Heart Failure, Adult

About this topic

Heart failure happens when your heart has trouble pumping the right amount of blood through the body. When the pump is not working well, blood can back up into the lungs. It can also cause swelling in the legs or other parts of the body. ‚
Heart failure is a long-term problem. Doctors work hard to treat heart failure in order to keep it from getting worse over time. ‚

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What are the causes?

Heart failure is most often caused by coronary artery disease or a heart attack. It may also be caused by problems with the hearts valves. You may have heart failure because you had an infection in your heart muscle. It may be due to high blood pressure or an abnormal heart rhythm. Sleep apnea or high blood sugar may also cause your heart not to work as well as it should. These causes result in a weak or damaged heart muscle. When your heart is weak or damaged, you may have heart failure. ‚

What can make this more likely to happen?

You are more likely to have heart failure if you are older or are someone who smokes. Black men have more heart failure. Having high blood pressure or being overweight can also raise your chances of having heart failure. So can drinking too much beer, wine, and mixed drinks (alcohol). People with long-term diseases like emphysema are more likely to have problems with their heart. ‚

What are the main signs?

Breathing problems like:
- Shortness of breath
- Cough that wont go away
- Wheezing
Extra fluid that causes:
- Swelling of feet, ankles, legs, or belly
- Gaining weight and you don't know why
- Need to pass urine more often
Problems sleeping like:
- Need to sleep sitting up or on many pillows
- Waking up often during sleep times
- Feeling tired, weak, or have no energy
General signs like:
- Increased heart rate
- Belly pain
- Loss of appetite and nausea
- Feeling lightheaded or dizzy
- Confusion and impaired thinking

How does the doctor diagnose this health problem?

The doctor will take your history and will do an exam. The doctor will listen to your heart and lungs, and may also feel your belly for liver swelling. The doctor will check your feet, ankles, and legs for swelling. ‚
The doctor may order: ‚

Lab tests
Chest x-ray
Electrocardiogram (ECG or EKG)
Echocardiogram
Exercise stress test
Radioactive imaging. This is a radionuclide scan.
Dye injected into the hearts arteries. This is coronary angiography.

How does the doctor treat this health problem?

Your doctor will treat you to help your heart work better. The doctor will also work to control your signs. Since other health problems may cause or make heart failure worse, it is important to also treat these. Your doctor may suggest: ‚

Diet and lifestyle changes to slow down progress of the illness
Drugs to help your heart work better, get rid of the extra fluid, and control your heart rate and blood pressure
Exercise and cardiac rehab
Bypass surgery or a heart stent to open blocked vessels to the muscle of your heart
Devices like a heart pump
Heart transplant

What lifestyle changes are needed?

Limit how much beer, wine, and mixed drinks (alcohol) you drink.
Limit the salt in your diet.
Lose weight if you are overweight.
Stop smoking.
Remain active. Talk with your doctor about the right amount of activity for you.
In severe cases, limit how much fluid you drink.
Be careful that you take your drugs each day as ordered by your doctor.
- If you cannot afford them, they may be able to help you.
- Do not stop your drugs if you have side effects. Talk to your doctor about them.
Check your weight each morning and write down your weight in a notebook. This will tell you if you are building up too much fluid. Weigh in the morning after you have passed urine. Weigh yourself with clothes on or off, but do it the same way each day. Make sure your scale is on a hard surface, not on carpet. Your doctor will tell you when you should call based on how much weight you gain in a day or over a week. Take your notebook to your doctor on your next visit.

What drugs may be needed?

Often patients will need to take more than one drug. Together, they will help the heart work as well as it can. Do not take any other prescription drugs, over-the-counter (OTC) drugs, herbals, or diet aids without asking your doctor. ‚
The doctor may order drugs to: ‚

Help relax blood vessels. This makes it easier for the heart to work and may also lower your blood pressure. These are ACE inhibitors and ARBs.
Slow down the heart rate so that it doesnt have to work as hard. These are beta blockers.
Help the heart beat stronger and better
Get rid of extra salt and water in the body. These are water pills or diuretics.

What changes to diet are needed?

Ask your doctor what kind of diet is best for you. The doctor may tell you to limit your salt and fat or how much fluid you drink.
The DASH diet may be helpful. The DASH diet helps to lower blood pressure. This diet includes lots of fruits, vegetables, low-fat dairy foods, and foods that are low in saturated fat, total fat, and cholesterol. Using the DASH diet with a low salt diet may lower blood pressure even more.

What can be done to prevent this health problem?

Keep a healthy weight.
Keep blood pressure, cholesterol, and high blood sugar under control.
Stop smoking. Do not use nicotine gum or patches unless your doctor says it is OK.
Exercise regularly. Talk to your doctor about which exercise program is best for you.

When do I need to call the doctor?

Activate the emergency medical system right away if you have signs of a heart attack. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have: ‚

Signs of heart attack:
- Chest pain
- Trouble breathing
- Fast heartbeat
- Feeling dizzy

Call your doctor if you have: ‚

Problems with breathing. These include an increase in shortness of breath, wheezing, needing to sleep while sitting up to breathe, or other breathing troubles.
Problems with swelling and weight gain. These include gaining more than 2 to 3 pounds in a day or 5 pounds in a week; more swelling in your feet, ankles or legs; passing more or less urine than normal; or passing dark urine.
Feelings of being very tired or weak
Pain in your arm(s), neck, jaw, belly, or back
Cough that does not go away or coughing up pink or white foamy mucus
A pounding heart that is racing very fast or skipping beats
You are not feeling better in 2 to 3 days or you are feeling worse

Helpful tips

Carry a list of all the drugs you take with you at all times. Include any over-the-counter (OTC) drugs or herbals. If you have an implanted pacemaker or defibrillator, carry the card for the device with you at all times.
Discuss any concerns with your doctor.

Where can I learn more?

American Heart Association ‚
http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/About-Heart-Failure_UCM_002044_Article.jsp ‚
Better Health Channel ‚
http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Congestive_heart_failure ‚
National Heart Lung and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/hf/ ‚
NHS Choices ‚
http://www.nhs.uk/conditions/heart-failure/pages/introduction.aspx ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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