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Heart failure is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. Heart failure, also known as congestive heart failure, may result from the following conditions: heart valve disease, high blood pressure (hypertension), infections of the heart valves and/or heart muscle, previous heart attack, coronary artery disease, congenital heart disease/defects (present at birth), cardiac arrhythmias, chronic lung disease, or diabetes.
A weakened heart also interferes with the kidney's ability to eliminate excess sodium and waste from the body. In heart failure, the body retains more fluid--resulting in swelling of the ankles and legs. Fluid also collects in the lungs, which causes shortness of breath.
Usually, the loss in the heart's pumping action is a symptom of an underlying heart problem. Nearly 5.7 million Americans are living with heart failure, and 670,000 new cases are diagnosed each year.
The severity of heart failure and symptoms depends on how much of the heart's pumping capacity has been lost. Symptoms may resemble other conditions or medical problems.
Diagnostic Procedures
In addition to a complete medical history and physical examination, diagnostic procedures for heart failure may include any, or a combination of, the following:
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Chest X-ray: a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
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Echocardiogram: a noninvasive test that uses sound waves to produce a study of the motion of the heart's chambers and valves. The echo sound waves create an image on the monitor as an ultrasound transducer is passed over the heart.
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Electrocardiogram (ECG or EKG): a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
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BNP testing: B-type natriuretic peptide (BNP) is a hormone released from the ventricles in response to increased wall tension (stress) that occurs with heart failure. The higher the BNP levels, the worse the heart failure.
Treatment
The cause of the heart failure will determine what kinds of treatment options are viable. If the heart failure is caused by a valve disorder, then heart valve surgery is usually performed. If the heart failure is caused by some other disease, then that disease is treated. Most cases of heart failure, however, are caused by a damaged heart muscle; although there's no cure for this, the right balance of medications, lifestyle changes, and sometimes special devices has proven to be successful.
The goal of treatment is to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy. Lifestyle changes for heart failure may include losing weight (if overweight), restricting salt and fat intake, quitting smoking, limiting alcohol, getting proper rest, controlling blood sugar (for people with diabetes), controlling blood pressure, and limiting fluids.
Depending on your specific case, your doctor may prescribe different medications to treat heart failure. These medications are commonly used to manage symptoms, help strengthen your heart, and reduce your heart's workload. Classes of medication include:
- Diuretics: also known as water pills, these make you urinate more often and prevent fluid from collecting in your body. Examples include furosemide (Lasix), bumentanide (Bumex), and amiloride (Midamor).
- Beta blockers: this class of drugs slows your heart rate and reduces blood pressure. Examples include carvedilol (Coreg), metoprolol (Lopressor), and bisoprolol (Zebeta).
- Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors improve blood flow by opening up narrowed blood vessels. Examples include enalapril (Vasotec), lisinopril (Zestril), and captopril (Capoten).
- Angiotensin II receptor blockers (ARBs): because of their similarities, ARBs are an alternative for those who can't tolerate ACE inhibitors. Examples include losartan (Cozaar) and valsartn (Diovan).
Recently, a new treatment came to the market that's different than commonly prescribed medications. The drug, Entresto, combines an ARB called valsartan with an enzyme called sacubitril. It may be used in conjunction with other heart failure therapies or in place of an ACE inhibitor or ARB. The drug makes it easier for the heart to work properly, and is showing strong success when compared to more standard medications.
