Kenneth Baughman, MD | | Other Cardiology Q & A Topics:
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What is heart failure?
A common misconception is that heart failure means that the heart will stop beating. Heart failure actually refers to a heart’s inability to pump blood properly.
There are two kinds of heart failure.Systolic heart failure refers to a weakened heart muscle that cannot pump enough blood out with each beat. With diastolic heart failure, a stiffened heart muscle is able to pump blood out normally, but, due to its inability to relax, is unable to sufficiently refill itself with blood.
For most patients, heart failure cannot be cured, but you can help to keep it from getting worse or even make it better by taking your medicine, eating the right foods, watching your fluids and exercising.
What causes heart failure?
Heart failure can be caused by any disease that weakens the heart muscle and prevents it from being able to pump enough blood to meet the body’s needs. These conditions include heart attack, high blood pressure, heart muscle infection, heart valve disease and diabetes. Even chemotherapy treatment can cause heart failure. However, the cause of heart failure is often never discovered.
What are the symptoms?
Regardless of its root cause, the important thing to remember is that heart failure can be treated, and, as with any health condition, it’s better to treat it sooner rather than later. With that in mind, here are some symptoms that may signify heart failure:
- Shortness of breath
- Difficulty breathing
- Coughing
- Fatigue
- Weakness
- Swelling in the feet or legs
- Loss of appetite
- Abdominal discomfort
- Weight gain
What are the treatments?
Do not be discouraged by the word “failure”. For most patients, heart failure cannot be cured, but you can prevent it from getting worse and often help it get better. Here are some things that you can do to feel better:
- Lifestyle changes (eat low salt food, watch your fluid intake, exercise, weigh yourself daily, quit smoking, avoid alcohol, go to your doctor’s appointments)
- Medications (diuretics, ACE Inhibitors, Angiotensin Receptor Blockers, Beta Blockers)
- Regular aerobic exercise, which provides remarkable benefits in restoring circulatory regulation as well as general well-being in heart failure and has been shown to decrease the need for hospitalization
- Budgeting your energy for those activities that are most important to you, allowing time for rest and recharging
For some patients, further therapies may be considered, such as:
- Devices to improve the timing of heart function, such as biventricular pacemakers
- Reconstructive surgical therapy, including bypass, valve repair and ventricular reconstruction
- Cardiac assist devices to provide mechanical support for pumping the left side or both sides of the heart
- Heart transplant
How is heart failure diagnosed?
To effectively diagnose heart failure, patients receive a comprehensive evaluation, which may include one or more of the following tests:
- Chest x-ray
- Echocardiogram (“Echo”)
- Electrocardiogram (“EKG” or “ECG”)
- Magnetic resonance imaging (“MRI”)
- Stress test
- Positron emission tomography (“PET” scan)
- Blood tests
- Heart catheterization
When would an assist device or transplantation be considered?
New treatment approaches can prevent many patients with advanced heart disease from ever needing a heart assist or replacement. However, in cases where severe symptoms persist despite maximal medical therapy, patients may be considered for assist devices or for a heart transplant.Careful evaluation is required to identify patients who would benefit from these procedures.
What innovative treatments are currently being performed at Brigham and Women’s Hospital?
The Advanced Heart Disease program offers a variety of clinical trials for patients. They are pioneering efforts in a number of areas, including:
- Implantable hemodynamic monitors that allow patients to transmit cardiac information from home to physicians for therapy adjustment
- New left ventricular assist devices that are smaller, quieter and more comfortable for continuous support of circulation.
- New therapies to improve kidney function in the setting of heart disease
- New hybrid therapies combining percutaneous interventions (injected or absorbed through the skin) and open surgical procedures (conventional or minimally invasive) for safe, effective and durable therapy with minimal surgical trauma.
- Intermittent outpatient infusions of vasoactive (changes the diameter of a blood vessel) medications
- Percutaneous mitral valve repair
- New therapies that may allow valve repair without surgery
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To make an appointment or learn more about Brigham and Women's Hospital Advanced Heart Disease Center, call 1-800-BWH-9999 or visit us at http://www.brighamandwomens.org/cvcenter/advancedheart/default.aspx.
