Heart Failure

Table of Contents

Overview

When the muscles of the heart do not pump blood properly, it is known as heart failure. A healthy heart works to push blood forward to deliver oxygen throughout the body. When the heart starts to weaken and blood is not pushed with enough force, fluid will start to build up in the body. This can make daily activities harder and can shorten a person’s life.

Certain heart conditions can contribute to the development of heart failure. These include high blood pressure and narrowed arteries in the heart. These heart conditions can cause the heart muscles to weaken or get stiff. The muscles in the heart can not fill or pump blood correctly through the body, which causes the heart to fail.

Types

The left side of the heart can have two different types of heart failure. When evaluating left-sided heart failure, an EF measurement is used. Ejection fraction (EF) measures how well the heart works. EF measures the amount of blood in the heart that is being pumped by each heartbeat. The typical person is around 50% or higher. It helps medical doctors determine if a person has heart failure.

  • Heart failure with reduced EF (HFrEF) is when the EF is lower than normal. HFrEF is when the heart muscle can only pump a small amount of blood with each beat. The heart muscle is weak and thus can not work to push a normal amount of blood out of the heart.
  • Heart failure with preserved EF (HFpEF) is when the heart is pumping, but not enough blood can move forward. HFpEFoccurs when the heart muscle is stiff. The stiffness in the heart causes the heart not to fill up correctly between heartbeats.

Causes

The cause of heart failure includes many conditions, and some are present without a person knowing. Some conditions cause heart damage directly, which leads to heart failure.

Causes of heart failure include:

  • Heart muscle disease is induced by drug or alcohol abuse or infection.
  • Congenital heart disease is present at birth.
  • A heart attack that has caused damage to the muscle tissue in the heart.

There are conditions people have that cause the heart to work harder. Over time the increased work can lead to heart failure.

  • Being overweight
  • Having a lung disease like chronic obstructive pulmonary disease (COPD)
  • High blood pressure (hypertension)
  • Diabetes

Heart failure can also be caused by other less common conditions.

Other, less common, conditions that contribute to heart failure include:

  • Severe anemia is when there are not enough red blood cells. The heart then tries to move the reduced number at an increased heart rate. This can overwork the heart over time and weaken the muscle.
  • Hyperthyroidism – High levels of thyroid cause the body to work faster, and the heart muscle works harder. Over time the heart muscle is weakened due to the increased workload.
  • Having an abnormal heart rhythm can cause the heart not to meet the body’s needs which can weaken the heart muscle over time.

Symptoms

Symptoms of heart failure occur because of the fluid building up in the body.

These symptoms include:

  • Fatigue and weakness during the day.
  • Shortness of breath during rest or exercise.
  • Loss of appetite, nausea, or having pain in the abdomen.
  • An increase in weight.
  • Coughing persistently with blood in the sputum.
  • Swelling of legs.

Heart failure can have a huge impact on a normal routine in life, like shortness of breath, which can impact daily activities. Even getting dressed can make a person feel exhausted. The swelling of the legs can make it painful to walk. Knowing the symptoms can help a person seek medical attention.

Treatment

Being diagnosed with heart failure can be overwhelming. There are many different treatments available. Heart failure treatment is dependent on the stage of the condition and if there are other medical conditions present.

One of the first steps taken in heart failure is a lifestyle change. This can be as simple as a change in eating habits and adding exercise to the daily routine. Another recommendation is adding medication to manage the workload on the heart.

Medication can also help manage conditions such as high blood pressure and diabetes. Cardiac rehabilitation is often recommended in the treatment of heart failure. It involves exercise monitored by a physician.

Lastly, treatment for heart failure may include surgery.

These can include:

  • Cardioverter-defibrillator to correct heart rhythms.
  • A heart transplant gives a person a new heart.
  • Ventricular assist devices help circulate blood in the body.

Medication

There are different types of medications to treat heart failure. The type of medication will depend on the recommendations of the healthcare team.

Medications for heart failure often work by reducing the fluid in the body, and include:

  • Diuretics make you urinate more to get rid of the excess fluid. Furosemide is also known as Lasix.
  • Aldosterone antagonist which is a diuretic that also spares potassium. These include spironolactone (Aldactone, Carospir) and eplerenone (Inspra).

For conditions where the heart is working hard, medications include:

Some medications help prolong life. This might need to happen if a heart transplant needs to occur.

  • ACE inhibitors can help prevent the progression of heart failure. These include lisinopril (Zestril), enalapril (Vasotec), or losartan (Cozaar), to list a few.
  • Entresto helps prevent heart damage.

Sources

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  2. Heart. Ejection Fraction Heart Failure Measurement. 2022. Available at Heart.org.
  3. PubMed. Heart Failure with Reduced Ejection Fraction: A Review. January 2020. Available at Pubmed.gov.
  4. AAFP. Heart Failure With Preserved Ejection Fraction: Diagnosis and Management. 2017. Available at AAFP.org.
  5. Heart. Causes of Heart Failure. 2022. Available at Heart.org.
  6. Hopkinsmedicine. Heart Failure. 2022. Available at Hopkinsmedicine.org.
  7. Webmd. Congestive Heart Failure and Heart Disease. 2022. Available at Webmd.com.
  8. CDC. How Cardiac Rehabilitation Can Help Heal Your Heart. January 2021. Available at CDC.gov.
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  23. Drugs. Inspra. March 2021. Available at Drugs.com.

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