What is congestive heart failure?
Congestive heart failure occurs when the heart is no longer able to pump enough blood. In medical terms, the heart has a decreased ejection fraction. Congestive heart failure can affect the right side or left side of the heart, or both.
According to the National Institute of Health (NIH), coronary artery disease, diabetes, and high blood pressure are the most common causes of congestive heart failure.
Other risk factors include heart attack, thyroid disorders, myocarditis, defective heart valves, abnormal heart rhythms, alcohol use, tobacco use, and obesity.
Who is affected by congestive heart failure?
According to the National Institute of Health, congestive heart failure affects 23 million people worldwide and 5.8 million people in the United States. It is a major cause of morbidity and mortality. The condition is most common in people ages 65 and older.
What are the clinical symptoms of congestive heart failure?
CHF affects many organs in the body due to poor blood perfusion, including the lungs, kidneys, and liver. Trouble breathing and exercise intolerance can occur.
In severe cases, one is unable to perform activities of daily living such as getting out of bed, dressing, walking, and bathing.
In left-sided heart failure, swelling of the feet and legs can occur. Kidney failure can also contribute to swelling.
Unexplained weight loss despite adequate caloric intake is common, also known as cachexia. This Youtube video explains the science behind congestive heart failure and provides an animated model detailing the anatomy of the heart.
What are the treatment options for congestive heart failure?
According to the American Heart Association, main treatment options for congestive heart failure include lifestyle modification, monitored cardiac rehabilitation, prescription medications, electronic heart implants, and surgical procedures. This article will explain in detail the specific treatment options in these broad categories.
How can quitting smoking improve your heart health?
Smoking cigarettes can increase heart rate and blood pressure due to the effects of nicotine. Quitting smoking will prevent further damage to the heart and improve symptoms of congestive heart failure. Smoking also increases the risk of blood clots and therefore quitting smoking will lower the risk of heart attack.
How does congestive heart failure affect your sex life and what changes do you need to make?
When you are first diagnosed with heart disease, it is important to discuss with your doctor what types of physical activity are safe for you to engage in, including sexual intercourse.
The American Heart Association states that it is safe to have sex once your heart condition is stabilized. It is important to take your prescribed medications even if side effects have a negative impact on your sexual function because the health of your heart should be a priority.
What kind of diet that is healthy for your heart?
Eat foods that are low in saturated fat, trans fat, sodium, and cholesterol. These nutrients tend to raise blood pressure and increase the risk of blood clots, both which can be detrimental to heart health.
The DASH diet published by the American Heart Association for managing blood pressure recommends plenty of fruits, vegetables, whole-grains, nut and legumes, low-fat dairy products, skinless chicken and fish, and vegetable oils. Red meats and sweetened foods and beverages should be limited.
How much alcohol can you drink if you have congestive heart failure?
Alcohol increases the risk of high blood pressure, which can exacerbate congestive heart failure. Therefore, people with congestive heart failure should drink alcohol in moderation.
The American Heart Association recommends limiting alcohol to 1 drink per day for women and 1-2 drinks per day for men.
Reduce your stress levels and stay well-rested.
Stress and lack of sleep correlate with high blood pressure and poor heart function. Reduce your stress levels by incorporating exercise and meditation.
If you struggle with anxiety, anger management, or depression, consider speaking to a counselor or psychologist to develop coping strategies. Maintaining a regular sleep schedule is also important for your stress levels and overall well-being.
Cardiac Rehabilitation can be life-changing for people with congestive heart failure.
Cardiac rehabilitation is a customized program for recovery in people who have experienced heart conditions such as heart attack or heart failure.
The Mayo Clinic supports that cardiac rehabilitation can lower your risk of death from heart disease and also lower the risk of developing future heart problems.
Cardiac rehabilitation involves a comprehensive evaluation by a doctor to assess your current status and needs, developing an exercise regimen suited for your abilities and health status, counseling and education about your condition and ways to manage heart failure, and support to help your resume your normal responsibilities.
A team of primary care doctors, cardiologists, nurses, dietitians, pharmacists, physical and occupational therapists, and social workers work together to develop a plan for you.
What is the role of implanted devices in congestive heart failure?
An ICD is an implantable cardiac defibrillator that can be life-saving. The ICD is implanted under the skin in the chest or abdomen. The device is able to monitor your heart rate 24 hours a day.
ICD’s can act as pacemakers, which means that they can send electric signals to your heart when an abnormal heart rhythm is detected. This can result in a return to a normal heart rhythm. Another option is CRT implantation.
CRT (cardiac resynchronization therapy) is selected for patients with a normal heart rhythm but reduced left heart ejection fraction. A cardiologist will be able to determine the most suitable device.
What are some diet modifications to reduce swelling?
Edema, or swelling, can occur with congestive heart failure because your heart is not able to keep up with the circulation of blood in the body. A low salt diet will reduce the amount of fluid your kidneys retain.
According to the 2013 ACCF/AHA Guideline for Management of Heart Failure, limiting your liquid intake to 1.5 to 2 liters per day is recommended.
What medications are available to reduce edema?
Diuretic medications can increase the amount of urine output by your kidneys, and thereby reducing the volume of fluid in your blood vessels. This lightens the load your heart has to pump, reducing swelling.
Diuretic medications are especially useful for people with reduced cardiac output in the left side of the heart.
Examples of diuretic medications used for heart failure include loop diuretics such as Lasix (furosemide) and Demadex (torsemide) and thiazide diuretics such as Zaroxolyn (metolazone).
What medications are available to improve heart function?
Although diuretics are the first-line agents for congestive heart failure, digoxin is first-line in people who also have atrial fibrillation.
According to Medscape, digoxin produces a small improvement in cardiac output by strengthening the heart muscles. Side effects of digoxin can be serious if dosing is too high.
According to Uptodate, digoxin poisoning can result in life-threatening cardiac arrhythmias, nausea, vomiting, abdominal pain, confusion, delirium, weakness, and electrolyte imbalances.
Anticoagulant medications can reduce the risk of blood clots and heart attacks.
A heart attack occurs when blood flow in the blood vessels of the heart is blocked. People with congestive heart failure may benefit from taking an anticoagulant medication to lower the risk of developing blood clots.
According to an article by Dr. Allison Tsao published for The American College of Cardiology, aspirin and warfarin have been proven to lower the risk of stroke and cardiac ischemia in patients with heart failure and risk factors such as diabetes, obesity, and atrial fibrillation.
How often should you visit your doctor if you have congestive heart failure?
How often you need to see your doctor depends on the severity of your heart failure. You may be under the care of both a general cardiologist in addition to a heart failure specialist.
People with mild to moderate symptoms can see their doctor two to three times a year. Those with more severe symptoms may need to see their doctor every month. Those who are very unstable may need the care of a nurse daily.
Heart replacement surgery is a last resort when all other treatment options have failed.
Surgery to replace the heart is a consideration when all other treatment options have failed. It may take months to years to find a compatible heart donor and there is also the risk that your body may reject the transplanted heart.
Dr. Robert Higgins at Johns Hopkins Hospital is leading a team to develop an artificial heart. The newest technology will require many clinical trials before it becomes accepted as a treatment.
People who are interested may elect to participate in clinical research studies to test the effectiveness and safety of new medical advances.
What is end-of-life care available for people with end-stage congestive heart failure?
Congestive heart failure is a disease with a high mortality rate. Palliative care should be considered in people with a short life-expectancy.
Hospice care can reduce the pain and dyspnea caused by heart failure. It is also important to provide psychological services to treat depression.
The decision regarding whether or not to resuscitate in the event of cardiac arrest should be communicated in advance.
Palliative care and end-of-life planning are crucial to ensuring a dignified death for people with end-stage congestive heart failure.
