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.
Symptoms Of Heart Failure
Symptoms of heart failure include:
- new or worsening shortness of breath
- difficulty lying flat at night
- fainting or passing out
- muscular fatigue, tiredness
- swelling of ankles or legs
- swelling of abdomen
- heart palpitations
- chest pain or discomfort in parts of the upper body
- unexplained coughing and wheezing
The Earliest Symptoms Of Heart Failure Are Often Very Subtle But It’s Dangerous To Ignore Them
It’s an unfortunate truth that your body slows down in your sixth and seventh decades. Climbing a flight of stairs that you once took two at a time can now feel as daunting as scaling Mount Everest. While some degree of vitality loss can be attributed to natural aging, fatigue and breathlessness may also be signals that your heart is not functioning as well as it should. “There is a general tendency for people to ignore heart failure symptoms and attribute them to just getting older. Therefore, it was very important for us to create an easy way to identify those symptoms,” says Dr. Mandeep R. Mehra, medical director of the Heart and Vascular Center at Harvard-affiliated Brigham and Women’s Hospital.
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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 .
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.
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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.
Quality Of Patient Care
Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.
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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 Are The Complications Of Heart Failure
Some of the complications from heart failure include:
- Irregular heartbeat.
- History of taking drugs that can damage your heart muscle, such as some cancer drugs.
Stage B is considered pre-heart failure. It means your healthcare provider has given you a diagnosis of systolic left ventricular dysfunction but youve never had symptoms of heart failure. Most people with Stage B heart failure have an echocardiogram that shows an ejection fraction of 40% or less. This category includes people who have heart failure and reduced EF due to any cause.
People with Stage C heart failure have a heart failure diagnosis and currently have or previously had signs and symptoms of the condition.
There are many possible symptoms of heart failure. The most common are:
- Shortness of breath.
- Need to urinate while resting at night.
- Rapid or irregular heartbeats .
- A dry, hacking cough.
- A full or hard stomach, loss of appetite or upset stomach .
There may be times that your symptoms are mild or you may not have any symptoms at all. This doesn’t mean you no longer have heart failure. Symptoms of heart failure can range from mild to severe and may come and go.
Unfortunately, heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.Its important to let your doctor know if you have new symptoms or if your symptoms get worse.
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History And Physical Exam
A clinician listens to your heart and lungs and measures your blood pressure and weight. They will also ask about your:
- Familys medical history, especially previous cardiac problems
- Medications, including prescriptions, over-the-counter drugs and supplements
- Personal medical history
Blood tests can measure several things related to heart failure:
- Sodium and potassium levels
- Creatinine, which helps measure how well your kidneys are working
- B-type natriuretic peptide , a hormone released from the ventricles in response to increased wall tension that occurs with heart failure
What Makes Yale Medicines Approach To Treating Congestive Heart Failure Unique
Yale Medicines team comprises heart failure cardiologists and cardiac surgeons, dedicated advanced-practice, registered nurses and nurse coordinators, dietitians, exercise physiologists, financial counselors, immunologists specializing in transplants, psychologists, and specialists in palliative care.
With a multidisciplinary approach, Yale Medicine physicians include the patients desires as well as input from the family to develop a comprehensive treatment plan that’s right for them.
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How Can I Improve My Quality Of Life With Heart Failure
There are several things you can do to improve your quality of life if you have heart failure. Among them:
- Eat a healthy diet. Limit your consumption of sodium to less than 1,500 milligrams each day. Eat foods high in fiber. Limit foods high in trans fat, cholesterol, and sugar. Reduce total daily intake of calories to lose weight if necessary.
- Exercise regularly. A regular cardiovascular exercise program, prescribed by your doctor, will help improve your strength and make you feel better. It may also decrease heart failure progression.
- Don’t overdo it. Plan your activities and include rest periods during the day. Certain activities, such as pushing or pulling heavy objects and shoveling may worsen heart failure and its symptoms.
- Prevent respiratory infections. Ask your doctor about flu and pneumonia vaccines.
- Take your medications as prescribed. Do not stop taking them without first contacting your doctor.
- Get emotional or psychological support if needed. Heart failure can be difficult for your whole family. If you have questions, ask your doctor or nurse. If you need emotional support, social workers, psychologists, clergy, and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.
When Is The Ideal Time To Take A Resting Heart Rate
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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.
What Are The Types Of Heart Failure
There are many causes of heart failure, but the condition is generally broken down into these types:
Left-sided heart failure
Heart failure with reduced left ventricular function The lower left chamber of your heart gets bigger and cannot squeeze hard enough to pump the right amount of oxygen-rich blood to the rest of your body.
Heart failure with preserved left ventricular function Your heart contracts and pumps normally, but the bottom chambers of your heart are thicker and stiffer than normal. Because of this, your ventricles can’t relax properly and fill up all the way. Because there’s less blood in your ventricles, your heart pumps out less blood to the rest of your body when it contracts.
Right-sided heart failure
Heart failure can also affect the right side of your heart. Left-sided heart failure is the most common cause of this. Other causes include certain lung problems and issues in other organs.
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What Can I Do To Recover After A Heart Attack
Take our quiz to see how much you know about cardiac rehabilitation.
If youve had a heart attack, your heart may be damaged. This could affect your hearts rhythm and its ability to pump blood to the rest of the body. You may also be at risk for another heart attack or conditions such as stroke, kidney disorders, and peripheral arterial disease .
You can lower your chances of having future health problems following a heart attack with these steps:
- Physical activityTalk with your health care team about the things you do each day in your life and work. Your doctor may want you to limit work, travel, or sexual activity for some time after a heart attack.
- Lifestyle changesEating a healthier diet, increasing physical activity, quitting smoking, and managing stressin addition to taking prescribed medicinescan help improve your heart health and quality of life. Ask your health care team about attending a program called cardiac rehabilitation to help you make these lifestyle changes.
- Cardiac rehabilitationCardiac rehabilitation is an important program for anyone recovering from a heart attack, heart failure, or other heart problem that required surgery or medical care. Cardiac rehab is a supervised program that includes
- Physical activity
- Education about healthy living, including healthy eating, taking medicine as prescribed, and ways to help you quit smoking
- Counseling to find ways to relieve stress and improve mental health
Angiotensin Converting Enzyme Inhibitors
ACE inhibitors relax and widen your blood vessels. This helps to improve the flow of blood around your body, which reduces the amount of work your heart has to do.
ACE inhibitors have been shown to improve the symptoms of heart failure, reduce the need for hospital admission and improve life expectancy caused by heart failure.
Your symptoms should improve within a few weeks of starting treatment.
The main side effects of ACE inhibitors are dizziness and a cough. You will need to have regular blood tests, at least once every year, while taking an ACE inhibitor.
If you are taking an ACE inhibitor, you should check with your doctor or pharmacist before taking any other medicines. In particular, nonsteroidal anti-inflammatory medicines should not be taken with an ACE inhibitor. You should also avoid products containing high levels of potassium, such as salt substitutes.
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Heart Failure With Preserved Ejection Fraction
In diastolic heart failure , the same pathophysiologic processes occur that lead to decreased cardiac output in systolic heart failure, but they do so in response to a different set of hemodynamic and circulatory environmental factors that depress cardiac output.
In HFpEF, altered relaxation and increased stiffness of the ventricle occur in response to an increase in ventricular afterload . The impaired relaxation of the ventricle then leads to impaired diastolic filling of the left ventricle .
Morris et al found that right venticular subendocardial systolic dysfunction and diastolic dysfunction, as detected by echocardiographic strain rate imaging, are common in patients with HFpEF. This dysfunction is potentially associated with the same fibrotic processes that affect the subendocardial layer of the LV and, to a lesser extent, with RV pressure overload. It may play a role in the symptomatology of patients with HFpEF.
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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When To Schedule A Medical Appointment
Talk with a medical professional if you notice any symptoms of heart failure. While having just one of these symptoms might not indicate heart failure, its still worth bringing up with a doctor, especially if youre at risk for heart failure.
If you notice any of the symptoms discussed above, monitor them to see how long they last. If your symptoms lasts for more than a week or two, or if you develop multiple symptoms, make an appointment as soon as possible.
Early treatment can prevent complications and help you stay healthy.
There are several risk factors for heart failure. Any one of these risk factors can lead to heart disease. Your risk goes up when you have a combination of factors.
The risk factors for heart failure include:
What Can You Expect From Heart Failure Treatment
Heart failure treatment is designed to dramatically reduce or halt your symptoms and hopefully prevent potential complications like kidney or liver damage, Dr. Wong says.
There are lots of medications that can be used to treat heart failure. In the early stages, the basic gist is that certain drugs can help to relax blood vessels, lower blood pressure, improve blood flow, and decrease the strain on your heart. Others can help you release extra fluid to keep it from building up in your body. If you progress to more advanced heart failure stages, there are medications that can help strengthen your heart muscle contractions to pump blood more effectively, according to the Mayo Clinic.
Youll likely be encouraged to make some lifestyle changes as well. According to the AHA, that can include things like quitting smoking if you use tobacco, avoiding alcohol, limiting your sodium intake or making other dietary changes, exercising regularly, prioritizing sleep, reducing stress, monitoring your blood pressure, and more.
Your doctor may also recommend certain surgeries or medical procedures if needed in more severe cases, which can include options like coronary bypass surgery, heart valve repair or replacement, a heart transplant, among others, depending on the specific cause of your heart failure.4
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Swelling And Weight Gain
Your feet, ankles, and abdomen are all areas of the body that can swell. Its possible to have some swelling after a workout or on a very hot day. When swelling occurs, its called edema.
Edema happens in heart failure because your kidneys arent able to properly filter sodium. Your heart then releases chemicals that cause the body to hold onto fluid. You might notice that your clothes or shoes no longer fit right, or that youve gained weight unexpectedly or quickly.