Heart failure (also known as chronic or congestive heart failure) is a condition in which your heart isnt pumping all the blood your body needs. Heart failure does not mean your heart has stopped functioning or will stop at any moment. It means your heart isnt working as it should. While heart failure is not curable, it is treatable through medication, symptom monitoring and lifestyle changes.
Heart failure is also more common than you may think. More than six million U.S. adults live with heart failure, yet many dont have a clear understanding of what heart failure is and how it can impact their lives.
Heart Failure Terms to Know
Congestive heart failure. Though often used interchangeably with heart failure, congestive heart failure indicates a serious form of heart failure that happens when fluid backs up in the veins, causing congestion.
Ejection fraction (EF). A measurement of how much blood the left ventricle pumps out with each contraction. A normal EF is between 50% and 70%.
- Preserved ejection fraction (HFpEF) is when the heart chambers stiffen and cannot fill with enough blood.
- Reduced ejection fraction (HFrEF) is when heart chambers become enlarged over time and cannot pump enough blood to the rest of the body.
Left-sided heart failure. The left ventricle of the heart is not able to pump enough blood to supply the rest of the body.
Right-sided heart failure. The right ventricle is too weak to supply enough blood to the lungs, causing build up in the veins.
Biventricular heart failure. When both sides of the heart are affected by heart failure.
Stages and Classes of Heart Failure
As you educate yourself about the different types and severity of heart failure, youll likely come across the terms stages and classes. These measurements help both in diagnosing the severity of the disease and developing an appropriate treatment plan.
Stages describe how much heart failure is present and go from A to D.
- Stage A. Patients have some risk factors, but no symptoms and no heart disease.
- Stage B. Heart disease is present but the patient is not experiencing symptoms.
- Stage C. The patient has heart disease and symptoms have started.
- Stage D. This is considered the final stage of heart failure. Symptoms are present and do not improve with treatment.
Classes (also known as functional classes) measure how well a person tolerates physical activity from one to five.
- Class I. Patients do not experience extreme fatigue, irregular heartbeat or trouble breathing while engaged in ordinary activity.
- Class II. Patients are comfortable at rest, but normal activity causes fatigue, irregular heartbeat and trouble breathing.
- Class III. Patients experience extreme symptoms while doing minor activity.
- Class IV. The heart is unable to keep up even when the patient is resting. Patients experience discomfort when carrying out any activity.
What Causes Heart Failure?
There isnt a single cause of heart failure; rather, any long-term or acute damage to the heart, like heart attack or high blood pressure, can lead to heart disease. Some of the most common include:
- Coronary artery disease
- Cardiomyopathy or cardiac amyloidosis
- Heart attack
- Congenital heart defects
- Valve damage
- Irregular heartbeat
Heart failure can also be caused by chronic conditions or traumatic events in the body such as:
- Severe lung disease
- Diabetes
- High blood pressure
Know Your Risk
Common risk factors associated with heart failure include obesity, high cholesterol, diabetes, kidney disease and tobacco use.
Symptoms of Heart Failure
Some patients who have heart failure dont have any symptoms or the symptoms are extremely mild. Your symptoms may also come and go. Typically, symptoms increase over time. Some of the most common include:
Lung congestion. When the heart cannot pump enough blood to the body, fluid can back up into the lungs causing:
- Shortness of breath (especially when engaged in physical activity)
- Inability to complete physical activity like walking up stairs
- Persistent cough or wheezing
Fluid retention. When the appropriate amount of blood cannot get to your kidneys, fluid builds up leading to:
- Swelling in the legs, ankles, feet or abdomen
- Weight gain
- Bloating
- Decreased appetite or nausea
Weakness. When your major organs cannot get enough blood to function properly, you may experience:
- Extreme fatigue
- Dizziness
- Confusion or brain fog
- Lightheadedness
Treating and Managing Heart Failure
Your provider will diagnose heart failure including the stage and class through one or more of the following diagnostic tests:
- Physical exam
- Blood test
- Echocardiogram
- Electrocardiogram
- X-ray
- Breathing tests
- Stress test
Once diagnosed, your medical team will work with you to come up with a plan to treat your heart failure that includes a combination of medication, devices and lifestyle changes. Unfortunately, heart failure is not curable, meaning you cant move backwards through the stages. Treatment is designed to slow the progression of the disease.
Medication. Depending on your specific diagnosis, your doctor may prescribe one more common class of medication used to treat heart failure: beta blockers, ACE inhibitors, ARNIs, diuretics and SGL2 inhibitors.
Devices. Some heart failure patients experience irregular heartbeat or rhythms. A pacemaker or implantable cardioverter defibrillator can help the heart beat normally. There have also been new developments in heart monitoring technology, like implantable devices that read heart pressure and fluid levels.
Heart failure treatments are crucial to keeping you as healthy as possible for as long as possible. But, not all treatments are right for every person. Monitor how you feel and communicate openly with your doctor about any worsening or new symptoms that arise. Never discontinue a treatment without first consulting with your doctor.
Its important to be fully present and active in your own treatment plan. While doctors have medical knowledge, you have vital and valuable knowledge too. You know yourself your lifestyle, need preferences and whats important to you better than anyone else. Here are a few ways to be an active participant in your own treatment plan:
- Write down questions prior to your appointment.
- If you dont understand, keep asking questions until you do.
- Bring a supportive friend or family member along to take notes and advocate on your behalf.
- Share your opinions, state your preferences and communicate your needs to your care team.
Your Heart Failure Lifestyle
Lifestyle is one of the most important factors when it comes to living even thriving with heart failure. Your doctor will likely recommend cutting out alcohol and tobacco products and making dietary changes to slow the progression of the disease.
Lifestyle changes arent easy, and it can feel overwhelming. Start by setting goals for your health based on doctor recommendations, then take it step-by-step.
- Step 1: Follow your treatment plan. If something changes, be sure to go back to your doctor and adjust the plan accordingly.
- Step 2: Manage your symptoms. Heart failure symptoms come and go and arent the same for everybody. Find the symptom management tools that work best for you.
- Step 3: Make recommended changes to your diet. This can mean cutting down on salt, liquids or eliminating foods that counteract your medications.
- Step 4: Move your body. Becoming more active, even a little bit at a time, is good for the body and mind.
- Step 5: Take your medications as prescribed.
- Step 6: Monitor your progress. Track changes to symptoms, weight changes or anything else going on in your body and discuss with your doctor.
- Step 7: Stay connected to the supportive people in your life, and connect with peers who are going through the same thing you are. Having an emotional support team is key to keeping you on track with health goals.
A heart failure diagnosis can be a devastating blow not to mention overwhelming. But many patients live and thrive with heart failure, and you can too. Start by downloading Mended Hearts GoTo Guide: Heart Failure. The 40-page guide includes in-depth information about your diagnoses, what to expect and how to work alongside your healthcare team to manage and treat heart failure.
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