Nyha Functional Classification System
The New York Heart Association functional classification considers heart failure symptoms that happen during exercise to determine stage. Patients can go back and forth between stages depending on how well-controlled symptoms are on a given day.
- Stage 1: The person has heart disease, but it isnt yet causing symptoms or limiting activities.
- Stage 2: The person has mild symptoms that only slightly limit activity.
- Stage 3: The person has significant limitations to activities. He or she is only comfortable when resting.
- Stage 4: The person has major limitations and experiences symptoms when at rest.
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.
What Are The Risk Factors For Heart Failure
Heart failure can happen to anyone. However, certain factors may increase your risk of developing this condition.
There is a higher incidence of heart failure in men compared with women, though the prevalence is about the same for all sexes.
People with diseases that damage the heart are also at an increased risk. These conditions include:
- ivabradine in some cases
- verquvo in some cases
Always speak with your doctor before taking new medications. Some medications are completely off-limits to people with heart failure, including naproxen and ibuprofen .
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Signs Of Heart Failure And How To Treat It
For some, its the shortness of breath while exercising or a dry, hacking cough. For others, swelling in the abdomen, legs or ankles begins. There are a variety of symptoms including sudden weight gain, fatigue, nausea, and waking up with shortness of breath that warn of heart failure, but not everyone heeds them as quickly as they should.
According to the U.S. Centers for Disease Control and Prevention , approximately 6 million adults have heart failure in the U.S. That number is estimated to grow to 8 million by 2030.
Congestive heart failure is caused by heart pump impairment, resulting in a variety of symptoms, says Dr. Brian Jaski, a cardiologist affiliated with Sharp Memorial and Sharp Community Medical Group. As the heart struggles to maintain output, the body holds onto extra fluid and the vital organs dont get enough oxygen.
Causes of heart failureDr. Jaski reports heart failure is caused by a variety of cardiac conditions, including:
Each of these conditions can be influenced by genetics, Dr. Jaski says, such as race or family healthy history. Illnesses and lifestyle choices also play a role, including:
-
High cholesterol
-
Consumption of too much alcohol
In a sense, heart failure can be viewed as the culmination of all insults to the heart over someones lifetime since, in general, heart muscle cells do not replicate after birth, he says. Because of the many potential causes, getting a complete diagnosis is important for the treatment of heart failure.
What Tests Diagnose Pulmonary Hypertension
Your provider may use several different tests for different purposes.
These tests measure the blood pressure in your pulmonary arteries:
- Right heart catheterization: This test is also called pulmonary artery catheterization. It measures the pressure inside your pulmonary arteries and checks how much blood your heart can pump per minute.
- Doppler echocardiogram: A Doppler echo uses sound waves to show how your right ventricle is working. It also measures blood flow through your heart valves. It allows your provider to calculate your systolic pulmonary artery pressure.
These tests look for the underlying cause of pulmonary hypertension:
- Blood tests: Check for a range of issues related to organ function, hormone levels and infections. Specific blood tests include a complete metabolic panel and a complete blood count.
- Chest CT scan: Looks for blood clots and other lung conditions that may be causing your pulmonary hypertension or making it worse.
- Chest X-ray: Shows if your right ventricle or pulmonary arteries are bigger than they should be.
- Polysomnogram : This overnight sleep test checks if you have sleep apnea.
- Pulmonary ventilation/perfusion scan: Looks for blood clots in your lungs.
Your provider may also perform a six-minute walk test. This test shows how much exercise you can handle and how much oxygen is circulating in your blood as you exercise. The results indicate if your pulmonary hypertension is mild or severe.
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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.
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
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Being Out In The Cold Can Stress The Heart
When people maybe go outside to shovel their snow, or do their yard work in the cold, theyre exposing their heart and their bodies to a level of effort that theyre not typically used to, says Dr. Matthew Saybolt, medical director of the structural heart disease program at Hackensack Meridian Jersey Shore University Medical Center.
Cold weather causes blood vessels to constrict, which can increase heart rate and blood pressure and stress your heart.
Not everybody is used to swinging hundreds of pounds of snow with a shovel, Cruzen says. Just because the driveway needs shoveling doesnt necessarily mean that you may be the best candidate to go out there and do it, so just remember to keep your activities reasonable, and where possible, dont exert yourself beyond what you normally would.
For those living in colder temperatures, doing the same outdoor activities you did in the warm months can also stress the heart. The cold affects the body differently. You expend more energy, so consider taking it slow.
Cardiologists recommend individuals at high risk for heart disease limit strenuous activities in the bitter weather when they can.
Know If You Or A Loved One Is At High Risk For Heart Disease
About half of Americans have one of three risk factors for heart diseaseincluding high blood pressure, high cholesterol, and smoking. If youre high-risk for heart disease, its important to be extra mindful of how the winter months change your routine, Cruzen says. Other risk factors include being overweight or obese, diabetes, physical inactivity, and extreme alcohol use.
For people who have a high-risk relative or friend, check in on themoffer to help them with difficult tasks in the cold, make meal accommodations, dont smoke around them, and dont nominate them to shovel the driveway, Cruzen says.
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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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What Causes Pulmonary Hypertension
Causes of pulmonary hypertension vary widely depending on the type of PH you have. They include a range of diseases and underlying conditions as well as environmental exposures .
Group 1 PH due to pulmonary arterial hypertension
There are many causes of pulmonary arterial hypertension. They include:
Some people develop PAH without any clear cause. These cases are known as idiopathic.
Group 2 PH due to left-sided heart disease
Heart problems are a common cause of pulmonary hypertension. Because the left and right sides of your heart work together, a problem with the left side also affects the right side. The right side of your heart is responsible for pumping blood into your pulmonary arteries. So, left-sided heart problems cause a chain reaction that affects the rest of your heart, your pulmonary arteries and your lungs.
Left-sided heart problems that can cause pulmonary hypertension include:
Group 3 PH due to lung disease or hypoxia
Lung problems are another common cause of pulmonary hypertension. Some people with left-sided heart disease also have lung disease or a lack of oxygen .
Lung issues that can cause pulmonary hypertension include:
Group 4 PH due to blockages in your lungs
This form of PH is usually caused by chronic thromboembolic pulmonary hypertension . CTEPH is a condition that involves blood clots and scarring in the arteries in your lungs.
Group 5 PH due to other disorders
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How Does Pulmonary Hypertension Affect My Body
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.
If I Have Obesity How Do I Reduce My Risk Of Heart Disease
Losing 5% to 10% of your weight can lower your risk factors for heart disease. Small lifestyle changes can help improve metabolic syndrome, which lessens your heart disease risk. These changes include:
- Aerobic exercise: 150 minutes a week of aerobic exercise can help reduce abdominal fat and overall obesity. That works out to 30 minutes of activity, five days a week. Choosing activities that you enjoy, such as brisk walking, dancing or swimming, can help you stay motivated.
- Dietary changes: Eating fewer calories can help reduce abdominal fat. Changing your diet can also help you lose weight and improve overall obesity. There are studies that support recommending the Mediterranean diet to help reduce your risk of heart attack and death related to heart problems. This diet includes eating mostly plant-based foods such as root and green vegetables, fresh fruits, legumes, nuts and whole grains, plus moderate servings of dairy, eggs, fish, lean poultry and seafood.
What other steps can I take to reduce my risk of heart disease?
Besides lifestyle changes, other options to help reduce your risk of heart disease include:
See your healthcare provider to come up with a plan for your weight loss that makes the most sense for you.
A note from Cleveland Clinic
Last reviewed by a Cleveland Clinic medical professional on 08/08/2022.
References
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How Are Obesity And Heart Disease Related
Obesity affects more than 40% of the U.S. population. The excess fat in obesity was originally thought to be harmless . However, we now know that excess fat causes chemical changes in your blood that increase your heart disease risk. When your fat cells become enlarged, they give off hormones that produce chronic inflammation.
Inflammation can lead to your body no longer using insulin efficiently . This means your body has trouble regulating your blood sugar levels, which can result in metabolic syndrome. Having this condition means you have risk factors that increase your chance of developing heart disease, such as:
How does body shape affect your heart disease risk?
Your risk of heart disease varies based on where your body stores excess fat. People with an apple shape have a higher risk of heart disease than people with a pear shape. Your healthcare provider may measure your waist circumference to understand the degree of abdominal obesity you have as this correlates well with a higher risk of heart disease.
How else can obesity affect your heart?
Increased body fat may also directly contribute to changes in your heart, including:
Obesity also increases your risk of irregular heartbeat . Research shows it may cause one-fifth of all cases of atrial fibrillation . Afib can lead to blood clots that cause stroke.
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.
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What Dietary Changes Should I Make
Your provider will give you specific recommendations. One key step involves reducing your sodium intake. This means:
- Avoid adding salt at the table or using seasoning salt.
- Avoid smoked, cured, salted and canned meat products.
- Buy foods that are low sodium or low salt.
- Limit fast foods and prepared foods.
Other dietary changes include:
- Eat foods high in fiber .
- Eat foods high in potassium .
- Eat foods high in magnesium .
- Limit foods that contain refined sugar, saturated fat and cholesterol.
Causes Of Heart Failure
Coronary heart disease is the major cause of heart attacks. A heart attack can cause scarring of the heart muscle, which means the muscle isnt able to pump blood and oxygen around the body properly. Risk factors for coronary heart disease include:
- electrocardiogram , to monitor the heart rate and pick up any unusual heart rhythms. An ECG can also help assess if the left ventricle is enlarged
- exercise tests or stress tests, to monitor how your heart works when youre physically active. These tests usually involve either walking on a treadmill or riding a stationary bike while connected to a heart monitor
- lung function tests, to assess how the lungs are working
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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.
What Is Pulmonary Hypertension
Pulmonary hypertension is a general diagnosis that means you have high blood pressure in your pulmonary arteries. These are the blood vessels that carry oxygen-poor blood from your heart to your lungs.
Pulmonary hypertension has many different causes. Its usually a complication of heart disease or lung disease. But many other diseases and environmental factors can raise your risk for PH.
Pulmonary hypertension is dangerous because it disrupts the flow of blood through your heart and lungs. High blood pressure in your pulmonary arteries causes these arteries to become narrow. As a result, your heart must work harder to pump oxygen-poor blood to your lungs.
Over time, PH damages your heart and causes problems throughout your body. It can be fatal without treatment.
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