What is heart failure?
The heart is a muscle that pumps oxygen-rich blood to all parts of
the body. When you have heart failure, the heart can’t pump as well as it should. Or
the heart muscle can’t relax and fill the pumping chamber with blood. Blood and
fluid may back up into the lungs. This causes congestive heart failure and pulmonary
edema. Some parts of the body also don’t get enough oxygen-rich blood to work
correctly. These problems lead to the symptoms of heart failure.
What are the symptoms of heart failure?
The most common symptoms of heart failure are:
Shortness of breath while resting, exercising, or lying
Weight gain from water retention
Visible swelling of the legs and ankles from fluid buildup.
Sometimes the belly (abdomen) may swell.
Severe tiredness (fatigue) and weakness
Loss of appetite, nausea, and belly pain
Cough that doesn’t go away. It can cause blood-tinged or
The severity of the condition and symptoms depends on how much of
the heart's pumping ability has been affected. The first step in managing heart
failure symptoms is knowing your baselines or what’s normal for you. How much do you
weigh? Are you gaining weight but eating the same amount? How much can you do before
you feel short of breath? Do your socks and shoes fit comfortably? Knowing what’s
normal for you will help you see when symptoms are getting worse. Once you know your
baselines, watch for changes daily.
The symptoms of heart failure may look like other health problems.
Always see your healthcare provider for a diagnosis.
How is heart failure treated?
The cause of heart failure will guide the treatment plan. If heart
failure is caused by a valve problem or coronary heart disease, then you may need
procedures such as percutaneous coronary intervention or surgery. If heart failure
is caused by a disease such as anemia or infection, then the healthcare provider
will treat the underlying disease.
Some causes of heart failure are reversible or short-term, such as
in an acute infection. For many causes of heart failure there is no cure. But many
forms of treatment can help with symptoms. They are listed below.
These healthy habits may help with heart failure:
Controlling blood pressure
Controlling blood sugar if you have diabetes
Losing weight, if needed
Limiting salt and fat in your diet
Not drinking alcohol or using illicit drugs
Getting enough rest
Other important lifestyle habits include getting
vaccines such as for the flu and pneumococcal pneumonia.
If you have sleep problems, getting a sleep study get help
find out what’s causing them. You may need to wear a C-PAP mask while you sleep.
This will make sure you get enough oxygen. Too little oxygen can put stress on
Many types of medicines are available for heart failure. They
enzyme (ACE) inhibitors. These medicines lower the pressure inside
the blood vessels and reduce the resistance against which the heart pumps.
They also help remodel the heart, which can promote better pumping
blockers (ARB). Some people get a cough and need to stop taking ACE
inhibitors. If that happens, an ARB may work for you. These help relax blood
vessels and reduce stress on the heart
receptor-neprilysin inhibitors (ARNIs). This medicine combines an
ARB and a neprilysin inhibitor which can help the heart as mentioned above
as well as promote salt and water loss.
Sinus node I-f channel
blocker. This medicine may be used to lower your heart rate, which
puts less stress on your heart.
reduce the amount of fluid in the body. They are among the most important
medicines in helping control fluid buildup in the body.
Vasodilators such as
hydralazine and nitroglycerin. These widen (dilate) the blood vessels and
reduce workload on the heart.
medicine helps the heart beat stronger and may help with controlling heart
rate if there is an abnormal heart rhythm.
help maintain normal heart rhythm in the presence of abnormal heart rhythm.
reduce the heart’s tendency to beat faster. They can also promote better
pumping over time.
This medicine blocks the effects of the hormone aldosterone, which causes
sodium and water retention.
Statins or PCKS9
inhibitors. These medicines lower the amount of bad cholesterol in
your blood. They are not used to treat heart failure. But you may take one
if you have high cholesterol, or have had a past heart attack and are at
risk for heart failure. People who have inherited forms of high cholesterol
(familial hypercholesterolemia) may get help from a new class of medicines
called PCKS9 inhibitors. These medicines lower cholesterol.
These include opening blocked arteries in the heart. This
brings back blood flow to the heart muscle. It helps the ventricles squeeze as
they should. The procedure can be done in the cardiac catheterization lab. It
uses balloons to push plaque and blood clots out of the artery. It also uses
stents to keep the artery open. This can also be done by bypassing blockages
during surgery (coronary artery bypass surgery).
Heart valve repair or
In some cases medicines can’t help heart failure caused by
heart valves that are narrowed (stenosed) or leak (regurgitant). The heart valve
can be repaired or replaced. This can be done as an open-heart procedure. Or it
can be done by going through a small tube (catheter) that is put into an artery
If your heart failure has also damaged your heart’s electrical
wiring system, pacemakers can be implanted to restore normal heart rate and
regularity. Cardiac resynchronizing pacemakers are used when one of the heart
wires is damaged. This is often the wire located in the left ventricle. These
pacemakers use implanted left and right sided wires to restore normal timing of
the heart contraction in order to improve heart function.
When heart muscle is damaged, dangerous heart circuits can
form in the heart muscle. This leads to possibly fatal heart rhythms. An ICD is
implanted in the body to sense and treat these cardiac arrest rhythms. It does
this by overdrive pacing the heart rhythm. Or by delivering an energy shock to
VAD (ventricular assist
These devices are surgically implanted in the chest. They
connect to an outside motor which helps pump blood from the heart to the rest of
the body. VADs can allow people with advanced heart failure to improve their
overall symptoms and to walk more. This can be used as a long-term treatment. Or
it can be used while someone waits for a donor heart for a transplant.
In some cases, the diseased heart must be replaced with a
healthy one from a donor.
Talk with your healthcare providers about the risks, benefits,
and possible side effects of all treatments.