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Treatments Congestive Heart Failure

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Left Ventricular Assist Devices

Congestive Heart Failure (CHF) Treatment, Management, Nursing Interventions & Medications Part 2

Left ventricular assist devices are mechanical pumps that can help if your left ventricle isn’t working properly and medication alone isn’t helping.

They may be used as a permanent treatment if you can’t have a heart transplant, or as a temporary measure while you wait for a transplant.

In addition to the pump, LVADs also include an external battery. A wire connecting this to the pump will need to be placed under your skin during the operation.

Read more about LVADs on the British Heart Foundation website.

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.

Is There A Treatment For Heart Failure

There are more treatment options available for heart failure than ever before. Tight control over your medications and lifestyle, coupled with careful monitoring, are the first steps. As the condition progresses, doctors specializing in the treatment of heart failure can offer more advanced treatment options.

The goals of treating heart failure are to try to keep it from getting worse , to ease symptoms, and to improve quality of life.

Some common types of medicines used to treat it are:

  • Aldosterone antagonists
  • Selective sinus node inhibitors
  • SGLT2 inhibitor

Your doctor may also recommend a program called cardiac rehabilitation to help you exercise safely and keep up a heart-healthy lifestyle. It usually includes workouts that are designed just for you, education, and tips to lower your chance of heart trouble, like quitting smoking or changing your diet.

Cardiac rehab also offers emotional support. You can meet people like you who can help you stay on track.

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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.

What Is The Outlook With Heart Failure

Treatment for Congestive Heart Failure

With the right care, congestive heart failure wont stop you from doing the things you enjoy. Your prognosis, or outlook for the future, will depend on:

  • How well your heart muscle is working.
  • How well you respond to your treatment plan.
  • How well you follow your treatment plan.

One study says that people with heart failure have a life span 10 years shorter than those who dont have heart failure. Another study showed that the survival rates of people with chronic heart failure were 80% to 90% for one year, but that dropped to 50% to 60% for year five and down to 30% for 10 years.

A different study found that people who had heart failure and were discharged from the hospital had expected life spans ranging from three to 20 years, depending on various factors like age and gender. Its important to look at your specific situation when considering your prognosis.

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What Is The Role Of Implanted Devices In Congestive Heart Failure

An ICD is an implantable cardiac defibrillator that can be life-saving. The ICD is implanted under the skin in the chest or abdomen. The device is able to monitor your heart rate 24 hours a day.

ICDs can act as pacemakers, which means that they can send electric signals to your heart when an abnormal heart rhythm is detected. This can result in a return to a normal heart rhythm. Another option is CRT implantation.

CRT is selected for patients with a normal heart rhythm but reduced left heart ejection fraction. A cardiologist will be able to determine the most suitable device.

Studies Have Shown That Several Classes Of Drugs Are Best To Treat Heart Failure

Heart failure patients may need multiple medications. Each one treats a different symptom or contributing factor and comes with its own instructions and rules.

You and your caregivers should work with your healthcare team to understand the medications and when, how often and in what dosage to take them.

Its important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects. Your doctor and your pharmacist are your best sources of information. Dont hesitate to ask them questions about your medicines.

It’s critical that people with heart failure take their medications exactly as directed by their healthcare provider, to optimize the benefits. The use of these drugs has saved lives, prolonged life and improved the hearts function.

The following list gives you a quick look at many typical medications to treat heart failure at different stages. Your prescription may have a different name from the ones listed here. Brand names commonly available in the United States are shown in parentheses after the generic name for each drug.

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Reduce Your Stress Levels And Stay Well

Stress and lack of sleep correlate with high blood pressure and poor heart function. Reduce your stress levels by incorporating exercise and meditation.

If you struggle with anxiety, anger management, or depression, consider speaking to a counselor or psychologist to develop coping strategies. Maintaining a regular sleep schedule is also important for your stress levels and overall well-being.

Heart Replacement Surgery Is A Last Resort When All Other Treatment Options Have Failed

Treatment of Congestive Heart Failure (CHF)

Surgery to replace the heart is a consideration when all other treatment options have failed. It may take months to years to find a compatible heart donor and there is also the risk that your body may reject the transplanted heart.

Dr. Robert Higgins at Johns Hopkins Hospital is leading a team to develop an artificial heart. The newest technology will require many clinical trials before it becomes accepted as a treatment.

People who are interested may elect to participate in clinical research studies to test the effectiveness and safety of new medical advances.

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Congestive Heart Failure Care At Uvm Medical Center

The UVM Medical Center is one of nine medical centers selected nationally to participate in the National Institutes of Health Heart Failure Research Network, a clinical research organization that performs studies that allow patients to receive ground-breaking treatments. We offer inpatient consultation services and comprehensive cardiac rehabilitation services and educational classes for patients living with heart failure.

All aspects of cardiac care at The UVM Medical Center are supported by a team of highly trained & skilled nurses and other healthcare practitioners. Our specialized team of heart experts includes:

  • General Cardiologists
  • Cardiothoracic Surgeons

American Heart Association Award

The University of Vermont Medical Center has proudly received the American Heart Associations Gold Get With The Guidelines

Resuscitation Quality Achievement Award for our commitment to treating in-hospital cardiac arrest, ultimately helping improve patient survival rates.

The Get With The Guidelines program was developed to help save lives of patients who experience in-hospital cardiac arrests by consistently following the most up-to-date research-based guidelines for treatment.

What Medications Are Available To Reduce Edema

Diuretic medications can increase the amount of urine output by your kidneys, and thereby reducing the volume of fluid in your blood vessels. This lightens the load your heart has to pump, reducing swelling.

Diuretic medications are especially useful for people with reduced cardiac output in the left side of the heart.

Examples of diuretic medications used for heart failure include loop diuretics such as Lasix and Demadex and thiazide diuretics such as Zaroxolyn .

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Symptoms Of Congestive Heart Failure

The symptoms of congestive heart failure depend on whether it causes a lack of oxygen supply to the organs or excess fluid buildup in the body.

In the first case, the symptoms include mental confusion, fatigue, and discolored or bluish skin. In the second case, heart failure can lead to symptoms, such as shortness of breath, coughing, wheezing, weight gain, swelling in the feet, legs, and abdomen, and loss of appetite.

Diagnosis Of Congestive Heart Failure In Dogs

New Treatments For Congestive Heart Failure On The Horizon

Diagnosing CHF in dogs involves closely examining the heart and overall health and, if possible, identifying the underlying heart disease. During the physical exam, your veterinarian will listen to your dog’s heart rhythm and lungs. With left-sided CHF, the lungs sound congested because of fluid buildup.

Chest X-rays are performed to look for pulmonary edema and heart enlargement. Basic laboratory testing, including blood work, will provide information about your dog’s overall health and organ function.

Heart tests include the electrocardiogram and echocardiogram. An ECG measures heart rate and rhythm. An echocardiogram is an ultrasound of the heart it measures heart chamber size and thickness and evaluates the heart’s pumping ability.

Using diagnostic test results, your veterinarian will classify the stage of your dog’s heart disease, described below, to determine a treatment plan.

  • Stage A: Risk of heart disease but no symptoms
  • Stage B: Presence of a murmur, ± structural changes to the heart, but no symptoms
  • Stage C: CHF is present and responding well to treatment
  • Stage D: CHF is present and not responding to treatment

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How Much Alcohol Can You Drink If You Have Congestive Heart Failure

Alcohol increases the risk of high blood pressure, which can exacerbate congestive heart failure. Therefore, people with congestive heart failure should drink alcohol in moderation.

The American Heart Association recommends limiting alcohol to 1 drink per day for women and 1-2 drinks per day for men.

Facts About Heart Failure In The United States

  • About 6.2 million adults in the United States have heart failure.1
  • In 2018, heart failure was mentioned on 379,800 death certificates .1
  • Heart failure costs the nation an estimated $30.7 billion in 2012.2 This total includes the cost of health care services, medicines to treat heart failure, and missed days of work.

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What Are The Stages Of Congestive Heart Failure

The New York Heart Association has developed a scale that commonly is used to determine the functional capabilities of heart failure.

New York Heart Association Functional Classification of Heart Failure

  • Class I: Patients without limitation of physical activity.
  • Class II: Patients with slight limitation of physical capacity, in which marked increase in physical activity leads to fatigue, palpitations, dyspnea, or anginapain they are comfortable at rest.
  • Class III: Patients with marked limitation of physical activity in which minimal ordinary activity results in fatigue, palpitation, dyspnea, or angina pain they are comfortable at rest.
  • Class IV: Patients who are not only unable to carry on any physical activity without discomfort but who also have symptoms of heart failure or angina syndrome even at rest the patient’s discomfort increases if any physical activity is undertaken.
  • About Congestive Heart Failure

    Congestive Heart Failure (CHF) Pathophysiology, Nursing, Treatment, Symptoms | Heart Failure Part 1

    Heart failure, sometimes called congestive cardiac failure , is a condition in which the heart muscle is weakened and cant pump as well as it usually does. The main pumping chambers of the heart can change size and thickness, and either cant contract or cant relax as well as they should. This triggers fluid retention, particularly in the lungs, legs and abdomen.

    The major causes of heart failure include coronary heart disease and heart attack, high blood pressure, damage to the heart muscle , heart valve problems and abnormal heart rhythms. Of these, coronary heart disease and heart attack are the most common causes.

    The major factors that contribute to coronary heart disease include:

    • reduced emotional and social wellbeing
    • physical inactivity.

    Heart failure is more common in elderly people. The survival rate for people with this disorder depends on the severity of their condition.

    Most common treatments for heart failure are medications and self-managed lifestyle changes. Some less-common treatments may require insertion of implantable cardiac devices or valve replacement.

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    What Kind Of Diet That Is Healthy For Your Heart

    Eat foods that are low in saturated fat, trans fat, sodium, and cholesterol. These nutrients tend to raise blood pressure and increase the risk of blood clots, both which can be detrimental to heart health.

    The DASH diet published by the American Heart Association for managing blood pressure recommends plenty of fruits, vegetables, whole-grains, nut and legumes, low-fat dairy products, skinless chicken and fish, and vegetable oils. Red meats and sweetened foods and beverages should be limited.

    Causes Of Congestive Heart Failure

    Irrespective of whether you call it congestive cardiac failure or simply heart failure, its most common causes include:

    • Heart rhythm disturbances

    Additionally, damaged or dying heart tissue due to an infection or a previous heart attack can result in congestive cardiac failure.

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    Congestive Heart Failure: Prevention Treatment And Research

    Congestive heart failure is a serious condition in which the heart doesnt pump blood as efficiently as it should. Despite its name, heart failure doesnt mean that the heart has literally failed or is about to stop working. Rather, it means that the heart muscle has become less able to contract over time or has a mechanical problem that limits its ability to fill with blood. As a result, it cant keep up with the bodys demand, and blood returns to the heart faster than it can be pumped outit becomes congested, or backed up. This pumping problem means that not enough oxygen-rich blood can get to the bodys other organs.

    The body tries to compensate in different ways. The heart beats faster to take less time for refilling after it contractsbut over the long run, less blood circulates, and the extra effort can cause heart palpitations. The heart also enlarges a bit to make room for the blood. The lungs fill with fluid, causing shortness of breath. The kidneys, when they dont receive enough blood, begin to retain water and sodium, which can lead to kidney failure. With or without treatment, heart failure is often and typically progressive, meaning it gradually gets worse.

    More than 5 million people in the United States have congestive heart failure. Its the most common diagnosis in hospitalized patients over age 65. One in nine deaths has heart failure as a contributing cause.

    What Is An Ejection Fraction

    Congestive Heart Failure doesnât happen in a day  it takes many months ...

    An ejection fraction is a measurement of the blood pumped out of your heart with each beat, expressed in a percentage. It can be measured using an echocardiogram , multigated acquisition scan, nuclear stress test, magnetic resonance imaging , or during a cardiac catheterization. A normal ejection fraction is between 50% and 70%.

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    How Can I Prevent Heart Failure

    You can prevent heart failure by preventing coronary heart disease and heart attack. The best way to do this is to reduce or eliminate the risk factors that lead to heart failure. You could:

    If you have had a heart attack, its even more important to manage your risk factors and follow your treatment plan. Make sure you check in frequently with your healthcare team.

    Some risk factors such as your age, whether you have other health conditions, or your genes may be outside your control. Speak with your doctor if you have concerns about developing heart failure, and how you can manage it.

    Can Surgery Be Used To Treat Heart Failure

    In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:

    • Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is . Although surgery is more risky for people with heart failure, new strategies before, during, and after surgery have reduced the risks and improved outcomes.
    • Heart valve surgery. Diseased heart valves can be treated both surgically and non-surgically .
    • Implantable left ventricular assist device . The LVAD is known as the “bridge to transplantation” for patients who haven’t responded to other treatments and are hospitalized with severe systolic heart failure. This device helps your heart pump blood throughout your body. It allows you to be mobile, sometimes returning home to await a heart transplant. It may also be used as destination therapy for long-term support in patients who are not eligible for transplant.
    • Heart transplant. A heart transplant is considered when heart failure is so severe that it doesn’t respond to all other therapies, but the person’s health is otherwise good.

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    What Are The Symptoms Of Heart Failure

    You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:

    • Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
    • Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen , and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.
    • Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
    • Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.

    If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart.

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