Heart failure occurs when the heart does not pump blood well and, as a result, blood circulates through the body with a delay. When this situation occurs, the body accumulates fluid and the organs do not receive all the blood they need.
Heart failure: symptoms
With heart failure, the symptoms may worsen as time goes by, manifesting themselves as:
- Tiredness, weakness or dizziness.
- Breathing problems and consequently the reduction of the level of activity. To alleviate this symptom it is recommended to add more pillows to sleep at night.
- Accelerated heart rate even when the patient is calm.
- Swelling of feet, ankles and legs or stomach.
Heart failure: diagnosis
When the Internal Medicine specialist raises the possibility of heart failure, he/she will perform an examination and may request the following tests:
- Electrocardiogram (ECG) to see if there is any abnormality in your heart rhythm or if you have had a heart attack in the past.
- “Brain natriuretic peptide” or “N-terminal prohormone brain natriuretic peptide,” a blood test to measure the level of this protein. With heart failure, CNP levels are higher than usual.
- Chest X-ray to detect the presence of fluid in the lungs and to check the shape and size of the heart and major blood vessels in the chest.
- Echocardiogram to analyze the heart as it beats, to see the size of the heart chambers, whether the pumping is sufficient and the functioning of the heart valves.
- A stress test during which the patient may be asked to walk or run on a treadmill while an ECG or other heart tests are performed. During physical activity the heart needs more blood and beats faster, so doctors will see if the heart is getting enough blood.
- Cardiac catheterization. The doctor will insert a thin tube into a blood vessel in a leg or arm and move it up to the heart or blood vessels to take measurements of this part. The specialist may also want to perform a coronary angiogram, which involves injecting the tube with a dye that shows up on x-rays to see if any of the arteries in the heart are partially or completely blocked.
Preventing heart failure
- Take your medicines even if you feel fine. Prescription medications will help you live better and longer, but they will only work if you take them as recommended by your doctor.
- Create a list of instructions, always accessible, on what actions to take if symptoms change, in addition to weighing yourself every day. If symptoms worsen or if you suddenly gain weight, you should take action.
- Call your doctor if you suddenly gain weight. Every morning after urinating and before breakfast, you should weigh yourself. Try to wear the same amount of clothing at all times and write your weight on a calendar. Notify your specialist if you gain one pound in one day or two or more in one week. In a heart failure patient, a sudden weight gain is a clear sign that your body is retaining too much fluid and you may need to change your medications.
- Reduce salt intake. Avoid foods that come in boxes or cans, unless the labels indicate that they are low in sodium. It is best to eat fresh or fresh-frozen foods and foods you prepare yourself. Ask your doctor how much salt you should eat. Your doctor may also limit the amount of fluids you drink.
- If you are overweight, lose weight. If you are overweight, your heart must work harder than usual to meet your body’s needs.
- Stop smoking. Smoking makes heart failure worse and increases your chances of having a heart attack or dying.
- Limit alcohol consumption. If you are a woman, drink no more than one drink a day. If you are a man, do not drink more than two.
- Be physically active. Your doctor will tell you which activities are safe for you. Walking or cycling most days of the week are the usual recommendations for easing symptoms. If you feel any discomfort while doing them, do not do them.
- If you wish to incorporate any new changes into your life, such as taking any additional medications or supplements, consult your doctor. For example, certain non-steroidal anti-inflammatory drugs may make your heart failure worse.
Heart failure: treatment
Today, there are numerous treatments for heart failure. Following the right one is the key to controlling the patient’s suffering, relieving or eliminating symptoms or worsening the condition. If you feel that the treatment is expensive, talk to your doctor about alternatives to reduce the cost. If you notice side effects or other problems when taking the medication, there is a possibility that your specialist may change it or reduce the dosage.
Other treatments include devices that help the heart pump blood harder or at the right rate, or surgeries to improve blood flow or even replace the heart.
If you have heart failure, it does not mean that your heart “failed” or stopped beating, but that it is not working as it should.