Overview
Heart failure, also known as congestive heart failure, occurs when the heart muscle can't pump blood as effectively as it should. This causes blood to back up and leads to fluid buildup, often in the lungs, which can cause shortness of breath. Certain heart conditions, such as narrowed arteries in the heart and high blood pressure, can gradually weaken or stiffen the heart, leading to heart failure. Treatment may help manage symptoms and improve quality of life, but it can be life-threatening if severe. Heart failure symptoms may include shortness of breath, fatigue, swelling in the legs and feet, rapid or irregular heartbeat, reduced ability to exercise, wheezing, a persistent cough, and swelling in the belly area. If you think you have symptoms of heart failure, consult your healthcare provider, and seek emergency medical help if you experience chest pain, fainting, or severe weakness.
Understanding the disease
Symptoms
The symptoms of heart failure may include shortness of breath with activity or when lying down, fatigue and weakness, swelling in the legs, ankles, and feet, rapid or irregular heartbeat, reduced ability to exercise, wheezing, a cough that doesn't go away or brings up white or pink mucus with spots of blood, swelling of the belly area, very rapid weight gain from fluid buildup, nausea, and lack of appetite, difficulty concentrating or decreased alertness. Additionally, chest pain if heart failure is caused by a heart attack. If you think you might have symptoms of heart failure, you should see your health care provider.
Risk Factors
The risk factors for developing heart failure include coronary artery disease, heart attack, heart valve disease, high blood pressure, irregular heartbeats, congenital heart disease, diabetes, sleep apnea, obesity, viral infections, and some medications such as diabetes drugs rosiglitazone and pioglitazone, as well as nonsteroidal anti-inflammatory drugs (NSAIDs) and other medications used to treat various conditions. Other risk factors include aging, alcohol use, smoking or using tobacco, and a family history of cardiomyopathy, heart failure, or sudden cardiac arrest.
Development
Heart failure can develop due to a variety of factors, including:
- Irregular heart rhythms (arrhythmias): These cause the heart to beat too fast or too slow, leading to an extra workload for the heart.
- Other diseases: Long-term diseases such as diabetes, HIV infection, an overactive or underactive thyroid, or a buildup of iron or protein can contribute to chronic heart failure.
- Certain heart conditions: Narrowed arteries in the heart and high blood pressure can gradually weaken or stiffen the heart muscle, causing it to pump blood inadequately.
- Certain health issues: Conditions like allergic reactions, illnesses that affect the whole body, blood clots in the lungs, severe infections, or the use of certain medications can cause sudden heart failure.
- Viruses attacking the heart muscle: Certain viruses, such as those causing myocarditis, can inflame the heart muscle and lead to heart failure.
- Congenital heart defects: Heart problems present at birth can cause the heart and its chambers or valves to function improperly, leading to heart failure over time. It is important to note that treating the underlying cause of heart failure can sometimes reverse or improve the condition.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect heart failure when you experience symptoms such as shortness of breath with activity or when lying down, fatigue and weakness, swelling in the legs, ankles, and feet, rapid or irregular heartbeat, reduced ability to exercise, wheezing, a cough that doesn't go away or brings up white or pink mucus with spots of blood, swelling of the belly area, very rapid weight gain from fluid buildup, nausea, and lack of appetite, or difficulty concentrating or decreased alertness. If you have chest pain, fainting, or severe weakness, you should call 911 or emergency medical help immediately.
Diagnosis
To diagnose heart failure, a healthcare provider will examine the patient and gather information about their symptoms and medical history. They may also listen to the patient's lungs and heart with a stethoscope and check for signs of swelling in the legs and belly. Blood tests, chest X-rays, electrocardiograms (ECG or EKG), and echocardiograms are common diagnostic tests that may be performed to determine if a person has heart failure.
Management and Treatment
Complications
Potential complications of heart failure include kidney damage or failure, other heart problems, liver damage, sudden cardiac death, and the need for a heart transplant or a device to help the heart pump blood. Other risk factors for heart failure include aging, alcohol use, smoking or using tobacco, and certain heart conditions such as narrowed arteries in the heart and high blood pressure. Regular health checkups are important for people with heart failure to monitor for complications, and lifestyle changes such as weight loss, exercise, reduced salt use, and stress management can help improve quality of life.
Prevention
heart failure can be prevented to some extent by managing and controlling the underlying conditions that can cause it, such as coronary artery disease, high blood pressure, diabetes, and obesity. Making lifestyle changes like quitting smoking, getting regular exercise, eating a healthy diet, maintaining a healthy weight, reducing stress, and taking medications as directed can help prevent heart failure. It's important to consult with a healthcare provider to determine the best course of action based on individual health conditions and risk factors.
Treatment
Treatments for heart failure include lifestyle changes, medications, and in some cases, surgical procedures or devices. Lifestyle changes may involve managing high blood pressure, controlling diabetes, quitting smoking, losing weight, reducing salt intake, and managing stress. Medications may include diuretics to reduce fluid buildup, ACE inhibitors, beta-blockers, and ARBs to improve heart function and manage blood pressure. In severe cases, surgical options such as a pacemaker, implantable cardioverter-defibrillator (ICD), or heart transplant may be considered. It is important to consult a healthcare professional for an accurate diagnosis and personalized treatment plan.
Preparing for medical consultation
To prepare for an appointment for heart failure, you should:
- Be aware of any pre-appointment restrictions: When you make the appointment, ask if there's anything you need to do in advance, such as restricting your diet or fasting before tests.
- Write down your symptoms: Include any symptoms you're experiencing, even those that may seem unrelated to heart failure.
- Gather key personal information: Prepare a list of your medical history, including any family history of heart disease, stroke, high blood pressure, or diabetes, and major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements you're taking: Include dosages for each item.
- Bring a family member or friend: Consider bringing someone along to the appointment who can help you remember important information and provide support.
- Write down questions to ask your healthcare provider: Prepare a list of questions to ensure you cover all the necessary topics during your appointment. Some basic questions to ask your healthcare provider include:
- What is likely causing my symptoms or condition?
- What tests do I need?
- Should I see a specialist?
- What treatment do you recommend? By being prepared and actively participating in your appointment, you can ensure that you receive the most accurate diagnosis and appropriate treatment for your heart failure.