How Is Systolic Heart Failure Treated
The first goal of treatment for HFrEF is to treat any underlying causes. For example, if you have hypertension, you may need drugs to manage your blood pressure. If you have diabetes, you should take medications to control blood sugar. Some patients may need surgery or an implanted device to help the heart function.
Your healthcare provider may also recommend some lifestyle changes to help manage underlying conditions and keep your heart as healthy as possible:
- Avoid alcohol, smoking and illegal drugs.
- Exercise regularly. Start slowly, and always warm-up and cool down.
- Limit salt intake. Most patients with heart failure should consume no more than 1,500 mg of sodium per day.
- Maintain a healthy weight. Track your weight, and report any sudden increases to your healthcare provider.
- Participate in a cardiac rehab program.
- Reduce stress and get plenty of rest.
How Can I Make My Medication More Effective
To help your medications work well, take them as prescribed. Take the amount recommended by your doctor, at the proper times.
Pay attention to additional instructions from your doctor or pharmacist. For example, note if you can take your medication with food, and if certain foods, beverages, or vitamin supplements can interfere with how the medication works. Always ask your doctor first before taking supplements.
Write down all the medications that you take and keep the list with you. If you have any questions write those down too, and make sure to ask your doctor.
Types Of Systolic Heart Failure
As we know, two types of heart failure conditions happen to our hearts. In this article, Ill talk about only Systolic heart failure. Systolic heart failure is classified into two types:
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Treatment Options For People With Acute Heart Failure
There is no cure for heart failure, but treatment can help improve your quality of life. Acute heart failure can have lasting effects on your body. Because of this, treatment is centered on managing symptoms and preventing future heart failure.
If you experience acute heart failure, youll likely stay in the hospital until youre in stable condition. During this time, you may need oxygen therapy. You might also need supplemental oxygen after you leave the hospital.
The cause of your acute heart failure will determine your treatment plan. In some cases, acute heart failure can be caused by undiagnosed chronic heart failure. Treatment for acute heart failure and chronic heart failure is often the same.
Treatment options for acute heart failure include medications, medical devices, and surgery.
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:
- a 24-hour ECG – in some cases, you may need this test which records the rhythm, rate and electrical activity of your heart over a longer period
- a chest x-ray to check if there’s fluid in your lungs or if a lung condition is causing the symptoms
- an echocardiogram an ultrasound of your heart to see how its working
- blood tests to check your overall health and for signs of a problem with your heart
- breathing tests to see if a lung problem is causing your breathlessness.
Your doctor may talk about the ejection fraction of your heart. This is to do with the amount of blood squeezed out of the main chamber of the heart with every beat. Its usually measured as a percentage over 50% is considered normal. Your ejection fraction is measured from an echocardiogram.Heart Failure can be classed into different groups depending on your ejection fraction. Depending on the percentage measured, and other tests, your heart failure may be classed as the following:
- heart failure with preserved ejection fraction – > 50%)
- heart failure with mildly reduced ejection fraction
- heart failure with reduced ejection fraction
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Heart Failure: Symptoms Causes And Diagnosis
Heart Failure is a serious condition where the heart is unable to supply a sufficient amount of blood to the body. When the body doesnt get sufficient blood supply, the major functions get disturbed.
There are many conditions including narrowed arteries, blocked arteries, or high blood pressure that can make the heart weak or stiff and further result in Heart Failure.
Warning Signs Of Worsening Systolic Heart Failure
Systolic heart failure can worsen gradually over time or quickly. Your doctor will explain the warning signs that systolic heart failure is getting worse. They may include any symptoms that intensify, such as:
- Cough that wont go away
- Dizziness, confusion or fainting
- Sudden increase of swelling in the belly, legs, ankles or feet
- Weight gain of 3 or more pounds in one day or 5 or more pounds in one week
You should always report worsening heart failure symptoms to your doctor. Quick treatment can help prevent complications of systolic heart failure, which include:
- Damage to the kidneys and liver
- Right-sided heart failure, which damages the right ventricle and leads to combined systolic and diastolic heart failure symptoms
Careful management is key to slowing the progression of systolic heart failure and preventing complications. You should be sure to attend all your follow-up appointments, follow your treatment plan and take all your medications as prescribed.
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What To Do If You Notice Worsening Heart Failure Symptoms
Heart failure can lead to serious complications, such as kidney or liver damage, other heart conditions, pulmonary hypertension and stroke. If youre experiencing worsening symptoms of heart failure, keep track of them and talk to your doctor.
Seek immediate medical attention or call 911 if you experience:
- Cough that brings up a white or pink foamy substance
- Fainting, dizziness or confusion
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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Types Of Heart Failure
The chambers where your blood is pumped out of the heart are called ventricles. These may stiffen so that they no longer fill properly. Or, if your heart muscle becomes weak, the ventricles can fail to pump hard enough.
Heart failure can begin on either the left or right side of your heart. Sometimes, both sides may fail at the same time. The different types of heart failure correspond to where the heart is failing:
Other Ways To Classify Heart Failure
Sometimes, doctors also identify types of heart failure based on whether you have known heart disease. These types are:
Acute decompensated heart failure
most common form of acute heart failure.
People with acute decompensated heart failure can sometimes have several conditions that affect their hearts, so it can be hard to know the exact cause of this type of heart failure.
De novo acute heart failure
De novo acute heart failure is less common. De novo is a medical term that means for the first time. This type describes heart failure when you do not have a previous diagnosis of heart disease.
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Pathophysiology Congestive Heart Failure
Congestive HF results in the activation of multiple compensatory mechanisms in an attempt to increase cardiac output. These frequently work in the short term however, the long-term effects can be detrimental to the heart via negative remodeling. The two primary mechanisms considered the neurohormonal response are activation of the sympathetic nervous system and activation of the renin-angiotensin-aldosterone system. Medical therapy is aimed at reducing the activity of these two systems. A third compensatory response occurs via B-type natriuretic peptide and A-type natriuretic peptide. See the summary image below.
When the carotid baroreceptors sense a low blood pressure, one response is to activate the SNS. This increases epinephrine and norepinephrine levels, which act to increase heart rate, contractility and afterload via peripheral vasoconstriction. In the short term, this will work to increase cardiac output and relieve HF symptoms however, chronically this has deleterious effects and causes further left ventricular systolic decline. Beta-blockers are the primary therapy to reduce this SNS activation.
Endothelin has negative effects in regards to remodeling and vasoconstriction however, clinical trials of endothelin inhibitors have never shown a benefit, and thus its role remains unclear.
Devices: Cardiac Resynchronization Therapy
From 25% to 30% of heart failure patients have an intraventricular conduction abnormality,, which can result in abnormalities of systolic and diastolic function. Biventricular pacing, in which a pacing lead is placed in the coronary sinus in addition to the right atrium and right ventricle, optimizes synchronization of ventricular contraction.,
MUSTIC was a randomized trial designed to assess the efficacy of biventricular pacing in heart failure patients. Entry criteria included NYHA class III heart failure for at least 1 month, left ventricular ejection fraction less than 35%, left ventricular end-diastolic diameter greater than 60 mm, and QRS duration longer than 150 ms. Patients were followed up at 9 and 12 months with 6-minute walking distance, peak oxygen consumption, changes in NYHA class, and left ventricular systolic function by echocardiography or radionuclide testing. Quality of life was assessed by the Minnesota Living With Heart Failure Questionnaire.
At 12 months, patients could walk significantly farther in 6 minutes, and their peak oxygen consumption had increased. They also reported significant improvement in quality of life, and NYHA class improved by 25%. MUSTIC was the first study to show a benefit in exercise tolerance, quality of life, improvement in cardiac performance, and reduction in heart failure symptoms with the use of biventricular pacing at 1 year.
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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.
Causes Of Congestive Heart Failure
The cause of congestive heart failure is usually related to damage to the heart muscle. The possibility of pre-existing impairments in the heart or other conditions that directly affect the pumping action of the heart pose as risk factors for CHF. While in adults the symptoms are most commonly a result of hypertension and coronary artery disease, in children, CHF is caused majorly by cardiomyopathy and congenital heart disease. Below is a list of all general causes and potential risk factors of congestive heart failure adults.
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Systolic Heart Failure: Causes Symptoms And Treatment
Systolic heart failure, also known as a systolic dysfunction, is one of the most common types of heart failure and it typically affects the left ventricle of the heart. The left ventricle does most of the heavy lifting when it comes to pumping blood through the heart. Systole is the critical phase of each heartbeat when the blood is pumped through the heart and sent to other parts of the body.
Ejection fraction is the term used for measuring the exact amount of blood thats being pumped through the different ventricles in the heart at any given time. A normal ejection fraction through the left ventricle should be about 55 percent or more per heartbeat. Any amount lower than that can lead to systolic heart failure, which is essentially a lack of sufficient blood supply being pumped through the heart.
Systolic heart failure occurs when the left ventricle becomes enlarged or inflamed to the point that its unable to fully contract. This prevents it from pumping blood with a strong enough force, which means other parts of the body wont receive sufficient blood supply or the nutrients they need to function normally.
This condition is typically the result of severe or advanced heart disease including high blood pressure, coronary artery disease, cardiomyopathy, and heart valve problems.
Keep reading to gain a comprehensive understanding and definition of systolic heart failure.
Changes In Function And Expression Of Ion Channels And Contractile Proteins
Various processes involved in the conversion of an electrical stimulus to a mechanical response i.e., excitation contraction coupling are altered in human heart failure part of these alterations are expression and function of the ion channels or transporters , contractile proteins , intracellular calcium transport processes . Both, the calcium induced calcium release and the intracellular calcium handling is affected in heart failure leading to reduced contractility and prolonged relaxation . In consequence, in human heart failure the frequency-induced force generation is reduced or even absent i.e., negative force-frequency-relationship the intracellular free calcium concentration is enhanced and the Ca2+ sensitivity of the contractile proteins is increased . Following reduced ß-adrenoceptor response in heart failure phosphorylation of several Ca2+-handling proteins is reduced and Ca2+ affinity of contractile proteins is increased. Both mechanisms impair contraction and relaxation further. In addition, Na efflux via the NCX is affected as well leading to increased intracellular Na and reduced K. In consequence, the resting membrane potential is shifted to depolarization which acts proarrhythmogenic. The altered intracellular Ca2+ handling in human heart failure affect also mitochondria energy production and in consequence further deteriorate myocardial function .
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What Is Reduced Ejection Fraction
Clinicians refer to systolic heart failure as heart failure with reduced ejection fraction because it occurs when your ejection fraction is low.
Ejection fraction is a measurement taken by an echocardiogram that determines how much blood your heart is pumping. A typical ejection fraction is between 5070%.
You may have heart failure if the ejection fraction is under 50%. An ejection fraction of 4149% is borderline. An ejection fraction of 40% or under is a low ejection fraction.
Heart Failure With Reduced Ejection Fraction
Systolic heart failure is also called heart failure with reduced ejection fraction .
Ejection fraction is the percentage of blood the left ventricle pumps out with every beat. A normal, healthy ejection fraction is 55% to 65%. If its higher or lower, that can indicate a heart problem.
With systolic heart failure, the ejection fraction is usually less than 50%.
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Systolic Vs Diastolic Heart Failure
Theres a huge difference between systolic and diastolic heart failure. As mentioned, the former means that the blood pumping ventricles in your heart arent contracting normally, which can cause a backup of blood flow and lack of sufficient supply to other parts of the body.
Diastolic heart failure, on the other hand, is when your heart muscles dont relax for a long enough period of time to allow the heart to refill itself with more blood after pumping. As a result, the heart muscles become increasingly stiff and eventually completely lose the ability to relax between heartbeats. Diastolic heart failure occurs when the heart is incapable of replenishing its blood supply during the resting period following each heartbeat.
At the end of the day, you should work closely with your doctor to ensure the quality of your overall health. Be proactive when it comes to matters concerning your healthespecially your heartand always report any abnormalities such as accelerated resting heart rates or difficulties with breathing, as these can be major signs that something is wrong. Your doctor is your ally when it comes to maintaining a healthy and ideal lifestyle and they have the resources to help you identify any potential causes of systolic dysfunction in the heart.
Do The Medications Have Side Effects
Most medications have side effects, so ask your doctor what to expect from the medication youre taking.
Common side effects from heart failure medications include dizziness, nausea, headache, and changes in appetite. Some side effects are harmless while others require prompt medical attention. Your doctor can explain which side effects are a concern and when to have them medically assessed.
An effective treatment approach for heart failure involves taking more than one medication, usually a combination of medications.
For example, rials have shown that ACE inhibitors reduce the risk of dying from heart failure by 17 percent. But adding a beta-blocker medication improves that risk reduction to as much as 35 percent. Including the aldosterone antagonist spironolactone improves the outcome even more.
A combined medication therapy can lower the risk of dying from heart failure over the next two years by as much as
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When To Get Emergency Help
Heart failure is not the same thing as a heart attack. But, like a heart attack, acute heart failure can be a life threatening event. Someone with acute heart failure will typically need emergency hospital care. If your symptoms are sudden or severe, call 911 or your local emergency services for help.
If not treated, heart failure can lead to serious complications. These complications can include cardiac arrest, which is when your heart stops beating.
Some people with heart failure may have several health conditions. If thats the case, it can be hard to know whats causing your symptoms.
But when it comes to symptoms of heart failure, its best to get them checked by a doctor right away. According to a 2017 study, fast treatment of acute heart failure can lead to better outcomes.