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What Are The Symptoms For Congestive Heart Failure

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What Are The Internal Mechanisms That Occur On Congestive Heart Failure

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

Congestive heart failure may be a result of the physiological mechanisms taking place internally due to various reasons-

It can stem from a condition medically known as cardiomyopathy. In this, the heart muscles essentially start to weaken and the normal pumping action is done forcefully.

High blood pressure can damage the muscles of the heart making it weak and unable to pump blood efficiently.

Damage to the heart valves either due to leakage or even blockage may lead to improper functioning of the valves to carry blood throughout the body. In a typical problem of heart leakage, there may be back flow of the blood, making the heart pump blood harder to compensate. This pressurizes the heart and may lead to congestive heart failure.

An incident of heart attack, medically called the myocardial infarction may also lead to congestive heart disease. This may lead to damage of the blood vessels or the chambers of the heart thereby leading to congestive heart disease.

What Are The Most Common Symptoms Of Congestive Heart Failure

Swelling is the most common symptom of congestive heart failure. Often, swelling is most apparent in the extremities, especially in the legs and ankles, but it can occur in other parts of the body as well. Fluid collection in and around the lungs can cause shortness of breath , especially during physical activity or when lying down. Other common symptoms of heart failure include fatigue, loss of appetite, and weight gain.

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.

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Common Causes Of Lower Limb Oedema

  • Gravitational disorderfor example, immobility
  • Congestive heart failure
  • Venous thrombosis or obstruction, varicose veins
  • Hypoproteinaemiafor example, nephrotic syndrome, liver disease
  • Lymphatic obstruction

Fatigue and lethargy

Fatigue and lethargy in chronic heart failure are, in part, related to abnormalities in skeletal muscle, with premature muscle lactate release, impaired muscle blood flow, deficient endothelial function, and abnormalities in skeletal muscle structure and function. Reduced cerebral blood flow, when accompanied by abnormal sleep patterns, may occasionally lead to somnolence and confusion in severe chronic heart failure.

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Congestive Heart failure: Causes and Types

If your family member has recently been diagnosed with congestive heart failure, now may be the ideal time to consider home health care. A home care service provider can be with your loved one on a customized schedule that is right for your family.

This means that even if you are not able to be with them, you can be confident in knowing they are getting everything they need to stay healthy, safe, and comfortable, as well as maintain as much independence and control as possible.

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What Is A Heart Failure Flare

A flare-up is when your heart failure symptoms suddenly get worse. This might include increased shortness of breath, increased swelling of your ankles or tummy or worsening cough. A flare-up might be triggered by an infection, but there may be no apparent reason. A flare-up is also known as an exacerbation.

Each flare-up can make your heart weaker. It’s a common cause of admission to hospital. It’s important to be prepared and know how to recognise the symptoms of a flare-up and what to do when they happen.

Symptoms Of Congestive Heart Failure

The symptoms of congestive heart failure are also associated with other diseases and ailments.

In the early stages of congestive heart failure, there is a possibility that you might not feel any changes or symptoms. But as the disease progresses, symptoms appear.

Following symptoms would indicate a person has congestive heart failure:

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What Are The Causes Of A Flare

A heart failure flare-up means you are retaining fluids in your body, such as in your lungs, ankles or tummy. Extra fluids can be due to a number of causes, including:

  • not taking your diuretics or other heart failure medicines regularly
  • recent changes in your heart failure medicines
  • an infection
  • feeling very unwell generally.

How Are Heart Failure And Its Causes Diagnosed

Congestive Heart Failure: Symptoms, Causes, and Treatment Options – St. Mark’s Hospital

Your doctor or GP will ask you questions about your symptoms and your past medical history. They will also examine you, including checking your pulse and blood pressure and listening to your heart.

Some tests can be done to help diagnose heart failure and its possible causes.

  • Blood tests such as testing for electrolytes, kidney function test, full blood count, thyroid function test or a brain natriuretic peptide test .
  • An electrocardiogram to check the electrical activity of your heart and for a heart rhythm that can cause heart failure.
  • An echocardiogram an echo is an ultrasound scan of your heart and shows how each part of your heart is functioning, and how much blood is being pumped with each beat.
  • A chest x-ray this can find out if there is fluid in your lungs and other lung conditions that can cause the same symptoms as heart failure.
  • Breathing tests such as spirometry a spirometry can find out if your breathlessness is caused by another lung condition.

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You Continue To Feel Worse Not Better

If you notice these symptoms of congestive heart failure and dont see a doctor, your condition will worsen. You may begin to feel tired and short of breath after getting dressed or walking across the room, states the NHLBI. Some people have shortness of breath while lying flat. Dr. Fonarow warns that its crucial to identify the condition before it progresses to an emergency because heart failure left untreated is an extremely dangerous downward slope. The survival rates with untreated heart failure are worse than with most cancers. Without adequate treatment, people will not be alive within five years of diagnosis.

Information For Healthcare Providers On Heart Failure

The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.

The following information on heart failure is taken from Auckland Regional HealthPathways, NZ, accessed March 2021:

Practice point

Check new onset shortness of breath

Unless history and physical examination clearly indicate a non-cardiac cause for their symptoms, evaluate all patients for heart failure who present with new onset shortness of breath on exertion, orthopnoea, or paroxysmal nocturnal shortness of breath.

The following information on managing exacerbations of heart failure is taken from Auckland Regional HealthPathways, NZ, accessed March 2021:

Red flags

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What Medications Should I Avoid If I Have Heart Failure

There are several different types of medications that are best avoided in those with heart failure including:

  • Nonsteroidal anti-inflammatory medications such as Motrin or Aleve. For relief of aches, pains, or fever take Tylenol instead.
  • Most calcium channel blockers
  • Some nutritional supplements, such as salt substitutes, and growth hormone therapies
  • Antacids that contain sodium

If youâre taking any of these drugs, discuss them with your doctor.

Itâs important to know the names of your medications, what theyâre used for, and how often and at what times you take them. Keep a list of your medications and bring them with you to each of your doctor visits. Never stop taking your medications without discussing it with your doctor. Even if you have no symptoms, your medications decrease the work of your heart so that it can pump more effectively.

Stage C Treatment Options

Congestive Heart Failure (CHF): Symptoms, Stages, Life Expectancy ...

Treatment at this stage focuses on managing your symptoms, optimizing your heart function, and preventing worsening of your condition.

Medications to treat stage C heart failure include:

  • Diuretics to reduce fluid retention
  • Beta blockers to help make your heart work less hard
  • SGLT2 inhibitors to reduce the risk of cardiovascular death and hospitalization for heart failure
  • Angiotensin-converting enzyme inhibitors
  • Angiotensin II receptor blockers
  • Entresto , which reduces the risk of death and hospitalization among patients with chronic heart failure
  • Aldosterone antagonists
  • Digoxin to help the heart beat stronger and more regularly
  • Possible cardiac resynchronization therapy
  • Possible implantable cardiac defibrillator therapy

In addition to the lifestyle changes for stages A and B, you may need to make the following changes:

  • Reduce your sodium intake
  • Restrict fluid intake
  • Keep track of your weight daily

Remember that even if the treatment causes your symptoms to get better or stop, you still need to continue treatment to slow the progression of your condition to stage D.

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Youre Always Worn Out

Simple activities like climbing stairs or vacuuming could leave you feeling lightheaded and fatigued. When the heart cant pump enough blood to meet the bodys needs, the body compensates by diverting blood away from less vital organsespecially muscles in the limbsand re-routing it to the brain and heart, according to the AHA. This fatigue is another symptom of congestive heart failure that can become particularly bothersome to patients, says Dr. Fonarow: It can get so debilitating they cant get through their daily activities.

What Are The Complications Of Heart Failure

Some of the complications from heart failure include:

  • Irregular heartbeat.
  • History of taking drugs that can damage your heart muscle, such as some cancer drugs.

Stage B

Stage B is considered pre-heart failure. It means your healthcare provider has given you a diagnosis of systolic left ventricular dysfunction but youve never had symptoms of heart failure. Most people with Stage B heart failure have an echocardiogram that shows an ejection fraction of 40% or less. This category includes people who have heart failure and reduced EF due to any cause.

Stage C

People with Stage C heart failure have a heart failure diagnosis and currently have or previously had signs and symptoms of the condition.

There are many possible symptoms of heart failure. The most common are:

  • Shortness of breath.
  • Need to urinate while resting at night.
  • Rapid or irregular heartbeats .
  • A dry, hacking cough.
  • A full or hard stomach, loss of appetite or upset stomach .

There may be times that your symptoms are mild or you may not have any symptoms at all. This doesn’t mean you no longer have heart failure. Symptoms of heart failure can range from mild to severe and may come and go.

Unfortunately, heart failure usually gets worse over time. As it worsens, you may have more or different signs or symptoms.Its important to let your doctor know if you have new symptoms or if your symptoms get worse.

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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.

Reversing Congestive Heart Failure

Pathophysiology of Congestive Heart Failure (CHF)

It is possible to reverse congestive heart failure. Once the condition of your heart is assessed, the physician will take further steps to treat your congestive heart failure and start appropriate treatment.

This treatment starts with medications and then other procedures may be done to attempt to help the heart get stronger. There are a lot of medications available that will help in improving the quality of your life.

Cardiac viability tests are non-invasive tests that should be done initially to asses if the heart muscle is still alive and if the hearts condition is reversible. Cardiac viability tests should be done prior to any invasive procedures, to make sure the heart condition is reversible and to see if the invasive procedure is truly needed.

For reversal of this disease, early diagnosis is very important.

Cardiac PET provides one of the best and easiest ways to assess for cardiac viability in all individuals.

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How Is Heart Failure Diagnosed

Your doctor will ask you many questions about your symptoms and medical history. Youâll be asked about any conditions you have that may cause heart failure . Youâll be asked if you smoke, take drugs, drink alcohol , and about what drugs you take.

Youâll also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

Other tests may be ordered, depending on your condition.

What Are Heart Failure Symptoms

If you have heart failure, you may not have any symptoms, or the symptoms may range from mild to severe. Symptoms can be constant or can come and go. Heart failure symptoms are related to the changes that occur to your heart and body, and the severity depends on how weak your heart is. The symptoms can include:

  • Congested lungs. A weak heart causes fluid to back up in the lungs. This 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. A weak heart pumps less blood to your kidneys and causes fluid and water retention, resulting in swollen ankles, legs, and abdomen and weight gain. This can also cause an increased need to urinate during the night as your body attempts to get rid of this excess fluid. Bloating in your stomach may cause a loss of appetite or nausea.
  • Dizziness, fatigue, andweakness. 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 fast or irregular heartbeat. Irregular heartbeats also can become more common as the heart weakens.

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Heart Failure Symptoms By Class And Stage

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Heart failure is a complex, chronic syndrome that gets worse over time. During the diagnostic process, physicians classify each case of heart failure. The American College of Cardiology/American Heart Association and the New York Heart Association have complementary classification systems.1-4

The ACC/AHA stages reflect the range from a high risk of developing heart failure to advanced heart failure and are associated with an approach to treatment plans.1-4 The New York Heart Association clinical classifications of heart failure reflect the severity of symptoms or functional limits due to heart failure.1-2 A diagnosis can have an assignment of a stage and a class.

Swelling And Weight Gain

congestive heart failure symptoms

Your feet, ankles, and abdomen are all areas of the body that can swell. Its possible to have some swelling after a workout or on a very hot day. When swelling occurs, its called edema.

Edema happens in heart failure because your kidneys arent able to properly filter sodium. Your heart then releases chemicals that cause the body to hold onto fluid. You might notice that your clothes or shoes no longer fit right, or that youve gained weight unexpectedly or quickly.

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How Can I Care For Myself With Heart Failure

Managing heart failure well needs the input of your GP, who knows about any other health issues you have that affect health failure. Other healthcare team members that may be involved include a heart specialist, heart failure nurse, dietitian and pharmacist.

There are also things you can do to monitor and improve your symptoms, including:

  • having a heart failure action plan
  • weighing yourself each day at the same time
  • healthy eating

Have A Heart Failure Action Plan

A heart failure action plan provides you with instructions and information on how to manage your heart failure on a daily basis and also how to recognise and cope with worsening symptoms, such as flare-ups . 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. At each visit with your healthcare provider, you can review the plan and make adjustments as needed.

Here’s an example of a heart failure action plan by the Heart Foundation NZ.

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