Congestive Heart Failure Drugs
There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.
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.
This may be achieved with:
Your doctor may recommend:
Classification Based On Course Of The Disease
Heart failure can develop suddenly, for instance after a heart attack or due to certain heart rhythm problems. This is known as acute heart failure.
But it usually develops gradually over time as a result of a different medical problem, such as permanently high blood pressure. This is known as chronic heart failure.
What Do The Left And Right Sides Of The Heart Do
The two sides of your heart work in different ways to pump blood.
- Left side: Receives oxygen-rich blood from your lungs and delivers it to the rest of your body. The oxygen helps organs, muscles and other tissue do their job.
- Right side: Receives oxygen-poor blood from your body and delivers it to your lungs. From there, you release carbon dioxide and take in more oxygen.
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How Do I Take Care Of Myself If I Have Right
The most important thing is to make healthy lifestyle habits part of your daily routine. The more you make healthy living part of your new lifestyle, the better youll feel. Try to:
- Work with a nutritionist or dietitian to create a nutritious, filling meal plan you can stick with long-term.
- Find an exercise routine you enjoy so youll be motivated to get moving every day.
- Track and manage your symptoms. Report any changes to your healthcare provider.
- Take medications as instructed.
How Is Chf Diagnosed
After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist.
The cardiologist will perform a physical exam, which will involve listening to your heart with a stethoscope to detect abnormal heart rhythms.
To confirm an initial diagnosis, a cardiologist might order certain diagnostic tests to examine your hearts valves, blood vessels, and chambers.
There are a variety of tests used to diagnose heart conditions. Because these tests measure different things, your doctor may recommend a few to get a full picture of your current condition.
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Surgery And Other Procedures
If medications are not effective in managing left-sided heart failure, or if symptoms are severe, surgery may be necessary. Depending on the condition of the heart and underlying cause of left-sided heart failure, surgical options can include device implants, heart repair or heart transplant.
Device implant surgeries for left-sided heart failure:
Left ventricular assist device surgery: This device can be implanted to help a weak heart pump more efficiently, and can be a primary treatment or a temporary measure while awaiting a heart transplant.
Pacemaker: This device can be implanted during minor surgery to help the right and left ventricle contract normally.
Heart repair or transplant surgeries for left-sided heart failure:
Heart transplant surgery: This surgery is done when all other left-sided heart failure treatments have failed. The damaged heart is surgically removed and replaced with a healthy heart from a deceased donor.
What Is Congestive Heart Failure
Congestive heart failure is a term that refers to the heart’s inability to pump adequate blood to the body. There are many causes of CHF in dogs. The two most common causes are:
- mitral valve insufficiency . MVI is a leaky mitral valve, which is the valve between the left atrium and the left ventricle.
- dilated cardiomyopathy .
For further information on these specific causes, please see the handouts “Dilated Cardiomyopathy in Dogs” and “Mitral Valve Disease in Dogs”.
Clinical signs of CHF vary depending on whether the dog has left- or right-sided heart failure.
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How Common Is Right
More than 6 million Americans have heart failure. Each year, more than 900,000 people receive a heart failure diagnosis.
Heart failure is rare in people younger than 50. With age, it becomes increasingly common. Studies have shown that around 2% of the population younger than 54 years old have heart failure. The number increases to around 8% about 1 in 12 for people over 75.
Heart Failure With Reduced Ejection Fraction Treatment
Treatment for anyone with heart failure should start with lifestyle modification such as:
- Diet modification, including low sodium and fluid intake
- Quitting smoking
- Increasing exercise
- Maintaining a healthy weight
Pharmacotherapy is the cornerstone of the treatment of HFrEF. The main validated heart failure medications are:
Medications are usually added based on how effective they are at managing your symptoms. Your cardiologist will likely start with a combination of an ACE inhibitor, beta-blocker, or diuretics for symptom relief. If you are still symptomatic and your LVEF is equal to or less than 35%, an MRA might be added.
If you are still symptomatic and your LVEF is equal to or less than 35%, your doctor may suggest replacing your ACE inhibitor with an angiotensin receptor-neprilysin inhibitor. Corlanor or cardiac resynchronization therapy might also be considered.
Finally, if you are still asymptomatic, digoxin, an LV assist device, or heart transplantation should be considered.
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Whats The Outlook For People With Right
For many people, the right combination of therapies and lifestyle changes can slow or stop the disease and improve symptoms. They can lead full, active lives.
About 1 in 10 American adults who live with heart failure have advanced heart failure. That means treatments arent working, and symptoms are getting worse. You may feel symptoms, such as shortness of breath, even when youre sitting. If you have advanced heart failure, talk with your care team about important care decisions and next steps.
Heart Failure With Reduced Ejection Fraction
Symptoms of HFrEF include:
- Shortness of breath
Your healthcare provider will also look for evidence that your left ventricle has reduced pumping power and isn’t able to deliver as much blood as it should. This is usually seen on an echocardiogram.
With HFrEF, the left ventricular ejection fraction is equal to or less than 40%. This means your heart is only pumping 40% or less of the blood it contains out into the body with each beat. This is considered the diagnostic hallmark of HFrEF.
If your echocardiography is inconclusive, your healthcare provider might order more tests. These may include:
- Radionuclide scan
- Cardiopulmonary exercise testing
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Risk Factors Associated With Left
As you may have guessed, there are people who are more prone to left-sided heart failure than others. Some of the left-sided heart failure risk factors are out of our control, while others are an indication of how important it is to pay attention to our overall health since we can have influence over it.
Here are some of the common risk factors:
- Blood clots: Clots in the lungs are known to lead to left-sided heart failure
- Chronic diseases: HIV, hyperthyroidism, hypothyroidism, diabetes, or a build-up of protein or iron can lead to left-sided heart failure.
- Congenital heart defects: These can prevent proper blood flow from the heart.
- Aortic stenosis: Blood flow slows and then the heart weakens when the aortic valve opening narrows.
- Cardiomyopathy: This is a hereditary condition that can lead to heart damage.
- Irregular heartbeats: Abnormal heart rhythms can weaken the heart muscle.
- Myocarditis: This is a condition that is caused by inflammation of the heart
- Pericardial constriction: This is inflammation that creates a sac covering the heart, which can scar and tighten the heart muscle.
- Previous heart attack: In some cases, this can impact the pumping of blood
- Medications: Some chemotherapy and diabetes medications may increase risk.
- Valvular heart disease: Damage to one of the four heart valves can prevent the heart from pumping blood properly.
- Viral infection: Some viral infections have the potential to damage heart muscle.
What Is Heart Failure
Although the term heart failure suggests your heart isnt able to function at all, it actually means your heart muscles just arent functioning well enough to support your bodys needs. It develops when your heart muscles are either too weak or not elastic enough to pump blood properly. About 6.2 million people in the United States are living with heart failure.
Heart failure is usually a chronic and progressive condition, but it can develop quickly after a heart attack or other conditions that damage your heart. The most common cause of heart failure is coronary artery disease, which is a narrowing of the arteries that supply blood to your heart.
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What Is The Difference Between Right
Right-sided congestive heart failure causes poor venous blood return to the heart. In other words, when the heart contracts or pumps, instead of the right ventricle pushing the blood through the lungs for oxygenation, some blood leaks through the tricuspid valve back into the right atrium. This blood backs up into the systemic circulation and consequently becomes congested. Fluid accumulates in the abdomen, interfering with the function of the organs in these areas. The abdomen may fill with fluid, a condition called ascites. Fluid may also leak from veins in the limbs, causing swelling, known as peripheral edema.
In left-sided congestive heart failure , when the heart contracts or pumps, instead of the left ventricle pushing the blood into the systemic circulation, some blood leaks through the mitral valve back into the left atrium and then it backs up into the lungs. Fluid then seeps into the lung tissue resulting in pulmonary edema. This causes coughing and difficulty breathing. Left-sided congestive heart failure is the most common form of congestive heart failure. The classic signs of heart failure, coughing and fluid in the chest, are most commonly caused by LS-CHF.
Heart Failure With Preserved Ejection Fraction Treatment
Diuretics are a mainstay of HFpEF treatment. For these medications to be helpful, however, you need to also make changes to your diet and overall lifestyle.
If you have HFpEF, your doctor will likely suggest you follow a treatment regimen that includes a combination of:
- Diet and lifestyle changes
- For some patients, a device to protect the heart from abnormal rhythms
Diet and Lifestyle Changes
If you have heart failure, the following lifestyle changes may help you manage your symptoms:
- Regular low-intensity aerobic exercise to strengthen the heart
- Cutting back on salt
- Limiting your alcohol consumption
- Quitting smoking
Reducing your salt intake is especially important. Too much salt in your diet can cause fluid retention. This will counteract the drugs that help relieve fluid accumulation.
The effectiveness of medication in the treatment of diastolic heart failure is inconclusive. Therefore, the best way to manage HFpEF is to treat its underlying cause, such as hypertension, diabetes, or coronary artery disease.
SGLT2 inhibitor medications are antidiabetic drugs that may be used to treat HFpEF in people with or without diabetes. In people with heart failure, taking this medication can help prevent heart failure episodes. Your doctor can determine whether you are able to use an SGLT2 inhibitor.
Management by Stage
The American College of Cardiology and the American Heart Association recommend that cardiologists manage heart failure by stage.
What Are The Symptoms Of Left Ventricular Failure
There are a number of different left-sided heart failure symptoms. As we mentioned earlier, shortness of breath occurs because of fluid backing up into the lungs. This shortness of breath often gets worse at night, so some sufferers have to sleep upright. As time goes on, left-sided heart failure can cause shortness of breath at any time of day even when resting.
Here are the other common symptoms of left ventricular failure:
Some of the symptoms described here are due to forward failure, which means the heart isnt pumping enough of the blood out to other parts of the body. Fatigue, chest discomfort, and a decrease in urine are caused by forward failure.
Other symptoms, such as difficulty breathing, coughing with blood, and weight gain are a result of backward failure, which occurs when the heart isnt receiving enough blood.
Congestive Cardiomyopathy In Dogs
The heart has four chambers: two chambers at the top, the right and left atria and two chambers on the bottom, the right and left ventricles. The right side of the heart collects blood from the body and pumps it into the lungs, where the blood is oxygenated. The oxygen rich blood is then collected by the left side of the heart, and from there it is pumped out into the body’s various organs.
Congestive left-sided heart failure refers to a condition in which the left side of the heart is not able to push blood through the body efficiently enough to meet the metabolic needs of the body, and frequently results in blood pooling in the lungs. This is the most common type of congestive heart failure in dogs. Low blood output from the heart causes tiredness, exercise intolerance and fainting.
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Heart Failure With Preserved Ejection Fraction
To make a diagnosis of HFpEF, your healthcare provider looks for:
- The clinical signs and symptoms of heart failure, and
- Evidence that the left ventricle contracts normally, or near normally, and that it pumps out greater than 50% of the blood it contains with each beat, and
- Evidence of reduced diastolic function seen on an echocardiogram
A diagnosis of diastolic heart dysfunction can also be measured invasively, using a catheter, or non-invasively, using doppler imaging techniques. Exercise tests can also help your healthcare provider diagnose your condition.
There are multiple conditions that can contribute to HFpEF, but the most common are:
- High blood pressure
What Are The Symptoms Of Left
Symptoms may be mild at first or you may think it’s a cold or allergy. You might not even notice them. But as heart functioning worsens, you may experience:
- Constant coughing.
- Shortness of breath with walking or bending over.
- Waking up short of breath or unable to lie flat at night.
- Swelling in your ankles, legs or abdomen.
Over time, the heart works harder to do its job. This causes complications that may include:
- Abnormal heart rates and rhythms .
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Do Dogs Have Heart Attacks
In humans a heart attack usually refers to myocardial infarction . Myocardial infarction refers to death of the cells in an area of the heart muscle or myocardium. Cell death is usually due to oxygen deprivation caused by obstruction of the coronary blood vessels that supply blood to the heart muscles. Heart attacks are rare in dogs but unexpected and sudden death in dogs diagnosed with any form of heart disease is possible.
Prevention And Prognosis Of Left
There are some left-sided heart failure prevention steps you can take. It is important to remember that not all risk factors can be controlled, but the following can certainly help a lot of people maintain good heart health.
- Balance sugar: Those who have diabetes need to watch what they eat and check their blood glucose level regularly.
- Eat healthily: Limiting salt, sugar, saturated fat, and cholesterol and opting to consume lots of fruit, vegetables and whole grains along with low-fat dairy is very important.
- Exercise: Moderate exercise can help circulation and decrease the level of stress on your heart.
- Maintain a healthy weight: Having a healthy weight means the heart will be less stressed.
- Regular check-ups: Getting regular check-ups so that your doctor has the ability to catch any signs or symptoms simply makes sense.
- Reduce stress: Since stress can contribute to irregular heartbeat, find ways to lower stress and anxiety.
- Substances: Reduce alcohol intake and stop smoking, as both can have a negative impact on heart health.
In addition to the above, its important to take any prescribed medications. If any new symptoms arise, let the doctor know as soon as possible. Left-sided heart failure prognosis can depend not only on the cause and severity of the symptoms but also on your attitude towards your health.
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How Can I Prevent Left
Living a heart-healthy lifestyle can lower your risk of left-sided heart failure. If youve already experienced this condition, healthy habits can help you avoid future issues.
Steps you can take to prevent left-sided heart failure include:
- Get high blood pressure or coronary artery disease under control.
- Make time for regular physical activity and a good nights sleep.
- Maintain a healthy weight and eat fruits and vegetables.
- Manage stress with deep breathing or relaxation techniques.
- Quitting tobacco if you use it and avoiding secondhand smoke.
What Clinical Signs Should I Expect
The most common clinical sign of congestive heart failure is persistent coughing accompanied by difficulty breathing. This is due mainly to pulmonary edema or the accumulation of fluid in the lungs. The enlarged heart will also push against the trachea, causing irritation that can induce a cough.
“The most common clinical sign of congestive heart failure is persistent coughing accompanied by difficulty breathing.”
Many dogs with CHF will tire out more easily, have reduced stamina, and do not engage in playing or walking as they once did. Coughing when at rest or sleeping, excessive panting, persistent loss of appetite, a swollen belly, and pale or bluish gums are also signs associated with heart failure. The dog will develop generalized weight loss and muscle wasting due to the effects of CHF on other body systems. If any of these signs develop in a pet with a heart murmur, notify your veterinarian immediately.
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