Treatment Of Severe Congestive Heart Failure
Severe congestive heart failure with acute is often diagnosed and initially treated in an emergency room setting. Treatment includes:
- Intensive monitoring and stabilization of heart rhythm and vital signs. In some cases, this may require cardiopulmonary resuscitation , and advanced life-support measures, such as and mechanical ventilation to support breathing.
- Intravenous medications to rapidly draw fluid out of the lungs and reduce strain on the heart
- Monitoring your heart rate and rhythm with an electrocardiogram and blood tests to determine the extent of heart damage
- Supplemental oxygen to ease breathing and increase the amount of oxygen that is delivered to the heart tissue and the rest of the body
- Treatment of abnormal heart rhythms with medications and possibly electrical or
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.
Lifestyle And Dietary Changes
Lifestyle and dietary changes that are often recommended for people with chronic heart failure include:
- Stopping smoking: People who smoke should stop. Doctors are able to advise on the best methods of doing this.
- Limiting alcohol intake: If a personâs condition was caused by alcohol consumption, they should stop. Doctors are able to advise on the best methods of doing this.
- Losing weight: If a person is overweight, they should lose weight. This can lessen the strain placed on the heart.
- Taking regular exercise: Exercise can help to reduce symptoms such as shortness of breath and fatigue. Before beginning a new exercise regimen, however, a person should consult their doctor about how to do this in a safe way.
- Limiting salt intake: Salt can cause the retention of excess fluid in the body. By managing the amount of salt in oneâs diet, therefore, chronic heart failure can be managed. A doctor will advise on how much salt should be consumed.
- Weighing yourself daily: It is important for people who have been diagnosed with chronic heart failure to weigh themselves daily. If a personâs weight increases by around 2 kg over a period of 1 to 3 days, they should contact a doctor. This is a sign of fluid retention and may require intervention.
People with severe chronic heart failure may be asked to limit the amount of fluid, including water, they consume. Doctors will advise on exactly how much fluid to drink and how to do this in a safe way.
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Women And Heart Failure
Women are just as likely as men to develop heart failure, but there are some differences:
- Women tend to develop heart failure later in life compared with men.
- Women tend to have heart failure caused by high blood pressure and have a normal EF .
- Women may have more shortness of breath than men do. There are no differences in treatment for men and women with heart failure.
Why A Cough May Be An Important Sign Of Heart Failure
Coughing generally is regarded as a symptom of a respiratory infection or an involuntary reaction to swallowing something “wrong,” but for people with heart failure a chronic cough can indicate their treatment isn’t working as well as it should. A so-called “cardiac cough” or “heart cough” also can be a side effect of certain medications used to treat heart failurein particular angiotensin-converting enzyme inhibitors). If you have heart failure and develop a cardiac cough, it will be important to work with your healthcare provider to figure out what’s causing it.
Laura Porter / Verywell
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Signs Symptoms And Complications
Symptoms of heart failure depend on the type of heart failure you have and how serious it is. If you have mild heart failure, you may not notice any symptoms except during hard physical work. Symptoms can depend on whether you have left-sided or right-sided heart failure. However, you can have symptoms of both types. Symptoms usually get worse as your heart grows weaker.
Heart failure can lead to serious and life-threatening complications.
What Is Ejection Fraction
Ejection fraction refers to how well your left ventricle pumps blood with each heart beat. Most times, EF refers to the amount of blood being pumped out of the left ventricle each time it contracts. The left ventricle is the heart’s main pumping chamber.
Your EF is expressed as a percentage. An EF that is below normal can be a sign of heart failure. If you have heart failure and a lower-than-normal EF , your EF helps your doctor know how severe your condition is.
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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.
How Is Congestive Heart Failure Treated
We assess the current health status of the patient to establish a baseline and develop a long-term health plan with the goal of improving the patients health, says Dr. Jacoby. This may involve the optimization of medicines and therapies, adding new medication or maybe enrollment in one of the clinical trials going on here.
Theres no quick fix, he says. Stabilizing and/or reversing a patients condition often involves long-term collaborative follow-up with a referring cardiologist or physician, Dr. Jacoby says.
In worst-case scenarios, we may offer advanced therapies, which include mechanical solutions, a heart transplant or hospice, Dr. Jacoby says. But first, we work very closely with our partners in cardiology and Interventional Cardiology Program at Yale to see if the patient would benefit from any interventional strategies.
“Yale has the best program in the area for heart transplants and artificial parts, but we want to exhaust all other options to avoid either if we can.
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Taking Action Against Fluid Retention
If you gain more than 2 pounds in a day or 4 pounds in a week, Dr. Eldrin advises taking these steps:
- Think about the foods you ate in the days before your weight gain and look for sources of extra sodium or fluid in your diet that you may be able to eliminate.
- If your weight doesn’t return to normal in a day or two, call your doctor or nurse for advice. You may need to increase your diuretic medicine or reconsider how much fluid you are drinking.
The Stages Of Dying From Congestive Heart Failure
There are more than five-million people in the United States affected by heart failure and approximately 500,000 new cases are diagnosed every year. This condition leads to the heart becoming too weak to pump blood throughout all the areas of the body. This results in the body being deprived of the nutrients and oxygen that are necessary to keep the body functioning properly. This condition can be either chronic or acute. There are four stages of dying from congestive heart failure and during the last stage, the body ultimately shuts down.
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Understanding Heart Failure In The Elderly
When a person has heart failure , it means that their heart is unable to pump enough blood throughout their body. Heart failure usually develops over time. As the heart weakens, it either cannot fill with enough blood, pump with enough force or both. While this cardiovascular condition sounds scary, heart failure does not imply that the heart has stopped working or is about to stop working.
What Are The Symptoms Of Heart Failure
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.
In general, heart failure gets worse over time. As it worsens, you may have more or different signs or symptoms. It is important to let your doctor know if you have new symptoms or if your symptoms get worse.
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What Is Heart Failure
Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the bodys needs for blood and oxygen. Basically, the heart cant keep up with its workload.
Watch an animation of heart failure.
At first the heart tries to make up for this by:
- Enlarging. The heart stretches to contract more strongly and keep up with the demand to pump more blood. Over time this causes the heart to become enlarged.
- Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
- Pumping faster. This helps increase the hearts output.
The body also tries to compensate in other ways:
- The blood vessels narrow to keep blood pressure up, trying to make up for the hearts loss of power.
- The body diverts blood away from less important tissues and organs , the heart and brain.
These temporary measures mask the problem of heart failure, but they dont solve it. Heart failure continues and worsens until these compensating processes no longer work.
Eventually the heart and body just cant keep up, and the person experiences the fatigue, breathing problems or other symptoms that usually prompt a trip to the doctor.
The bodys compensation mechanisms help explain why some people may not become aware of their condition until years after their heart begins its decline.
About Congestive Heart Failure
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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Diagnosing Chronic Heart Failure
Diagnosis is typically based on a personâs medical history, a physical examination and a series of tests. Tests are used by doctors to identify the underlying cause of the chronic heart failure and may include:
- Echocardiogram : This test uses high-frequency sound waves to provide doctors with an insight into the different functions of the heart. It is considered the most important tool in the diagnosis of heart failure.
- Electrocardiogram : Used to test and record the heartâs rhythm and electrical activity.
- Chest X-ray: Able to give doctors a picture of the heart. Can also reveal if there is a buildup of fluid.
- Brain natriuretic peptide or N-terminal pro-BNP : A blood test to measure BNP or NT-proBNP protein levels, both of which tend to be elevated in people with heart failure.
In some cases, other tests, including urine tests and MRI scans, may also be used.
Living With Congestive Heart Failure: What To Expect
Yes, there are several lifestyle changes you should take into account if youve been diagnosed with congestive heart failure. But remember your diagnosis doesnt mean you should necessarily stop doing things you love.
You are supposed to be exercising walking, biking, swimming, or doing light weight exercises, says Mountis. The American Heart Association recommends at least 30 minutes of moderate intensity aerobic activity at least five days a week for optimal heart health. Avoid exercises that make you feel breathless, and make sure to talk to your doctor before starting a new exercise routine.
Your healthcare provider will also likely suggest dietary changes that can help reduce the swelling associated with congestive heart failure and slow the progression of the condition. Those changes may include following a low- or reduced-salt diet, or reducing how much fluid you drink to lessen the bodys water content.
Other lifestyle changes that can slow the progression of heart failure include:
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Quality Of Patient Care
Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient care we provide and how we are measured compared with other hospitals.
Types Of Heart Failure
There are a few different types of HF and each has its own unique symptoms, depending on which areas of the organ are affected. In normal hearts, blood vessels called veins bring oxygen-poor blood from the body to the right side of the heart. It is then pumped through the pulmonary artery to the lungs, where it becomes re-oxygenated. From there, the blood returns to the left side of the heart and is pumped through a large artery called the aorta that distributes it throughout the body.
Heart failure is a chronic, progressive condition, meaning it is persistent and worsens over time. Cardiac conditions like heart attack and high blood pressure, as well as conditions like diabetes and kidney disease can cause cumulative damage to the heart. At first, the organ finds ways to compensate, but over time these methods of keeping up with an increasing workload cause more damage to the heart muscles. The hearts chambers may compensate by stretching to pump more strongly, which causes the walls to thin, or they may thicken as the muscles of the heart build up to provide more force.
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Lifestyle And Home Remedies
Making lifestyle changes can often help relieve signs and symptoms of heart failure and prevent the disease from worsening. These changes may be among the most important and beneficial you can make. Lifestyle changes your doctor may recommend include:
- Stop smoking. Smoking damages your blood vessels, raises blood pressure, reduces the amount of oxygen in your blood and makes your heart beat faster.
If you smoke, ask your doctor to recommend a program to help you quit. You cant be considered for a heart transplant if you continue to smoke. Avoid secondhand smoke, too.
- Discuss weight monitoring with your doctor. Discuss with your doctor how often you should weigh yourself. Ask your doctor how much weight gain you should notify him or her about. Weight gain may mean that youre retaining fluids and need a change in your treatment plan.
- Check your legs, ankles and feet for swelling daily. Check for any changes in swelling in your legs, ankles or feet daily. Check with your doctor if the swelling worsens.
- Eat a healthy diet. Aim to eat a diet that includes fruits and vegetables, whole grains, fat-free or low-fat dairy products, and lean proteins.
- Restrict salt in your diet. Too much sodium contributes to water retention, which makes your heart work harder and causes shortness of breath and swollen legs, ankles and feet.
If you have severe heart failure, your doctor may also suggest you limit the amount of fluids you drink.
How To Prevent Heart Failure And Manage Symptoms
Chronic heart failure is usually caused by other diseases or conditions that damage the heart muscle, such as coronary artery disease, diabetes and high blood pressure. However, acute HF can come on suddenly due to a heart attack, infection or pulmonary embolism . Taking steps to maintain a healthy cardiovascular system will significantly minimize the risk of developing heart failure.
Maintaining desirable cholesterol levels and blood pressure is crucial for heart health. Clogged arteries can contribute to high blood pressure, causing the heart to work harder and raising the risk of HF.
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Diabetes, obesity, smoking cigarettes and excess alcohol consumption all have negative impacts on heart health. Lifestyle changes, such as eating a healthy diet and exercising regularly, can be beneficial at any age. However, starting these healthy habits early on is vital because the damage caused by heart disease can be permanent. Be sure to discuss diet and/or exercise changes with a physician before beginning a new regimen.
For more information on treatments for heart failure, how it progresses and tips on managing symptoms of this condition, read Caring for a Loved One with Heart Failure.
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What Causes Heart Failure
Heart failure can be caused by many medical conditions that damage the heart muscle. Common conditions are:
- Coronary artery disease affects the arteries that carry blood and oxygen to the heart . The normal lining inside the arteries breaks down, the walls of the arteries become thick, and deposits of fat and plaque partially block the flow of blood. Over time, the arteries become very narrow or completely blocked, which causes a heart attack. The blockage keeps the heart from being able to pump enough blood to keep your organs and tissues healthy. When arteries are blocked, you may have chest pain and other symptoms of heart disease.
- Heart attack. A heart attack happens when a coronary artery suddenly becomes blocked and blood cannot flow to all areas of the heart muscle. The heart muscle becomes permanently damaged and muscle cells may die. Normal heart muscle cells may work harder. The heart may get bigger or stiff .
- Cardiomyopathy. Cardiomyopathy is a term that describes damage to and enlargement of the heart muscle not caused by problems with the coronary arteries or blood flow. Cardiomyopathy can occur due to many causes, including viruses, alcohol or drug abuse, smoking, genetics and pregnancy .
- Tobacco and illicit drug use.
- Medications. Some drugs used to fight cancer can lead to heart failure.