How Is Heart Failure Treated
Your healthcare providers will help you manage any other health conditions that may be causing your heart failure. The goals of treatment are to manage, slow, or reverse heart damage. Treatment may include the following:
- Medicines may be given to help regulate your heart rhythm and lower your blood pressure. You may also need medicines to help decrease extra fluid. Medicines, such as NSAIDs, may be stopped if they are making your heart failure worse. Do not stop any of your medicines on your own.
- Cardiac rehab is a program run by specialists who will help you safely strengthen your heart. In the program you will learn about exercise, relaxation, stress management, and heart-healthy nutrition. Cardiac rehab may be recommended if your heart failure is not severe.
- Oxygen may help you breathe easier if your oxygen level is lower than normal. A CPAP machine may be used to keep your airway open while you sleep.
- Surgery can be done to implant a pacemaker or another device in your chest to regulate your heart rhythm. Other types of surgery can open blocked heart vessels, replace a damaged heart valve, or remove scar tissue.
Outlook For Heart Failure
Heart failure is a serious long-term condition that will usually continue to get slowly worse over time.
It can severely limit the activities youre able to do and is often eventually fatal.
But its very difficult to tell how the condition will progress on an individual basis.
Its very unpredictable. Lots of people remain stable for many years, while in some cases it may get worse quickly.
What Are The Signs And Symptoms Of Heart Failure
The signs and symptoms depend on how severe your heart failure is. The signs and symptoms you have may be due to the backup of fluid and blood in your tissues. It may also be due to decreased oxygen in your blood. You may have any of the following:
- Trouble breathing with activity that worsens to trouble breathing at rest
- Shortness of breath while lying flat
- Severe shortness of breath and coughing at night that usually wakes you
- Feeling lightheaded when you stand up
- Purple color around your mouth and nails
- Confusion or anxiety
- Periods of no breathing, then breathing fast
- Lack of energy , or trouble sleeping
- Swelling in your ankles, legs, or abdomen
- Heartbeat that is fast or not regular
- Fingers and toes feel cool to the touch
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Surgery For Heart Failure
Your doctor may recommend surgery to implant a medical device that helps the heart function more effectively:
- Pacemaker, which maintains a steady heart beat in people with a slow or irregular heartbeat
- Implantable cardioverter defibrillator , which monitors the heart for fast rhythm and delivers an electrical shock to reset normal rhythm
- Left ventricular assist device , which takes over the pumping action of the heart
People with advanced heart failure may be candidates for heart transplantation. A heart transplant replaces the diseased heart with a donated heart from a person who has died.
What Are The Current Treatment Options
The proper treatment for right-sided heart failure depends on the underlying condition causing it. Treating right-sided heart failure usually involves using one or more medications, lifestyle measures, and possibly implanted devices that support the hearts ability to pump. Treating left-sided heart failure is also important.
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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 Are The Symptoms Of Heart Failure
The main symptoms of heart failure are:
- Shortness of breath when youre active or resting, because youre not getting enough oxygen.
- Swollen feet, ankles, stomach and around the lower back area, caused by fluid build up.
- Feeling unusually tired or weak because theres not enough blood and oxygen getting to your muscles.
You should see your GP immediately if you begin to experience any of these symptoms.
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Atrial Natriuretic Peptide And B
ANP and BNP are endogenously generated peptides activated in response to atrial and ventricular volume/pressure expansion. ANP and BNP are released from the atria and ventricles, respectively, and both promote vasodilation and natriuresis. Their hemodynamic effects are mediated by decreases in ventricular filling pressures, owing to reductions in cardiac preload and afterload. BNP, in particular, produces selective afferent arteriolar vasodilation and inhibits sodium reabsorption in the proximal convoluted tubule. It also inhibits renin and aldosterone release and, therefore, adrenergic activation. ANP and BNP are elevated in chronic heart failure. BNP especially has potentially important diagnostic, therapeutic, and prognostic implications.
For more information, see the Medscape Drugs & Diseases article Natriuretic Peptides in Congestive 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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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.
Systolic And Diastolic Failure
Systolic and diastolic heart failure each result in a decrease in stroke volume. This leads to activation of peripheral and central baroreflexes and chemoreflexes that are capable of eliciting marked increases in sympathetic nerve traffic.
Although there are commonalities in the neurohormonal responses to decreased stroke volume, the neurohormone-mediated events that follow have been most clearly elucidated for individuals with systolic heart failure. The ensuing elevation in plasma norepinephrine directly correlates with the degree of cardiac dysfunction and has significant prognostic implications. Norepinephrine, while directly toxic to cardiac myocytes, is also responsible for a variety of signal-transduction abnormalities, such as downregulation of beta1-adrenergic receptors, uncoupling of beta2-adrenergic receptors, and increased activity of inhibitory G-protein. Changes in beta1-adrenergic receptors result in overexpression and promote myocardial hypertrophy.
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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.
Myocytes And Myocardial Remodeling
In the failing heart, increased myocardial volume is characterized by larger myocytes approaching the end of their life cycle. As more myocytes drop out, an increased load is placed on the remaining myocardium, and this unfavorable environment is transmitted to the progenitor cells responsible for replacing lost myocytes.
Progenitor cells become progressively less effective as the underlying pathologic process worsens and myocardial failure accelerates. These featuresnamely, the increased myocardial volume and mass, along with a net loss of myocytesare the hallmark of myocardial remodeling. This remodeling process leads to early adaptive mechanisms, such as augmentation of stroke volume and decreased wall stress and, later, to maladaptive mechanisms such as increased myocardial oxygen demand, myocardial ischemia, impaired contractility, and arrhythmogenesis.
As heart failure advances, there is a relative decline in the counterregulatory effects of endogenous vasodilators, including nitric oxide , prostaglandins , bradykinin , atrial natriuretic peptide , and B-type natriuretic peptide . This decline occurs simultaneously with the increase in vasoconstrictor substances from the RAAS and the adrenergic system, which fosters further increases in vasoconstriction and thus preload and afterload. This results in cellular proliferation, adverse myocardial remodeling, and antinatriuresis, with total body fluid excess and worsening of heart failure symptoms.
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What Is The Difference Between Left And Right
Heart failure can occur in the left side of the heart, the right side of the heart or on both sides. The major difference between left-sided heart failure and right-sided heart failure is in the side of the heart that is weakened. In left-sided heart failure, the left side of the heart is weakened and results in reduced ability for the heart to pump blood into the body. In right-sided heart failure, the right side of the heart is weakened and results in fluid in your veins, causing swelling in the legs, ankles, and liver.
To understand these conditions, it is important to know a little about how blood flows through the heart.
The heart is made up of four chambers. The upper chambers are called atria and the lower chambers are called ventricles. Each side of the heart has paired upper and lower chambers. Blood returns from the body and enters the right atrium. From there it moves to the right ventricle, which pumps it to the lungs where it is oxygenated. Blood moves from the lungs into the left atrium, down to the left ventricle and then out to the body to supply organs and tissues with oxygen and nutrients.
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Right Ventricular Myocardial Infarction
People who have a myocardial infarction caused by a blockage in the right coronary artery may suffer from damage to the right ventricular muscle, producing right-sided heart failure. Treating a right ventricular heart attack is similar to treating any myocardial infarction, including rapidly opening up the blocked blood vessel with clot-busting drugs or a stent.
However, because right-sided heart failure can limit the amount of blood that reaches the left side of the heart, drugs aimed mainly at treating left-sided ventricular weakness need to be used with great caution in people having right ventricular heart attacks.
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When Should I See A Healthcare Provider About Right Heart Failure
If you have chest pains or suspect you may be having a heart attack, call 911 or go to the nearest emergency room.
Get in touch with your healthcare provider if you experience:
- Shortness of breath.
What else should I ask my provider?
If you have right-sided heart failure, ask your provider:
- What treatment is best for me?
- Is there a special diet I should follow?
- Should I go to cardiac rehab?
- Will I need surgery?
- Will I need a heart transplant?
- What can I do to stop heart failure from progressing?
- What medications will I need?
A note from Cleveland Clinic
Right-sided heart failure means the right side of the heart can no longer pump blood efficiently. Fluid builds up in tissues, causing swelling. Treatment focuses on managing symptoms so the disease doesnt worsen. Healthy lifestyle habits, along with cardiac rehab, improve symptoms for many people. Other treatment options include cardiac devices and surgery. If you have shortness of breath, swelling or chest discomfort, talk to your healthcare provider.
What Causes Heart Failure
There are lots of reasons why you may have heart failure. It can be sudden or it can happen slowly over months or years.
The most common causes of heart failure are:
- a heart attack which can cause long-term damage to your heart, affecting how well the heart can pump.
- high blood pressureâ putting strain on the heart, which over time can lead to heart failure.
- cardiomyopathyâ a disease of the heart muscle. There are different types which can either be inherited or caused by other things, such as viral infections or pregnancy.
Heart failure can also be caused by:
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Frequent Urination At Night
One of the other symptoms of this condition is frequent urination at night, which is also known as nocturia. This is usually seen as an effect of the edema, wherein the fluid that gets accumulated on the ankle and legs returns into systemic circulation when the person is sleeping or is in supine position. This leads to excessive urine being produced, and hence excess urination.
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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.
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How Is Heart Failure Diagnosed
Your doctor will ask about your medical history, symptoms and examine you. You may then be sent for tests such as:
- an echocardiogram
- breathing tests to see if a lung problem is causing your breathlessness
- a chest x-ray to check if thereâs fluid in your lungs or if a lung condition is causing the symptoms.
Your doctor may talk about the ejection fraction of your heart. This refers to the amount of blood that is squeezed out of your left ventricle every time your heart beats. Its usually measured as a percentage over 50% is considered normal. Your ejection fraction is measured from an echocardiogram.Some people with heart failure can have a normal ejection fraction, so ejection fraction is used alongside other tests to diagnose heart failure.
Surgery And Other Procedures
If medications are not effective in managing right-sided heart failure, or if symptoms are severe, a ventricular-assist device implant or a heart transplant, may be necessary.
- Ventricular assist device surgery: This device can be implanted to help a weak heart pump more efficiently.
- Heart transplant surgery: This surgery is done when all other right-sided heart failure treatments have failed. The damaged heart is surgically removed and replaced with a healthy heart from a deceased donor.
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What Is Congestive Heart Failure In Cats
Congestive heart failure is a term that refers to the heartâs inability to pump enough blood to the body. Due to this, blood starts to back up into the lungs and fluid accumulates in the chest, abdomen, or both. This lead to further constriction of the heart and lungs, and limits oxygen flow throughout the body. There are many causes of CHF in cats, but the two most common causes are:
- Mitral valve insufficiency , which refers to a leaky mitral valve, which is the valve between the left atrium and the left ventricle.
- Dilated cardiomyopathy , which is when the heart chambers enlarge and lose their ability to contract.
Clinical signs of CHF vary depending on whether the cat has left- or right-sided heart failure.
Right-sided congestive heart failure
This occurs when a heart contraction causes some blood to leak into the right atrium from the right ventricle rather than being pushed through the lungs and becoming oxygenated. As a result, the main circulation system becomes congested with blood, and fluid accumulates in the abdomen, interfering with adequate organ function. Excess fluid might also build up in the limbs and cause swelling known as peripheral edema.
Left-sided congestive heart failure
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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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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.
Left Sided Heart Failure
primary cause of right sided heart failure.
When the left ventricle is not working as effectively, fluid pressure increases and ends up moving back through the lungs. This can cause an overload to the heartâs right side.
Consequently, when the right side is unable to pump blood, fluid accumulates in the veins, resulting in swelling.
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