Faces Of Heart Failure
Heart failure occurs when something damages the heart muscle or reduces the hearts 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 bodys 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 cant pump enough oxygen-rich blood to meet the bodys 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 doesnt 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.
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How Common Is Heart Failure
In the United States alone, more than six million adults have been diagnosed with heart failure.
Heart failure is usually divided into two categories based on which side of the heart it mainly affects. The right side of the heart collects oxygen-depleted blood from the body and brings it to the lungs to be filled with fresh oxygen. The left side of the heart receives oxygen-rich blood from the lungs and sends it out to the rest of the body.
While the end result is the same, symptoms can vary based on whether the right or left side of the heart is affected.
Verywell / Jessica Olah
What Is The Life Expectancy For An Elderly Person With Congestive Heart Failure
In a recent study, it was reported that patients hospitalized with moderate systolic heart failure faced a median expected survival time of 2.4 years if they were aged 71 to 80 years and 1.4 years if they were aged 80 years or more. In patients with more advanced systolic dysfunction, life expectancy was even shorter.
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Living Well With Heart Failure
The Heart Foundation has developed a range of resources for people living with heart failure, and their families and carers.
- Living well with heart failure booklet, which includes information about what to do when you feel sick, managing symptoms, and monitoring your fluid and salt intake.
- Living well with heart failure video series, which includes seven videos covering topics to help you manage your condition. The series is available in a range of languages.
- Heart failure fact sheet, which includes questions to ask your health professional and what changes you might need to make to your daily life.
- Heart failure action plan, which helps you to identify the most important parts of your heart failure management to focus on right now.
Access these resources on the Heart Foundation website.
Right Sided Vs Left Sided Heart Failure
When right sided heart failure occurs, the increased pressure in the veins causes dispersion of fluid to surrounding tissues. This happens because this side of the heart is too weak to pump blood forward to the lungs.
The result may be a buildup of fluid in various parts of the body, including the legs, abdomen, and liver.
When left sided heart failure occurs, a person
Right sided heart failure can be due to the following conditions:
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What Do I Need To Know About Heart Failure
Heart failure is a condition that does not allow your heart to fill or pump properly. Heart failure may begin on the left or right side of the heart. If one side does not work properly, the other side has to work harder to function. Over time, heart failure affects both sides of the heart. Heart failure is a long-term condition that tends to get worse over time. It is important to manage your health to improve your quality of life.
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Shortness Of Breath While Lying Flat And With Exertion
Shortness of breath while lying flat. People who have left heart failure may experience shortness of breath when lying flat . The person will start using two or three pillows to prop themselves up while in bed so that they can breathe easier. If the shortness of breath is more severe, the person may begin sleeping in a chair or recliner.
Shortness of breath with exertion. Shortness of breath with exertion is referred to as dyspnea on exertion. Dyspnea on exertion occurs because the lungs cannot supply enough oxygen and the heart cannot adequately pump oxygen-rich blood to the body. Initially, the shortness of breath may occur when walking long distances or up flights of stairs, but as the heart failure progresses, less activity may produce more symptoms.
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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 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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How Is Amyloidosis Related To Heart Failure
As stated by the Cleveland Clinic, cardiomyopathy is one of the medical conditions that damage the heart muscle and can cause heart failure. Cardiomyopathy refers to conditions that affect the myocardium . Cardiomyopathy can make your heart stiffen, enlarged or thickened and can cause scar tissue. As a result, your heart cant pump blood effectively to the rest of your body. In time, your heart can weaken and cardiomyopathy can lead to heart failure.
One of the common types of cardiomyopathy is Transthyretin amyloid cardiomyopathy , characterized by an abnormal protein buildup in the hearts left ventricle . ATTR-CM is a life-threatening, underrecognized, and underdiagnosed type of amyloidosis that affects the heart and is associated with heart failure. It was once considered a rare disease, but recently, improved diagnostic tools and greater attention to early manifestations of the disease are leading to an increasing number of diagnosed cases.
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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.
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Weight Gain And Increased Urination
Weight gain. Weight gain is common with an increase in fluid retention. This may come on gradually or relatively quickly. One way to measure the effectiveness of treatment is to monitor your daily weight is.
Frequent urination during the night . When excess fluid is mobilized, the kidneys recognize the extra water within the bloodstream and they may produce more urine. This often occurs at night when the legs are elevated leading to frequent nighttime urination .
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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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Heart Failure: Pumping And Filling Problems
Normally, the heart stretches as it fills with blood , then contracts to pump out the blood . The main pumping chambers in the heart are the ventricles.
Heart failure due to systolic dysfunction usually develops because the heart cannot contract normally. It may fill with blood, but the heart cannot pump out as much of the blood it contains because the muscle is weaker or because a heart valve malfunctions. As a result, the amount of blood pumped to the body and to the lungs is reduced, and the ventricle usually enlarges.
Heart failure due to diastolic dysfunction develops because the heart muscle stiffens and may thicken so that the heart cannot fill normally with blood. Consequently, blood backs up in the left atrium and lung blood vessels and causes congestion. Nonetheless, the heart may be able to pump out a normal percentage of the blood it receives .
The heart chambers always contain some blood, but different amounts of blood may enter or leave the chambers with each heartbeat as indicated by the thickness of the arrows.
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Comorbidities: Anemia Iron Deficiency Kidney Failure Diabetes Frailty
Moderate anemia is often prevalent in patients with heart failure regardless of HFrEF or HFpEF . The incidence is higher in women, elderly and diabetic patients as well as in patients with renal failure. Increased blood loss in patients treated with oral anticoagulants , aspirin or both as well as decreased absorption of vitamin and/or iron may favor anemia. Similar as in other chronic illnesses iron deficiency is common in heart failure and may influence prognosis worse. Whether anemia and/or iron deficiency are markers of heart failure severity or whether they affect outcome of heart failure disease and thus should be treated is not entirely clear. In patients with heart failure with as well as without anemia intravenous ferric carboxymaltose has improved quality of life and NYHA class but not prognosis .
Heart failure and chronic kidney disease frequently coexist and share many risk factors also. CKD worsen prognosis in heart failure patients however, patients with severe CKD often have been excluded from randomized clinical trials and thus there is limited evidence-based therapy available.
Comorbidities and aging via influencing cognitive and self-care ability affect management of heart failure patients. Also, polypharmacy is present often. In addition, frailty is common in these patients. In consequence, a multidisciplinary team is needed to take care especially for older heart failure patients to reduce hospitalizations and improve outcome.
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Can A Holter Monitor Detect Heart Failure
Your doctor may recommend a Holter monitor to evaluate your heart health. It provides important information about your heart health in relation to your age, physical exam, medical history, and other tests. A Holter monitor by itself cannot diagnose all types of heart conditions or predict future heart problems.
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How Can You Treat Right
Unlike left-sided heart failure, the treatments for right-sided heart failure are less straightforward.
The treatment is directed at the underlying causes of right ventricular dysfunction. If you have right-sided heart failure, your doctor will instruct you to manage your symptoms by taking diuretics, eating a low-salt diet, and limiting fluid intake. These treatments are advised for all people with right-sided heart failure.
Other suggested treatments are based on the most likely cause of right-sided heart failure.
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Surgery And Percutaneous Procedures
Surgery may be appropriate when certain underlying disorders are present. Surgery in patients with advanced HF should be done in a specialized center.
Surgical closure of congenital or acquired intracardiac shunts can be curative.
If HF is primarily due to a valvular disorder Overview of Cardiac Valvular Disorders Any heart valve can become stenotic or insufficient , causing hemodynamic changes long before symptoms. Most often, valvular stenosis or insufficiency… read more , valve repair or replacement should be considered. Patients with primary mitral regurgitation are more likely to benefit than patients with mitral regurgitation secondary to LV dilation, in whom poor myocardial function is likely to continue postoperatively. Surgery is preferably done before myocardial dilation and damage become irreversible. More recently, percutaneous mitral valve repair procedure , in which a clip is applied to approximate the anterior and posterior mitral leaflets, has been shown to reduce death and HF hospitalization in carefully selected patients with symptomatic HF despite optimal medical management and moderate to severe or severe mitral regurgitation with preserved LV size is a syndrome of ventricular dysfunction. Left ventricular failure causes shortness of breath and fatigue, and right ventricular failure causes peripheral and abdominal… read more ).
The Flow Of Blood Through Your Heart
To understand the different types of heart failure, it helps to know how your heart pumps blood:
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What Is The Importance Of Ejection Fraction
Ejection fraction is one way to measure the severity of the condition. If its below normal, it can mean the patient has heart failure. The ejection fraction tells the healthcare provider how good of a job the left or right ventricle is doing at pumping blood. Usually, the EF number is talking about how much blood the left ventricle is pumping out because its the hearts main pumping chamber.
Several non-invasive tests can measure the EF. A normal left ventricular ejection fraction is 53% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in the left ventricle is pumped out with each heartbeat. The EF can go up and down, based on the heart condition and how well the treatment works.
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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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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.
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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Treatment Of Heart Failure Congestive In Dogs
Dogs with moderate to severe problems may need to be hospitalized until the condition is stabilized. Taps will be inserted to remove fluid from the abdomen and around the heart . Strong diuretics, such as furosemide, may be injected to further encourage fluid elimination, and dogs may need additional oxygen.
Once the immediate attack is stabilized, long-term medications will be prescribed to help to control symptoms. Diuretics and ace inhibitors are the most common medications used to reduce fluid build-up and improve blood flow. Pimobendan can increase the force of the hearts contractions, and digoxin may be prescribed if your dogs heart rate is very fast. Beta-blockers and calcium blockers could also be suggested depending on your dogs condition. Most treatment plans will combine a number of different medications.
Other treatment will focus on eliminating the problem that is causing CHF. If your dog has heartworm, it can be treated with medication once your dogs symptoms are stabilized. Some conditions, like atrial septal defect, can be treated with surgery. Others cannot. Valve replacement is only done very rarely in dogs, so problems that affect the valves are often only untreatable symptomatically.
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