Stages Of Heart Failure
In 2001, the American Heart Association and American College of Cardiology described the âStages of Heart Failure.â These stages, which were updated in 2005, will help you understand that heart failure is often a progressive condition and can worsen over time. They will also help you understand why a new medication was added to your treatment plan and may help you understand why lifestyle changes and other treatments are needed.
The stages classified by the AHA and ACC are different than the New York Heart Association clinical classifications of heart failure that rank patients as class I-II-III-IV, according to the degree of symptoms or functional limits. Ask your doctor what stage of heart failure you are in.
Check the table below to see if your therapy matches what the AHA and ACC recommend. Note that you cannot go backward in stage, only forward.
The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.
The New York Heart Association clinical classifications of heart failure rank people as class I-II-III-IV, according to the degree of symptoms or functional limits. You can ask your doctor if you want to know what stage of heart failure youÃ¢re in.
Faces Of Heart Failure
Heart failure occurs when something damages the heart muscle or reduces the heart’s ability to pump effectively. Most often, the damage stems from coronary artery disease or heart attack. But faulty heart valves, longstanding high blood pressure, or genetic disease may also be to blame. No matter what the cause, the failing heart can no longer pump well enough to keep up with the body’s demand for oxygen-rich blood.
To help both doctors and patients quickly spot a possible combination of heart failure symptoms, the Heart Failure Society of America developed a handy tool that goes by the acronym FACES.
F = Fatigue. When the heart can’t pump enough oxygen-rich blood to meet the body’s energy needs, a general feeling of tiredness or fatigue sets in.
A = Activity limitation. People with heart failure are often unable to do their normal activities because they become easily tired and short of breath.
C = Congestion. Fluid buildup in the lungs can result in coughing, wheezing, and breathing difficulty.
E = Edema or ankle swelling. When the heart doesn’t have enough pumping power to force used blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs, and abdomen. Excess fluid can also cause rapid weight gain.
What Are The Symptoms Of A Cardiac Cough
The symptoms of a cardiac cough vary depending on the specific cause. Possible symptoms include:
- A wet cough that produces sputum that may be slightly pink due to blood
- Heavy wheezing, or a whistling sound that happens while breathing, accompanied by coughing
- Shortness of breath while engaging in activities or lying down
- Paroxysmal nocturnal dyspnea
- A bubbling feeling in the chest due to fluid buildup in the lungs
- A long-term dry cough that doesn’t get better when treated
If you’re showing signs of a cardiac cough, you may also have other symptoms of heart failure such as fatigue and swelling.
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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.
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Diagnosis Of Heart Failure In Children
Your child’s healthcare provider will obtain a complete medical history and physical examination, asking questions about your child’s appetite, breathing patterns, and energy level. Other diagnostic procedures for heart failure may include:
Blood and urine tests
Chest X-ray. A diagnostic test which uses invisible X-ray beams to produce images of internal tissues, bones, and organs onto film.
Electrocardiogram . A test that records the electrical activity of the heart, shows abnormal rhythms , and may detect problems with the heart muscle.
Echocardiogram . A noninvasive test that uses sound waves to evaluate a study of the motion of the heart’s chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
Cardiac catheterization . An invasive test that introduces a small catheter into the heart from the groin or arm. This allows the measurement of various pressures inside the heart to aid in the diagnosis of heart failure. In addition, biopsies of the heart tissue may be obtained in order to determine the underlying cause of heart failure.
Nausea Or Lack Of Appetite Have Come Out Of Nowhere
Another area of the body the heart considers non-vital when theres trouble? Your digestive system. With blood being diverted, your stomach and gastrointestinal tract are getting less blood, and that can slow their functions way down, Dr. Greenfield says. You might have a range of effects, including indigestion, lack of appetite, nausea, and constipation.
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Medications For Heart Failure
Certain medications can help treat heart failure and its underlying cause:
- Aldosterone blockers block the effects of the hormone aldosterone, encouraging the body to release sodium and water. They also help prevent scarring in the heart.
- Angiotensin receptor-neprilysin inhibitor : Treatment with sacubitril-valsartan reduces excess fluid in the body and relaxes blood vessels. This makes it easier for your heart to pump blood. Alternatives to ARNIs include angiotensin-converting enzyme inhibitors andangiotensin receptor blockers .
- Beta blockers make the heart beat more slowly and with less force. They also help keep heart rhythm regular.
- Sodium-glucose transport protein 2 inhibitors are diabetes drugs that have recently been found to be very beneficial in heart failure. They help remove glucose via the kidneys into the urine.
Other medications can relieve the heart failure symptoms:
- Diuretics reduce the amount of fluid in the body.
- Vasodilators dilate the blood vessels and reduce the hearts workload.
- Digoxin helps the heart beat stronger with a more regular rhythm.
- Anti-arrhythmics control arrhythmia and maintain normal heart rhythm.
What To Do If You Notice Worsening Heart Failure Symptoms
Heart failure can lead to serious complications, such as kidney or liver damage, other heart conditions, pulmonary hypertension and stroke. If youre experiencing worsening symptoms of heart failure, keep track of them and talk to your doctor.
Seek immediate medical attention or call 911 if you experience:
- Cough that brings up a white or pink foamy substance
- Fainting, dizziness or confusion
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Congestive Heart Failure Symptoms: A Closer Look At The Warning Signs
Congestive heart failure happens when the cardiac muscle lacks the strength and elasticity to pump oxygenated blood to all body parts. Unfortunately, more than six million American adults have a potentially deadly and progressive condition called congestive heart failure.
Lets talk about the symptoms you should watch forboth in yourself and your loved ones for congestive heart failure and where you can go in Boca Raton, FL, for comprehensive heart care.
What Are Heart Failure Symptoms
If you have heart failure, you may not have any symptoms, or the symptoms may range from mild to severe. Symptoms can be constant or can come and go. Heart failure symptoms are related to the changes that occur to your heart and body, and the severity depends on how weak your heart is. The symptoms can include:
- Congested lungs. A weak heart causes fluid to back up in the lungs. This can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
- Fluid and water retention. A weak heart pumps less blood to your kidneys and causes fluid and water retention, resulting in swollen ankles, legs, and abdomen and weight gain. This can also cause an increased need to urinate during the night as your body attempts to get rid of this excess fluid. Bloating in your stomach may cause a loss of appetite or nausea.
- Dizziness, fatigue, andweakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
- Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a fast or irregular heartbeat. Irregular heartbeats also can become more common as the heart weakens.
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Or Having To Pee Much More Often
All that fluid youre retaining has to go somewhere eventually. Thats when you may find yourself always having to pee, especially multiple times in the middle of the night. Sometimes, people brush this off as a sign of aging, says Dr. Quinones-Camacho, or drinking too much water close to bedtime. Unfortunately, some people try to correct the issue by cutting down on water intake during the day, but this can make fluid retention worse, since the body starts holding on to water in order to prevent dehydration. That cycle gets even uglier with heart failure because dehydration causes strain and increases your heart rate.
Youre Lightheaded Or Feel Confused Often
Even though the heart prioritizes brain function when theres an issue, heart failure might be caused by a circulation issue, according to Dr. Greenfield. When that happens, not enough blood may be reaching your brain, and that can lead to symptoms like dizziness, mild disorientation, confusion, or even challenges with memory and concentration. In extreme cases, you may experience fainting.
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Imaging And Other Tests
Other tests provide pictures of the heart and surrounding structures or show how well the heart is working:
- Electrocardiogram : An electrocardiogram test uses small sensors to measure heart rate , rhythm and electrical impulses.
- Chest X-ray: A chest X-ray is a picture of your lungs, heart and surrounding structures. It can show whether there is fluid in your lungs from heart failure, or if your heart muscle is enlarged.
- Echocardiogram : Echocardiography uses sound waves to create images of your heart. It can show how thick the heart muscle has become, as well as measure ejection fraction.
- MRI: MRI is an advanced imaging test that takes pictures of the heart and surrounding structures. It helps determine your heart function and size and whether there are any changes in the heart muscle. A cardiac MRI may help your doctors identify causes of heart failure.
How Does Heart Failure Affect The Body
Heart failure can affect the right side of the heart, the left side of the heart, or both sides.
When the right side of the heart begins to function less efficiently, it is unable to pump much blood forward into the vessels of the lungs. Because of the congestion in the right side of the heart, blood flow begins to back up into the veins. Eventually, swelling is noticed in the feet, ankles, lower legs, eyelids, and abdomen due to fluid retention.
When the left side of the heart fails, it is unable to pump blood forward out to the body efficiently. Blood begins to back up into the vessels in the lungs, and the lungs become stressed. Breathing becomes faster and more difficult. Also, the body does not receive enough blood to meet its needs, resulting in fatigue and poor growth in children.
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What Are The Symptoms Of Heart Attack
The major symptoms of a heart attack are
- Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
- Feeling weak, light-headed, or faint. You may also break out into a cold sweat.
- Pain or discomfort in the jaw, neck, or back.
- Pain or discomfort in one or both arms or shoulders.
- Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.
Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting. Women are more likely to have these other symptoms. Learn more about women and heart disease.
Every 40 seconds, someone in the United States has a heart attack.1Learn more facts about heart attack and heart disease.
Youre Suddenly Gaining Weight
The fluid buildup that may be in your legs can back up higher into the abdomen and arms. This rapid weight gain is often mistaken for fat accumulation, but its actually water weight from fluid retention, says Dr. Quinones-Camacho. This can happen suddenly, she adds, like seeing an additional five pounds over a few days, particularly in the belly.
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Early Symptoms Of Heart Failure
A person with early heart failure might not have any noticeable signs. When early symptoms occur, they can be subtle and easy to miss or ignore. Early signs of heart failure include:
- Shortness of breath, at first when youre active and later even when youre sitting or lying down
- Lowered ability to exercise or be active
- Confusion or forgetfulness
- Frequent fatigue, sleepiness or weakness
- Palpitations, or a fluttering feeling in your chest, as the heart pumps harder and faster
Without treatment, heart failure can worsen over time. Symptoms that were once mild can become increasingly more severe, and may prevent you from doing everyday tasks.
Symptoms Of Heart Failure
The main symptoms of heart failure are:
- breathlessness after activity or at rest
- feeling tired most of the time and finding exercise exhausting
- feeling lightheaded or fainting
- swollen ankles and legs
Some people also experience other symptoms, such as a persistent cough, a fast heart rate and dizziness.
Symptoms can develop quickly or gradually over weeks or months .
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Types Of Heart Failure
The main types of heart failure are named for where they occur in the heart:
- Left-sided heart failure
- Biventricular heart failure
Clinicians also may classify heart failure as:
- Acute: You have active symptoms of heart failure, with either a new diagnosis or with long-term heart failure.
- Chronic: You have a history of heart failure, but your condition is relatively stable with no symptoms or with manageable symptoms.
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.
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Exercise Seems Much Harder Than It Should Be
The feeling of air hunger can happen at rest but its especially acute with exertioneven walking across a room can feel like too much effort. If youre trying to get in an actual workout, increased activity raises your heart rate, which means its trying to pump faster and you could find yourself really gasping for air then. People often think theyre just out of shape when they cant catch their breath, Dr. Greenfield says. They think they need to get to the gym. But what they need is to get to the doctor.
Limited Ability To Exercise Or Be Active
Are you unable to complete physical tasks that used to be a breeze or not go as hard at the gym as you used to, but donât know why? If so, itâs probably best to consult your doctor because this could be the sign of a serious health problem.
âPeople with heart failure are often unable to do their normal activities because they become easily tired and short of breath,â the experts at Harvard Health say.
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