Many people think that heart failure means the heart will stop beating, but this is not true. Heart failure actually means that the heart is not functioning properly and is unable to pump enough blood throughout the body to meet all of the body’s needs. With heart failure, the heart muscle weakens and blood is not pumped forward to the lungs and other parts of the body. This causes a shortage of oxygen and nutrients that can result in weakness and fatigue. Also, blood can backup and cause fluid to leak from the blood vessels into tissues, resulting in congestion. In the lungs this congestion can make breathing difficult and in the feet and legs it causes swelling.
Any disease that weakens the heart muscle can lead to heart failure including heart attack, high blood pressure, infection of the heart muscle, heart valve disease, diabetes and chemotherapy medications. For many patients, though, the cause is never known.
The symptoms of heart failure include shortness-of-breath, difficulty breathing, cough, fatigue and tiredness, weakness, swelling in the feet or legs, loss of appetite, discomfort in the abdomen, and weight gain.
Several types of medications can help alleviate the symptoms of heart failure and prevent the symptoms from worsening. These include diuretics, ACE-inhibitors, Beta-blockers and IV therapy. Diet, exercise, smoking cessation and limiting alcohol intake also are important in managing heart failure. Newer treatments have been developed for heart failure patients with symptoms that cannot be controlled by medications and lifestyle changes. These include pacemakers used to resynchronize the heart’s pumping rhythm and mechanical pumps that take over the pumping action of the weakened heart. The most complex treatment is heart transplantation but this option is reserved only for appropriate candidates as a last resort. Each year over 40,000 Americans need a heart transplant and only 2,500 operations are performed as determined by the number of available organs.
Research in the area of heart failure continues to grow and Brigham and Women’s Hospital has several clinical trials that are currently ongoing. New surgical procedures to repair heart valves and remodel the heart’s left ventricle are currently being performed. In addition, while still premature, there are great research advancements involving stem cells and artificial hearts that are being conducted at the Cardiovascular Center.
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