As part of National Heart Awareness Month in February, we’re looking at the issue of heart failure today.
Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems.
The term “heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care, said Dr. Ross Butschek, a cardiologist at the Intermountain Healthcare Heart Institute.
Heart failure is a very common condition. About 5.7 million people in the United States have heart failure. Both children and adults can have the condition, although the symptoms and treatments differ. The Health Topic focuses on heart failure in adults.
Currently, heart failure has no cure. However, Dr. Butschek said treatments – such as medicines and lifestyle changes – can help people who have the condition live longer and more active lives. Researchers continue to study new ways to treat heart failure and its complications.
The leading causes of heart failure are diseases that damage the heart. Examples include ischemic heart disease, high blood pressure and diabetes.
Heart failure develops over time as the heart’s pumping action grows weaker. The condition can affect the right side of the heart only, or it can affect both sides of the heart. Most cases involve both sides of the heart.
Right-side heart failure occurs if the heart can’t pump enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if the heart can’t pump enough oxygen-rich blood to the rest of the body.
Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen, and the veins in the neck. Right-side and left-side heart failure also may cause shortness of breath and fatigue (tiredness).
Conditions that damage or overwork the heart muscle can cause heart failure. Over time, the heart weakens. It isn’t able to fill with and/or pump blood as well as it should. As the heart weakens, certain proteins and substances might be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.
Causes of heart failure include:
- Ischemic heart disease
- High blood pressure
- Other heart conditions or diseases
- Other factors
Ischemic Heart Disease
Ischemic heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart muscle.
Plaque narrows the arteries and reduces blood flow to your heart muscle. The buildup of plaque also makes it more likely that blood clots will form in your arteries. Blood clots can partially or completely block blood flow. Ischemic heart disease can lead to chest pain or discomfort called angina, a heart attack, and heart damage.
Diabetes is a disease in which the body’s blood glucose (sugar) level is too high. The body normally breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.
In diabetes, the body doesn’t make enough insulin or doesn’t use its insulin properly. Over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.
High Blood Pressure
Blood pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup.
Blood pressure is considered high if it stays at or above 140/90 mmHg over time. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher.
Other factors also can injure the heart muscle and lead to heart failure. Examples include:
- Alcohol abuse, cocaine, or other illegal drug use
- Thyroid disorders (having either too much or too little thyroid hormone in the body)
- Too much vitamin E
- Treatments for cancer, such as radiation and chemotherapy
Signs and Symptoms
The most common signs and symptoms of heart failure are:
- Shortness of breath or trouble breathing
- Fatigue (tiredness)
- Swelling in the ankles, feet, legs, abdomen, and veins in the neck
All of these symptoms are the result of fluid buildup in your body. When symptoms start, you may feel tired and short of breath after routine physical effort, like climbing stairs.
As your heart grows weaker, symptoms get worse. You may begin to feel tired and short of breath after getting dressed or walking across the room. Some people have shortness of breath while lying flat.
Early diagnosis and treatment can help people who have heart failure live longer, more active lives. Treatment for heart failure depends on the type and severity of the heart failure.
The goals of treatment for all stages of heart failure include:
- Reducing symptoms
- Stopping the heart failure from getting worse
- Increasing your lifespan and improving your quality of life
Treatments usually include heart-healthy lifestyle changes, medicines, and ongoing care. If you have severe heart failure, you also may need medical procedures or intervention.
Heart-Healthy Lifestyle Changes
Your doctor may recommend heart-healthy lifestyle changes if you have heart failure. Heart-healthy lifestyle changes include:
- Heart-healthy eating
- Aiming for a healthy weight
- More physical activity
- Quitting smoking
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