Heart failure affects nearly 5.7 million people in the United States, according to the Centers for Disease Control. Although statistics say that about half of those diagnosed with heart failure will die within five years of their diagnosis, early treatments, lifestyle changes, and interventions can slow the progress of heart failure and lead to a better quality of life. The key to early diagnosis is recognizing symptoms of congestive heart failure early on.
What is Congestive Heart Failure?
The organs and tissues of the body need oxygen in order to function properly. Blood is the body’s oxygen delivery system. The blood carries oxygen from the lungs to other organs.
The heart works to pump the blood through the body so that oxygen is delivered effectively. This video by Edmond Hui for a TED talk illustrates how a healthy heart pumps blood.
When the heart cannot pump the blood through the body effectively, congestive heart failure occurs. If the blood is not pumped effectively, it will back up. This raises the pressure inside the blood vessels and causes fluid to leak into surrounding tissues.
Congestive heart failure is a serious medical condition, but the severity and progression of the disease vary from person to person.
It can develop quickly in some, while progress gradually in others. It can be categorized by its stages of progression, as talked about in this youtube video.
What Causes Congestive Heart Failure?
Congestive heart failure is not a disease itself, but a syndrome that can have many different causes. The heart itself becomes weak due to other heart problems or problems with the blood vessels.
Common causes of heart failure include cardiomyopathy, damaged heart valves, coronary artery blockage, previous or impending heart attacks, environmental exposures like alcohol and cocaine, infections, hypertension, congenital heart disease, and arrhythmias.
According to St. Jude’s Medical, about half of all cases of congestive heart failure are caused by underlying coronary artery disease. In addition to more common causes of heart failure, there are hundreds of less common causes. In many cases, the exact cause of congestive heart failure is unknown.
Certain lifestyle choices are associated with a worsening of congestive heart failure. Smoking tobacco products and drinking alcohol excessively can exacerbate heart failure. Morbid obesity and a sedentary lifestyle can contribute to heart failure. A diet high in salt can make fluid retention worse for patients.
How is Congestive Heart Failure Diagnosed?
Early symptoms of congestive heart failure are often mistaken by patients for other medical problems. Physicians diagnose congestive heart failure with the aid of images and other tests. These include chest x rays, electrocardiogram, blood tests, echocardiogram, stress tests, MRI’s, and cardiac catheterization.
What are the Symptoms of Congestive Heart Failure?
Symptoms of congestive heart failure occur in different parts of the body depending on what part of the heart has a reduced pumping mechanism. The early symptoms of congestive heart failure are often disregarded or not associated with a heart issue.
Fluid collects in the lungs when the left ventricle of the heart fails to pump effectively. This extra fluid, or edema, makes it hard for the lungs to expand fully to take in oxygen.
Breathing can become labored resulting in shortness of breath. This shortness of breath typically occurs when patients are lying down or when they are performing an activity.
Respiratory issues like coughing and shortness of breath are common early symptoms of congestive heart failure. Patients who have chronic breathing issues like asthma, COPD, and emphysema may not associate these symptoms with a heart problem.
They may see breathing issues as a worsening of their previously diagnosed condition. Often, patients think they have a virus like a cold or the flu when respiratory symptoms occur.
An early sign of congestive heart failure is an intolerance to exercise. When the heart cannot pump blood effectively, the body can not get the oxygen it needs during physical exertion to function properly.
Fatigue and shortness of breath when attempting to exercise can occur, limiting a person’s ability to even walk at a normal pace.
As heart failure progresses, patients often experience periods of shortness of breath when at rest or in the middle of the night. This is due to excess fluid building up in the lungs, making it difficult to breathe while lying down.
Failure of the right ventricle in the heart to pump properly results in fluid collecting in the lower extremities. The legs and feet will swell up due to fluid retention.
When pressure is applied to the swollen areas, an indentation will be left. This is called pitting edema, which is a common sign of congestive heart failure in the right ventricle.
The upper legs and abdomen will collect fluid as the right heart failure progresses. The fluid increases the weight of a patient. This weight gain from the retained fluid can be an accurate way to assess the progression of congestive heart failure in patients.
What is the Treatment for Congestive Heart Failure?
The cause of congestive heart failure often dictates the type of treatment that will be most effective. The goals of treatment are to relieve troublesome symptoms, prevent the condition from worsening, and correct any underlying cause.
Symptoms of shortness of breath and swollen extremities can be relieved by removing the excess fluid that has accumulated. Improving the functioning of the heart muscle and thereby improving blood flow and oxygen delivery in the body can be achieved with various treatments.
Diet and lifestyle changes can drastically improve the quality of life, slow down the progress of the heart failure, and relieve symptoms.
Treating symptoms at home and following a physician’s directives will improve the outlook for patients. Elevating the legs and feet when they swell and reducing salt intake can reduce and treat the amount of swelling that occurs.
Smoking tobacco products should be avoided. Alcohol use should be limited to one drink or less per day. Reducing emotional stress is important for slowing the progression of heart failure.
High altitude environments should be avoided because of the lower levels of oxygen. Herbal medicines and supplements should only be taken under the direct care of a physician.
Medications can relieve the symptoms of heart failure and also treat some of the causes. Common types of medications prescribed for congestive heart failure include diuretics, vasodilators, beta-blockers, inotropes, ACE inhibitors, and calcium channel blockers are all useful in treating heart failure symptoms and some of the underlying causes.
In addition to medications and lifestyle changes, there are procedures and interventions that can be used to treat heart failure. Angioplasty is a procedure used to treat heart failure that occurs due to coronary artery disease.
A small catheter is inserted into the artery and a balloon is placed and inflated. This balloon pushes cholesterol deposits out of the way so that blood can flow more easily.
A pacemaker is useful in treating heart failure due to an irregular or slow rhythm. It is a device that uses electrodes to control the rate of the heart.
It can speed the heart up during an activity that requires more oxygen. It also can help the heart maintain a regular pace when it starts to beat irregularly.
When congestive heart failure is caused by arrhythmias, an ICD can be helpful. This is a device that is capable of delivering an electrical shock to the heart, similar to external paddles used during CPR. When a life-threatening arrhythmia occurs, this internal device can shock the heart back into a normal rhythm.
When damage has occurred that causes congestive heart failure, surgery may be an option to treat the underlying cause. Surgery can be helpful for patients with valve damage, heart defects, coronary artery blockages, and thickened pericardium.
A coronary artery bypass graft can be helpful for patients with severe coronary artery disease. This surgery rearranges the coronary arteries so that blood flow is rerouted around any blockages. When a heart valve is damaged, valve replacement surgery may be an option.
There is a point where too much damage to the heart has been done and its ability to pump blood to the body is permanently damaged. When this occurs, a heart transplant is the only viable option to prolong life.
A heart transplant is for younger patients without other medical conditions that would limit the effectiveness of a new heart. An LVAD is a device that can be placed in order to prolong life while a patient waits for a new heart.
What is the Outlook for Patients with Congestive Heart Failure?
The treatments available today for patients who have suffered a heart attack or have other heart issues have been able to prolong lives for millions of Americans.
The prevalence of heart failure is projected to increase dramatically over the next decades, according to the American Heart Association.
Aging can eventually lead to heart failure for those who were lucky to survive a cardiac event earlier on. Technology and newer medications are helping patients with heart failure live longer with a better quality of life.