From Our Health Library At Upmccom
- Destination therapy
Bridge to transplantation
Each year, more people with end-stage heart failure are evaluated and listed for transplantation. Unfortunately, there are not enough suitable donor organs for all of the patients waiting for a heart transplant.
People who are listed for heart transplantation and are too ill to wait any longer, or are expected to have prolonged wait times, are referred for a VAD as a bridge to transplantation. The VAD allows them to recover and wait at home for an organ to become available.
Bridge to recovery
In some cases of heart failure particularly newly diagnosed CHF or heart failure after other cardiac surgery the heart may recover after a period of support on a VAD. These patients are supported temporarily as a bridge to recovery.
After implantation, the VAD is turned down and the heart is reassessed to see if its function has improved enough to allow the VAD to be removed.
Typically, people recommended for VAD as a bridge to recovery have CHF as a result of:
- Viral infection
- Another cause of heart disease that has not responded to medical therapy
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
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Possible Causes Of Congestive Heart Failure
WebMD says there are a number of possible reasons why one would develop CHF, largely due to sustained damage. For example, it says that a heart attack that blocks your coronary artery can cease the blood flow to your heart muscle. Meanwhile, other factors that can damage the heart include infections and substance abuse.
The source explains that diseases such as thyroid disease and diabetes can be causes of heart failure. Coronary artery disease in particular can limit the supply of blood to the heart muscle due to an issue with the arteries . Other health conditions such as high blood pressurecan also contribute to CHF.
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Congestive Heart Failure Symptoms Causes Diagnosis Treatments & Preventions
Congestive Heart Failure Symptoms Cardiovascular diseases are a big problem for the world. It is among the leading causes of death. The World Health Organization believes cardiovascular disease takes 17.9 million lives each year.
Even the Centers for Disease Control and prevention of the United States have several programs to teach the general public about cardiovascular health. The rising population of obese and overweight people in the United States is also becoming one of the biggest reasons for the rising numbers of people with cardiovascular diseases.
As per the latest data points released by the Centers for Disease control and prevention, The United States can have more than 45% obese population by the year 2025. That is why today we are here to discuss congestive heart failure symptoms. Obesity is among the biggest causes of the condition, and you need to learn everything about it.
What Are The Stages Of Congestive Heart Failure
There are four stages of heart failure: stage A, B, C, and D. The stages differ from each other ranging from the stage of developing elevated risk of heart failure to advanced heart failure.
Stage A:This is the stage of pre-heart failure. It shows that there are greater chances of developing heart failure if you have a strong family history of the same or have one or more of these medical conditions.
Coronary artery disease
History of taking drugs that lead to damage of the heart muscle
Stage B:It is the stage of asymptomatic or silent heart failure. The diagnosis shows systolic left ventricular dysfunction but no symptoms of a heart failure. This stage includes people who have a heart failure as well as reduced EF .
Stage C: People who fall under this stage currently have or previously had symptoms of heart failure. Some of these symptoms are as follows.
Shortness of breath
Feeling weak or fatigued
Swollen abdomen, feet, ankles, and lower legs
Stage D: This is the advanced stage where the symptoms do not get better even with treatment. It is the final stage of heart failure.
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What Is Mild Congestive Heart Failure
Clinical studies have shown that approximately 50% of patients with heart failure have a relatively normal or slightly reduced heart function. A popular method of evaluating heart function is by calculating an ejection fraction. This is usually done by obtaining an echocardiogram and measuring how much blood is pumped with each contraction divided by the total amount of blood contained in the left ventricle. Some patients with heart failure and normal pump function can have an ejection fraction of greater than 50% or preserved ejection fraction. This is known as diastolic dysfunction, which is a condition in which the heart does not relax normally. Some patients with slightly reduced pump function, also known as mild systolic dysfunction, can have an ejection fraction in the range of 40- 49% or heart failure with mid-range ejection fraction.
When compared to heart failure patients with reduced ejection fraction , patients with preserved or mid-range ejection fraction are predominantly elderly women with more comorbidities such as hypertension, atrial fibrillation, and diabetes type 2.
What Support Is Available With Advanced Heart Failure
The Heart Foundation NZ provides resources and support for those living with a heart condition. You can also find a local support group in your area here. Contact them using their online form or visit their website here.
Extra support is also available if you need it. Talk to your healthcare team to find out how you can access this. It includes:
- equipment to help with your daily chores, such as chair raisers and shower stools
- mobility parking and taxi vouchers to help you get around your community
- carer support to help support your carer who is looking after you
- counselling or mental health support
- needs assessment if you want to move into a rest home or other residential care.
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Bias And Heterogeneity Assessment
Bias assessment was performed using QUADAS2. Although publication bias is the most wellknown metaanalysis bias, the methodology for detecting publication bias is not well settled. Lin et al.22 suggested applying multiple tests for publication bias, and thus we evaluated publication bias with Begg’s, Egger’s, and Deeks’ tests, as well as by visual assessment.20, 23 Deeks’ test was calculated by plotting the ln against 1/effective sample size 1/2 and testing for asymmetry of this plot. The ESS can mitigate the effects of unequal total numbers of disease and nondisease participants. In contrast, Begg’s method uses rank correlation of lnDOR with the variance of the lnDOR and Egger’s method uses a linear regression model with lnDOR with the standard error of the lnDOR weighted by the inverse variance of the lnDOR.24 Heterogeneity analysis was conducted using the I2 method, describing the percentage of total variation across studies attributable to the heterogeneity.20, 25
Look After Your Mental Health
Try to avoid stressful situations. If you get stressed, use relaxation techniques such as taking 6 slow, deep breaths. Doing something where you feel useful and gain a sense of achievement can help you regain balance in your life. It also helps to have plenty of rest and get a good night’s sleep, as this allows your body and mind to restore. Talking to family/whnau members can also help. If you need more support, ask your healthcare team for a referral to a psychologist or counsellor.
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Have A Healthy Body Weight
Losing weight if you are overweight helps takes the strain off your heart and can help you feel better. If you are underweight or have a poor appetite, having foods that are higher in calories and protein, or high-energy drinks, can help boost your energy. Ask your doctor, nurse or dietitian for advice on how to reach a healthy weight.
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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What Should I Do If I Have A Flare
The best way to manage a heart failure flare-up is to have a heart failure action plan. A heart failure action plan is a written document that provides you with instructions and information on how to manage your heart failure on a daily basis, and how to recognise and cope with worsening symptoms.You can develop your heart failure action plan with your healthcare provider and fit the plan to suit how severe your heart failure is and your wishes. When you have a flare-up, follow the steps on your action plan as discussed with your healthcare provider. At each visit, you and your healthcare provider can review your plan and make adjustments as needed.
However, having an action plan doesn’t replace your doctor. It means you can respond quickly and recognise symptoms that require you to seek medical attention. You should still see your doctor as soon as possible after a flare-up. Tell your doctor or nurse if your symptoms don’t improve after following the steps on your action plan.
You may need to go to hospital for severe flare-ups.
See your doctor or go to the nearest emergency department if you or someone you care for has heart failure and experiences the following:
Weigh Yourself Each Day
Your doctor may recommend you do this to check whether you have any extra fluids. If you put on more than 2kg over a few days, your body is retaining fluid, not fat. Your doctor will help you work out your target weight this is your weight with no extra fluid, and is the weight at which your body and heart work best. Weigh yourself every morning each day at the same time . Use digital scales, and use these on a firm surface, eg, lino or tiles. Then record your weight on your heart failure action plan and remember to bring it with you to every appointment with your healthcare team.Other than weighing yourself, you also need to check for swelling. Check whether your rings, waistband, socks or shoes feel tighter. You can also press firmly into the skin of your ankle, shin and knee with your finger. If your finger makes a dent that doesnt quickly fill, you have swelling. You should also monitor any changes in your breathing. If you are more short of breath than usual or have more swelling, you are likely to retain more fluid. Follow the steps in your action plan as discussed with your healthcare team or contact your doctor if you are concerned about any aspect of your health.
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Heart Failuresigns And Symptoms
Heart failure is a condition in which the heart fails to function properly. The terms “heart failure” and “congestive heart failure ” don’t mean that the heart has actually “failed” or stopped but mean one or more chambers of the heart “fail” to keep up with the volume of blood flowing through them.
Heart failure is brought on by a variety of underlying diseases and health problems.
Your condition may involve the left side, the right side or both sides of the heart. Each side has two chambers:
- An atrium or upper chamber
- A ventricle or lower chamber
Any one of these four chambers may not be able to keep up with the volume of blood flowing through it.
Two types of heart dysfunction can lead to heart failure, including:
- Systolic Heart Failure This is the most common cause of heart failure and occurs when the heart is weak and enlarged. The muscle of the left ventricle loses some of its ability to contract or shorten. In turn, it may not have the muscle power to pump the amount of oxygenated and nutrient-filled blood the body needs.
- Diastolic Failure The muscle becomes stiff and loses some of its ability to relax. As a result, the affected chamber has trouble filling with blood during the rest period that occurs between each heartbeat. Often the walls of the heart thicken, and the size of the left chamber may be normal or reduced.
What You Can Do For Your Loved One
In addition to symptom management, its important for the family caregiver to learn how to recognize the end-of-life signs for CHF, and when they should contact hospice. Hospice care will be able to address the specific needs of CHF patients in their final days, and help them to get the most out of what time they have left.
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Our Favorite Apps And Gadgets
This app can help you to keep track of your liquid intake to avoid excess fluid buildup, which can lead to complications. You can also track your weight, since sudden increases in weight can be due to water retention. Another great thing about this app is that it alerts you if your blood pressure or weight gets high enough that you should tell your doctor. It also allows you to send reports on your fluid intake and weight to your healthcare provider.
This app, developed in partnership with the Heart Failure Society of America, is your one-stop shop for recording symptoms, vital signs, and medications to help you manage congestive heart failure. You can also track your information and keep a journal to maintain wellness and emotional health.
Signs And Symptoms Of Congestive Heart Failure
Your heart controls the main transportation system in your body your bloodstream which is necessary to carry nutrients and oxygen to all of your cells. For some people, the heart can begin to not work properly, and this is called congestive heart failure.
Many people assume that heart failure is the same thing as a heart attack or that it means that the heart has stopped, but this isnt the case. Congestive heart failure can put you at risk of damage to the heart, liver, and/or kidneys.
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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.