Essential Facts About Heart Failure

Essential Facts About Heart Failure

Learn about the causes, symptoms and treatments to keep your heart pumping strong.

Contrary to popular belief, heart failure doesn’t mean that your heart suddenly stops beating. “Heart failure is when your heart cannot adequately deliver oxygen-rich blood to other organs,” says Ram Wadehra, MD, a cardiologist with Our Lady of Lourdes Medical Center in Camden, New Jersey. It contributed to about 1 in 9 deaths in 2009.

Heart failure is debilitating and can be deadly in the long term, but it’s also preventable. A good diet, enough exercise, not smoking, avoiding drugs and excessive alcohol and managing stress can all go a long way to preventing it. Learn the must-know facts about causes, symptoms and treatment of heart failure.

Causes and symptoms
Heart failure is most commonly caused by other heart diseases or heart disease risk factors. Coronary artery disease (CAD), where plaque builds up in the arteries and reduces blood flow, is one of the most common causes. High blood sugar levels seen in diabetes damages the blood vessels in and around the heart and can weaken the muscle. High blood pressure can also weaken the heart.  

Other causes of heart failure can include heart rhythm problems or damage to the heart muscle, such as from a heart attack. “Sometimes there’s a viral infection that can weaken the heart,” says Dr. Wadehra. “Other times it’s too much alcohol. Some chemotherapy medicines can also cause heart failure.”

Congestion—a buildup of fluid, usually in the lungs, legs or abdomen—is often but not always a symptom of heart failure. With congestive heart failure, blood doesn’t get pumped in and out of the heart efficiently, causing it to get backed up and seep into other body parts—usually the lungs, legs or abdomen.

Other heart failure symptoms include:

  • Fatigue
  • Coughing or wheezing caused by congestion, a buildup of fluid in the lungs
  • Shortness of breath, also caused by congestion
  • Swelling of the legs or belly
  • Loss of appetite
  • Confusion

Wadehra says the different symptoms can sometimes be mistaken for other conditions. “People sometimes think they have pneumonia or asthma when there’s congestion in the lungs,” he says. “Swelling is also a symptom of chronic liver disease. It’s not any one thing and it depends on the patient’s symptoms, but heart failure is generally confused with other conditions that cause poor blood flow or fluid retention.”

Different types of heart failure
The heart can fail in a number of different ways. First, an anatomy lesson. The heart has two chambers on top, called the right and left atria, and two on the bottom, the right and left ventricles. Between the chambers are valves that allow blood to flow in and out. Blood is collected on the right side of the heart and pushed to the lungs for oxygenation, then returns to the left side, where it’s pumped out into the arteries that carry it to the rest of the body.

“There are many different types of heart failure,” says Wadehra. Both the right and left sides of the heart can be weakened and fail, and they have slightly different symptoms. “Right-sided heart failure can often manifest in leg and abdominal swelling, more fluid retention and weight gain symptoms,” Wadehra says. “Left-sided heart failure often relates to fluid in the lungs.” One can lead to the other, he adds.

Left-sided heart failure can come in two different varieties. Either the heart becomes too weak to push enough blood out during the contraction (systolic heart failure), or it becomes too stiff to fully relax and fill with blood (diastolic heart failure). Heart failure can also develop slowly over time, or it can come on—or worsen—quickly.

Complications and treatment
About half of everyone who develops heart failure will die within five years, according to the Centers for Disease Control and Prevention (CDC). Kidney failure is a common complication of heart failure. More than 40 percent of people with heart failure also have kidney disease. Heart rhythm problems—known as arrhythmias—including atrial fibrillation often appear alongside heart failure.

Now for the good news: There are a number of treatment options for heart failure. “Our goal with heart failure is to improve heart function with medications and medical and lifestyle interventions,” says Wadehra. Controlling your salt intake and your weight can help keep heart failure from getting worse and will reduce how hard the heart has to work. On the medication side, diuretics, ACE inhibitors, beta-blockers and nitrates can help. Surgery, as well as devices such as pacemakers and defibrillators, are other treatment options. “Heart failure is something we can treat and improve with medication, good care and good follow-up,” Wadehra says.

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