Stages C And D With Preserved Ef
Treatment for patients with Stage C and Stage D heart failure and reserved EF includes:
- Treatments listed in Stages A and B.
- Medications for the treatment of medical conditions that can cause heart failure or make the condition worse, such as atrial fibrillation, high blood pressure, diabetes, obesity, coronary artery disease, chronic lung disease, high cholesterol and kidney disease.
- Diuretic to reduce or relieve symptoms.
YOU ARE THE MOST IMPORTANT PART OF YOUR TREATMENT PLAN!
It is up to you to take steps to improve your heart health. Take your medications as instructed, follow a low-sodium diet, stay active or become physically active, take notice of sudden changes in your weight, live a healthy lifestyle, keep your follow-up appointments, and track your symptoms. Talk to your healthcare team about questions or concerns you have about your medications, lifestyle changes or any other part of your treatment plan.
Hypertension Or High Blood Pressure
Another cause of congestive heart failure is high blood pressure or hypertension. If you have high blood pressure, your heart muscle works extra hard to pump blood through your body.
As time passes, because of the overexertion, the muscles in your heart can become too weak or too stiff to properly circulate blood to your body. If you have high blood pressure, your heart muscle workextra hard to pump blood through your body.
Get Support And Know Your Options
Living with heart failure may cause fear, anxiety, depression, and stress. Talk to your healthcare team or a professional counselor. They can help you find or learn ways to cope.
- Get treatment for depression. If you are depressed, your doctor may recommend medicines or other treatments that can improve your quality of life.
- Join a patient support group. You can learn how other people who have similar symptoms have coped with them. Your doctor may be able to help you find local support groups, or you can check with an area medical center.
- Seek support from family and friends. Letting your loved ones know how you feel and what they can do to help can help lower your stress and anxiety.
- Know your treatment options. If your heart failure is very serious, palliative or hospice care can improve your quality of life and help make your daily life more comfortable. This type of care focuses on managing your symptoms, helping you avoid unnecessary tests or treatments, and providing support to your loved ones.
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How To Prevent Heart Failure
The key to preventing heart failure is to reduce your risk factors. You can control or eliminate many of the risk factors for heart disease high blood pressure and coronary artery disease, for example by making lifestyle changes along with the help of any needed medications.
Lifestyle changes you can make to help prevent heart failure include:
- Not smoking
- Controlling certain conditions, such as high blood pressure and diabetes
- Staying physically active
Treatment Options For Congestive Heart Failure
Thankfully, there are several treatment options available to cats suffering from congestive heart failure. If your cat has fluid built up in their chest or belly, your veterinarian may perform an emergency procedure called a thoracocentesis or abdominocentesis where they use a needle and syringe to remove this excess fluid. Removing this fluid can help keep your cat comfortable while they do additional diagnostics to determine the cause of the heart failure and may even save your cat’s life. Depending on the cause of the heart disease, your veterinarian may prescribe one or several medications that work together to prevent future episodes of congestive heart failure. Medications used to treat the congestive signs of heart failure in cats are oftentimes the same medicines used for humans suffering from congestive heart failure.
These medications are often available in pill, liquid or even transdermal forms. Most are even available in generic formulations. Your veterinarian may prescribe medications that help the heart muscles and blood vessels to relax or that aid in removing excess fluid from the lungs. Your veterinarian may also consider prescribing a mild blood-thinner to reduce your cat’s risk of developing dangerous blood clots.
Though it can be alarming to hear that your cat is in heart failure, there are a number of drugs available. Therefore, it may take some tweaking to find a medication plan that suits your cat best.
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What Is The Difference Between Right
Right-sided congestive heart failure causes poor venous blood return to the heart. In other words, when the heart contracts or pumps, instead of the right ventricle pushing the blood through the lungs for oxygenation, some blood leaks through the tricuspid valve back into the right atrium. This blood backs up into the systemic circulation and consequently becomes congested. Fluid accumulates in the abdomen, interfering with the function of the organs in these areas. The abdomen may fill with fluid, a condition called ascites. Fluid may also leak from veins in the limbs, causing swelling, known as peripheral edema.
In left-sided congestive heart failure , when the heart contracts or pumps, instead of the left ventricle pushing the blood into the systemic circulation, some blood leaks through the mitral valve back into the left atrium and then it backs up into the lungs. Fluid then seeps into the lung tissue resulting in pulmonary edema. This causes coughing and difficulty breathing. Left-sided congestive heart failure is the most common form of congestive heart failure. The classic signs of heart failure, coughing and fluid in the chest, are most commonly caused by LS-CHF.
Heart Failure Patients Too Optimistic
Study Shows Patients Overestimate Their Life Expectancy
A new study shows nearly two-thirds of people with congestive heart failure overestimate their remaining life expectancy by an average of 40% compared with what’s realistic based on their prognosis.
Heart failure, which occurs when the heart is too weak to pump enough blood to meet the body’s needs, causes 55,000 deaths each year and indirectly contributes to 230,000 more deaths annually in the U.S.
Although there have been recent improvements in congestive heart failure treatment, researchers say the prognosis for people with the disease is still bleak, with about 50% having an average life expectancy of less than five years. For those with advanced forms of heart failure, nearly 90% die within one year.
“Patient perception of prognosis is important because it fundamentally influences medical decision making regarding medications, devices, transplantation, and end-of-life care,” write researcher Larry A. Allen, MD, MHS, of the Duke Clinical Research Institute and colleagues in The Journal of the American Medical Association.
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What Are The Signs And Symptoms Of Congestive Heart Failure
Shortness of breath
The hallmark and most common symptom of left heart failure is shortness of breath and may occur.
Right heart failure, left heart failure, or both
Can Congestive Heart Failure Be Prevented
Unfortunately, when cats are diagnosed with congestive heart failure many will succumb to their heart disease within one year of the initial diagnosis. However, if heart disease can be identified BEFORE congestive heart failure develops, your cat has the potential remain your faithful companion for several years if their heart disease responds well to treatment. As the only person who sees your cat daily, your close attention is paramount. Closely monitor your cat’s weight, as both an increase or a drop in weight can be related to heart disease in cats. Ensure that your cat receives a well-balanced diet, as nutrition plays a large part in feline heart disease as well. There are therapeutic cat foods available for cats with heart disease to slow the disease’s progression.
Annual exams and routine blood work are also recommended, as this allows your vet to watch for trends of creeping blood values before they are outside the normal ranges. If you have an at-risk purebred cat or a cat who you know has a history or heart disease in their family, an annual heart ultrasound to screen for early signs of heart disease should also be discussed with your veterinarian. There are also genetic tests for HCM available and your veterinarian can discuss whether or not these may be appropriate for your pet.
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.
Medications Used To Treat Congestive Heart Failure
Treatment of congestive heart failure also includes medications. Doctors prescribe medicine to manage symptoms and to make it easier for the heart to function, which will improve symptoms and reduce the risk of complications.
- Angiotensin-converting enzyme inhibitors , which lower blood pressure and reduce on the heart
- Angiotensin-II receptor blockers , which are an alternative to lower blood pressure for those who can’t tolerate ACE inhibitors. Examples include losartan and valsartan .
- Combination valsartan-sacubitril , which is used in place of an ARB or ACE inhibitor
- Aldosterone blockers , which may be used for severe congestive heart failure
- Anticoagulants , which prevent the formation of blood clots that can lead to heart attack and
- Beta-blockers , which lower blood pressure, control heart rate, and reduce strain on the heart
- Cholesterol-lowering medications , which can reduce the risk of heart attack and stroke. Cholesterol-lowering medications also reduce the risk of recurrent heart attack and stroke.
- Digitalis drugs , which slow and strengthen the beating of the heart to make the heart muscle more effective in pumping blood
- Diuretics , which pull excess fluid out of the lungs and tissues of the body by increasing urine production
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When Is Surgery Necessary For Congestive Heart Failure
Surgery can repair some underlying causes of heart failure, such as blockage of the coronary arteries, a valve problem, a congenital heart defect, or thickened pericardium. For patients with severe coronary artery disease, coronary artery bypass graft surgery can be conducted to circumvent blockages in vessels and ensure that the heart muscle maintains its blood supply. Valve replacement surgery can also be performed to repair malfunctioning heart valves. However, once the heart’s ability to pump blood is severely, permanently, and irreversibly impaired, no surgery can repair the damage. The only alternative is a heart transplant. This option is for patients who are not elderly and who do not have other medical conditions that would make it unlikely for a heart transplant to be successful. Heart transplant evaluations are done in specialized centers. Over the years there have been new innovations in the field of cardiac surgery and if a heart transplant is not available, a left ventricular assist device may be implanted to help prolong life.
Left ventricle assist device : This device is surgically implanted to mechanically bypass the left ventricle. It can be used as a âbridge to transplantâ until a heart transplant is available.
- Alternatively, LVADs are also being used as âdestination therapyâ in patients who are not eligible for a transplant, but only at approved specialized medical centers.
Congestive Heart Failure Follow-up
Who Is At Risk For Heart Failure
About 5.7 million people in the United States have heart failure 10). The number of people who have this condition is growing.
Heart failure is more common in:
- People who are age 65 or older. Aging can weaken the heart muscle. Older people also may have had diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays among people on Medicare.
- Blacks are more likely to have heart failure than people of other races. Theyre also more likely to have symptoms at a younger age, have more hospital visits due to heart failure, and die from heart failure.
- People who are overweight. Excess weight puts strain on the heart. Being overweight also increases your risk of heart disease and type 2 diabetes. These diseases can lead to heart failure.
- People who have had a heart attack. Damage to the heart muscle from a heart attack and can weaken the heart muscle.
Children who have congenital heart defects also can develop heart failure. These defects occur if the heart, heart valves, or blood vessels near the heart dont form correctly while a baby is in the womb. Congenital heart defects can make the heart work harder. This weakens the heart muscle, which can lead to heart failure. Children dont have the same symptoms of heart failure or get the same treatments as adults.
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Stage D And Reduced E
Patients with Stage D HF-rEF have advanced symptoms that do not get better with treatment. This is the final stage of heart failure.
Stage D treatment
The usual treatment plan for patients with Stage D heart failure includes:
- Treatments listed in Stages A, B and C.
- Evaluation for more advanced treatment options, including:
- Heart transplant.
- Research therapies.
Center For Advanced Heart Failure/cardiomyopathy At Brigham And Womens Hospital
The Center for Advanced Heart Failure/Cardiomyopathy, an integral part of the Heart & Vascular Center at Brigham and Womens Hospital , brings together heart failure experts, including cardiologists, interventional cardiologists, cardiac surgeons, cardiovascular imaging specialists, congenital heart disease specialists, and many others, to care for patients as one team. Together, the team tailors therapies to each patients needs, offering the latest medical, interventional, and surgical approaches to congestive heart failure treatment.
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What Are The 4 Stages Of Congestive Heart Failure
Heart failure gets worse over time if it isnt treated. CHF has four stages:
Stage A is pre-heart failure. This is when your risk of developing heart failure is high because of family history or medical conditions you have, like high blood pressure, diabetes, or a history of alcohol abuse. In this stage, if you make major lifestyle changes, you might be able to avoid developing CHF altogether.
Stage B is still pre-heart failure. That means you have some type of heart disease , but have not developed symptoms of HF. Lifestyle changes can help but likely wont be enough. Depending on your underlying condition, your doctor may start you on medication, like beta blockers and/or ACE inhibitors.
Stage C means you’ve been diagnosed with heart failure. You have symptoms like shortness of breath, fatigue, weak legs, or swollen feet or ankles. Stage C treatmentin addition to the treatments for Stages A and Blikely calls for more medication, including pills to remove fluid by making you urinate more.
Stage D means advanced congestive heart failure. The symptoms are serious and don’t get better with treatment. Your doctor will talk with you about the need for additional drugs and possibly surgeries or procedures.
How Do They Remove Fluid From Congestive Heart Failure
The current in-hospital treatment for CHF involves removal of excess fluid with diuretic medication and/or ultrafiltration in which a machine bypasses the kidneys and filters water and salt from the body. However, these treatments can have unwanted side effects such as low blood pressure and worsening kidney function.
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How Do I Reduce My Risk For Heart Failure
You can reduce your risk for heart failure by controlling the conditions which can lead to heart failure. Actions such as quitting smoking, eating a healthy diet, and exercising regularly are recommended for all patients. People should have their blood sugar, cholesterol, and blood pressure checked regularly.
Finally, you should meet with an experienced cardiologist if you have risks for heart disease, possible symptoms, or family history.
Congestive Heart Failure Causes
These conditions or diseases can cause congestive heart failure by weakening or damaging the heart over time, often without a patient even knowing it:
- Coronary artery disease or heart attack This condition causes a build-up of fatty plaque in the arteries of the heart, weakening it. Heart attack can cause scarring and damage to the heart muscle.
- Faulty heart valves A damaged valve caused by a congenital disability, infection, or CAD, cannot work efficiently. This causes the heart to work harder and weaken over time.
- High blood pressure The extra exertion placed on the heart from high blood pressure will weaken or stiffen the heart over time, decreasing efficiency.
- Myocarditis This inflammation is caused by disease that may lead to left-sided heart failure.
- Cardiomyopathy Damage to the muscle. This can be caused by various reasons, including genetic factors, drug abuse, infection, or disease.
- Heart arrhythmia This condition causes the heart to beat with an abnormal rhythm, too fast , or too slow . This creates extra work for the heart and can damage it over time.
- Chronic disease Several chronic conditions may lead to heart damage over time, such as diabetes, hyperthyroidism, HIV, etc.
When dealing with an issue, the heart will compensate in particular ways that eventually cause damage through the whole body. Compensations used by a diseased heart include:
- Diverting blood flow from less essential tissues
- Narrowing blood vessels
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