What is Heart Failure?

Despite  the way it sounds, the term "heart failure" simply means that your heart isn't pumping blood as well as it should.  Heart failure does not mean your heart has stopped working or that you are having a  heart attack (though people who have heart failure often have had a heart attack in the past). Heart failure  is also called congestive heart failure (CHF). "Congestive" means fluid is building up in  the body because the heart isn't pumping properly. 

What causes heart failure? 

Heart failure has many different causes. Sometimes the exact cause cannot be found.  The most common causes of  heart failure are listed below: 

Coronary artery disease (when the  blood supply to the heart is partially  or completely blocked);  with or without a heart attack in  the past 

• Problems with  the heart muscle itself (cardiomyopathy) 
• High blood pressure (hypertension) 
• Problems with any of the heart valves 
• Abnormal heart rhythms (arrhythmias) 
• The use of toxic substances (such as alcohol or drug abuse) 
• Congenital heart defect (a heart problem you were born with) 
• Diabetes 
• Thyroid problems 

What are the symptoms of heart failure? 

Some people who have heart failure have few problems or symptoms. The following is a list of symptoms people who have heart failure might experience: 

• Shortness of breath (perhaps when walking, climbing stairs or being active) 
• Shortness of breath when lying down 
• Lack of appetite 
• Waking up in the night, suddenly breathless 
• General tiredness or weakness, including the reduced ability to exercise 
• Swelling of  the legs, feet or ankles 
• Swelling of the abdomen 
• Rapid or irregular heartbeat 
• Rapid weight gain (1 or 2 pounds a day for 3 days in a row) 
• Chronic cough or wheezing 
• Nausea 

Call your doctor if you have any of these symptoms, especially if you've had heart problems before. 

How will my doctor know if I have heart failure? 

Your doctor will ask you about your medical history and symptoms. He or she will give you a physical exam and may order some  the following tests: 

• Blood tests 
• Urine tests 
• Chest X-ray 
• Electrocardiogram (also called EKG or ECG) 
• Echocardiogram 
• Radionuclide ventriculography 

An electrocardiogram records  the electrical activity of your heart. It can help diagnose  heart rhythm problems or damage  to the heart. An echocardiogram is a test that sends out sound waves that allow your doctor to see pictures  of your heart. The pictures show your doctor how well your  heart is pumping. 

Radionuclide ventriculography involves injecting a very small amount of a radioactive substance into your blood. This substance travels  to your heart. A special camera or scanner uses  the radioactive substance to produce pictures that show your doctor how well your heart is pumping.  The radioactive substance is safe and leaves your body completely after  the test is finished. 

What treatment will I need? 

Much can be done to improve how well the heart pumps  and to treat  the symptoms, but heart failure cannot be completely cured. An important part of treatment is taking care of any underlying problems, such as lowering high blood pressure or fixing a heart valve. Treatment also includes lifestyle changes and medicine. Here are some important things you should talk about with your doctor: 

• Diet:  Your doctor will likely tell you to reduce the amount  of salt you eat. He or she may also tell you to eat a diet low  in fat  and cholesterol.
• Alcohol:  You will be advised to limit alcohol. 
• Exercise:  Most people with heart failure can still exercise, but your doctor will help you decide how much  and what kind  of exercise you can do. 
• Weight:  Your doctor will tell you if you need to lose weight. 
• Family support: Your family can be an important source of support, so involve them when possible. Ask friends for help too. 
• Other sources of support:  Your doctor can give you information about support groups. It sometimes helps to talk with other  people who have similar problems. 

What medicines will I need to take? 

Many different medicines are used to treat heart failure. You may need one or more medicines, depending on your symptoms. Your doctor will talk about these medicines with you. It may take some time to find the best type of medicine and the best dosage (amount) of medicine for you. 

Several kinds of medicines are commonly used to treat heart failure: 

• ACE inhibitors.  ACE inhibitors help open (dilate) your arteries and lower your blood pressure, improving blood flow. 
• Diuretics.  Diuretics are often called "water pills" because they cause you to urinate more often and help keep fluid from building up  in your body. They can also decrease fluid that collects in your lungs. This will help you breathe easier. 
• Beta-blockers.  Beta blockers can lower blood pressure and slow a rapid heartbeat. They may also help prevent some heart rhythm problems. 
• Digoxin. Digoxin (also called digitalis) helps  the heart pump better by strengthening the muscle contractions of the heart. 

You might need to take other medicines if you  have other problems or if you experience side effects with any of these medicines. 

When you're taking medicine for  heart failure, you'll also need to have blood tests to check your potassium level  and kidney function. How often you need blood tests depends on  the type and strength of medicine you  are taking. Many patients take heart failure medicines without any problems. However, if you have concerns about  the medicine  or think you may be having side effects, you should talk to your doctor. It's very important that you take your medicine exactly as your doctor tells you. 

How often will I need to see my doctor? 

If you’ve just been in hospital for heart failure, be sure to follow up with your doctor within the first week of being home. At first, you may need to be checked as often as every week to see how you're responding to the medicine. Once your doctor has adjusted your medicine and you're feeling better, you may need to be seen less often. 

When should I call my doctor? 

Call your doctor if you have any of the signs or symptoms of heart failure listed above. Other serious problems with your heart or lungs can cause symptoms that are similar to heart failure. 

You should call your doctor if you have any questions about your condition or medications. 

 

Notes: Dr. Nelson Crumfield

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EditText of this page (last edited June 27, 2010)