Heart failure is a condition that affects the heart’s ability to pump and receive blood. This decreases the ability of the heart to maintain the needs of the body and might lead to congestion of the lungs and body with fluid, thus the old term “congestive heart failure.”

• High blood pressure
• Coronary artery disease (CAD) or previous heart attack
• Diabetes
• Increased age
• Smoking
• Obesity
• Drug or alcohol abuse
• Family history

According to Maged F. Azer, MD, FAAC, medical director of the St. Joseph Hospital Heart Failure Program, “The best treatment of heart failure is prevention.” You can decrease your risk by:

• Adequately treating high blood pressure
• Exercising
• Losing weight (speak with your physician about a goal that is right for you)
• Quit smoking and avoid second-hand smoke
• Avoid excessive alcohol intake (ask your physician about what is right for you)
• Eat a low-cholesterol and low-fat diet

• Swelling in the feet, ankles or abdomen
• Shortness of breath or cough that won’t go away
• Excessive urination at night
• Weight gain of more than 2 pounds overnight
• Fatigue, dizziness or lightheadedness
• A change in ability to do daily activities
• “Racing” heart rate

• Seek medical advice from your health care provider early on; avoid waiting until symptoms grow worse.
• If symptoms progress, go to the Emergency Department for evaluation.
• The key to successfully treating heart failure is to diagnose the condition in its earliest stages and manage it aggressively to prevent symptoms from worsening.

After you have described your symptoms and your physician has performed a physical examination, one of several diagnostic tests may be used to diagnose heart failure and assess your current heart health.

These diagnostic procedures may include:

• Echocardiogram: An ultrasound of the heart that is used to evaluate the structures of the heart and its ability to pump blood.
• Chest X-ray: used to check for congestion of the lungs and to detect an increase in the size of the heart.
• Stress testing (stress echo or stress nuclear studies): usually done after an initial phase of treatment and helps to evaluate for blockages in the heart vessels or coronary arteries.
• Cardiac catheterization: a procedure involving the injection of dye into the heart through a needle inserted into the groin. It is used to find out if there are blockages in the heart vessels.
• Devices such as a stent or angioplasty may be placed during this procedure that help to “open” the blockages.

The main goals in treating heart failure include:

• Finding a potentially treatable cause and halt or (in certain circumstances) reverse this condition
• Controlling symptoms and improving the overall outcome using the appropriate therapy

However, recognizing symptoms of heart failure is the first step in managing and treating heart failure. Early detection can prompt you to seek medical care in a timely manner.

Lifestyle modification

Lifestyle modification is one of the main ways to treat heart failure and includes:

• Quit smoking and avoid second-hand smoke.
• Follow a low-sodium diet. You should consume no more than 2,000 mg of sodium per day (refer to nutrition labels). Do not cook with salt or add salt to your food.
• Exercise: consult your physician prior to beginning any exercise routine. It is important to know how well your heart is functioning so you have realistic expectations for your activity level.
• Weigh daily: this is one of the most important ways to detect fluid retention. You should call your physician if you gain more than 2 pounds overnight.
• Fluid restriction: you should consume no more than 2 liters (64 oz.) of fluid per day.
• Take all the medications as they are prescribed by your physician.

Medications

Medications are prescribed to improve quality of life, symptoms of congestion, avoid hospital admissions and prevent stroke or heart attack. Your doctor may prescribe any combination of the following types of medications:

• ACE Inhibitors: improve the heart function and efficiency (examples include: Lisinopril/Prinivil, Captopril/Capoten, Enalapril/Vasotec)
• Beta-Blockers: decrease the workload of the heart (examples include: Coreg/Carvedilol, Metorprolol/Toprol)
• Diuretics: work in the kidney to rid body of excess fluid (examples include: Lasix/Furosemide, Aldactone/Spironolactone, Metolazone)
• Digoxin: improves the heart’s ability to pump blood effectively
• “Blood thinners” help prevent heart attack and stroke (may include Aspirin and Coumadin/Warfarin)

Opening blocked arteries

If you have blocked coronary (heart) arteries, your physician may advise you to have a Coronary Artery Bypass surgery or a stent or angioplasty (devices to open the blockage).

Cardiac Resynchronization Therapy

Your physician may advise you to have Cardiac Resynchronization Therapy (CRT). This is a surgical procedure that includes placing a device in the left upper part of your chest (like a pacemaker) that is designed to synchronize your heart contractions so that your blood is pumped more effectively.

Heart transplant

Your physician may refer you to a heart transplant center for evaluation. Not all heart failure patients qualify for a transplant.

Left Ventricular Assist Device

A Left Ventricular Assist Device (LVAD) is an implantable heart pump that may be used as a temporary treatment until a heart transplant can be performed. This is used in patients with advanced stages of heart failure.