Monday, January 30, 2023

Treatments For Congestive Heart Failure

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What Are Some Diet Modifications To Reduce Swelling

Congestive Heart Failure Diagnosis and Treatment

Edema, or swelling, can occur with congestive heart failure because your heart is not able to keep up with the circulation of blood in the body. A low salt diet will reduce the amount of fluid your kidneys retain.

According to the 2013 ACCF/AHA Guideline for Management of Heart Failure, limiting your liquid intake to 1.5 to 2 liters per day is recommended.

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.

New Moms And Heart Failure Risk

The research supports the notion that at-risk women need closer observation during that time period.

The researchers also say that because many women are discharged from hospital care just a couple of days after giving birth and arent given a follow-up appointment until about six weeks later, the way doctors regard women who might be at risk of heart failure needs to change.

They call for comprehensive postpartum discharge health education, with emphasis on signs and symptoms to look for and when or where to seek immediate care.

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What Is The Outlook For People With Heart Failure

With the right care, heart failure may not stop you from doing the things you enjoy. Your prognosis or outlook for the future will depend on how well your heart muscle is functioning, your symptoms, and how well you respond to and follow your treatment plan.

Everyone with a long-term illness, such as heart failure, should discuss their desires for extended medical care with their doctor and family. An “advance directive” or “living will” is one way to let everyone know your wishes. A living will expresses your desires about the use of medical treatments to prolong your life. This document is prepared while you are fully competent in case you are unable to make these decisions at a later time.

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How Can I Prevent Heart Failure

What Is The Treatment For Congestive 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.

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What Is An Ejection Fraction

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%.

How Is Congestive Heart Failure Diagnosed

Patients will typically have an intake visit with a heart specialist and nurse or physicians assistant. During this visit, the doctor will review the patients prior records and his or her current health status. This allows the doctor to establish a picture of where the patient is along the spectrum, and make a plan for prognosis and treatment.

The process often takes more than one meeting and involves both the patients local cardiologist or referring physician.

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Medicines For Heart Failure

Most people with heart failure are treated with medication. Often you’ll need to take 2 or 3 different medicines.

Some of the main medicines for heart failure include:

  • SGLT2 inhibitors

You may need to try a few different medicines before you find a combination that controls your symptoms but doesn’t cause unpleasant side effects.

How Can I Keep My Heart Failure From Getting Worse

Understanding Congestive Heart Failure (CHF) & Most Common Treatments

Monitor your symptoms. Check for changes in how much fluid builds up in your body by weighing yourself every day. Check for swelling, too.

See your doctor regularly. They’ll make sure you’re staying healthy and that your heart failure isn’t getting worse. They’ll ask to review your weight record and list of medications.

If you have questions, write them down and bring them with you to your appointment. Call your doctor if you have urgent concerns.

Tell all the doctors you see about your heart failure, the medications you take, and any restrictions you have. Also, tell your heart doctor about any new drugs prescribed by another doctor.

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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 .

What Is Heart Failure

Heart failure doesnât mean the heart has stopped working. Rather, it means that the heart works less efficiently than normal. Due to various possible causes, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart canât pump enough oxygen and nutrients to meet the body’s needs.

The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. The kidneys may respond by causing the body to retain fluid and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested. Congestive heart failure is the term used to describe the condition.

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Causes Of Heart Failure

The heart is a double pump made up of four chambers. Deoxygenated blood from the veins enters the right upper chamber , is passed to the right lower chamber , and then pumped to the lungs.

Oxygenated blood from the lungs enters the left upper chamber and then enters the left lower chamber . The blood is then pumped around the body, under pressure, via arteries.

In a person with heart failure, one or both ventricles dont empty properly. This leads to increased pressure in the atria and the nearby veins. This backlog of blood can affect the kidneys and lungs interfering with their function and leading to a build-up of fluid in the lungs, abdominal organs and legs.

In some people with heart failure, rather than failed pumping of the blood from the ventricle, there is failed relaxation of the ventricle.

If the heart is not pumping and becomes stiff and unable to relax, it can cause the blood to pool in the hearts ventricles. This can cause pressure build up and can put strain on the heart.

Heart failure can be caused by several conditions, including:

Pharmacological Management Of Heart Failure

Treatment for Congestive Heart Failure

Drugs used in heart failure include those used to initially manage mild to moderate failure and those used more commonly in severe to very severe conditions.

First Agents Used:

  • ACE Inhibitors: work by increasing vasodilation and decreasing workload of the heart in patients with CHF.
  • Diuretics: promote the removal from the body of excess water, salts, poisons, and accumulated metabolic products, such as urea. See also Aldosterone Receptor Antagonists
  • Glycosides and Congestive Heart Failure: a class of drugs that includes digoxin, digitoxin and ouabain. Such agents increase the force of contraction of the heart which underlies their use in some cases of heart failure.
  • Beta-Blockers : decrease the excessive activity of the sympathetic nervous system which is characteristic of CHF.
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy

    Additional Agents:

  • More aggressive diuretic therapy eg Loop diuretics such as Furosemide , one of the most commonly used drugs in the treatment edema caused by congestive heart failure .
  • Selection of agents and their combinations depend on initial clinical state and on patient responsiveness to initial therapy.

    An implantable cardioverter-defibrillator is indicated for primary prevention of sudden cardiac death in patients with HF who have an LVEF of less than or equal to 35%.

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    What Causes Heart Failure

    Heart failure is caused by many conditions that damage the heart muscle, including:

    • Coronary artery disease.Coronary artery disease , a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
    • Heart attack. A heart attack happens when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that doesnât work the way it should.
    • Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.
    • Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can happen when several diseases or conditions are present at once.

    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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    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.

    Symptoms Of Heart Failure

    Congestive Heart Failure – Treatments

    Symptoms of heart failure include:

    • new or worsening shortness of breath
    • difficulty lying flat at night
    • fainting or passing out
    • muscular fatigue, tiredness
    • swelling of ankles or legs
    • swelling of abdomen
    • heart palpitations
    • chest pain or discomfort in parts of the upper body
    • unexplained coughing and wheezing

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    Treatment And Medication Options For Congestive Heart Failure

    Heart failure is a chronic condition, and there is no cure. However, once youve been diagnosed, there are several things you can do to treat the condition and manage it so that it does not progress. Chief among them are lifestyle changes. That includes exercising and maintaining a heart-healthy diet thats low in saturated fat, trans fats, and cholesterol.

    What Are The Clinical Symptoms Of Congestive Heart Failure

    CHF affects many organs in the body due to poor blood perfusion, including the lungs, kidneys, and liver. Trouble breathing and exercise intolerance can occur.

    In severe cases, one is unable to perform activities of daily living such as getting out of bed, dressing, walking, and bathing.

    In left-sided heart failure, swelling of the feet and legs can occur. Kidney failure can also contribute to swelling.

    Unexplained weight loss despite adequate caloric intake is common, also known as cachexia. This Youtube video explains the science behind congestive heart failure and provides an animated model detailing the anatomy of the heart.

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    Surgical Options To Treat Underlying Causes Of Heart Failure

    • Coronary artery bypass graft to prevent and treat heart failure caused by blocked arteries. During bypass surgery, blood vessels taken from another part of the body usually the leg are attached to the clogged artery to create a detour around the blockage. This is conventionally done through open-heart surgery, but some patients may be candidates for minimally invasive CABG, an alternative offered at UCSF.
    • Angioplasty, another treatment for blocked arteries. A thin flexible tube called a catheter is inserted through a small incision in the groin or neck into a blood vessel. In one procedure, a balloon is introduced through the catheter into the center of a blocked blood vessel. When the balloon is inflated, the blockage material is compressed back against the walls of the artery. A small metal device, called a stent, may be inserted through the catheter to serve as a permanent barrier to keep the plaque compressed. In another type of procedure, instruments are introduced through the catheter to remove the plaque.
    • Implantation of pacemakers and other devices such as artificial heart valves
    • Repairing congenital heart defects

    Surgical treatments for heart failure itself include:

    How Is Congestive Heart Failure Treated

    Buy Congestive Heart Failure Medicine from Streamline Pharma(p) Ltd ...

    Doctors will assess the current health status of the patient to establish a baseline, and develop a long-term health plan. This may involve the optimization of medicines and therapies, adding new medication, or possibly enrollment in a clinical trial.

    Stabilizing and/or reversing a patients condition often involves long-term, collaborative follow-up with a referring cardiologist or physician.

    In serious situations, advanced therapies, which include mechanical solutions, a heart transplant, or hospice, may be offered.

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    Factors That Can Worsen Symptoms Of Heart Failure

    The symptoms of heart failure can be worsened by a number of factors, including:

    • too much salt, fluid, or alcohol in the diet
    • some viral and bacterial infections
    • kidney diseases

    Treatment for heart failure may include:

    • medicines, such as
    • diuretics to remove excess fluid and improve symptoms of heart failure
    • mineralcortiocoid receptor antagonists are also recommended and used in most patients with heart failure to reduce mortality and hospitalisation
    • ACE inhibitors to open up blood vessels, reduce blood pressure and reduce sodium retention and water retention
    • certain beta-blockers to slow the heart rate and reduce its work
    • aldosterone blockers to reduce blood pressure and reduce the effects of damage to the heart muscle
    • ACE inhibitors, beta blockers and aldosterone blockers can increase survival and reduce the likelihood of hospitalisation.
  • addressing the underlying disorder for example, treatment of high blood pressure
  • lifestyle changes such as regular gentle physical activity, losing excess body fat, stopping smoking, adhering to healthy eating patterns with low salt, restricting alcohol and having adequate rest
  • surgery to replace narrowed or leaking heart valves
  • coronary bypass surgery in some cases
  • heart transplant in extreme cases.
  • 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.

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    Nutrition And Dietary Supplements

    Heart failure is a serious medical condition and should be treated by conventional medicine. You should never add supplements or complementary and alternative medicine therapies to your regimen unless specifically instructed to do so by your physician. It is best to work with a health care provider trained in the use of nutritional medicine. Many people with heart conditions take multiple medications, including blood-thinning medications, blood pressure medications, and others. The supplements below can interact with these and many other medications and may not be right for people with certain medical conditions. You should use the supplements listed below only under the supervision of your cardiologist, and a doctor who understands the contraindications and interactions associated with these supplements.

    Amino acids. A few small studies suggest these amino acids might be helpful for heart failure. More research is needed:

    • Arginine . Arginine can lower blood pressure, and may be unsafe to take with blood pressure medications. It may also interact negatively with medications that increase blood flow, such as nitrates, as well as medications used to treat erectile dysfunction.
    • Taurine . Taurine can interact with lithium, and may be unsafe in people with bipolar disorder.

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