Congestive Heart Failure – DrugWatch.com

About 6.4 million American adults have heart failure, and it was a contributing cause in 1 in 8 deaths in 2017, according to the Centers for Disease Control and Prevention.

Heart failure doesnt mean your heart has stopped, it just means that it doesnt pump enough blood. This weakened ability to pump blood causes fluid and blood to back up into the lungs, making it hard to breathe and causing swelling in the ankles, feet and legs.

People who are 65 years or older, people who are overweight, people who have had a heart attack and African Americans are at greatest risk for CHF. It also affects more men than women.

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Heart failure can affect the left side of the heart, the right side or both. Each type has slightly different symptoms. The type of CHF also affects the type of treatment.

Left-sided heart failure occurs when the left ventricle of the heart no longer pumps enough blood. Its the most common type of failure. Because of this, the veins that carry blood away from the lungs the pulmonary veins build up with blood. When this happens, people may have shortness of breath, trouble breathing or coughing. It gets worse during physical activity.

There are two kinds of left-sided failure.

The left ventricle can no longer contract normally, and the heart is too weak to push enough blood into the body.

The left ventricle becomes stiff and loses its ability to relax, and the heart doesnt properly fill up with blood in between beats.

Right-sided heart failure occurs when the right ventricle cannot pump enough blood to the lungs, causing blood to build up in the veins that bring blood to the lungs. This causes fluid to leak out from the veins into the surrounding tissues. Fluid usually builds up in the legs, but sometimes it can also build up in the belly or genital area.

Failure in both sides of the heart is called biventricular heart failure. This type combines the symptoms of both left and right heart failure.

Congestive heart failure has four stages. It begins with stage I sometimes called class I or pre-heart failure. It then progresses over time to stage IV, sometimes called class IV or advanced heart failure.

Treatment recommendations and symptoms are different depending on the stage.

Signs of heart failure can appear in anyone at any age, even in young children that may be born with heart defects. But it usually affects older people with weakened hearts from other diseases.

There may be no symptoms in the early stages, but people start having symptoms in stage II and they get progressively worse, especially without treatment.

Symptoms include:

Congestive heart failure is usually caused by another disease or health condition. This is especially true of conditions that cause damage to the heart or make it work harder than it should. The most common health problems that may cause heart failure are high blood pressure, coronary artery disease and previous heart attack.

Health conditions that may cause CHF include:

One in five Americans will develop heart failure, according to the American Heart Association. Certain people are more at risk of developing the disease. Some of these risks, such as keeping a healthy weight, are changeable. Other risks, such as genetics, are not.

The heart muscle weakens with age and people over 65 are most likely to have heart failure. They may also have more health conditions that make them susceptible to heart failure.

Among all races, African Americans have the highest rate of heart failure. They tend to have symptoms younger, have more deaths from heart failure and also have more hospital visits because of the disease.

Overweight or obese people have a greater risk of heart failure because excess weight puts strain on the heart. People who are overweight also have a greater risk of Type 2 diabetes and heart disease both conditions can lead to heart failure.

People who have had a previous heart attack have weaker heart muscles. This can lead to heart failure.

Heart failure can run in families. Children born with heart defects are also at risk for heart failure.

In addition to health problems, some medications may cause or worsen CHF. Be sure to tell the doctor about all medications you take.

Medications Linked to CHF include:

A cardiologist is typically the specialist who can diagnose CHF. The doctor will ask the patient about any symptoms they may be having, such as swelling or shortness of breath. Its important to tell the doctor if you have other health conditions such as heart disease, high cholesterol, high blood pressure, kidney disease and diabetes.

Along with a physical exam, the doctor may order tests to check for CHF.

These tests help the doctor figure out what caused the heart failure. They can also rule out heart failure. Many of them are geared toward looking at how the heart is functioning and its pumping strength.

Doctors will order blood tests for anemia and kidney or thyroid problems. The symptoms of these conditions may mimic heart failure. The doctor will also check cholesterol levels.

People with heart failure have high levels of BNP in the blood a hormone released by the lower chambers of the heart (ventricles). Depending on the severity of heart failure, the levels of levels of NT-pro BNP change. Higher levels mean the ventricles are more stressed. People with a level of more than 450 picogram/milliliter(pg/mL) one trillionth of a gram per milliliter for patients under age 50 or 900 pg/mL for patients 50 and older may signify heart failure.

Measuring levels of a hormone called B-type Natriuretic Peptide (BNP) can help diagnose heart failure and its stage. Higher levels mean more damage to the heart.

Doctors insert a long, thin tube called a catheter into an artery in the leg or arm. Sometimes doctors also insert dye to record videos of the heart valves, chambers and blood vessels. This can show how well the heart is pumping.

An X-ray can show fluid buildup around the lungs and heart and how big the heart muscle is.

An echo is an ultrasound that can show how well the heart pumps, the function of the valves, the blood flow and the hearts size. It can measure the pressure in the heart and the ejection fraction (EF) a measurement of the blood pumped out of the heart with each beat.

EF measures how much blood the heart pumps with each beat. Doctors can test for EF using several methods: echocardiogram (echo), magnetic resonance imaging (MRI), multigated acquisition (MUGA) scan, during a heart catheterization and during a nuclear stress test. Normal EF is between 55% and 70%. This can change depending on how well heart failure is managed and treated. This can also help diagnose the stage of heart failure and tell the doctor how well treatment is working.

Doctors use this test to check the hearts electrical activity. Electrodes are connected to wires connected to sticky patches placed on a persons body. Information from electrodes creates a graph on a monitor. Abnormal heart rhythms may signal heart failure.

In this test, a special camera called a gamma camera creates a video of the heartbeat and how the ventricles work after the health care provider injects a small amount of radioactive dye into a vein.

A stress test shows doctors how the heart reacts to activity and stress. Patients may get on a treadmill or bike while blood pressure, heart rate and electrocardiograph are measured. People who cannot exercise may take a drug that mimics exercise.

Treatment plans for CHF focus on stopping or slowing disease progression because there is no cure for CHF. Once a person progresses to the next stage, there is no reversing it. Cardiologists are specialists that develop treatment plans for people with CHF.

Medication is the main treatment for CHF and people with the condition typically have to take medicines for the rest of their lives to stay healthy. Patients should speak to their health care provider right away if they develop side effects.

If medication fails to help, patients may benefit from surgery to repair heart valves or clear blood vessels.

Angiotensin converting enzyme (ACE) inhibitors dilate blood vessels to lower blood pressure and lessen the workload on the heart. They also lower the amount of heart-damaging hormones.

Drugs in this class include Prinivil (Lisinopril) and Capoten (captopril). Common side effects include dizziness, increased potassium levels, drug cough and changes in kidney function. Patients should get regular blood tests to check kidney function.

These drugs work similarly to ACE inhibitors, but dry cough side effects are less severe.

Drugs in this class include Diovan (valsartan) and Cozaar (losartan). Like ACE inhibitors, these drugs may damage kidneys so tests for kidney functions are recommended. Common side effects include dizziness, changes in kidney function and increased potassium levels.

These drugs cause the heart to beat more slowly and with less force. They also lower blood pressure.

Drugs in this class include Toprol (metoprolol) and Coreg (carvedilol). Common side effects are fatigue, dizziness, drowsiness, headache and upset stomach. Dont stop taking a beta blocker without talking to a health care provider.

People sometimes call diuretics water pills because they work by removing excess fluid from the body. Because diuretics cause the body to lose potassium, people may need to take potassium supplements.

Drugs in this class include Lasix (furosemide), Bumex (bumetanide) and Zaroxolyn (metolazone). Common side effects include dizziness, increased urination, skin rash, changes in kidney function, increased blood sugar levels, gout and dehydration.

These medications work by stopping the body from making too much aldosterone, a hormone that can damage the heart.

Drugs in this class include Inspra (eplerenone) and Aldactone (spironolactone). Common side effects include breast swelling or tenderness in men and women, increased potassium and changes in kidney function. Patients should get routine kidney and potassium tests.

This drug slows the heart rate and may improve the hearts pumping ability. Blood tests are needed to find the right dose. Common side effects include digestive problems, poor appetite and nausea.

This medicine helps relax blood vessels and reduce the strain on the heart. These drugs are primarily helpful for treating heart failure in African Americans, and studies have shown the medicine can reduce the risk of death, according to the National Heart, Lung and Blood Institute.

Common side effects include dizziness, headache and swelling in the extremities.

Because heart failure is a serious, progressive condition, prevention is important. For people living with CHF, there are things they can do to stop or slow disease progression and improve their quality of life.

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To avoid heart failure, theres a need to prevent other heart problems.

To avoid heart failure, theres a need to prevent other heart problems, Johns Hopkins cardiologist Dr. Steven Jones said.

Ways to Prevent Heart Failure

CHF prognosis depends on the stage of disease, what caused the disease and how effective the treatment is.

In general, people with class I or II CHF have the best prognosis. People with heart failure caused by coronary artery disease or primary cardiomyopathy had worse survival rates than people with other causes, according to researcher M. Matoba and colleagues at the Kanazawa Medical University in Japan.

Average CHF Survival Rates

Source: Japanese Circulation Journal

Currently, CHF has no cure. People living with the disease have to commit to heart-healthy lifestyles and take medication regularly.

To stay healthy, here are some tips to follow.

Tips for Living Better with CHF

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Congestive Heart Failure - DrugWatch.com