What is wrong with me? Part 2
Heart failure, also called congestive heart failure, is a condition in which the heart can no longer pump enough blood to the rest of the body.
Causes, incidence, and risk factors
Heart failure is present when the following changes are present:
- Your heart muscle cannot pump, or eject, the blood out of the heart very well. This is called systolic heart failure.
- Your heart muscles are stiff and do not fill up with blood easily. This is called diastolic heart failure.
Perhaps the most common cause of heart failure is coronary artery disease (CAD), a narrowing of the small blood vessels that supply blood and oxygen to the heart. Heart failure can also occur when an infection weakens the heart muscle. Such a disorder is called cardiomyopathy.
Other heart problems that may cause heart failure are:
- Congenital heart disease
- Heart attack
- Heart valve disease
- Some types of abnormal heart rhythms (arrhythmias)
- Shortness of breath with activity, or after lying down for a while
- Swelling of feet and ankles
- Swelling of the abdomen
- Weight gain
- Irregular or rapid pulse
- Sensation of feeling the heart beat (palpitations)
- Difficulty sleeping
- Fatigue, weakness, faintness
- Loss of appetite, indigestion
- Decreased alertness or concentration
- Decreased urine production
- Nausea and vomiting
- Need to urinate at night
Signs and tests
- Fluid around the lungs (pleural effusion)
- Irregular heartbeat
- Leg swelling (edema)
- Neck veins that stick out (are distended)
- Swelling of the liver
The following tests may be used to diagnose or monitor heart failure:
- Chest x-ray
- Cardiac stress tests
- Heart CT scan
- Heart catheterization
- MRI of the heart
- Nuclear heart scans
The most common tests, the ECG, is used at every doctor's appointment and I get an echo several times a year to keep track if my heart's progression.
You will need to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weigh yourself at the same time each day and on the same scale, with little to no clothes on.Weight gain can be a sign that your body is holding onto extra fluid and your heart failure is worsening. Talk to your doctor about what you should do if your weight goes up more than 5 lbs or if you develop more symptoms.
Other important measures include:
- Take your medications as directed. Carry a list of medications with you wherever you go.
- Limit salt intake.
- Do not smoke.
- Stay active. For example, walk or ride a stationary bicycle. Your doctor can provide a safe and effective exercise plan for your degree of heart failure. DO NOT exercise on days that your weight has gone up from fluid retention or you are not feeling well.
- Lose weight if you are overweight.
- Look for foods that are labeled “low-sodium,” “sodium-free,” “no salt added,” or “unsalted.” Check the total sodium content on food labels. Be especially careful of canned, packaged, and frozen foods. A nutritionist can teach you how to understand these labels.
- Don’t cook with salt or add salt to what you are eating. Try pepper, garlic, lemon, or other spices for flavor instead. Be careful of packaged spice blends as these often contain salt or salt products (like monosodium glutamate, MSG).
- Avoid foods that are naturally high in sodium, like anchovies, meats (particularly cured meats, bacon, hot dogs, sausage, bologna, ham, and salami), nuts, olives, pickles, sauerkraut, soy and Worcestershire sauces, tomato and other vegetable juices, and cheese.
- Take care when eating out. Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese.
- Use oil and vinegar, rather than bottled dressings, on salads.
- Eat fresh fruit or sorbet when having dessert.
Your doctor may prescribe the following medications:
- ACE inhibitors such as captopril, enalapril, lisinopril, and ramipril to open up blood vessels and decrease the work load of the heart
- Diuretics including hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, torsemide, bumetanide, and spironolactone to help rid your body of fluid and salt (sodium)
- Digitalis glycosides to help the heart muscle to contract properly and help treat some heart rhythm disturbances
- Angiotensin receptor blockers (ARBs) such as losartan and candesartan for those who have side effects with ACE inhibitors
- Beta-blockers such as carvedilol and metoprolol, which may be helpful for some patients
SURGERIES AND DEVICES
Heart valve surgery, coronary bypass surgery (CABG), and angioplasty may help some people with heart failure.The following devices may be recommended for certain patients with heart failure:
- A pacemaker to help treat slow heart rates or other heart signaling problems
- A biventricular pacemaker to help the both sides of your heart contract at the same time; it is also called cardiac resynchronization therapy.
- An implantable cardioverter-defibrillator that recognizes life-threatening, abnormal heart rhythms and sends an electrical pulse to stop them. I have one of these implanted and should be replacing it this summer.
- Intra-aortic balloon pump (IABP)
- Left ventricular assist device (LVAD)
- Irregular heart rhythms (can be deadly)
- Pulmonary edema
- Total heart failure (circulatory collapse)
Possible side effects of medications include:
Of all the many bad things about CHF, the worst is taking diuretics. HATE IT. They destroy my ability to lead a normal life. Stumble It! JBlog Me