Living – yes, living! – with heart failure

Heart failure may sound pretty serious, even deadly, butthese days it’s often a condition people can live with long-term.

Heart failure can make it hard to carry out your dailyactivities, and it may eventually become life threatening. But advances indiagnosis and treatment have improved the health and quality of life of manypeople who have the condition.

Heart failure develops when a weakened heart is unable topump out blood with the right amount of force. When blood moves through thesystem sluggishly, it can back up in a person’s veins on the return trip to theheart. It’s because of this “congestion” that heart failure is often referredto as congestive heart failure. The problem can often be traced to a past heartattack, high blood pressure, or coronary artery disease (heart arteries thathave 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, doctorsperform tests of the heart’s pumping strength, which is known as its ejectionfraction. The ejection fraction shows how much blood the right and leftventricles (the heart’s pumping chambers) can pump out with each contraction.Because the left ventricle is the main pumping chamber, the ejection fractionis usually measured there.

Interestingly, heart failure can be present withoutaffecting the ejection fraction. This is most likely to occur in older womenwho have hypertension, diabetes, or both. But in such cases the person willhave other signs and symptoms of heart failure.

Cardiac imaging tests can confirm the diagnosis. The bestchoice is echocardiography, which uses sound waves to create an image of theheart at work. If your doctor suspects heart failure, she or he will also checkyour 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 coronaryartery disease, high blood pressure, a previous heart attack, diabetes, andthyroid disorders. If you have one of these conditions, you may be able to keepheart failure from developing or getting worse by exercising regularly,following a heart-healthy diet, quitting smoking, and taking medications tocontrol your particular risk factors.

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

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

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

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

Stay on course

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