Despite the way it sounds, the term "heart failure" means that your heart isn't pumping blood as well as it should. Heart failure doesn't mean your heart has stopped working. Heart failure is also called congestive heart failure. "Congestive" means fluid is building up in the body because the heart isn't pumping properly.
The causes of heart failure:
Heart failure has many different causes. Sometimes the exact cause can't be found. The most common causes of heart failure are listed below:
- Coronary artery disease (narrowing of the blood vessels to the heart)--often people with heart failure have had a heart attack in the past
- Problems with the heart muscle itself (known as cardiomyopathy)
- High blood pressure (also known as hypertension)
- Problems with any of the heart valves
- Irregular heart rate seen either as a missing or an extra pulse repeating too often.
- Toxic substances (such as alcohol abuse)
The symptoms of heart failure:
Some people with heart failure have few problems or symptoms. The following is a list of problems that people with heart failure might have:
- Shortness of breath (perhaps when walking or climbing stairs)
- Shortness of breath when lying down flat in bed
- Waking up in the night, suddenly breathless
- General tiredness or weakness
- Swelling of the legs (usually, just the feet or ankles)
- Rapid weight gain (1 or 2 pounds a day for 3 days in a row)
- Chronic cough
Call your doctor if you have any of these symptoms, especially if you've had heart problems before.
The useful tests:
Your doctor will probably suspect heart failure based on your medical history, symptoms and a physical exam. He or she might also order some the following tests:
- Blood tests
- Chest x-ray
- Electrocardiogram ( ECG)
The last 2 tests are often used to make sure of the diagnosis. An echocardiography is a test that causes no pain. A probe is moved across the surface of your chest. It sends out sound waves that allow your doctor to get pictures of your heart. The pictures show your doctor how well your heart is pumping.
The Treatment of heart failure:
Much can be done to improve the heart's pumping and to treat the symptoms, but heart failure can't be completely cured. An important part of treatment is taking care of any underlying problems, such as high blood pressure. Treatment also includes lifestyle changes and medicine. Here are some important things you should talk about with your doctor:
Medications useful in heart failure:
- Diet--you may be told to reduce the amount of salt you eat. Other changes in diet may be advised, depending on other health problems you may have.
- Alcohol--you will be advised to drink less 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.
- Family support--your family can be a big help to you, so involve them when possible.
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 a while to find the best medicine and the optimum dose for you.
Several kinds of medicines are commonly used to treat heart failure:
ACE inhibitors. (Enalapril, Lisinopril) ACE inhibitors help open dilate your arteries and lower your blood pressure, improving blood flow.
Diuretics. Diuretics are often called "water pills" because they make you urinate more often and help keep fluid from building up in your body. They can also decrease fluid that collects in your lungs, which helps you breathe easier.
Beta blockers. Beta blockers can improve blood flow and may help prevent some heart rhythm problems.
Digoxin. Digoxin (also called digitalis) helps the heart pump better. It may be combined with other medicines.
Vasodilators. Like Sorbitrate, Nitrates, Dihydrallazine act by dilating the blood vessels in the body and hence reducing the workload on the heart.
You might need to take other medicines if you have other problems or if you have side effects with any of these medicines.
When you're taking medicine for heart failure, you'll need to have blood tests to check the level of a substance in your blood known as potassium and to check your kidney functions. How often you need blood tests depends on the type and strength of medicine you are taking. Many patients take these 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 advised by your doctor.
At first, you may need to be seen as often as every week to check how you're reacting to the medicine. After your doctor has adjusted your medicine and you're feeling better, you may need to be seen less often.
You should call your doctor if you are short of breath or have swelling in your ankles or feet. You should also call if you gain 3 to 5 pounds in 1 or 2 days. (To keep track of your weight, weigh yourself each morning after urinating but before you eat anything.)
You should call your doctor if you have any questions about your condition or medicine.
This is a general overview on this topic and may not apply to everyone. To find out if this handout applies to you and to get more information, talk to your doctor.
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