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How Is Congestive Heart Failure Treated

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Treatment of Congestive Heart Failure (CHF)

Whether you were recently diagnosed with heart failure or have been living with it for years, the Vanderbilt Heart and Vascular Institute team is here to give you the resources, care and support you need to thrive. Designed to help you navigate your journey, our care guide explores:

  • Symptoms to be aware of.
  • Progressive stages of heart failure.
  • Related conditions.
  • Early and advanced-stage treatment options.
  • And more.

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.

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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How Do I Prepare For A Chest X

Chest X-rays require little to no preparation. When you get ready for the appointment, wear loose, comfortable clothing that does not contain metal and leave jewelry at home.

If you have body piercings, ask your X-ray center for specific instructions. Body jewelry can interfere with clear images. You may need to remove it or replace it with an acrylic retainer.

What Is The Prognosis For Children With Congenital Heart Defects

Congestive Heart Failure Drugs Market Slumps Temporarily amid Covid

The prognosis depends on the defect. In many cases, children with congenital heart defects go on to live normal lives. In most cases, people with heart defects are at greater risk for developing infection of the heart and valves. They may need to take antibiotics when having certain dental or surgical procedures in order to prevent endocarditis, an infection of the hearts lining.

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Congestive Heart Failure Lifestyle Changes

The most important lifestyle changes recommended for people with CHF is the restriction of dietary sodium and fluid. Patients with CHF often have excess fluid and overconsumption of sodium and fluid only worsen this condition. Most doctors recommend that no more than 2 grams of sodium be consumed each day by those with CHF and fluid intake is typically restricted to about 2 quarts a day.

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.

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Who Gets Congestive Heart Failure And What Are The Risk Factors

An estimated 6.2 million people in the United States have heart failure. Diseases and conditions that increase the risk of developing heart disease or cardiovascular disease also increase the risk of eventually developing congestive heart failure as a complication.

Risk factors include:

  • Atherosclerosis and coronary artery disease
  • Excessive alcohol consumption
  • Sedentary lifestyle
  • Smoking

Having high levels of certain substances in the body, which can be determined by blood tests, can also increase the risk for and congestive heart failure. These include:

  • High cholesterol, which can lead to atherosclerosis
  • High C-reactive protein level, which reflects inflammation
  • High homocysteine level, which may damage artery walls and increase the risk of developing . Blood clots can cause a and lead to congestive heart failure.

Reducing your risk of congestive heart failure

You can reduce your risk of developing heart disease and congestive heart failure by:

  • Eating a heart-healthy diet that is low in saturated fat and trans fats and high in fiber, whole grains, fruits, and vegetables
  • Limiting alcohol intake to one drink per day for women and two drinks per day for men
  • Maintaining a healthy weight

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Congestive Heart Failure: Prevention Treatment And Research

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

    Congestive heart failure is a serious condition in which the heart doesnt pump blood as efficiently as it should. Despite its name, heart failure doesnt mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a result, it cant keep up with the bodys demand, and blood returns to the heart faster than it can be pumped outit becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the bodys other organs.

    The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contractsbut over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they dont receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse.

    More than 5 million people in the United States have congestive heart failure. Its the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause.

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    Nitrates Apresoline Beta Blockers And Inotropes Drugs For Congestive Heart Failure

    Nitrates are venous vasodilators that include isosorbide mononitrate and isosorbide dinitrate . They are commonly used in combination with an arterial vasodilator, such as hydralazine .

    • 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:

    Be The Star Of Your Team

    It takes a team to manage heart failure, and you are the key player. 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 also lend a hand. But it’s up to you to take your medicine, change your diet, live a healthy lifestyle, keep your follow-up appointments, and be an active member of the team.

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    How Does A Chest X

    Your bodys tissues vary in thickness. When radiation passes through your body, each structure in your body allows a different amount of radiation to pass through.

    For example, your bones are very thick and dont allow much radiation to pass through. Bones look white on an X-ray image. Your lungs, however, allow more radiation through. Your lungs look gray on an X-ray image.

    Healthcare providers look at the colors and shading on an X-ray to diagnose and treat health conditions.

    Surgery And Medical Device Options

    Heart Failure

    The goal of surgery is to make your heart work better.

    . Routes blood around a blocked artery. Learn more about heart bypass surgery.

    Cardiac resynchronization therapy . When your heartbeat is off-kilter, it can make heart failure worse. This treatment uses a pacemaker that sends timed electrical impulses to both of your heart’s lower chambers so they pump better and more in sync. Your doctor may call it a biventricular pacemaker. They could also pair it with an ICD . Read more on CRT, also called biventricular pacing, for heart failure.

    Heart transplant. This is done when heart failure is so severe that it doesn’t respond to any other treatments. Get more information on heart transplant for heart failure.

    Heart valve surgery. If a faulty heart valve causes your heart failure, your doctor may recommend repairing or replacing it. A surgeon can repair or replace the valves. Find out more on heart valve disease.

    Implantable cardioverter-defibrillator . This device is similar to a pacemaker. It’s put under your skin in your chest. Wires lead through your veins and into your heart to keep track of your heart rhythm. If your heart starts to beat at a dangerous rhythm, or if it stops, the ICD tries to pace your heart or shock it back into normal rhythm. An ICD can also act as a pacemaker and speed your heart up if it’s going too slow. Learn more about ICDs for heart failure.

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    How Common Are These Procedures How Often Are These Procedures Performed

    Heart transplants overall are uncommon. In 2020, there were just under 8,200 transplants worldwide. The overwhelming majority of those were in the United States. Other countries with the highest numbers of transplants were Germany, France and Spain.

    Heart transplants are uncommon for two reasons:

    • Donor heart shortage. Transplanting a heart requires a donor, and donors are in short supply. Part of the reason it’s hard to find a donor is because the donor and recipient must be a “match.” Without this matching, the recipient’s immune system is more likely to reject the donor’s heart.
    • Transplant complexity. Heart transplants are very complicated surgeries, and there are fewer than 150 hospitals in the U.S. that perform them.

    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.

  • Angiotensin II receptor blockers work by preventing the effect of angiotensin II at the tissue level. Examples of ARB medications include candesartan , irbesartan , olmesartan , losartan , valsartan , telmisartan , and eprosartan . These medications are usually prescribed for people who cannot take ACE inhibitors because of side effects. Both are effective, but ACE inhibitors have been used longer with a greater number of clinical trial data and patient information.
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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.

    What Is The Prognosis And Life Expectancy For Congestive Heart Failure

    Congestive Heart Failure: Treatments
    • 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.

  • Class I includes patients with a weakened heart but without limitation or symptoms.
  • Class II describes patients whose only limitation is heavier workloads.
  • Class III includes patients who experience limitations with everyday activity.
  • Class IV describes patients with severe symptoms at rest or with any degree of effort.
  • 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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    What Happens In Congestive Heart Failure

    The heart has two upper chambers and two lower chambers . Normally, blood:

  • comes from the body into the right atrium
  • flows to the right ventricle, which pumps it out to the lungs to pick up oxygen
  • comes from the lungs into the left atrium
  • flows into the left ventricle which pumps it out to the body to deliver oxygen
  • But in heart failure, the heart cant work as it should and not enough blood and oxygen get to the organs. And blood backs up in the heart and then into the lungs.

    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.
    • Your symptoms.
    • 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.

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    What Is The Importance Of Ejection Fraction

    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.

    How Is Congestive Heart Failure Treated

    Congestive Heart Failure (CHF): Symptoms, Stages, Life Expectancy

    Doctors will assess the current health status of the patient to establish a baseline, and develop a long-term health plan with the goal of improving the patients health. This may involve the optimization of medicines and therapies, adding new medication, or possibly enrollment in a clinical trial.

    Stabilizing and/or reversing a patients condition often involves long-term, collaborative follow-up with a referring cardiologist or physician.

    In serious situations, advanced therapies, which include mechanical solutions, a heart transplant, or hospice, may be offered.

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