Heart Failure

In heart failure, the heart is unable to pump the right amount of blood throughout the body. This causes blood to back up in the veins. Depending on which part of the heart is affected, this can lead to a buildup of excess fluid in the lungs, feet, and elsewhere. Heart failure can worsen with time, which may lead to the use of many treatments. Because of this, doctors are aggressive in treating heart failure to try to prevent it from worsening.

  • Causes

    The leading causes of heart failure are:

    • Coronary artery disease
    • Heart attack

    Other common causes include:

    • Problems with the heart's valves due to:

      • Rheumatic heart disease
      • Bacterial endocarditis
      • Congenital defects
      • Calcium deposits from atherosclerosis
    • High blood pressure
    • Diabetes

    Other less common causes include:

    • Cardiomyopathy—weakened, damaged heart muscle from various causes
    • Certain medicines
    • Abnormal heartbeats—arrhythmias
    • Hyperthyroidism—overactive thyroid
    • Amyloidosis
    • Kidney failureand/or liver failure
    • Thiamine (vitamin B1) deficiency

  • Definition

    In heart failure, the heart is unable to pump the right amount of blood throughout the body. This causes blood to back up in the veins. Depending on which part of the heart is affected, this can lead to a buildup of excess fluid in the lungs, feet, and elsewhere. Heart failure can worsen with time, which may lead to the use of many treatments. Because of this, doctors are aggressive in treating heart failure to try to prevent it from worsening.

    Blood Flow through the Heart
    heart
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  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.

    Your bodily fluids may be tested. This can be done with:

    • Blood tests
    • Urine tests

    Your heart may be examined. This can be done with:

    • Electrocardiogram
      (ECG)
    • Echocardiogram
    • Exercise stress test
    • Nuclear scanning
    • Coronary angiography

  • Prevention

    The best way to prevent heart failure is to reduce your risk of:

    • Coronary artery disease
    • High blood pressure
    • Diabetes

    Take these steps to reduce your risk:

    • Begin a safe exercise program with the advice of your doctor.
    • If you smoke, quit.
    • Limit alcohol.
    • Lose weight if needed. After you have lost weight, maintain a healthy weight.
    • Eat a healthy diet. The DASH diet, in particular, may reduce the risk of high blood pressure and heart failure, particularly in women. The DASH diet is:

      • Rich in fruits, vegetables, and low-fat dairy foods
      • Low in saturated fat, total fat, and cholesterol
    • Eat whole grain breakfast cereal. In addition to the other healthy habits, this may reduce your risk.

  • Risk Factors

    Factors that increase your chances of getting heart failure include:

    • Increased age
    • Obesity
    • Excess intake of salt and fat
    • Excess alcohol intake
    • Sex: male
    • Race: Black
    • Smoking
    • Pregnancy
    • High fever
    • Severe infection
    • Chronic lung disease—emphysema
    • Chemotherapy

  • Symptoms

    Symptoms include:

    • Shortness of breath—at first only with activity, then progressing to shortness of breath at rest
    • Unexplained weight gain
    • Swelling of feet, ankles, or legs
    • Need to sleep propped up
    • Fatigue, weakness
    • Wheezing
    • Cough—may be dry and hacking or wet sounding, may have a pink, frothy sputum
    • Frequent urination, especially at night
    • Abdominal pain

  • Treatment