About this topic

Heart failure happens when your heart has trouble pumping the right amount of blood through the body. This means the body will not receive the oxygen it needs to work well. When the pump is not working well, blood can back up into the lungs, neck, belly, and arms. It can also cause swelling in the legs or other parts of the body.

Heart failure is a long-term problem and will get worse over time. Your doctor will work hard to treat your heart failure and to keep you as healthy as possible.

Image(s)

What are the causes?

Heart failure is most often caused by coronary artery disease or a heart attack. It may also be caused by problems with the heart’s valves. You may have heart failure because you had an infection in your heart muscle. It may be due to high blood pressure or an abnormal heart rhythm. Sleep apnea or high blood sugar may also cause your heart not to work as well as it should. These causes result in a weak or damaged heart muscle. When your heart is weak or damaged, you may have heart failure.

What can make this more likely to happen?

You are more likely to have heart failure if you are older or are someone who smokes. Black men have more heart failure. Having high blood pressure or being overweight can also raise your chances of having heart failure. So can drinking too much beer, wine, and mixed drinks (alcohol). People with long-term diseases like emphysema are more likely to have problems with their heart.

What are the main signs?

• Breathing problems like:
  • Shortness of breath
  • Cough that won’t go away
  • Wheezing
  • More trouble breathing at night or when you lay down
• Extra fluid that causes:
  • Swelling of feet, ankles, legs, or belly
  • Gaining weight and you don’t know why
  • Need to pass urine more often, especially at night
• Problems sleeping like:
  • Need to sleep sitting up or on many pillows
  • Waking up often during sleep times
  • Feeling tired, weak, or have no energy
• General signs like:
  • Increased heart rate or irregular heart beat
  • Loss of appetite and nausea
  • Feeling lightheaded or dizzy, especially right when you stand up
  • Confusion and impaired thinking

How does the doctor diagnose this health problem?

The doctor will take your history and will do an exam. The doctor will listen to your heart and lungs, and may also feel your belly for liver swelling. The doctor will check your feet, ankles, and legs for swelling.
The doctor may order:

• Lab tests
• Chest x-ray
• Electrocardiogram (ECG or EKG)
• Echocardiogram
• Exercise stress test
• Radioactive imaging. This is a radionuclide scan.
• Dye injected into the heart’s arteries. This is coronary angiography.

How does the doctor treat this health problem?

Your doctor will treat you to help your heart work better. The doctor will also work to control your signs. Since other health problems may cause or make heart failure worse, it is important to also treat these. Your doctor may suggest:

• Diet and lifestyle changes to slow down progress of the heart failure
• Drugs to help your heart work better, get rid of the extra fluid, and control your heart rate and blood pressure
• Exercise and cardiac rehab
• Bypass surgery or a heart stent to open blocked vessels to the muscle of your heart
• Devices like a heart pump
• Heart transplant

What lifestyle changes are needed?

• • Limit how much beer, wine, and mixed drinks (alcohol) you drink.
  • Limit the salt in your diet to what you have been told. Talk to your doctor or a dietician.
  • Lose weight if you are overweight.
  • Stop smoking.
  • Remain active. Talk with your doctor about the right amount of activity for you.
  • Stop activity if you have symptoms like chest pain, shortness of breath, or feel dizzy.
  • Let your doctor know if you get more tired while you do an activity or you are not able to do as much activity as you did before.
  • Limit how much fluid you drink to the amount you have been told to take.
  • Be careful that you take your drugs each day as ordered by your doctor.
    • If you cannot afford them, they may be able to help you.
    • Do not stop your drugs if you have side effects. Talk to your doctor about them.
    • Take your drugs even if you feel well.
  • Check your weight each morning and write down your weight in a notebook. This will tell you if you are building up too much fluid. Weigh in the morning after you have passed urine. Weigh yourself with clothes on or off, but do it the same way each day. Make sure your scale is on a hard surface, not on carpet. Your doctor will tell you when you should call based on how much weight you gain in a day or over a week. Take your notebook to your doctor on your next visit.

What drugs may be needed?

Often patients will need to take more than one drug. Together, they will help the heart work as well as it can. Do not take any other prescription drugs, over-the-counter (OTC) drugs, herbals, or diet aids without asking your doctor.
The doctor may order drugs to:

• • • Help relax blood vessels. This makes it easier for the heart to work and may also lower your blood pressure. These are ACE inhibitors and ARBs.
    • Slow down the heart rate so that it doesn’t have to work as hard. These are beta blockers.
    • Help the heart beat stronger and better
    • Get rid of extra salt and water in the body. These are water pills or diuretics.

What changes to diet are needed?

• • • Ask your doctor or dietician what kind of diet is best for you. The doctor may tell you to limit your salt and fat or how much fluid you drink.
    • The DASH diet may be helpful. The DASH diet helps to lower blood pressure. This diet includes lots of fruits, vegetables, low-fat dairy foods, and foods that are low in saturated fat, total fat, and cholesterol. Using the DASH diet with a low salt diet may lower blood pressure even more.
    • Learn to read labels to see how much salt or sodium is in foods. Lowering your salt intake will help you control some of your symptoms.

What can be done to prevent this health problem?

• • • Keep a healthy weight.
    • Keep blood pressure, cholesterol, and high blood sugar under control.
    • Stop smoking. Do not use nicotine gum or patches unless your doctor says it is OK.
    • Exercise regularly. Talk to your doctor about which exercise program is best for you.

When do I need to call the doctor?

• • • Signs of heart attack:
      • Chest pain
      • Trouble breathing
      • Fast heartbeat
      • Feeling dizzy

Call your doctor if you have:

• • • Problems with breathing. These include an increase in shortness of breath, wheezing, needing to sleep while sitting up to breathe, using more pillows at night, or other breathing troubles.
    • Problems with swelling and weight gain. These include gaining more than 2 to 3 pounds (0.9 to 1.35 kg) in a day or 5 pounds (2.25 kg) in a week; more swelling in your feet, ankles or legs; passing more or less urine than normal; or passing dark urine. You may notice that your shoes are tighter or you have rings around your ankles or knees where your socks end.
    • Feelings of being very tired or weak
    • Pain in your arm(s), neck, jaw, belly, or back
    • Cough that does not go away or coughing up pink or white foamy mucus
    • A pounding heart that is racing very fast or skipping beats or does not otherwise feel normal
    • You are not feeling better in 2 to 3 days or you are feeling worse

Helpful tips

• • • Carry a list of all the drugs you take with you at all times. Include any over-the-counter (OTC) drugs or herbals. If you have an implanted pacemaker or defibrillator, carry the card for the device with you at all times.
    • Discuss any concerns with your doctor.

Where can I learn more?

American Heart Association
http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsp

Better Health Channel
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/congestive-heart-failure-chf

NHS Choices

http://www.nhs.uk/conditions/heart-failure/pages/introduction.aspx

Reference: Heart Failure in adults ,Lexicomp,Wolters Kluwer Health, Inc