|
Cardiologist at Dreyer Medical Clinic-Mercy Campus/Rush-Copley Campus
If you or a loved one has heart failure, you are not alone. Nearly 5 million Americans are living with heart failure today. More than 550,000 new cases of heart failure are diagnosed in the U.S. every year. Twenty percent of hospital admissions every year are for heart failure, and for people age 65 and older, congestive heart failure (CHF) is the main reason for hospitalization.
Cardiac abnormalities can be structural or functional or both. Heart failure does not mean the heart has quit working or the person has stopped breathing. Heart failure simply means the heart is not able to pump blood as effectively as it should. The body may be able to live with less blood flow without any symptoms, and the rest of the body compensates to cope with heart failure. However, when fluid build-up starts, due to the ineffective blood flow, a person can develop CHF.
Some of the common signs of CHF are shortness of breath with activity, fatigue during activity, an inability to sleep lying down without using several pillows, waking up gasping for air, abdominal bloating, weight gain, poor appetite, coughing at night, and swelling of the lower extremities. These symptoms are caused by fluid build-up in the lungs, gut walls, legs, and/or in the lung sac.
The heart is a muscular sac which pumps out blood with each heartbeat. The percentage of blood being pumped out of the heart is called the ejection fraction (EF). The pumping function, or EF, of a normal heart is around 55% to 60%, meaning 55% to 60% of the blood leaves the heart with each heartbeat.
While there are many different ways to classify heart failure, the main classification is based on the function of the heart. If the EF is greater than 50%, then the heart failure is called diastolic heart failure. Diastolic heart failure is due to a stiffer heart which cannot relax, so fluid builds up in the lungs causing congestion. About 20% to 50% of all heart failure patients have this type, and it is more prevalent in elderly, obese females with a history of hypertension and diabetes.
If the EF is less than 50%, then the heart failure is called systolic heart failure. Systolic heart failure is due to a weaker and bigger heart that cannot pump the fluid out of the heart, causing fluid build up in the lungs. Whenever fluid builds up in the lungs, shortness of breath, cough, and fatigue will follow. Systolic heart failure affects all ages, but typically appears more often in males and in those aged 50 to 70.
To make certain a person with heart failure can function normally without symptoms and live a near normal life, the patient and his or her physician must work together. Lifestyle modification is extremely important and includes the following:
- restriction of sodium (salt)
- monitoring of weight
- adhering to medication schedule
- moderating alcohol intake
- avoiding NSAIDs (non-steroidal anti-inflammatory drugs)
- exercising regularly
These disciplines, although simple, are crucial to the management of heart failure, but will require significant will power and self-policing from the individual with heart failure.
The medical community can help too, because many medications have been developed in recent years and are proven to not only make heart failure easier to live with, but to actually help a person with CHF live longer. These include beta blockers, ACE-inhibitors, diuretics, and digoxin when necessary. Sometimes surgical therapy, cardiac resynchronization, and various heart devices, such as an implanted defibrillator or pacemaker, are options that can bring improvements to a person with heart failure at later stages.
Despite the availability of medications and technology to improve the survival and quality of life for heart failure patients, there is still no cure for heart failure at the present time. However, some types of heart failure patients may return to a normal heart function if the original cause was due to pregnancy, virus infection, or another rare cause.
The good news is heart failure can be prevented. Keep your blood pressure, diabetes (if you have it), and cholesterol under control. If a heart attack should occur, medications can help prevent heart failure.
Look for more information about heart failure from these credible websites: www.americanheart.org (American Heart Association), www.hfsa.org (Heart Failure Society of America), www.nhlbi.nih.gov (National Institutes of Health), and www.mayoclinic.com (Mayo Clinic).
|
