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
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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.
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About Heart And Vascular Institute
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.
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When To Get Medical Advice
See a GP if you experience persistent or gradually worsening symptoms of heart failure.
Call 999 for an ambulance or go to your nearest A& E department as soon as possible if you have sudden or very severe symptoms.
A number of tests can be used to help check how well your heart is working, including blood tests, an ECG and an echocardiogram.
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How Is Diastolic Heart Failure Diagnosed
Your healthcare provider asks you about your symptoms and family health history. Your provider also conducts a physical exam and listens to your heart with a stethoscope.
You may have specific tests to diagnose heart failure, such as:
- Chest X-ray to take images of your chest and heart.
- Electrocardiogram , a record of the electrical activity in your heart.
- Echocardiogram, using sound waves to evaluate the structure and function of your heart muscle and valves.
- Exercise stress test, increasing your heart rate with medicine or as you walk on a treadmill to see how your heart responds.
- Cardiac catheterization, using a catheter to measure your hearts pressure and blood flow.
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.
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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
Treatments For Heart Failure
Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition.
How you’re treated will depend on what is causing your heart failure.
Common treatments include:
- lifestyle changes including eating a healthy diet, exercising regularly and stopping smoking
- medicine a range of medicines can help many people need to take 2 or 3 different types
- devices implanted in your chest these can help control your heart rhythm
- surgery such as a or a heart transplant
Treatment will usually be needed for life.
A cure may be possible when heart failure has a treatable cause. For example, if your heart valves are damaged, replacing or repairing them may cure the condition.
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What Are The Risk Factors For Heart Failure
Heart failure can happen to anyone. However, certain factors may increase your risk of developing this condition.
There is a higher incidence of heart failure in men compared with women, though the prevalence is about the same for all sexes.
People with diseases that damage the heart are also at an increased risk. These conditions include:
- ivabradine in some cases
- verquvo in some cases
Always speak with your doctor before taking new medications. Some medications are completely off-limits to people with heart failure, including naproxen and ibuprofen .
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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The Flow Of Blood Through Your Heart
To understand the different types of heart failure, it helps to know how your heart pumps blood:
What Part Of The Heart Fails Mainly In A Left
Left-sided heart failure occurs when the left ventricle, the heart’s main pumping power source, is gradually weakened. When this occurs, the heart is unable to pump oxygen-rich blood from the lungs to the heart’s left atrium, into the left ventricle and on through the body and the heart has to work harder.
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What To Look Out For
The potential warning signs of a heart attack can include:
- chest pain or pressure
To prevent heart disease, including heart attack and heart failure, try the following healthy heart tips:
- Avoid unhealthy foods. Limit or avoid foods high in sodium, sugar, and saturated or trans fats.
- Limit alcohol. Excess alcohol consumption can increase the risk of heart disease. Try to limit intake to two drinks per day for men and one drink per day for women.
- Quit smoking. Smoking can increase your risk of many health conditions, including heart disease. If you smoke, work with your healthcare professional to develop a quit plan.
- Be active. Get regular exercise. A good goal is 30 minutes of physical activity, 5 days per week.
- Manage weight. Obesity raises your risk of heart disease. Your doctor can recommend safe ways to help you lose weight.
- Treat other health conditions: Make sure other health conditions are properly managed. If you take medications, use them as directed by your doctor.
- See your doctor regularly.Routine checkups can help identify and treat health conditions early, including heart disease.
- Choose heart-healthy foods. Aim to eat a diet rich in:fresh fruits and vegetables:
Why Does Fluid Build Up In Chf
With congestive heart failure, the heart’s capacity to pump blood cannot keep up with the body’s need. As the heart weakens, blood begins to back up and force liquid through the capillary walls. The term congestive refers to the resulting buildup of fluid in the ankles and feet, arms, lungs, and/or other organs.
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What Are The Treatments For Heart Failure
Your treatment will depend on the type of heart failure you have and how serious it is. There’s no cure for heart failure. But treatment can help you live longer with fewer symptoms.
Even with treatment, heart failure usually gets worse over time, so you’ll likely need treatment for the rest of your life.
Most treatment plans include:
You may need heart surgery if:
- You have a congenital heart defect or damage to your heart that can be fixed.
- The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
- A biventricular pacemaker .
- A mechanical heart pump or a total artificial heart).
As part of your treatment, you’ll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.
How Does Diastolic Heart Failure Affect My Body
When the left side of your heart stiffens, your heart:
- Cant relax properly between beats.
- Doesnt fill up with as much blood as it should.
- Pumps out less blood to the rest of your body than a healthy heart would.
As a result, you experience symptoms of heart failure. You might feel short of breath or fatigued . Your breathing may get worse at night when you try to lay flat. You may also notice swelling in your belly or legs . These symptoms might get worse over time.
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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.
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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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.
Precipitating Causes Of Heart Failure
A previously stable, compensated patient may develop heart failure that is clinically apparent for the first time when the intrinsic process has advanced to a critical point, such as with further narrowing of a stenotic aortic valve or mitral valve. Alternatively, decompensation may occur as a result of the failure or exhaustion of the compensatory mechanisms but without any change in the load on the heart in patients with persistent, severe pressure or volume overload. In particular, consider whether the patient has underlying coronary artery disease or valvular heart disease.
The most common cause of decompensation in a previously compensated patient with heart failure is inappropriate reduction in the intensity of treatment, such as dietary sodium restriction, physical activity reduction, or drug regimen reduction. Uncontrolled hypertension is the second most common cause of decompensation, followed closely by cardiac arrhythmias . Arrhythmias, particularly ventricular arrhythmias, can be life threatening. Also, patients with one form of underlying heart disease that may be well compensated can develop heart failure when a second form of heart disease ensues. For example, a patient with chronic hypertension and asymptomatic LV hypertrophy may be asymptomatic until an MI develops and precipitates heart failure.
- Profound anemia
- Nutritional deficiencies
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Types Of Heart Failure
divides heart failure into one of three categories based on the part of your heart thats affected:
- Diastolic failure. This means your left ventricle doesnt relax properly due to stiffness and your heart doesnt fill with enough blood between beats, or the pressure for the heart to function is very high.
- shortness of breath when lying down
- sleeping on extra pillows at night
Causes Of Heart Failure
Heart failure is often the result of a number of problems affecting the heart at the same time.
Conditions that can lead to heart failure include:
- coronary heart disease where the arteries that supply blood to the heart become clogged up with fatty substances , which may cause angina or a heart attack
- high blood pressure this can put extra strain on the heart, which over time can lead to heart failure
- conditions affecting the heart muscle
- heart rhythm problems , such as atrial fibrillation
- damage or other problems with the heart valves
- congenital heart disease birth defects that affect the normal workings of the heart
Sometimes obesity, anaemia, drinking too much alcohol, an overactive thyroid or high pressure in the lungs can also lead to heart failure.
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