Heart Disease and Congestive Heart Failure

Contents

Causes

Symptoms

Diagnosis

If there treatment available?

Prevention from worsening

How can i prevent further heart damage?

What medications should i avoid if i have heart failure?

Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.

CAUSES

Heart failure is caused by many conditions that damage the heart muscle, including:

• Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.
• Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly.
• Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.
• Conditions that overwork the heart. Conditions including high blood pressure, valve disease, thyroid disease, kidney disease, diabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once.

SYMPTOMS

You may not have any symptoms of heart failure, or the symptoms may be mild to severe. Symptoms can be constant or can come and go. The symptoms can include:

• Congested lungs. Fluid backup in the lungs can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.

• Fluid and water retention. Less blood to your kidneys causes fluid and water retention, resulting in swollen ankles, legs, abdomen (called edema), and weight gain. Symptoms may cause an increased need to urinate during the night. Bloating in your stomach may cause a loss of appetite or nausea.

• Dizziness, fatigue, and weakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.

• Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a rapid or irregular heartbeat.

If you have heart failure, you may have one or all of these symptoms or you may have none of them. They may or may not indicate a weakened heart.

DIAGNOSIS

Your doctor will ask you many questions about your symptoms and medical history. You will be asked about any conditions you have that may cause heart failure (such as coronary artery disease, angina, diabetes, heart valve disease, and high blood pressure). You will be asked if you smoke, take drugs, drink alcohol (and how much you drink), and about what drugs you take.

You will also get a complete physical exam. Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

• Blood tests. Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia.

• B-type Natriuretic Peptide (BNP) blood test. BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen, and decrease when the heart failure condition is stable.

• Chest X-ray. A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

• Echocardiogram. This test is an ultrasound which shows the heart's movement, structure, and function. 

• The Ejection Fraction (EF) is used to measure how well your heart pumps with each beat.

• Electrocardiogram (EKG or ECG) . An EKG records the electrical impulses traveling through the heart.

• Cardiac catheterization. This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.

• Stress Test. Noninvasive stress tests provide information about the likelihood of coronary artery disease.

Other tests may be ordered, depending on your condition.

IF THERE TREATMENT AVAILABLE?

There are more treatment options available for heart failure than ever before. Tight control over your medications and lifestyle, coupled with careful monitoring, are the first steps. As the condition progresses, doctors specializing in the treatment of heart failure can offer more advanced treatment options.

PREVENTION FROM WORSENING

• Keep your blood pressure low. In heart failure, the release of hormones causes the blood vessels to constrict or tighten. The heart must work hard to pump blood through the constricted vessels. It is important to keep your blood pressure controlled so that your heart can pump more effectively without extra stress.

• Monitor your own symptoms. Check for changes in your fluid status by weighing yourself daily and checking for swelling. Call your doctor if you have unexplained weight gain (3 pounds in one day or 5 pounds in one week) or if you have increased swelling.

• Maintain fluid balance. Your doctor may ask you to keep a record of the amount of fluids you drink or eat and how often you go to the bathroom. Remember, the more fluid you carry in your blood vessels, the harder your heart must work to pump excess fluid through your body. Limiting your fluid intake to less than 2 liters per day will help decrease the workload of your heart and prevent symptoms from recurring.

• Limit how much salt (sodium) you eat. Sodium is found naturally in many foods we eat. It is also added for flavoring or to make food last longer. If you follow a low-sodium diet, you should have less fluid retention, less swelling, and breathe easier.

• Monitor your weight and lose weight if needed.  Weigh yourself at the same time each day, preferably in the morning, in similar clothing, after urinating but before eating, and on the same scale. Record your weight in a diary or calendar. If you gain two kilograms in one day or three kilograms in one week, call your doctor. Your doctor may want to adjust your medications.

• Monitor your symptoms. Call your doctor if new symptoms occur or if your symptoms worsen. Do not wait for your symptoms to become so severe that you need to seek emergency treatment.

• Take your medications as prescribed. Medications are used to improve your heart's ability to pump blood, decrease stress on your heart, decrease the progression of heart failure, and prevent fluid retention. Many heart failure drugs are used to decrease the release of harmful hormones. These drugs will cause your blood vessels to dilate or relax (thereby lowering your blood pressure).

• Schedule regular doctor appointments. During follow-up visits, your doctors will make sure you are staying healthy and that your heart failure is not getting worse. Your doctor will ask to review your weight record and list of medications. If you have questions, write them down and bring them to your appointment. Call your doctor if you have urgent questions. Notify all your doctors about your heart failure, medications, and any restrictions. Also, check with your heart doctor about any new medications prescribed by another doctor.

HOW CAN I PREVENT FURTHER HEART DAMAGE?

In an effort to prevent further heart damage:

• Stop smoking .

• Reach and maintain your healthy weight.

• Control high blood pressure, cholesterol levels, and diabetes.

• Exercise regularly.

• Do not drink alcohol.

• Have surgery or other procedures to treat your heart failure as recommended.

WHAT MEDICATIONS SHOULD I AVOID IF I HAVE HEART FAILURE?

There are several different types of medications that are best avoided in those with heart failure including:

• Nonsteroidal anti-inflammatory medications.

• Some antiarrhythmic agents

• Most calcium channel blockers

• Some nutritional supplements, such as salt substitutes, and growth hormone therapies

• Antacids that contain sodium (salt)

• Decongestants

If you are taking any of these drugs, discuss them with your doctor.

Source: http://www.webmd.com/heart-disease/guide-heart-failure