Heart Failure is a growing problem worldwide and leading cause of admissions in the hospital. Heart failure may not be a curable disease but understanding the disease and treatment options can help with better management of the symptoms.
1. What is Heart Failure?
It is inability of heart to pump enough blood to meet body needs due to muscle weakness or muscle stiffness. Heart failure is NOT heart attack.
2. What are the types of heart failure?
Systolic HF (Muscle weakness)
Weak heart muscle is not able to pump enough blood
Diastolic HF (Muscle thickening and stiffness)
Thick heart muscle is not able to pump blood in normal way
Right Sided Heart failure seen in patients with lung disease.
3. What are the signs and symptoms of heart failure?
Shortness of breath or breath difficulty and leg swelling are most common symptoms. The other symptoms are cough, weight gain, fatigue, not able to lie flat due to breathing difficulty.
4. What are the causes or risk factors for heart failure?
Heart attack, High blood pressure, Obesity, Diabetes, Heart valve damage, Family history of heart disease, Age more than 65 years.
5. Is Heart Failure very common?
Yes. According to American Heart Failure Society of America there are currently 6 million Americans with heart failure and number will reach more than 8 million in next decade.
6. What are the tests used for diagnosis of heart failure?
Commonly ordered tests for patients with heart failure include ECG, echocardiogram, chest X-ray and blood work. Echocardiogram (echo) gives information on strength of heart muscle and gives Ejection Fraction or EF. EF more than 55% is considered normal in most echo labs. Some patients may need stress test or cardiac catheterization.
7. What are the treatment options for heart failure?
There has to be significant lifestyle changes including salt restriction, fluid restriction, quitting smoking/alcohol. You may be placed on several medications from different categories: water pill to get rid of extra fluid, Beta blocker and Ace inhibitor or ARBs (commonly used medication for blood pressure) to strengthen heart muscle. Few patients may need ICD or implanted defibrillators or referral to centers for advanced heart failure for surgical options.
8. What are the stages for heat failure?
There are two types of staging system for heart failure.
One is based on severity of patient symptoms –New York Heart Association Functional Class (NYHA)
NYHA I: No limitation of physical activity
NYHA II: Slight limitation of physical activity
NYHA III: Marked limitation of physical activity due to breathing difficulty.
NYHA IV: Shortness of breath at rest
In 2001 ACC/AHA introduced new staging system based on damage to the heart
Stage A: No structural disease of heart but High Risk for developing CHF but
Stage B: Has structural disease of heart but never had signs and symptoms.
Stage C:structural heart disease with past or current symptoms of CHF
Stage D: End stage heart failure requiring specialized treatment
9. What is the prognosis of heart failure?
Heart failure is not a death sentence any more. Many patients who have heart failure improve or stabilize with medications. Prognosis for heart failure has improved over the last decade due to ongoing medical research and availability of new medications and surgical options like LVAD (Heart pump), heart transplant.
Reviewed by Dr. Saurabh Jha, Cardiologist, Springfield Clinic Cardiology