Heart Failure

Heart failure is characterized by the heart’s inability to pump an adequate supply of blood. Without sufficient blood flow, all major body functions are disrupted. Heart failure is a collection of symptoms and problems that weaken your heart. Some people with heart failure have trouble with pumping blood out to the body. Others may experience a hardening and stiffening of the heart muscle itself, causing issues with the filling of heart with blood. Heart failure can affect the right or left side of your heart, or sometimes both at the same time. No matter what form it takes, heart failure can be a chronic condition.

According to HeartHealthyWomen.org (sponsored in part by the Cardiovascular Research Association and the Department of Health and Human Services), about 5 million Americans are living with a heart that’s failing. Most of these individuals are men. However, women are more likely to die from untreated cases of heart failure (HeartHealthyWomen).

The symptoms of heart failure can appear suddenly, especially after a heart attack. A problem with the heart valves that control the flow of blood in the heart chambers can also cause acute symptoms.

Chronic heart failure can be easily recognized, particularly through shortness of breath and swelling of the extremities. However, some early symptoms are not specific and you may be tempted to ignore them. Heart failure is a serious medical condition that requires treatment. Early treatment increases your chances of long-term recovery with fewer complications.

Seek immediate medical attention if you notice changes in your ease of breathing, have chest or arm pain, or experience a change in your heart rate or rhythm.

Many symptoms are not specific for heart disease, but if you have a family history of heart disease and you experience any of the symptoms below, you should seek medical attention:

• excessive fatigue
• sudden weight gain
• loss of appetite
• coughing (sometimes with phlegm)
• irregular pulse
• heart palpitations
• abdominal swelling
• shortness of breath
• leg and ankle swelling
• protruding neck veins

Heart failure is a condition in itself, but it is most often related to another disease or health ailment. The most common cause of heart failure is coronary artery disease (sometimes called coronary heart disease), which is a disease that causes narrowing of the arteries that supply blood and oxygen to the heart.

Related diseases or factors that may lead to, or put an individual at higher risk for, heart failure include:

• disorder of the heart muscle (cardiomyopathy) that causes the heart to become weak
• congenital (present at birth) heart defects
• heart attack
• heart valve disease
• certain types of arrhythmias (irregular heart rhythms)
• high blood pressure
• emphysema (a lung disease)
• diabetes
• an overactive or underactive thyroid
• cancer treatments
• HIV/AIDS
• drug or alcohol use
• severe forms of anemia (a deficiency of red blood cells, which leads to a lack of oxygen to your tissues)

According to the National Heart, Lung, and Blood Institute, an excess of vitamin E may also lead to heart failure (NHLBI).

Heart failure can occur in either the left- or right-hand side of your heart. Sometimes both sides of your heart may fail at the same time. Left-sided and right-sided heart failure are very different from a physical standpoint.

Left-side heart failure is the most common type of heart failure, according to HealthyHeartWomen.org. The left ventricle is located in the bottom left-hand side of your heart. This area pumps oxygen-rich blood to the rest of your body. Left-side heart failure occurs when the left ventricle does not pump efficiently, and your body does not receive enough oxygen-rich blood. The blood instead backs up into your lungs, causing shortness of breath and fluid accumulation.

The right heart ventricle is responsible for pumping blood to your lungs to collect oxygen. Right-side heart failure happens when the right side of your heart can’t perform its job adequately. Usually right-side heart failure occurs in response to left-side failure. The backup of blood in the lungs caused by left-side heart failure makes the right ventricle work harder. This overload of work can cause the right side of the heart to fail. Right-side heart failure can also accompany other conditions, such as lung disease.

Heart failure is also classified in two other ways: diastolic and systolic. The term “diastolic” has to do with filling of the heart with blood. The word “systolic” refers to pumping blood.

Diastolic heart failure occurs when the heart muscle becomes stiffer than normal. The stiffness, due to heart disease, means that your heart does not fill with blood as easily as a normal heart. The filling problem, called “diastolic dysfunction,” leads to a lack of blood being pumped out to your body. This type of heart failure is more common in women (HeartHealthyWomen).

Systolic heart failure refers to the inability of the heart to adequately contract. The contractions of the heart are necessary to pump oxygen-rich blood out to the body. The pumping problem, called “systolic dysfunction,” happens when your heart is weak. This type of heart failure is more common in men (HeartHealthyWomen).

Both diastolic and systolic heart failure can occur on the left or right sides of the heart. You may experience the condition on both sides of the heart.

Heart failure can happen to anyone. According to HeartHealthyWomen.org, one in five people over the age of 40 will develop heart failure at some point (HeartHealthyWomen). However, there are certain known factors that may increase your risk of developing this condition.

African American women are at the highest risk compared to other genders and races. Still, men are overall more susceptible to this condition across all ethnicities (HeartHealthyWomen).

Other risk factors include:

• anemia
• overactive thyroid (hyperthyroidism)
• underactive thyroid (hypothyroidism)
• emphysema
• sedentary lifestyle
• malnutrition or a high-fat diet

An echocardiogram is the most effective way to diagnose heart failure. This procedure utilizes sound waves to create detailed pictures of the heart. It helps your doctor to determine the current state of your heart, as well as the causes for your condition. Your doctor may use an echocardiogram in conjunction with other tests, including:

• chest X-rays: radiologic imaging of the heart and the surrounding organs
• MRIs: magnetic resonance imaging that shows images of the heart without the use of radiation
• nuclear scans: a test that uses traces of injected radioactive materials to create images of the heart’s chambers
• catheterization: a dye assisted X-ray exam in which the doctor inserts a thin tube (catheter) in a blood vessel and guides it into the heart—this test can show how blood is currently flowing through your heart
• stress exam: a test in which an electrocardiogram machine monitors your heart function during exercise, such as running on a treadmill
• Holter monitor: a test in which electrode patches are placed on your chest and attached to a small machine called a Holter monitor, which records the electrical activity of your heart—this machine is worn for 24 to 48 hours

Medical tests will also correlate with the physical signs of heart failure. For instance, leg swelling, an irregular heartbeat, and noticeable neck veins may make your doctor suspect heart failure almost immediately.

Treating heart failure depends on the stage of your condition. Early treatment can improve symptoms instantly, but it is still recommended that you receive regular testing every three to six months. Ultimately, the goal of treatment is to increase your lifespan.

Medication

Early stages of heart failure may be treated with medications to help your symptoms and prevent your condition from getting worse. Certain medications are prescribed to:

• increase your heart’s blood-pumping abilities
• reduce blood clots
• decrease your heart rate, when applicable
• remove excess sodium and replenish potassium
• decrease cholesterol levels

Always ask your doctor before taking new medications. Some types are completely off-limits to heart failure patients, including naproxen and ibuprofen.

Surgery

Some heart failure patients require surgery, such as coronary bypass surgery. For this surgery, the surgeon takes a healthy piece of artery and attaches it to the blocked artery. This causes the blood to bypass the blocked, damaged artery and flow through the new one.

The surgeon may also perform an angioplasty, in which a tube with a small balloon attached is inserted into the blocked or narrowed artery. Once it reaches the problem artery, the balloon is inflated, which opens the artery. Sometimes, the doctor inserts a permanent stent into the blocked or narrowed artery. A stent is a wire mesh tube that holds the artery open permanently, which decreases the chance of future artery narrowing.

Other patients will need pacemakers to help control heart rhythms. These small devices are placed into the chest and can slow the heart down when it is beating too fast, or increase the rate if it is too slow. Pacemakers are often used in conjunction with bypass surgery as well as medications.

Heart transplants are used in the final stages of heart failure when all other measures have failed. During a transplant, a surgeon removes a portion of your heart, or the whole organ, and replaces it with a healthy donor version.

A healthy lifestyle can aid in the treatment of heart failure, as well as prevent heart disease from occurring in the first place. Losing weight can significantly decrease your risk of heart failure, as well as reducing salt in your diet. Eating too much salt can significantly worsen heart failure in a short amount of time.

Other healthy lifestyle habits include:

• reducing alcohol intake
• not smoking
• reducing fat in diet
• getting regular exercise (ask your doctor for recommendations if you currently have heart failure)
• getting adequate sleep

According to the National Heart, Lung, and Blood Institute, sleep disorders, such as sleep apnea, can worsen heart failure (NHLBI).

Untreated heart failure can eventually lead to congestive heart failure, a condition in which unpumped blood backs up into other areas of your body. In this potentially fatal condition, you may experience fluid retention in your limbs as well as in your organs, such as the liver and lungs.

Heart Attack

A heart attack may also occur as a result of a heart failure-related complication.

Call 911 right away if you experience:

• crushing chest pain
• chest discomfort (squeezing, tightness)
• discomfort in the upper body (including numbness or a cold feeling)
• excessive fatigue
• faintness
• rapid heart rate
• vomiting
• nausea
• cold sweats

Heart failure is a long-term condition that requires ongoing treatment to prevent complications. When left untreated, the heart can weaken so severely that it can be fatal.

It is important to recognize that heart failure can happen to anyone so that you can take lifelong preventive measures to stay healthy. Always contact your doctor if you suddenly experience any new and unexplained symptoms.

This condition is chronic, meaning that it will likely get worse over time. Medications and surgeries can help you to live a better quality of life, but such treatment measures may not help if you have a severe case of heart failure. Heart failure is fatal in the worst cases.

Early treatment is key in preventing the most serious cases of heart failure.