Heart failure is a condition in which the heart can no longer pump enough oxygen-rich blood to nourish the body.
Movement of blood through the body is slowed and pressure in the heart is increased. It is often a chronic, long-term condition, but in some cases it occurs suddenly.
A recipient of the American Heart Association's "Get With the Guidelines" Heart Failure and Stroke Gold Performance Achievement Award in 2012, Littleton Adventist Hospital ensures that each patient receives excellent care and treatment in cardiac services.
Heart failure may affect only one side of the heart, however, the condition more commonly affects both sides. As the heart works to provide enough blood to feed the body, it overextends itself and eventually becomes weakened. The kidneys respond to this condition by causing the body to retain water and sodium. Fluids collect in the arms, feet, ankles and other organs and the body becomes congested - and is termed congestive heart failure.
Causes of Heart Failure
Heart failure occurs when disease affects the heart in one of the following three ways:
1. Weakening the heart muscle.
2. Stiffening the heart muscle.
3. Increasing the demand for oxygen by the body's tissues beyond what the heart can supply.
Types of Heart Failure
Your heart fills and empties with each beat. The filling process is called diastole and the emptying process is called systole. When the lower chambers (ventricles) of the heart contract, blood pumps out to the rest of the body. After emptying, the heart muscles relax and blood flows from the upper chambers (atria) of the heart into the ventricles.
- Systolic heart failure - when the heart cannot properly eject blood.
- Diastolic heart failure - when heart muscles are stiff and do not fill easily.
Both systolic and diastolic heart failure result in the deficiency of oxygen-rich blood throughout the body. The effects are particularly noticeable during exercise or increased activity.
Common Symptoms of Heart Failure
- Shortness of breath with activity, or after lying down
- Swelling of feet and ankles
- Abdominal swelling
- Weight gain
Call 911 for the following:
- Crushing chest pain
- Rapid and irregular heartbeat
- Irregular or rapid pulse
- Heart palpitations
- Difficulty sleeping
- Fatigue, weakness, faintness
- Loss of appetite, indigestion
Other Possible Symptoms
- Decreased alertness or concentration
- Decreased urine production
- Nausea and vomiting
- Need to urinate at night
- Infants may sweat during feeding
Some patients show no symptoms prior to heart failure.
If congestive heart failure is suspected, a full evaluation may be performed to determine the condition of the heart.
The following are tests that may be ordered:
- Chest X-ray
- Cardiac stress tests
- Heart CT scan
- Heart catheterization
- MRI of the heart
- Nuclear heart scans
These, along with urine, blood chemistry and other lab tests can provide further information on the severity of the condition and help physicians determine the best care for the patient.
Centura Health at Home is the first in Colorado to implement a telehealth system that allows us to monitor patients through the use of a two-way video monitoring station. This ability to see patients in-between regular home visits allows Centura Health at Home to reinforce the education process and to maintain closer contact with patients.
If the heart is in danger of heart failure, exams will be scheduled every three to six months to monitor the progression of the disease. One way to track the condition at home is to watch for weight gain - increased water retention can be a sign that the heart is worsening.
Other helpful suggestions include:
- Limiting sodium intake
- Eating a healthy diet
- Staying active
- Losing weight (if overweight)
- Not smoking
- Receiving proper rest
- Elevating feet if swelling occurs
- Taking medication as directed
Some cases may require heart valve surgery, coronary bypass surgery (CABG) or angioplasty to improve the functioning of the heart.
Certain devices may be recommended including:
- A pacemaker - to help treat slow heart rates or other heart signaling problems.
- A biventricular pacemaker - to help the both sides of the heart contract simultaneously.
- An implantable cardioverter - defibrillator that recognizes life-threatening, abnormal heart rhythms and sends an electrical pulse to stop them.
When heart failure is severe or a patient is awaiting a heart transplant, the following my be required:
- Intra-aortic balloon pump (IABP)
- Left ventricular assist device (LVAD)
These devices are not permanent solutions but can be life saving. If a patient becomes dependent on circulatory support, a heart transplant will be necessary.
When to Contact a Physician
Contact a physician if experiencing weakness, increased cough or sputum production, sudden weight gain or swelling or unexplained symptoms.