Tuesday, November 29, 2022

How To Treat Congestive Heart Failure

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Congestive Heart Failure Procedures And Interventions

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

Other treatment or procedures may be offered, depending on the underlying cause of the heart failure.

Angioplasty: This is an alternative to coronary bypass surgery for some people whose heart failure is caused by coronary artery disease and may be compounded by heart damage or a previous heart attack. Angioplasty is performed to treat narrowing or blockage of a coronary artery that supplies the left ventricle with blood. The narrowing or blockage is caused by cholesterol deposits.

  • Angioplasty begins with the cardiac catheterization procedure during which a long, thin tube called a catheter is inserted through the skin, into a blood vessel, and threaded into the affected artery. This procedure is performed while the person is under local anesthesia.
  • At the point of the atherosclerotic narrowing or blockage, a tiny balloon and/or an expandable metal stent, attached to the end of the catheter, is inflated and/or deployed.
  • The expanded stent pushes aside the cholesterol deposits that are blocking the artery so that blood can flow through in a more normal manner.

Pacemaker: This device controls the rate of the heartbeat. A pacemaker may keep the heart from going too slow, increasing heart rate when the heart is not increasing enough with activity. It also helps sustain regular rates when the heart is not beating in a coordinated way. Or, the pacemaker performs some combination of these.

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Monitoring Congestive Heart Failure

If you are living with congestive heart failure, your doctor will help you determine the best way to monitor your condition and reduce your chance of future hospitalizations.

Self-Management SkillsDoctors recommend that people with congestive heart failure develop good self-management skills to help manage their conditions. These self-management skills include:

  • Weighing yourself and recording your weight daily, reporting any gains of more than 2-3 pounds over two days or 4-5 pounds over one week to your doctor
  • Following a low-sodium diet
  • Taking all the medications your doctor prescribes

Your doctor can also provide recommendations for limiting your fluid intake, getting regular exercise, and quitting smoking, all of which can help manage your heart failure.

CardioMEMS HF SystemSelect patients may be eligible for the CardioMEMS HF System. Approved by the U.S. Food and Drug Administration in 2014, the system uses a small sensor implanted in your pulmonary artery and an external electronic system to transmit information directly to your doctor’s office.

With the CardioMEMS HF System, you take daily readings of our pulmonary artery pressure from home. The readings are delivered securely to your doctor’s office through an external electronic system, and can help your doctor determine if your condition is getting worse before you have symptoms. Your doctor can then adjust your medication or treatment plan and help you avoid hospitalization.

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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Can A Dog Recover From Fluid In The Lungs

If you take your dog to the vet as soon as you notice his breathing difficulties, he will be injected with a diuretic and a cardiac stimulant.Under the effect of the diuretic, your dog will evacuate the fluids lodged in his lungs and will regain his normal breathing capacity.He will survive this episode but you will have to increase your monitoring to avoid a recurrence.

Left Ventricular Assist Devices

Treatment for Congestive Heart Failure

Left ventricular assist devices are mechanical pumps that can help if your left ventricle isn’t working properly and medication alone isn’t helping.

They may be used as a permanent treatment if you can’t have a heart transplant, or as a temporary measure while you wait for a transplant.

In addition to the pump, LVADs also include an external battery. A wire connecting this to the pump will need to be placed under your skin during the operation.

Read more about LVADs on the British Heart Foundation website.

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Stay On Top Of Medications

One of the most important things for managing congestive heart failure is to take medications consistently and according to instructions. Know which drugs the person youre caring for needs to take and how often they should take them. Also find out what to do if they miss a dose.

If they live alone, you can fill a pillbox with the medications they should take each day of the week. You can also post a simple daily medication schedule on their refrigerator or in their bathroom so they can check off each dose as they take it.

If your loved one has difficulty following the schedule, you might want to call them at regular intervals to make sure they have taken their medications.

Pharmacological Management Of Heart Failure

Drugs used in heart failure include those used to initially manage mild to moderate failure and those used more commonly in severe to very severe conditions.

First Agents Used:

  • ACE Inhibitors: work by increasing vasodilation and decreasing workload of the heart in patients with CHF.
  • Diuretics: promote the removal from the body of excess water, salts, poisons, and accumulated metabolic products, such as urea. See also Aldosterone Receptor Antagonists
  • Glycosides and Congestive Heart Failure: a class of drugs that includes digoxin, digitoxin and ouabain. Such agents increase the force of contraction of the heart which underlies their use in some cases of heart failure.
  • Beta-Blockers : decrease the excessive activity of the sympathetic nervous system which is characteristic of CHF.
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy

    Additional Agents:

  • More aggressive diuretic therapy eg Loop diuretics such as Furosemide , one of the most commonly used drugs in the treatment edema caused by congestive heart failure .
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy.

    An implantable cardioverter-defibrillator is indicated for primary prevention of sudden cardiac death in patients with HF who have an LVEF of less than or equal to 35%.

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    From Our Health Library At Upmccom

    • Destination therapy

    Bridge to transplantation

    Each year, more people with end-stage heart failure are evaluated and listed for transplantation. Unfortunately, there are not enough suitable donor organs for all of the patients waiting for a heart transplant.

    People who are listed for heart transplantation and are too ill to wait any longer, or are expected to have prolonged wait times, are referred for a VAD as a bridge to transplantation. The VAD allows them to recover and wait at home for an organ to become available.

    Bridge to recovery

    In some cases of heart failure particularly newly diagnosed CHF or heart failure after other cardiac surgery the heart may recover after a period of support on a VAD. These patients are supported temporarily as a bridge to recovery.

    After implantation, the VAD is turned down and the heart is reassessed to see if its function has improved enough to allow the VAD to be removed.

    Typically, people recommended for VAD as a bridge to recovery have CHF as a result of:

    • Viral infection

    What Are The Types Of Heart Failure

    Congestive Heart Failure: Symptoms, Causes, and Treatment Options – St. Mark’s Hospital

    Systolic dysfunction happens when the heart muscle doesn’t contract with enough force, so there is less oxygen-rich blood pumped throughout the body.

    Diastolic dysfunction happens when the heart contracts normally, but the ventricles donât relax properly or are stiff, and less blood enters the heart during normal filling.

    A calculation done during an echocardiogram, called the ejection fraction , is used to measure how well your heart pumps with each beat to help determine if systolic or diastolic dysfunction is present. Your doctor can discuss which condition you have.

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    How To Recognize The Symptoms Of Pulmonary Edema In Dogs

    Your dog appears weak, coughs frequently, and his breathing is accelerated.You hear crackling sounds with each breath and he seems to be gasping for air with his mouth open.He also presents an intolerance of any effort.

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    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.

  • While lying flat
  • While awakening the person from sleep or
  • Due to fluid accumulation in the lungs or the inability of the heart to be efficient enough to pump blood to the organs of the body when called upon in times of exertion or stress.
  • Chest Pain

  • Chest pain or angina may be associated, especially if the underlying cause of the failure is coronary heart disease.
  • Right heart failure, left heart failure, or both

  • People with right heart failure leak fluid into the tissue and organs that deliver blood to the right heart through the vena cava.
  • Backpressure in capillary blood vessels causes them to leak water into space between cells and commonly the fluid can be found in the lowest parts of the body.
  • Gravity causes fluid to accumulate in the feet and ankles but as more fluid accumulates, it may creep up to involve all of the lower legs.
  • Fluid can also accumulate within the liver causing it to swell and within the abdominal cavity .
  • Ascites and hepatomegaly may make the patient feel bloated, nauseated, and have abdominal pain with the feeling of distension.
  • Depending upon their underlying illness and the clinical situation, patients may have symptoms of right heart failure, left heart failure, or both.
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    Diagnosis Of Congestive Heart Failure In Dogs

    Diagnosing CHF in dogs involves closely examining the heart and overall health and, if possible, identifying the underlying heart disease. During the physical exam, your veterinarian will listen to your dog’s heart rhythm and lungs. With left-sided CHF, the lungs sound congested because of fluid buildup.

    Chest X-rays are performed to look for pulmonary edema and heart enlargement. Basic laboratory testing, including blood work, will provide information about your dog’s overall health and organ function.

    Heart tests include the electrocardiogram and echocardiogram. An ECG measures heart rate and rhythm. An echocardiogram is an ultrasound of the heart it measures heart chamber size and thickness and evaluates the heart’s pumping ability.

    Using diagnostic test results, your veterinarian will classify the stage of your dog’s heart disease, described below, to determine a treatment plan.

    • Stage A: Risk of heart disease but no symptoms
    • Stage B: Presence of a murmur, ± structural changes to the heart, but no symptoms
    • Stage C: CHF is present and responding well to treatment
    • Stage D: CHF is present and not responding to treatment

    Types Of Congestive Heart Failure In Dogs

    Heart Failure
    • Left-sided congestive heart failure: This causes pressure to back up in the vessels that pump blood into the left ventricle of the heart. Blood leaks through the mitral valve, which causes excess fluid to become congested in the lungs. Fluid accumulates in the lungs and leads to coughing, exercise intolerance, difficulty breathing, and a high respiratory rate.
    • Right-sided congestive heart failure: This causes pressure to build up in the vessels where blood flows into the right atrium from the veins in the body. Rather than leaking through the mitral valve, blood leaks where it is pumped into the heart and becomes congested within the body. This pressure can lead to fluid buildup in the chest cavity, the abdomen , the liver, and even the limbs . These dogs can also experience difficulty breathing due to pressure around the lungs.

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    What Is Heart Failure

    Heart failure doesnât mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart canât pump enough oxygen and nutrients to meet the body’s needs.

    The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. The kidneys may respond by causing the body to retain fluid and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested. Congestive heart failure is the term used to describe the condition.

    How To Keep Heart Failure From Worsening

    To keep heart failure from worsening, a patient must make major changes in their life: Theyll need to eat differently, remember to take their medications, keep as active as possible, and reduce stress. Some of these changes might require breaking habits acquired over many years. As a caregiver, you can help your loved one maximize their quality and length of life. Below are some ways to help.

    Keep alert for worsening symptoms. Call the doctor immediately if you observe any of the following:

    • Sudden weight gain
    • Increased swelling in the legs or ankles
    • Shortness of breath while at rest
    • A dry, hacking cough or wheezing
    • Dizzy or fainting spells
    • Increased fatigue or feeling unwell all the time
    • Abdominal pain or swelling

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    Dog Heart Disease Treatment

    Treating heart failure is essential to improve muscle strength, control possible arrhythmia, and maintain normal blood pressure and adequate blood circulation.

    It is also imperative to manage to heal excess fluids from the lungs, chest, and abdomen.

    Again, treatment depends on your dogs specific condition.

    If he is in respiratory distress, your dog must be hospitalized urgently.

    He will then be placed under oxygen to be stabilized.

    If the heart failure is due to mitral damage, your dog may be treated with Pimobendane , a positive inotrope that strengthens the contraction of the heart and improves blood circulation.

    Prescribing a diuretic like furosemide significantly reduces fluid buildup in the lungs.

    Finally, an ACE, an angiotensin-converting enzyme, like Enalapril is added to relax blood vessels and reduce hypertension while helping the heart to pump more efficiently.

    Anticoagulant Medications Can Reduce The Risk Of Blood Clots And Heart Attacks

    Congestive Heart Failure: Treatments

    A heart attack occurs when blood flow in the blood vessels of the heart is blocked. People with congestive heart failure may benefit from taking an anticoagulant medication to lower the risk of developing blood clots.

    According to an article by Dr. Allison Tsao published for The American College of Cardiology, aspirin and warfarin have been proven to lower the risk of stroke and cardiac ischemia in patients with heart failure and risk factors such as diabetes, obesity, and atrial fibrillation.

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    How Does Congestive Heart Failure Affect Your Sex Life And What Changes Do You Need To Make

    When you are first diagnosed with heart disease, it is important to discuss with your doctor what types of physical activity are safe for you to engage in, including sexual intercourse.

    The American Heart Association states that it is safe to have sex once your heart condition is stabilized. It is important to take your prescribed medications even if side effects have a negative impact on your sexual function because the health of your heart should be a priority.

    Factors That Can Worsen Symptoms Of Heart Failure

    The symptoms of heart failure can be worsened by a number of factors, including:

    • too much salt, fluid, or alcohol in the diet
    • some viral and bacterial infections
    • kidney diseases

    Treatment for heart failure may include:

    • medicines, such as
    • diuretics to remove excess fluid and improve symptoms of heart failure
    • mineralcortiocoid receptor antagonists are also recommended and used in most patients with heart failure to reduce mortality and hospitalisation
    • ACE inhibitors to open up blood vessels, reduce blood pressure and reduce sodium retention and water retention
    • certain beta-blockers to slow the heart rate and reduce its work
    • aldosterone blockers to reduce blood pressure and reduce the effects of damage to the heart muscle
    • ACE inhibitors, beta blockers and aldosterone blockers can increase survival and reduce the likelihood of hospitalisation.
  • addressing the underlying disorder for example, treatment of high blood pressure
  • lifestyle changes such as regular gentle physical activity, losing excess body fat, stopping smoking, adhering to healthy eating patterns with low salt, restricting alcohol and having adequate rest
  • surgery to replace narrowed or leaking heart valves
  • coronary bypass surgery in some cases
  • heart transplant in extreme cases.
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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.

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