (CHF) Pathophysiology, Nursing, Treatment, Symptoms | Heart Failure Part 1

Pulmonary hypertension can cause serious problems in your body, including:

PH is dangerous for people who are pregnant. It can cause complications for both the birthing parent and fetus.

Without treatment, pulmonary hypertension can overtax your heart and eventually be fatal. High blood pressure in your pulmonary arteries forces your heart to work harder to send oxygen-poor blood to your lungs. Your right ventricle is responsible for pumping this blood to your lungs. So, over time, PH causes your right ventricle to get bigger due to the extra work. This condition can lead to right-sided heart failure.

Right-sided heart failure has a ripple effect throughout your body. It can disrupt the normal workings of many organs and systems.

Because pulmonary hypertension can affect your entire body, its essential that youre diagnosed and treated as early as possible. Your provider will prescribe treatment based on whats causing your PH. No matter the cause, untreated PH is life-threatening.

Congestive Heart Failure Drugs

There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.

ACE inhibitors

Angiotensin-converting enzyme inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cant tolerate ACE inhibitors.

You may be prescribed one of the following:

voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

ACE inhibitors shouldnt be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:

  • Potassium-sparing diuretics and potassium supplements. These diuretics can cause potassium buildup in the blood, which may lead to abnormal heart rhythms. Examples include: riamterene , eplerenone , and spironolactone .
  • Nonsteroidal anti-inflammatory drugs .NSAIDs such as ibuprofen, aspirin, and naproxen, can cause sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.

Beta-blockers

This may be achieved with:

Diuretics

Your doctor may recommend:

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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What Is An Ejection Fraction

An ejection fraction is a measurement of the blood pumped out of your heart with each beat, expressed in a percentage. It can be measured using an echocardiogram , multigated acquisition scan, nuclear stress test, magnetic resonance imaging , or during a cardiac catheterization. A normal ejection fraction is between 50% and 70%.

How Does A Healthy Heart Work

Congestive Heart Failure doesnt happen in a day  it takes many months ...

The heart is part of the circulatory system, which carries blood throughout the body. The heart is made of muscle and works like a pump to keep the blood moving through the blood vessels .

The heart has 4 chambers the right atrium and the left atrium on top and the right and left ventricles on the bottom. The heart is divided by a solid wall called the septum into 2 sides: the right side sends blood to the lungs to get oxygen, while the left side of the heart moves oxygen-rich blood to the rest of the body through the aorta .

Blood enters the heart through the right atrium and moves to the right ventricle, where it then moves through the pulmonary artery to the lungs to pick up oxygen. The newly oxygenated blood then enters the heart through the left atrium and moves to the left ventricle, where it is sent through the aorta to the rest of the body.

There are also 4 valves in the heart, which open and close to allow blood to move through the chambers:

  • The aortic valve, located on the left side of the heart, between the aorta and the left ventricle.
  • The mitral valve, located between the left ventricle and the left atrium.
  • The pulmonary valve, located on the right side of the heart between the right ventricle and the pulmonary artery .
  • The tricuspid valve, located on the right side of the heart between the right ventricle and the right atrium.

The exterior of the heart.

Blood vesselsarteries, veins, and capillaries–are also involved in helping blood flow:

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How Is Pulmonary Hypertension Diagnosed

Your provider will perform a physical exam and run tests to reach a pulmonary hypertension diagnosis.

First, youll have a physical exam to check for signs of pulmonary hypertension as well as other heart or lung issues. During this exam, your provider will:

  • Ask you questions about your health and your medical history.
  • Ask about your symptoms.
  • Check the size of the veins in your neck. Bulging neck veins could be a sign of right-sided heart failure.
  • Check the size of your liver by feeling the upper right area of your tummy.
  • Listen to your heart and lungs with a stethoscope.
  • Look at your belly, ankles and legs for edema.
  • Measure your blood pressure.
  • Measure the oxygen level in your blood using a pulse oximeter.

Pulmonary hypertension can be difficult to diagnose since many signs of PH are similar to those of other conditions. So, after your physical exam, your provider may run some tests to get more information.

Your provider may also refer you to a pulmonologist or cardiologist.

What Are The Stages Of Pulmonary Hypertension

There are four main stages of pulmonary hypertension. The World Health Organization calls these functional classes. Theyre based on the symptoms you feel and refer to how well you can carry out your daily activities. As PH gets worse, the symptoms become more noticeable and more disruptive to your daily life.

  • Class 1: You dont have any symptoms.
  • Class 2: You dont have symptoms when youre resting. But you feel some discomfort or shortness of breath during some routine activities. These include household chores and climbing stairs.
  • Class 3: You may still feel fine when youre resting. But its now much harder to do normal tasks because you feel tired or short of breath.
  • Class 4: You have symptoms even when youre resting. The symptoms get worse when you try to do any normal task.

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What Is The Life Expectancy For People With Pulmonary Hypertension

The life expectancy varies from person to person. It depends how quickly youre diagnosed and what other medical conditions you have. Talk with your provider about what you can expect in your individual situation.

Pulmonary hypertension is a progressive disease. That means it gets worse over time. It progresses more quickly in some people than in others. Treatment can improve your chances of surviving pulmonary hypertension for many years.

What Medications Should I Avoid If I Have Heart Failure

An Osmosis Video: Congestive Heart Failure (CHF) Explained

There are several different types of medications that are best avoided in those with heart failure including:

  • Nonsteroidal anti-inflammatory medications such as Motrin or Aleve. For relief of aches, pains, or fever take Tylenol instead.
  • Most calcium channel blockers
  • Some nutritional supplements, such as salt substitutes, and growth hormone therapies
  • Antacids that contain sodium

If youâre taking any of these drugs, discuss them with your doctor.

Itâs important to know the names of your medications, what theyâre used for, and how often and at what times you take them. Keep a list of your medications and bring them with you to each of your doctor visits. Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively.

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What Can Be Done To Prevent Pediatric Congenital Heart Defects

In most cases, there is no way to prevent heart defects. However, certain precautions can be taken:

  • A pregnant woman should not drink alcohol or take drugs that have not been prescribed to her.
  • Women with certain chronic conditions should ask their doctors for advice on medications or special diets before they become pregnant.
  • A woman who is able to become pregnant should get 400 micrograms of folate or folic acid per day to prevent birth defects.

How Common Is Pulmonary Hypertension

Some types of PH are rare, such as pulmonary arterial hypertension and PH caused by blood clots. But other types are much more common, especially PH caused by heart or lung problems.

We dont know exactly how many people around the world have pulmonary hypertension. But some estimates show PH may affect 1 in 100 people. This means 50 million to 70 million people are living with PH.

PH is even more common among older adults. Around the world, about 1 in 10 adults over age 65 have PH.

Researchers believe the number of people diagnosed with PH will rise in the next few decades.

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What Is Heart Failure

Heart failure, or congestive heart failure, is a long-term condition that gets worse over time. Although the name sounds like your heart has stopped working, heart failure means your heart isnt able to pump blood as well as it should. When your heart has less pumping power, that can damage your organs and fluid can collect in your lungs.

Precipitating Causes Of Heart Failure

Congestive Heart failure: Causes and Types

A previously stable, compensated patient may develop heart failure that is clinically apparent for the first time when the intrinsic process has advanced to a critical point, such as with further narrowing of a stenotic aortic valve or mitral valve. Alternatively, decompensation may occur as a result of the failure or exhaustion of the compensatory mechanisms but without any change in the load on the heart in patients with persistent, severe pressure or volume overload. In particular, consider whether the patient has underlying coronary artery disease or valvular heart disease.

The most common cause of decompensation in a previously compensated patient with heart failure is inappropriate reduction in the intensity of treatment, such as dietary sodium restriction, physical activity reduction, or drug regimen reduction. Uncontrolled hypertension is the second most common cause of decompensation, followed closely by cardiac arrhythmias . Arrhythmias, particularly ventricular arrhythmias, can be life threatening. Also, patients with one form of underlying heart disease that may be well compensated can develop heart failure when a second form of heart disease ensues. For example, a patient with chronic hypertension and asymptomatic LV hypertrophy may be asymptomatic until an MI develops and precipitates heart failure.

  • Profound anemia
  • Nutritional deficiencies

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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 ” don’t 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 Is Congestive Heart Failure

Heart failure describes the inability or failure of the heart to meet the needs of organs and tissues for oxygen and nutrients. This decrease in cardiac output, the amount of blood that the heart pumps, is not adequate to circulate the blood returning to the heart from the body and lungs, causing the fluid to leak from capillary blood vessels. This leads to symptoms that may include shortness of breath, weakness, and swelling.

Understanding blood flow in the heart and body

The right side of the heart pumps blood to the lungs while the left side pumps blood to the rest of the body. Blood from the body enters the right atrium through the vena cava. It then flows into the right ventricle where it is pumped to the lungs through the pulmonary artery, which carries deoxygenated blood to the lungs. In the lungs, oxygen is loaded onto red blood cells and returns to the left atrium of the heart via the pulmonary veins. Blood then flows into the left ventricle where it is pumped to the organs and tissues of the body. Oxygen is downloaded from red blood cells into the various organs while carbon dioxide, a waste product of metabolism, is added to be removed from the lungs. Blood then returns to the right atrium to start the cycle again. The pulmonary veins are unusual in that they carry oxygenated blood, while the pulmonary artery carries deoxygenated blood. This is a reversal of duties versus the roles of veins and arteries in the rest of the body.

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What Is Ejection Fraction

The ejection fraction is a measurement your doctor will use to determine the type of heart failure and to assess the stage of heart disease.

The ejection fraction represents the percentage of blood pumped out of the left ventricle when the heart contracts. When blood leaves the left ventricle, it moves into the aorta to deliver blood loaded with oxygen to the rest of the body.

In a healthy heart, the ejection fraction ranges from around 52%74%. When the ejection fraction drops below 52%, its considered low. Your healthcare professional may use your ejection fraction to determine the severity of heart failure.

When Should I Go To The Er

Congestive Heart Failure

Go to the emergency department or call your local emergency number if you have:

  • A fast heart rate that wont go down.
  • Fainting spells with loss of consciousness.
  • Hickman catheter complications with intravenous prostacyclins. These include infection, catheter displacement, solution leak, bleeding and IV pump malfunction.
  • Shortness of breath that doesnt go away when you rest.
  • Sudden and severe chest pain.
  • Sudden and severe headache.
  • Sudden weakness or paralysis in your arms or legs.

A note from Cleveland Clinic

A pulmonary hypertension diagnosis can cause a range of emotions. It takes time to process the diagnosis, learn whats going on inside your body and figure out how to move forward. Work with your provider to get the resources you need. Involve your family and friends in your lifestyle changes. Educate them on your condition. And most of all, know its OK to ask for help and lean on others as you adjust to your new normal.

Last reviewed by a Cleveland Clinic medical professional on 06/02/2022.

References

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What Is The Outlook With Heart Failure

With the right care, congestive heart failure wont stop you from doing the things you enjoy. Your prognosis, or outlook for the future, will depend on:

  • How well your heart muscle is working.
  • How well you respond to your treatment plan.
  • How well you follow your treatment plan.

One study says that people with heart failure have a life span 10 years shorter than those who dont have heart failure. Another study showed that the survival rates of people with chronic heart failure were 80% to 90% for one year, but that dropped to 50% to 60% for year five and down to 30% for 10 years.

A different study found that people who had heart failure and were discharged from the hospital had expected life spans ranging from three to 20 years, depending on various factors like age and gender. Its important to look at your specific situation when considering your prognosis.

What Causes Heart Failure

Although the risk of heart failure doesnt change as you get older, youre more likely to have heart failure when youre older.

Many medical conditions that damage the heart muscle can cause heart failure. Common conditions include:

  • Tobacco and recreational drug use.
  • Medications. Some drugs used to fight cancer can lead to heart failure.

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