To Your Health: Controlling risk factors, symptoms key to living with heart failure
By Dr. Ripple Doshi Interventional Cardiologist January 28, 2014 1:20PM
Dr. Ripple Doshi | Supplied photo
Updated: March 3, 2014 2:11PM
More than 5 million Americans live with a serious condition called heart failure.
While the term “heart failure” implies that the heart has stopped working or “failed,” that’s not actually the case. Instead, heart failure occurs when the heart can’t keep up with its work load.
According to the American Heart Association, congestive heart failure (CHF) is the leading cause of hospitalization (and readmissions) for men and women over age 65. It is responsible for 11 million doctor office visits annually, and nearly 550,000 new cases of CHF are diagnosed every year.
Heart failure often develops after other conditions have damaged or weakened the heart.
To perform well, the body depends on the heart’s pumping action to deliver oxygen- and nutrient-rich blood to the body’s cells. When the cells are nourished properly, the body functions normally.
With heart failure, the weakened heart can’t supply the cells with enough blood, resulting in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become difficult.
Conditions such as narrowed arteries in the heart (coronary artery disease) or high blood pressure gradually leave the heart too weak or stiff to fill and pump efficiently.
Not all conditions that lead to heart failure can be reversed, but treatments can improve the symptoms and help you live a longer, more enjoyable life.
The best way to prevent heart failure is to control conditions that cause heart failure in the first place, such as coronary artery disease, high blood pressure, diabetes or obesity.
Symptoms and causes of heart failure
The most common symptoms of heart failure include shortness of breath when you exert yourself or lie down. Many individuals describe a “drowning” feeling while lying flat in bed and need pillows to prop themselves up to breathe easier.
In fact, one of the key questions we ask patients during an appointment for suspected heart failure is, “How many pillows do you sleep on at night?”
Other symptoms include fatigue and weakness; swelling or edema in the legs, ankles and feet; a rapid or irregular heartbeat; a reduced ability to exercise or perform physical activity; a persistent cough or wheezing, especially with white or pink blood-tinged phlegm; an increased need to urinate; sudden weight gain from fluid retention; lack of appetite and nausea; decreased alertness; elevated blood pressure; or chest pain, if your heart failure is caused by a heart attack. Seek immediate medical help if you experience severe symptoms such as trouble breathing or chest pain.
Heart failure can involve the left side, right side or both sides of the heart, but it typically begins with the left side, where the left ventricle — the heart’s main pumping chamber — is located.
Coronary artery disease is the most common cause of heart failure. Over time, arteries that supply blood to the heart muscle narrow from a buildup of fatty deposits. As this occurs, blood moves more slowly through the narrowed arteries, leaving some areas of the heart muscle weak and chronically deprived of oxygen-rich blood.
Other causes include high blood pressure; faulty heart valves; damage to the heart muscle (cardiomyopathy); inflammation of the heart muscle caused by a virus (myocarditis); congenital heart defects from birth, abnormal heart rhythms; and chronic diseases such as diabetes and thyroid disease.
In many cases, heart failure can be managed through dietary restrictions alone. In general, heart failure patients should limit salt intake to no more than 2,000 milligrams a day, and total fluid intake to no more than 1.5 liters.
Doctors also treat heart failure with very effective medications. The most common include diuretics (to reduce fluid buildup); ACE inhibitors (to reduce blood pressure and strain on the heart); and beta blockers (to slow the heart rate and lower blood pressure).
In some cases, doctors may recommend surgery to treat the underlying problem causing your heart failure, such as angioplasty or coronary artery bypass surgery to restore blood flow through the heart; and heart valve repair or replacement if a faulty valve is causing your heart failure.
Should you develop an abnormal heart rhythm as a result of your CHF, you may be a candidate for an implantable cardioverter defibrillator (ICD), a small device that’s placed in the chest to help treat irregular heartbeats and deliver electrical pulses to help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest.
If you or someone you love has heart failure, the most important thing you can do is keep it under control by weighing yourself daily, limiting salt and fluids, limiting alcohol, exercise with your doctor’s approval, take your medications as prescribed, schedule regular doctor appointments, monitor your symptoms and call your doctor if new symptoms develop or your existing symptoms worsen.
As with any chronic condition, heart failure is best controlled by early diagnosis, prevention and minimizing your risk factors.
To determine your personal risk of heart disease, Ingalls offers HeartAware, a free online risk assessment. Simply visit www.Ingalls.org/HeartAware. HeartAware takes less than seven minutes and can be completed in the comfort of your home or office. A printable report is available upon completion and includes information about your risk factors as well as easy-to-read educational material about how to stay heart-healthy.
If your assessment reveals three or more risk factors for heart disease, you are eligible to receive a free health screening that includes a full lipid profile, blood-glucose level and measurements of blood pressure, body mass index and waist circumference. Afterward, an Ingalls nurse navigator will follow up to discuss your results and make a plan to minimize your future risks for heart disease.
For more information or a referral to a cardiologist, call Ingalls Care Connection at (708) 915-2273.
Dr. Ripple Doshi is a board-certified interventional cardiologist at Ingalls Memorial Hospital, which is a member of the Southland Health Alliance.