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HEART FAILURE

What is a heart failure?

Heart failure does not mean that the heart no longer works; it actually means that the heart is not able to continuously pump oxygen-rich blood in and out of the heart. When someone is suffering from heart failure their body is not receiving the amount of oxygenated blood necessary to function properly.

There are various types of heart failure:

Left-sided heart failure is caused by an issue with the chambers in left-side of the heart. There are two types of left-sided heart failure.
Diastolic heart failure refers to the condition in which the heart muscles stiffen and do not fill up easily.
Systolic heart failure refers to the condition in which the heart does not pump the blood out very well.
Right-sided heart failure is often a result of left-sided heart failure. The right side of the heart pumps blood to the lungs to be re-oxygenated. When the left side of the heart fails it causes fluid pressure to build up, which directly affects the lungs and the right-side of the heart.
Congestive heart failure occurs when the blood flow out of the heart slows, which causes the rest of the blood in the body to back-up resulting in swelling or edema.

What causes heart failure?

There are numerous causes of heart failure but each leads to the heart not being able to pump blood effectively. The most common causes are:

  •  Coronary artery disease (the narrowing of the heart’s arteries), which weakens the heart’s muscles.
  •  High blood pressure, which leads to the heart’s muscles stiffening.
  •  Heart attack.
  •  An infection that leads to the weakening of the heart’s muscle.
  •  A leaky heart valve.
  •  Emphysema.

What are the symptoms of heart failure?

More often than not, heart failure occurs over time. However, in some patients in can happen out of the blue. At first, people who suffer from heart failure often notice symptoms when they are active. But as the disease progresses these symptoms often present themselves at all points in time, including rest periods.
The most common symptoms we at Exempla Rocky Mountain Cardiovascular Associates hear from our patients include:

  •  Adema (swelling as a result of fluid retention)
  •   Chest pain
  •   Elevated blood pressure
  •  Fatigue and/or weakness
  •   Heart palpitations
  •   Increased need to urinate at night
  •  Loss of appetite accompanied by nausea
  •  Persistent cough or wheezing
  •  Shortness of breath

How is heart failure diagnosed?

Exempla Rocky Mountain Cardiovascular Associates identifies heart failure with one or more of the following diagnostic tests:

  •  Blood tests
  •   Cardiac computerized tomography (CT)
  •  Chest X-Ray
  •   Coronary Catheterization
  •   Echocardiogram
  •   Electrocardiogram (ECG)
  •   Magnetic Resonance Imaging (MRI)
  •  Stress Test

How is heart failure treated?

Rarely is heart failure treated with surgery. Often patients who suffer from heart failure are asked to take medications. These medications are used to treat the symptoms of heart failure in an attempt to prevent it from getting worse. There is no cure for heart failure.

Some of the medications your doctor may prescribe include:

  •  ACE inhibitors
  •   Aldosterone antagonists
  •   Angiotensin II receptor blockers
  •   Beta Blockers
  •   Digoxin
  •  Diuretics
  •   Inotropes

Other treatments for heart failure include:

  •  Implantable cardioverter-defibrillators (ICDs) – prevent abnormal heart rhythms
  •  Cardiac resynchronization therapy (CRT) and Pacemakers – these implantable devices make it so that both the left and right sides of the heart beat or pump at the same rate
  •  Heart Valve repair

Smoking is a major risk for several diseases including heart disease, stroke, and several cancers. Even low-tar cigarettes and light smoking can increase the risk of heart disease substantially. There are now several alternative approaches to helping people stop smoking. These include nicotine-replacement patches and gum as well as oral medication.

If you are able to stop smoking, your risk of a heart attack or stroke decreases within a few weeks. The risk goes down to that of a nonsmoker within about 2 years. In addition, a lot of patients comment that they feel healthier and have more energy after they've stopped smoking.

Hypothyroidism can increase blood cholesterol levels and that contributes to heart disease; however, if the hypothyroidism is being treated with a thyroid hormone, then the cholesterol returns to normal.

Birth control pills can cause a small increase in the risk of thrombosis and heart attack. That occurs mainly in people who have been on the pill for more than 10 years and who smoke cigarettes.

There is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female. Obviously, you cannot change your family history, but a positive history should suggest the need to improve all the other risk factors like stopping smoking and decreasing cholesterol.

Heart disease is potentially reversible by attending to risk factors like cholesterol, blood pressure, and smoking. Several studies have shown, for example, that aggressive lowering of blood cholesterol with LDL levels below 100 can open up blocked coronary arteries at least partially. Perhaps I should explain that LDL cholesterol is the "bad" cholesterol component.

I would suggest a diet that is balanced among all the main food groups, with fat content making up no more than 30 percent of calories and most of that fat being unsaturated. I would not advise patients to eat a diet that is restricted in carbohydrates or fruits and vegetables, because this may adversely affect vitamin intake and blood cholesterol.

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