Heart failure, also known as congestive heart failure, is a condition where your heart doesn’t pump enough blood to meet your body’s needs. This can occur if your heart is too weak to pump appropriately or can’t fill up with enough blood. According to the Centers for Disease Control and Prevention, more than 6 million adults in the United States have heart failure. It is a serious condition that currently has no cure. However, appropriate treatment such as medications, healthy lifestyle changes, and occasionally devices and procedures can help many people improve and maintain their quality of life. 

Causes and Risk Factors

In heart failure, the heart muscle may become damaged and weakened, and the heart’s main pumping chambers (the ventricles) may stretch to the point that the heart can’t pump enough blood through the body. In some people, the ventricles may become stiff and not fill properly between beats. Over time, the heart can no longer keep up with the body’s demands.

In heart failure with reduced ejection fraction (HFrEF) or systolic heart failure, the left side of your heart is weak and can’t pump enough blood to the rest of your body. Many conditions can damage or weaken your heart and lead to heart failure. Some may be present without your knowing it:

• Coronary artery disease. Coronary artery disease is the most common cause of heart failure. It’s caused by the buildup of fatty deposits in the arteries, which reduces blood flow and can lead to a heart attack.
• Heart Attack. A heart attack occurs suddenly when a coronary artery becomes completely blocked. This can damage your heart muscle and may mean that your heart can no longer pump as well as it should.
• Faulty heart valves. The valves of the heart ensure that blood flows in the proper direction. A damaged valve (due to a heart defect, coronary artery disease, infection, trauma, etc.) increases the heart’s workload, which can weaken it over time.
• Abnormal heart rhythms. Abnormal heart rhythms may cause your heart to beat too fast, creating extra work for your heart. A slow heart rate can also lead to heart failure.
• Damage to the heart muscle. Heart muscle damage can have many causes. This includes certain diseases, infections, heavy alcohol use, and the toxic effect of drugs, such as some forms of chemotherapy and illicit drugs such as cocaine. Genetic factors can also play a role.

In heart failure with preserved ejection fraction (HFpEF) or diastolic heart failure, the left side of your heart is too stiff to completely relax between heartbeats. This means it can’t fill up with enough blood to pump out to your body. 

• High blood pressure. High blood pressure and other conditions that make your heart work harder are the leading causes of heart failure with preserved ejection fraction. Learn more about controlling your hypertension at https://wordpress.com/post/fnpwrite.wordpress.com/359
• Chronic Conditions. Conditions that stiffen the heart’s chambers, such as obesity and diabetes, can also lead to this type of heart failure. Over time, your heart muscle thickens to adapt to these conditions, making it stiffer.

Signs and Symptoms

Heart failure symptoms depend on your type of heart failure and its severity. Heart failure signs and symptoms may include:

• Shortness of breath with activity or when lying down
• Swelling in the legs, ankles, and feet
• Inability to sleep lying flat
• Very rapid weight gain from fluid buildup
• Nausea and lack of appetite
• Fatigue and weakness
• Difficulty concentrating or decreased alertness

Treatment

There is currently no cure for heart failure, but proper treatment can help you live a longer, more active life with fewer symptoms. 

Healthy lifestyle changes

Your provider may recommend heart-healthy lifestyle changes, including:

• Lower your sodium (salt) intake. Salt may make fluid buildup worse.
• Aim for a healthy weight. Extra weight can increase the workload for your heart. 
• Regular physical activity. Ask your healthcare provider about how active you should be during daily activities, work, leisure time, and exercise.
• Quit smoking. For free help quitting smoking, you may call the National Cancer Institute’s Smoking Quitline at 1-877-44U-QUIT 

(1-877-448-7848).

• Avoid or limit alcohol. Your provider may recommend that you limit or stop drinking alcohol.
• Manage risk factors. Controlling the factors that may worsen heart failure, like blood pressure, diabetes, and heart rhythm can improve heart health.

Medications

Medical therapy for heart failure will depend on the severity of your disease and other present conditions, such as liver or kidney dysfunction.

The current “gold standard” for medical therapy includes:

• Beta-blockers
• Angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), or angiotensin receptor/neprilysin inhibitors (ARNIs)
• Aldosterone Antagonists such as Aldactone (spironolactone)
• Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors (Jardiance or Farxiga)
• Diuretics such as Lasix, HCTZ, chlorthalidone, Bumex, etc. 

You and your doctor should personalize your heart failure treatment based on the severity of your disease, the presence of other chronic diseases, the severity of symptoms, etc. Always speak to your cardiologist or primary care provider so that you can tailor a plan that is safe and effective for you. Stay healthy Kingsport!