What Are The Stages Of Congestive Heart Failure
The New York Heart Association has developed a scale that commonly is used to determine the functional capabilities of heart failure.
New York Heart Association Functional Classification of Heart Failure
Center For Advanced Heart Failure/cardiomyopathy At Brigham And Womens Hospital
The Center for Advanced Heart Failure/Cardiomyopathy, an integral part of the Heart & Vascular Center at Brigham and Womens Hospital , brings together heart failure experts, including cardiologists, interventional cardiologists, cardiac surgeons, cardiovascular imaging specialists, congenital heart disease specialists, and many others, to care for patients as one team. Together, the team tailors therapies to each patients needs, offering the latest medical, interventional, and surgical approaches to congestive heart failure treatment.
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.
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What Makes Yale Medicines Approach To Treating Congestive Heart Failure Unique
We have a very patient-focused team at Yale Medicine, says Dr. Jacoby. Every person seen here, we treat as an individual, rather than offering a simple cookie-cutter treatment plan.
Yale Medicines multidisciplinary team comprises of 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.
In our multidisciplinary approach, we include the patients desires as well as input from the family, Dr. Jacoby says. We develop a plan for social work support and take into account all of their financial and emotional stresses in addition to their physical treatment needs.
How Palliative And Hospice Care Can Help With End
Both palliative and hospice care focus on the whole person, including their physical, emotional, social, and spiritual needs. The main difference is that palliative care can be given at any time during a serious illness, and hospice care is given near the end of life typically when a persons prognosis is six months or less.
Palliative and hospice care can also provide help with making difficult treatment decisions, such as whether to be resuscitated if the persons heart stops, or whether to have a tube placed in their throat to help them breathe.
Similarly, people with end-stage heart failure may need to decide when to disable certain medical devices implanted in their body:
- Implantable cardioverter defibrillator . Patients can have the shock function turned off, or not replace the battery when the current one runs out. Electrical shocks from ICDs can cause unnecessary distress for patients and loved ones at the end of life.
- Left ventricular assist device . Typically, the patient decides when this heart pump will be shut off before it is implanted. The decision can be discussed again as the end of life nears.
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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. .
Your doctor may order blood tests to check the levels of certain molecules, such as brain natriuretic peptide . These levels rise during heart failure. Blood tests can also show how well your liver and your kidneys are working.
Tests to measure your ejection fraction
Your doctor may order an echocardiography or other imaging tests to measure your ejection fraction. Your ejection fraction is the percent of the blood in the lower left chamber of your heart that is pumped out of your heart with each heartbeat. Ejection fraction tells your doctor how well your heart pumps. This helps your doctor diagnose the type of heart failure you have and guide your treatment.
- If 40% or less of the blood in your left ventricle is pumped out in one beat, you have heart failure with reduced ejection fraction.
- If 50% or more of the blood in your left ventricle is pumped out in one beat, you have heart failure with preserved ejection fraction.
If your ejection fraction is somewhere in between , you may be diagnosed with heart failure with borderline ejection fraction.
What Are The Signs And Symptoms Of Congestive Heart Failure
Shortness of breath
The hallmark and most common symptom of left heart failure is shortness of breath and may occur.
Right heart failure, left heart failure, or both
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Why Its Important To Know Your Ef
If you have a heart condition, it is important for you and your doctor to know your EF. Your EF can help your doctor determine the best course of treatment for you. Measuring your EF also helps your healthcare team check how well our treatment is working.
Ask your doctor how often you should have your EF checked. In general, you should have your EF measured when you are first diagnosed with a heart condition, and as needed when your condition changes.
Diuretics And Vasodilator Drugs For Congestive Heart Failure
Medications help control both the underlying causes of heart failure and the symptoms. Medications are the most critical part of therapy for heart failure. Usually, several types of medications are required to address as many of the physiologic imbalances as possible.
People with heart failure usually take several different medications that work in different ways to lessen heart failure symptoms, to prevent worsening of the underlying disease, and to prolong life.
Diuretics : The buildup of fluid is usually treated with a diuretic.
Vasodilators: These medications enlarge the small arteries or arterioles, which relieve the systolic workload of the left ventricle. Therefore, the heart has to work less to pump blood through the arteries. This also generally lowers blood pressure. Just as importantly, they reduce the levels of certain deleterious hormones and signals that can worsen heart failure.
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What Medications Should I Avoid If I Have Heart Failure
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.
What Are The Types Of Heart Failure
There are many causes of heart failure, but the condition is generally broken down into two types:
Heart failure with reduced left ventricular function The lower left chamber of the heart gets bigger and cannot squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of the body.
Heart failure with preserved left ventricular function The heart contracts and pumps normally, but the bottom chambers of the heart are thicker and stiffer than normal. Because of this, the ventricles can’t relax properly and fill up all the way. Because there’s less blood in the ventricles, less blood is pumped out to the rest of the body when the heart contracts.
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Sleep Apnea And Heart Failure
Sleep apnea is a common but potentially serious sleep disorder that affects an estimated 30 million people in the United States, according to an article published in August 2016 in the Journal of Sleep Medicine.
People who have sleep apnea experience interruptions in breathing that can last 10 seconds or more and occur repeatedly throughout the night, as many as 30 times or more in the span of an hour.
This chronic disruption of the normal sleep cycle can leave individuals with the condition feeling exhausted and sleepy during the day, and will put them at increased risk for health problems associated with inadequate sleep, including irritability, problems with memory or concentration, anxiety, and depression.
Sleep apnea is commonly found in people with heart failure.
Heart failure can cause retention of sodium and water, and doctors suspect that the excess fluid may enter the lungs at night and lead to obstructive apnea. Heart failure also seems to be linked to problems with the respiratory control system, which may be a cause of central sleep apnea, notes the Mayo Clinic.
This is the leading heart disease organization in the United States. Their online resources on heart failure offer clear explanations of the condition for both patients and family members, as well as links to many other tools and resources. You can also find information on your local AHA office and learn about volunteer opportunities.
Early Attention To Heart Disease
Congestive heart failure is one of the leading causes of death in the elderly and is not curable. The best course is to avoid or treat early known causes of the disease to prevent or limit damage to the heart. See your doctor if you notice early signs that might indicate CHF such as shortness of breath or fluid in your legs.
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When To Call The Doctor
If you have any signs of heart disease, call your health care provider right away. Don’t wait to see if the symptoms go away or dismiss them as nothing.
- You have chest pain or other symptoms of a heart attack
- You know you have angina and have chest pain that doesn’t go away after 5 minutes of rest or after taking nitroglycerine
- You think you may be having a heart attack
- You become extremely short of breath
- You think you may have lost consciousness
Carrus Health Advanced Radiology Department
At Carrus Health, we provide the imaging tests you need for a clinical diagnosis of congestive heart failure. We currently offer CT Scans, X-rays, and ultrasounds to diagnose your condition. Our radiology facility in Sherman, Texas is spacious, clean, and comfortable.
To schedule an appointment, please call Carrus Health at 870-2600. Our friendly staff looks forward to assisting you.
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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.
Reversing Congestive Heart Failure
It is possible to reverse congestive heart failure. Once the condition of your heart is assessed, the physician will take further steps to treat your congestive heart failure and start appropriate treatment.
This treatment starts with medications and then other procedures may be done to attempt to help the heart get stronger. There are a lot of medications available that will help in improving the quality of your life.
Cardiac viability tests are non-invasive tests that should be done initially to asses if the heart muscle is still alive and if the hearts condition is reversible. Cardiac viability tests should be done prior to any invasive procedures, to make sure the heart condition is reversible and to see if the invasive procedure is truly needed.
For reversal of this disease, early diagnosis is very important.
Cardiac PET provides one of the best and easiest ways to assess for cardiac viability in all individuals.
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Congestive Heart Failure Treatments
Currently, there is no cure for congestive heart failure. Treatments are designed to reduce symptoms and slow the progression of the disease. However, early diagnosis and treatment can help you lead a long and active life. The good news is that more congestive heart failure treatment options exist today than ever before. The specific treatment plan prescribed for you will depend largely upon the type of heart failure you have and on its underlying causes. All treatment options will have the same four basic goals:
1. Treat the underlying diseases and conditions causing your heart failure.
2. Reduce the symptoms of heart failure.
3. Stop your heart failure from getting worse.
4. Maximize the quality and length of your life after diagnosis.
Treatment options for congestive heart failure will fall under one of four categories:
Nitrates Apresoline Beta Blockers And Inotropes Drugs For Congestive Heart Failure
- Nitroglycerin is a nitrate preparation that is administered to treat acute chest pain, or angina.
Hydralazine is a smooth muscle arterial vasodilator that may be used for congestive heart failure. Clinical trial data has shown hydralazine plus nitrates to be especially effective in African-Americans with heart failure, when used in addition to ACE inhibitors or ARBs.
- Isosorbide dinitrate and hydralazine is a fixed dose combination of isosorbide dinitrate and hydralazine . This drug is indicated for heart failure in African-Americans based in part on results of the African American Heart Failure Trial .
- Hydralazine is also especially valuable in patients who have poor kidney function and/or are intolerant to ACE inhibitors and ARBs.
Beta-blockers: These drugs slow down the heart rate, lower blood pressure, and have a direct effect on the heart muscle to lessen the workload of the heart. Specific beta-blockers, such as carvedilol and long-acting metoprolol , have been shown to decrease symptoms, hospitalization due to congestive heart failure, and deaths. Other beta-blockers include bispropolol , atenolol , propranolol , and , but they are generally not used with significant congestive heart failure.
Getting the most out of congestive heart failure medications involves the following:
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