Living—yes, LIVING!— with heart failure

Heart failure can make it hard to carry out your daily activities, and it may eventually become life threatening. But advances in diagnosis and treatment have improved the health and quality of life of many people who have the condition.

Heart failure develops when a weakened heart is unable to pump out blood with the right amount of force. When blood moves through the system sluggishly, it can back up in a person’s veins on the return trip to the heart. It’s because of this “congestion” that heart failure is often referred to as congestive heart failure. The problem can often be traced to a past heart attack, high blood pressure, or coronary artery disease (heart arteries that have been narrowed by fatty deposits).

Recognizing the problem     
Typical symptoms of heart failure include:

• fatigue
• shortness of breath
• a rattle in the chest known as rales
• fluid buildup, usually in the legs, ankles, and lungs
• decreased ability to exercise or be physically active.

To find out whether a person has heart failure, doctors perform tests of the heart’s pumping strength, which is known as its ejection fraction. The ejection fraction shows how much blood the right and left ventricles (the heart’s pumping chambers) can pump out with each contraction. Because the left ventricle is the main pumping chamber, the ejection fraction is usually measured there.

Interestingly, heart failure can be present without affecting the ejection fraction. This is most likely to occur in older women who have hypertension, diabetes, or both. But in such cases the person will have other signs and symptoms of heart failure.

Cardiac imaging tests can confirm the diagnosis. The best choice is echocardiography, which uses sound waves to create an image of the heart at work. If your doctor suspects heart failure, she or he will also check your cholesterol and blood sugar levels and your liver and kidney function.

Get ahead of your risk factors
Some of the main risk factors for heart failure are coronary artery disease, high blood pressure, a previous heart attack, diabetes, and thyroid disorders. If you have one of these conditions, you may be able to keep heart failure from developing or getting worse by exercising regularly, following a heart-healthy diet, quitting smoking, and taking medications to control your particular risk factors.

Recently, the American College of Cardiology and the American Heart Association put together updated guidelines for doctors who treat people who are at risk for, or already diagnosed with,
heart failure. The new recommendations help doctors determine the best treatments for each person.

There are many medicines now available to treat heart failure. For example, angiotensin-converting enzyme (ACE) inhibitors are drugs prescribed to lower blood pressure. They also can relieve heart-failure symptoms and reduce the risks of hospitalization and death for people with this condition.

In many cases an ACE inhibitor is combined with a beta-blocker and a diuretic. Beta-blockers reduce heart rate, which helps to control blood pressure. Diuretics, commonly known as “water pills,” prompt the body to eliminate the buildup of fluids and sodium in body tissues that occurs as a result of heart failure.

Some people with heart failure  require an implanted cardioverter defibrillator (ICD). This device is implanted in the person’s chest to help regulate heart rhythm.

Stay on course
Heart failure is a serious condition, but it’s often a treatable one. Be sure to talk with your doctor about the best ways to stay healthy so you can enjoy your life for many years to come.