Heart Failure: Symptoms, Causes, Diagnosis, and Prevention

What is Heart Failure?

Heart failure is a chronic condition in which the heart is unable to pump blood efficiently, leading to reduced blood flow to the body’s organs and tissues. This can result in fatigue, shortness of breath, and fluid retention. In this article, we will explore the symptoms, causes, classification, diagnosis, complications, treatment, and prevention of heart failure.

Symptoms of Heart Failure

Common symptoms of heart failure include:

• Shortness of breath (dyspnea)
• Fatigue and weakness
• Swelling (edema) in the legs, ankles, and feet
• Rapid or irregular heartbeat
• Persistent cough or wheezing with white or pink blood-tinged phlegm
• Increased need to urinate at night
• Swelling of the abdomen (ascites)
• Sudden weight gain from fluid retention
• Lack of appetite and nausea
• Difficulty concentrating or decreased alertness

Causes of Heart Failure

Heart failure can be caused by various factors that damage or overwork the heart muscle, such as:

• Coronary artery disease: Narrowing of the arteries that supply blood to the heart muscle.
• High blood pressure (hypertension): Increased pressure on the heart to pump blood, causing the heart muscle to weaken or stiffen over time.
• Heart attack: Damage to the heart muscle caused by a blocked blood supply.
• Diabetes: High blood sugar levels can damage the blood vessels and nerves that control the heart.
• Obesity: Excess weight places additional stress on the heart.
• Sleep apnea: Interrupted breathing during sleep, leading to oxygen deprivation and increased stress on the heart.

Classification: Types of Heart Failure

Heart failure is classified based on the side of the heart affected and the nature of the dysfunction:

1. Left-sided heart failure: The left ventricle fails to pump blood effectively, resulting in shortness of breath and fluid buildup in the lungs. It can be further divided into:
   • Systolic heart failure: The left ventricle cannot contract effectively.
   • Diastolic heart failure: The left ventricle cannot relax and fill with blood properly.
2. Right-sided heart failure: The right ventricle is unable to pump blood effectively, leading to fluid buildup in the body’s extremities and organs.
3. Congestive heart failure: A combination of left and right-sided heart failure, resulting in fluid accumulation throughout the body.

Diagnosis: How Do You Know if You Have Heart Failure?

To diagnose heart failure, healthcare providers may use a combination of the following methods:

• Physical examination: Assessing symptoms, medical history, and risk factors.
• Blood tests: Checking for markers of heart failure, such as B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP).

• Chest X-ray: Identifying fluid buildup in the lungs or an enlarged heart.
• Electrocardiogram (ECG): Recording the heart’s electrical activity to detect abnormal heart rhythms or other issues.
• Echocardiogram: Using ultrasound technology to create images of the heart, enabling assessment of its structure and function.
• Stress test: Evaluating heart function during physical activity or under induced stress.
• Cardiac MRI or CT scan: Producing detailed images of the heart and its blood vessels.

Complications after the Disease

Heart failure can lead to several complications, including:

• Kidney damage or failure
• Heart rhythm problems (arrhythmias)
• Liver damage
• Stroke
• Heart valve problems

Treatment of Heart Failure

Treatment for heart failure typically involves a combination of lifestyle changes, medications, and medical procedures or devices:

Lifestyle Changes

• Adopting a heart-healthy diet
• Engaging in regular physical activity, as recommended by a healthcare provider
• Maintaining a healthy weight
• Managing stress
• Avoiding tobacco and limiting alcohol consumption

Medications

• ACE inhibitors or ARBs: Help relax blood vessels and lower blood pressure
• Beta-blockers: Reduce the heart rate and the force of the heart’s contractions
• Diuretics: Help eliminate excess fluid and sodium from the body
• Aldosterone antagonists: Block the effects of the hormone aldosterone, reducing fluid retention and strain on the heart
• Inotropic agents: Improve the heart’s pumping ability (used in severe cases)

Medical Procedures and Devices

• Implantable cardioverter-defibrillator (ICD): Monitors heart rhythm and delivers electrical shocks to correct abnormal heartbeats
• Cardiac resynchronization therapy (CRT): Coordinates the contractions of the heart’s ventricles, improving their efficiency
• Ventricular assist devices (VADs): Mechanical pumps that help the heart pump blood
• Heart transplant: Replacing the damaged heart with a healthy donor heart (in severe cases)

Prevention

To prevent heart failure, consider the following measures:

• Adopt a heart-healthy diet
• Engage in regular physical activity
• Maintain a healthy weight
• Manage stress effectively
• Monitor and control blood pressure, cholesterol, and blood sugar levels
• Avoid smoking and limit alcohol consumption
• Seek regular medical checkups and follow your healthcare provider’s recommendations

In conclusion, understanding the symptoms, causes, classification, and diagnosis of heart failure is crucial for early detection and effective management. By adopting a heart-healthy lifestyle, monitoring your health, and seeking medical advice, you can significantly reduce your risk of developing heart failure and its associated complications.

Article verified by Theresa Piekarski, RN MSN BSBA
Director of Clinical Services