Cardiovascular / CardiologyHeart DiseaseHypertensionVascular

Congestive heart failure: Things to know

While congestive heart failure that sound like it does not actually mean that the heart has collapsed. Cardiac failure, however, is a severe condition in which the heart does not properly pump blood throughout the body.

We depend on the heart’s pumping action to provide nutrient- and oxygen- blood to every cell within the body. When cells aren’t well nourished, the body can not function properly.

When the heart is weakened and can’t supply enough oxygen to the body, the patient is exhausted and breathless. It is difficult daily tasks which were once taken for granted.

Heart failure is a severe disease and, generally, there is no remedy. The patient can still lead an enjoyable, meaningful, and productive life with the right care though.

Approximately 5.7 million people in the United States have heart failure, the National Heart, Lung and Blood Institute says.

Heart failure, heart attack, and cardiac arrest

A man suffering from heart attack
Heart failure comes in many forms and has many causes.

Here, we explain some important terms:

  • Heart attack – this is death of heart muscle due to the blockage of a coronary artery. The heart muscle dies because it is starved of oxygen (because blood is not getting to it).
  • Heart failure – this means the heart muscle cannot pump blood around the body properly. It is not a heart attack.
  • Cardiac arrest – this means the heart stops, blood circulation stops, and there is no pulse.

Causes

Any factors that damage the heart muscle causes a heart failure. Including:

  • Coronary artery disease – the coronary arteries supply the heart muscle with blood. If these are blocked or the flow is reduced, the heart does not receive the blood supply it needs.
  • Heart attack – a sudden block of the coronary arteries; this causes scars in the heart’s tissues and decreases how effectively it can pump.
  • Cardiomyopathy – damage to the heart muscle other than by artery or blood flow problems; for instance caused by drug side effects or infections.
  • Conditions that overwork the heart – for instance, valve disease, hypertension (high blood pressure), diabetes, kidney disease, or heart defects present from birth.

The following are risk factors for congestive heart failure; can increase the probability of this:

  • Diabetes – especially diabetes type 2.
  • Obesity – people who are both obese and have diabetes type 2 have an increased risk.
  • Smoking – people who smoke regularly run a significantly higher risk of developing heart failure.
  • Anemia – a deficiency of red blood cells.
  • Hyperthyroidism – overactive thyroid gland.
  • Hypothyroidism – underactive thyroid gland.
  • Myocarditis – inflammation of the heart muscle, usually caused by a virus, leading to left-sided heart failure.
  • Heart arrhythmias – abnormal heart rhythms, they may cause the heart to beat too fast, creating more work for the heart. Eventually the heart may weaken, leading to heart failure. If heartbeat is too slow not enough blood may get out from the heart to the body, leading to heart failure.
  • Atrial fibrillation – an irregular, often rapid heart beat; patients with atrial fibrillation have a higher risk of hospitalization due to heart failure, a study found.
  • Emphysema – a chronic disease that makes it hard for the patient to breathe.
  • Lupus – the patient’s immune system attacks healthy cells and tissues.
  • Hemochromatosis – a condition where iron accumulates in the tissues.
  • Amyloidosis – one or more organ systems in the body accumulate deposits of abnormal proteins.

Symptoms

Fatigue and dizziness are possible symptoms of heart failure.
Fatigue and dizziness are possible symptoms of heart failure.

The following are potential heart failure symptoms:

Congested lungs – fluid builds up in the lungs and induces shortness of breath even when resting and particularly when lying down. It can also cause hot, coughing cough.

Fluid retention – it can induce water retention as less blood is pumped to the kidneys. This can cause knees, legs and abdomen to become swollen. This may also cause increased weight gain and urination.

Fatigue and dizziness – when less blood enters the body’s organs, it can cause feelings of fatigue. Since less blood enters the brain may cause dizziness and confusion, too.

Irregular and quick heartbeats – the heart could be beating faster to try to overcome the lack of blood being pumped for each heart contraction.

Heart failure shares symptoms with other diseases, so if anyone lacks the signs, it doesn’t mean heart failure is present.

Whoever encounters more than one of the symptoms, however, should inform their doctor and ask for a heart assessment.

Those who have been diagnosed with heart failure should track their symptoms closely and promptly report any unexpected changes to their doctor.

Types

There are many different types of heart failure:

Left-sided heart failure

Left side cardiac insufficiency is the most common type of congestive heart failure. The left side of the heart is in charge of pumping blood to the rest of the body. Blood piles up into the lungs, because it is not pumped from the heart efficiently. This can result in shortness of breath and build-up of fluid.

Right-sided heart failure

The right side of the heart pumps blood to the lungs, where oxygen is stored. Quite commonly, right-side failure is caused by fluid build-up in the lungs due to a failure on the left. Certain conditions may also cause this, like lung disease.

Diastolic heart failure:

It occurs when the muscle in the heart becomes stiffer than usual. Since the heart is stiff, it doesn’t fully fill with blood; this is known as diastolic dysfunction.

Since the heart doesn’t fill up with blood, it can’t move as much blood around the body as required. Which can take place on either side of the neck.

Systolic heart failure:

Systolic dysfunction describes the failure of the heart to effectively pump after blood has been pumped. Sometimes, it happens when the heart is sluggish or swollen. Which can take place on either side of the neck.

Diagnosis

Originally, most people should see their doctor if they have symptoms. The doctor will speak with the patient about the symptoms. If the doctor suspects a heart attack, more tests may be required, such as:

  • Blood and urine tests – these will check the patient’s blood count and liver, thyroid, and kidney function. The doctor may also want to check the blood for specific chemical markers of heart failure.
  • Chest X-ray – an X-ray will show whether the heart is enlarged. It will also show whether there is fluid in the lungs.
  • An ECG (electrocardiogram) – this device records the electrical activity and rhythms of the patient’s heart. The test may also reveal any damage to the heart from a heart attack. Heart attacks are often the underlying cause of heart failure.
  • An echocardiogram – this is an ultrasound scan that checks the pumping action of the patient’s heart. The doctor measures the percentage of blood pumped out of the patient’s left ventricle (the main pumping chamber) with each heartbeat – this measurement is called the ejection fraction.

The doctor may also carry out the following additional tests:

  • Stress test – the aim here is to stress the heart and study it. The patient may have to use a treadmill or exercise machine, or take a medication that stresses the heart.
  • Cardiac MRI (magnetic resonance imaging) or CT (computed tomography) scan – they can measure ejection fraction as well as the heart arteries and valves. They can also determine whether the patient had a heart attack.
  • B-type natriuretic peptide (BNP) blood test – BNP is released into the blood if the heart is overfilled and struggling to function properly.
  • Angiogram (coronary catheterization) – a catheter (thin, flexible tube) is introduced into a blood vessel until it goes through the aorta into the patient’s coronary arteries. The catheter usually enters the body at the groin or arm. A dye is injected through the catheter into the arteries. This dye stands out on an X-ray and helps doctors detect coronary artery disease (arteries to the heart that have narrowed) – another cause of heart failure.

Prevention and management

Smoking
Giving up smoking is a way to reduce the likelihood of heart failure, or slow its progression.

There are many changes in lifestyle which reduce the chances of developing heart failure, or at least delay its progression. Including:

  • Give up smoking.
  • Eat sensibly, this includes plenty of fruit and vegetable, good quality fats, unrefined carbohydrates, whole grains, and the right amount of daily calories.
  • Exercise regularly and stay physically active (check with your doctor).
  • Keep blood pressure low.
  • Maintain a healthy body weight.
  • Quit alcohol, or at least consume alcohol within the national recommended limits.
  • Get at least 7 hours good quality sleep each night.
  • Mental stress may be bad for the heart over the long-term. Try to find ways of reducing exposure to mental stress.
  • Individuals who already have heart failure should be up-to-date with their vaccinations, and have a yearly flu shot.

Treatments

Damage to the pumping action of the heart caused by a heart attack can not be remedied. Nevertheless, existing therapies will dramatically enhance the patient’s quality of life by keeping the disease under control and helping to reduce many of the symptoms.

Treatment also focuses on addressing any disorders that can cause heart failure, which in turn will reduce the heart strain. A doctor or cardiologist will speak to the patient about medical options and recommend the right decisions, depending on the particular circumstances.

Some heart failure treatments include:

Medications

  • ACE inhibitors (inhibitors of Angiotensin-Converting Enzyme) – these drugs help the arteries relax, lower blood pressure, making it easier for the heart to pump blood around the body – they lower the heart’s workload. Ace inhibitors generally boost the performance of the heart and invariably improve the quality of life of the heart failure patient. These drugs are unsuitable for some patients, though. They can cause an irritating cough in some people.
  • Diuretics – these help patients with swollen ankles. They also relieve breathlessness caused by heart failure. Diuretics remove water and salt from the kidneys in the urine. There are three main types of diuretics – loop diuretics, thiazide diuretics, and potassium-sparing diuretics.
  • Anticoagulants – these drugs make it harder for the blood to clot; they help thin the blood and help prevent a stroke. The most commonly used anticoagulant is Warfarin. However, it has to be carefully monitored by the doctor to ensure the blood thinning effect is not excessive, and it will only be used if you have another reason to thin your blood. There have been a lot of studies on this discussion point. Most point toward no anticoagulation in patients without a diagnosis of afibrilation with or without another indication.
  • Digoxin – a drug for patients with a fast irregular heart rhythm. Digoxin slows down the heartbeat.
  • Beta-blockers – all heart failure patients benefit from beta-blockers.
  • Antiplatelet medicine – these stop the blood platelets from forming clots in the blood. Aspirin is an antiplatelet drug that can be suitable for people with a very high risk of a heart attack or stroke and a low risk of bleeding. Current guidelines no longer recommend the widespread use of aspirin to prevent cardiovascular disease.

Surgery

Not everybody who has heart failure responds to drug therapy. Coronary artery bypass graft-this is the most common procedure for congestive heart failure caused by coronary artery disease.

Heart valve surgery – to patch a faulty valve that contributes to increased heart function.

Implantable left ventricular assist device (LVAD) – this will help the heart pump blood for patients who have not responded to other therapies and are being hospitalized. It is also used by people awaiting a transplant.

Heart transplant – surgery is the best choice if no other therapies or operations will help. Transplants are not used in situations where the patient is stable other than the heart problem.

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