Focus on Conditions: Congestive Heart Failure

What is Congestive Heart Failure?

Heart Failure is a serious health condition affecting nearly 5 million Americans. This is a condition in which the heart can't pump (supply) enough blood to the body's other organs and is generally chronic in nature. Many patients become short of breath and tired particularly when doing some type of physical activity.

Diagnosis

The evaluation of symptomatic patients with suspected heart failure is directed at confirming the diagnosis, determining the cause, establishing the severity of heart failure, and guiding therapy evaluation and should include a focused history and physical examination, a chest X-Ray, echocardiogram and an electrocardiogram.

Risk Assessment

Any of the following conditions can cause heart failure, which can damage or weaken your heart over time.

• Coronary artery disease and heart attack. Coronary artery disease is the most common form of heart disease and the most common cause of heart failure.
• High blood pressure (hypertension). Blood pressure is the force of blood pumped by your heart through your arteries. If your blood pressure is high, your heart has to work harder than it should to circulate blood throughout your body.
• Faulty heart valves. The four valves of your heart keep blood flowing in the proper direction through the heart. A damaged valve forces your heart to work harder to keep blood flowing as it should.
• Damage to the heart muscle (cardiomyopathy). Some of the many causes of heart muscle damage, also called cardiomyopathy, include infections, alcohol abuse, and the toxic effect of drugs such as cocaine or some drugs used for chemotherapy.
• Myocarditis. Myocarditis is an inflammation of the heart muscle. It's most commonly caused by a virus and can lead to left-sided heart failure.
• Abnormal heart rhythms (heart arrhythmias). Abnormal heart rhythms may cause your heart to beat too fast. This creates extra work for your heart.
• Other diseases. Chronic diseases such as diabetes, severe anemia, hyperthyroidism, hypothyroidism, emphysema, lupus, hemochromatosis and amyloidosis also may contribute to heart failure.

Signs:

• Shortness of breath, especially when lying down
• Tired, run-down feeling
• Swelling in feet, ankles and legs
• Weight gain from fluid buildup

Treatment

Making lifestyle changes can often help relieve signs and symptoms of heart failure and prevent the disease from worsening. These changes may be among the most important and beneficial you can make:

• Stop smoking. Smoking damages your blood vessels, reduces the amount of oxygen in your blood and makes your heart beat faster.
• Weigh yourself daily. Do this each morning after you've urinated, but before you've had breakfast.
• Restrict sodium.
• Maintain a healthy weight. If you're overweight, your dietitian will help you work toward your ideal weight.
• Limit fats and cholesterol. In addition to avoiding high-sodium foods, limit your intake of saturated fat, trans fat and cholesterol.
• Limit alcohol and fluids.
• Exercise. Exercise was once forbidden for people with heart failure. But, moderate exercise helps keep the rest of your body healthy and conditioned, reducing the demands on your heart muscle.
• Reduce stress. When you're anxious or upset, your heart beats faster and you breathe more heavily.
• Sleep easy. If you're having shortness of breath, especially at night, sleep with your head propped up at a 45-degree angle using a pillow or a wedge.

Conclusion:

You can't reverse many conditions that lead to heart failure, but heart failure can often be treated with good results. Medications and lifestyle changes, such as exercising, reducing salt intake, managing stress, treating depression, and especially losing excess weight, also can help prevent fluid buildup and improve your quality of life. The best way to prevent heart failure is to control risk factors and aggressively manage any underlying conditions such as coronary artery disease, high blood pressure, high cholesterol, diabetes or obesity.

Reference:

The American Heart Association and Mayo Clinic

CHSLI programmatic offerings:

The Congestive Heart Failure Program at St. Francis Hospital offers a comprehensive approach to diagnosis and management of all stages of heart failure and pulmonary hypertension. Our team includes cardiologists, registered nurses and nurse practitioners who offer a variety of cutting-edge approaches to heart failure management including intravenous therapy, external enhanced counterpulsation (EECP), as well as implementation of personalized plan of care according to ACC/AHA guidelines.

Contact Information:

Director Congestive Heart Failure Program:
Justine Lachmann, MD, Director Congestive Heart Failure Program, 516-629-2090

St. Catherine of Siena Medical Center:
Brian Geller, MD, Chief of Cardiology, 631-979-8880

St. Charles Hospital:
Peter Bruno, MD, Chief of Cardiology, 631-689-7700

Mercy Medical Center:
Thierry Duchatellier, MD, Chief of Cardiology, 516-678-1444

Good Samaritan Hospital Medical Center:
Larry Altschul, MD, Chief of Cardiology, 631-669-2555