Heart Failure

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What is heart failure?

Heart failure, also called congestive heart failure, is a condition in which the heart cannot pump enough oxygenated blood to meet the needs of the body's other organs. The heart keeps pumping, but not as efficiently as a healthy heart. Usually, the heart's diminished capacity to pump reflects a progressive, underlying condition.


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What causes heart failure?

Heart failure may result from any or all of the following:

  • Heart valve disease caused by past rheumatic fever or other infections

  • High blood pressure (hypertension)

  • Active infections of the heart valves and/or heart muscle (for example, endocarditis or myocarditis)

  • Previous heart attack(s) (myocardial infarction). Scar tissue from prior damage may interfere with the heart muscle's ability to pump normally.

  • Coronary artery disease. Narrowing of the arteries that supply blood to the heart muscle.

  • Cardiomyopathy or another primary disease of the heart muscle

  • Congenital heart disease or defects (present at birth)

  • Cardiac arrhythmias (irregular heartbeats)

  • Chronic lung disease and pulmonary embolism

  • Certain medications

  • Excessive sodium (salt) intake

  • Anemia and excessive blood loss

  • Complications of diabetes


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What are the symptoms of heart failure?

The following are the most common symptoms of heart failure. However, each individual may experience symptoms differently. Symptoms may include:

  • Shortness of breath during rest, exercise, or while lying flat

  • Weight gain

  • Visible swelling of the legs and ankles (due to a buildup of fluid), and, occasionally, swelling of the abdomen

  • Fatigue and weakness

  • Loss of appetite, nausea, and abdominal pain

  • Persistent cough that can cause blood-tinged sputum

The severity of the condition and symptoms depends on how much of the heart's pumping capacity has been compromised.

The symptoms of heart failure may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.


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Treatment for heart failure

Specific treatment for heart failure will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

The cause of the heart failure will dictate the treatment protocol established. If the heart failure is caused by a valve disorder, then surgery may be performed. If the heart failure is caused by a disease, such as anemia, then the underlying disease will be treated. Although there is no cure for heart failure due to damaged heart muscle, many forms of treatment have been used to treat symptoms very effectively.

The goal of treatment is to improve a person's quality of life by making the appropriate lifestyle changes and implementing drug therapy.

Treatment of heart failure may include:

  • Controlling risk factors

  • Medication

  • Biventricular pacing/cardiac resynchronization therapy. A new type of pacemaker that paces both pumping chambers of the heart simultaneously to coordinate contractions and to improve the heart's function. Some heart failure patients are candidates for this therapy.

  • Implantable cardioverter defibrillator. A device similar to a pacemaker that senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm.

  • Heart transplantation

  • Ventricular assist devices (VADs). These are mechanical devices used to take over the pumping function for one or both of the heart's ventricles, or pumping chambers. A VAD may be necessary when heart failure progresses to the point that medications and other treatments are no longer effective.

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