Heart failure happens when your heart stops being able to pump blood around your body efficiently. This may be due to the heart being stiff or weak, which can happen for many reasons.
The body and its organs need oxygen-rich blood to work. When your heart cannot effectively supply blood to the body, you can experience tiredness and shortness of breath, among other symptoms.
Heart failure is sometimes also called congestive heart failure, and you may hear the terms used interchangeably. However, congestive heart failure is a type of heart failure that requires immediate medical attention.
It’s also important to keep in mind that heart failure is not the same as a heart attack. Heart failure means your heart isn’t pumping blood effectively, and it can happen for many reasons. A heart attack, on the other hand, is a blockage in blood flow to the heart, and it’s one of the many causes of heart failure.
Knowing the signs to look out for is important to catch it as early as possible and receive the proper treatment.
Signs of heart failure
Heart failure affects about 6.2 million adults in the United States. When you have heart failure, your body and organs can’t function as well as they should because your heart can’t pump enough blood to your whole body. This leads to weakness and swollen limbs, among other symptoms. Six common signs and symptoms of heart failure are:
1. Fatigue, tiredness, and weakness
Not having enough blood reach your whole body can lead to feelings of weakness, fatigue, and tiredness. This is because your body diverts blood from muscle tissues to vital organs like the brain and heart.
This is why you can become easily tired after doing common and everyday activities, like walking and climbing stairs.
2. Difficulty breathing
Research finds that heart failure can affect your lungs and your breathing in various ways. For example, it can lead to obstruction of your airways, lower lung capacity, lower ability of your lungs to exchange gases (which is essential to take in oxygen and expel CO2), and lower control of your breathing (which can lead to hyperventilation).
Heart failure commonly causes shortness of breath because there is a backup of blood in the lungs, which affects the ease of your breathing. It causes shortness of breath when you’re doing activities or when you’re lying flat on your back (orthopnea).
All of these can lead to a feeling of breathlessness or difficulty breathing when you’re doing everyday tasks.
3. Nausea and appetite changes
Heart failure can lead to nausea and lack of appetite because your stomach is not getting enough blood supply. It may also be due to the backup of blood in the liver and other organs in your abdomen.
4. Confusion
A person with heart failure can experience confusion and changes in memory. According to the American Heart Association (AHA), this is because of the reduced blood flow to the brain due to the heart’s weakened ability to pump blood and changing levels in vital substances in the blood, like sodium.
5. Edema, or fluid buildup
Hands, feet, ankles, and legs swell up because of fluid buildup. This happens because the heart can’t efficiently pump blood or empty the heart chambers of blood. Because of this, blood returning from the body to the heart gets backed up in the veins and blood vessels.
Heart failure also leads to fluid buildup because the kidneys sense insufficient blood flow, so they start to hold on to salt and water.
Edema and fluid buildup can lead to weight gain as well.
6. Increased heart rate
Your heart may pump faster in order to make up for not pumping enough blood to the rest of the body. This increases your heartbeat.
Types and stages
Heart failure is classified into different types and stages.
Two types of heart failure are:
- Left-sided heart failure: The left side of the heart has to work much harder to pump the same amount of blood.
- Right-sided heart failure: This usually happens because of left-sided failure. The right side becomes damaged and lowers its ability to pump blood properly. This leads to a backup of blood in your veins.
Many times, both sides of the heart are affected.
There are four stages of heart failure. According to the staging systems of the American College of Cardiology and AHA, these are:
- Stage A: There’s a higher chance of heart failure, but there are no symptoms of heart failure or structural heart disease.
- Stage B: There’s structural heart disease but no symptoms of heart failure. This means that the heart’s pumping capacity has begun to be affected.
- Stage C: The heart isn’t pumping efficiently, and the person experiences symptoms of heart failure, such as fatigue and difficulty breathing.
- Stage D: This is the severe stage of heart failure in which there’s significant structural damage to the heart. People with heart failure at this stage can experience symptoms like breathlessness, fatigue, and rapid heartbeat, even at rest.
Diagnosis
To diagnose heart failure, healthcare professionals will ask about your and your family’s medical history and perform a physical exam.
An echocardiogram is the most common and reliable test. It uses sound waves to create an image of your heart, allowing doctors to check that it’s working as it should be.
They may also order other tests, such as:
- blood and urine test
- chest X-ray
- electrocardiogram
- cardiac MRI
- genetic testing
Treatments and prevention
Heart failure doesn’t have a cure, but it can be prevented and treated.
Ways to keep your heart healthy include:
- eating a balanced diet that’s low in sodium
- managing underlying conditions like diabetes, high blood pressure, and high cholesterol
- exercising and doing physical activity for 30 minutes five times a week
- quitting smoking if you smoke
- avoiding or reducing the amount of alcohol you drink
- reducing stress with practices like meditation and yoga
- getting quality sleep
Treatment options for heart failure include:
- Medications: A healthcare professional may prescribe medications to address heart failure symptoms. You may need to take different types of medication. These include:
- Angiotensin-converting enzyme inhibitors (ACE inhibitors): captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Qbrelis), perindopril (Aceon), ramipril (Altace)
- Angiotensin receptor blockers (ARBs): candesartan (Atacand), losartan (Cozaar), valsartan (Diovan)
- Aldosterone antagonists: spironolactone (Aldactone)
- Beta-blockers: bisoprolol (Zebeta), carvedilol (Coreg)
- Diuretics: furosemide (Lasix), bumetanide (Bumex)
- SGLT-2 inhibitors: empagliflozin (Jardiance), dapagliflozin (Farxiga)
- Neprilysin inhibitors: sacubitril/valsartan (Entresto)
- Surgery: There are several surgical options depending on the severity of the heart failure. These include cardiac ablation, bypass operation, and a heart transplant. These options depend on the underlying cause behind the heart failure.
- Implanted devices: The doctor may consider placing a device to help regulate your heart rhythm, such as a pacemaker, or that helps your heart pump blood, such as a ventricular assist device.
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