Heart Failure
(Also known as: congestive heart failure)
Heart failure happens when the heart does not pump as strongly as it needs to. When the heart is not pumping well, the rest of the body does not get the blood and oxygen it needs to work properly.
The increased effort needed to pump enough blood can cause physical changes in the heart over time. These changes can include enlargement of the heart and thickening of the ventricle walls. Heart failure can also cause a backup of fluid in the lungs or other parts of the body. If too much fluid builds up in the lungs, a life-threatening condition called pulmonary edema can occur.
There are several different classifications and definitions of heart failure. A person's classification or stage of heart failure may be directly related to the extent of damage to the heart or to the level of heart function. Various symptoms and their acuteness are often used as indicators.
Causes
Heart failure is the result of damage to the heart. This damage can be caused by many different heart conditions, including:
- Coronary artery disease
- Heart valve disease
- High blood pressure
- Heart rhythm problems
- Thickening of the heart muscle
- Genetic disorders
Symptoms
Many symptoms of heart failure can easily be confused with the effects of aging or physical inactivity. Symptoms of heart failure can include:
- Shortness of breath, especially when lying flat
- Chest heaviness or discomfort
- Coughing
- Tiredness, even without physical activity
- Swelling of the ankles, legs, or abdomen
- Sudden weight gain of more than 2 lbs over two days or 5 lbs in a single week
- Continuous bloated or full sensation
- Change in or loss of appetite
- Nausea
- Frequent nighttime urination
Diagnosis
Tests commonly used to diagnose heart failure include:
- Echocardiogram: to determine the volume of blood pumped by the heart
- Electrocardiogram: to identify problems with heart rhythm
- MUGA scan (Left ventricular function study): a nuclear medical test to provide information about blood flow in the heart and pumping function during rest
- Persantine myoview: a nuclear medical test to detect the presence of blockages in the blood vessels supplying the heart
- Cardiac catheterization: to identify blocked or restricted arteries
- Blood tests
Treatment/Management
A variety of approaches can be taken in treating and managing heart failure. Only a trained specialist can determine the appropriate methods for any particular case.
Drug Therapies: Medications can include ACE inhibitors, beta blockers, diuretics, and a variety of other pharmaceuticals.
Surgery: A minority of patients are considered for surgical treatment options including the following:
- Cardiomyoplasty
- Coronary artery bypass surgery
- Mechanical assist devices, such as an implantable cardioverter-defibrillator (ICD) or a left ventricular assist device (LVAD)
- In rare cases, heart transplant
Lifestyle: Changes in diet, weight loss, and physical activity can alleviate symptoms and improve prognosis. In particular, fluid restrictions and a low-salt diet are essential.
Risk Factors and Prevention
Smoking, high blood pressure, and excess weight all increase the risk of developing heart failure and related conditions. Each of these risk factors can be controlled to help prevent the onset of heart failure and other forms of heart disease.
For more information, see the Heart Failure Patient Guide.
