Heart failure occurs when disease, injury, or years of wear and tear interfere with the heart's ability to pump as effectively and efficiently as it should. When that happens, a cascade of physiological changes is set in motion. The end result is that many body parts don't get the blood flow that they need.
Although the term "heart failure" conjures up the catastrophe of a suddenly lifeless heart, the condition is better described as a gradual decline in the heart's ability to pump.
Think if it this way: Imagine your heart as the central warehouse of a nationwide delivery system. The trucking fleet is your blood, ferrying vital supplies (oxygen and nutrients) to all corners of your body and picking up waste. Your arteries and veins are superhighways and secondary roads connecting cities and towns (cells and tissues) along the way. When the system is operating at prime efficiency, a steady stream of cargo-laden vehicles leaves the central hub at a rapid clip every day. Once their freight is delivered, they pick up the next load and return to the central warehouse.
If the warehouse falters, freight-filled trucks jam the cargo bays. Others are stranded in remote locations, unable to make deliveries or pick-ups. Customers along the routes struggle to survive without fresh supplies.
Once a slow but sure death sentence, heart failure for many people is now a chronic condition that can be coped with thanks to advances in medications, the development of heart-assisting devices, and the possibility of heart transplants.
Heart Failure Articles
High-quality chocolate may lower the risk of heart failure in middle-aged and older women when eaten once or twice a week. An observational study of 31,000 older women in Sweden found that those who ate one to two servings a week had a lower risk of heart failure.
Concern about possible overuse of implantable cardioverter-defibrillator devices has led to a reevaluation of their benefits and risks. According to some critiques, ICDs might have been given too much credit for preventing deaths in key clinical trials, when other factors, such as the use of beta blockers, might have been responsible. Others have pointed out that the management of heart failure has improved because of wider use of beta blockers and ACE inhibitor drugs, so the risk of fatal ventricular arrhythmias in heart failure patients has decreased, very possibly making ICDs less useful than they once were. Confidence in ICDs has also been undercut in recent years by recalls of flawed devices. Some doctors have also called for more discussion and consideration of the various drawbacks and complications of ICDs. For example, perhaps as many as one out of every five ICD patients receives an "inappropriate shock" from the device that's triggered by something other than a serious ventricular arrhythmia.
A bedlike device that shakes the body head-to-toe stimulates blood vessels and improves blood flow, which may benefit people with heart failure who have difficulty exercising.
Dealing with the pain and aggravation of a broken bone or burst appendix isn't easy. But at least there's an end in sight. Once the bone or belly heals, you're pretty much back to normal. That's not true for high blood pressure, heart failure, diabetes, arthritis, osteoporosis, or other chronic conditions. With no "cure" in sight, they usually last a lifetime.
You can live with a chronic condition day to day, responding to its sometimes swiftly changing symptoms and problems. Or you can take charge and manage the disease instead of letting it rule you.
Have you had chest pain or pressure since you were discharged from the hospital?
How severe is it?
How long does it last?
Does it stay in your chest or radiate to other parts of your body?
Did you have this pain before your heart attack? What brings it on? How frequently do you get it?
What were you doing just prior to the chest pain?
Do you ever get chest pain or pressure at rest?
What relieves the chest pain?
If you take nitroglycerin, how many doses do you usually need to take before the pain goes away?
How often do you take nitroglycerin?
Do you get short of breath when you lie down or exert yourself?
Do you awaken in the middle of the night short of breath?
Do your ankles swell?
Do you ever feel lightheaded?
Have you fainted?
Do you get rapid or pounding heartbeat for no reason?
Do you know what each of the medications you are taking does?
Do you know the side effects of each medication?
Are you having any side effects?
Are you taking an aspirin every day?
Are you doing everything you can to modify the risk factors that can worsen your coronary artery disease (cigarette smoking, high blood pressure, high cholesterol, and diabetes are the most important risk factors)?
Are you participating in a supervised exercise program?
Are you resuming your normal activities?
Are you sexually active?
Have you returned to work?
Have you been feeling depressed since your heart attack?
Have you been able to reduce the stress in your life?
Have you been fatigued?
Heart rate, blood pressure, and weight
Pulses in your wrist, groin, and feet
Listen over the major arteries in the neck, groin, and feet (for abnormal noises)
Look at the veins in the neck to see if there is extra fluid in your body
Heart and lungs
Ankles and legs (for swelling)
Blood tests for glucose, lipid panel (cholesterol levels) and C-reactive protein (CRP)
Exercise stress test
Thiazide diuretics like hydrochlorothiazide (Esidrix, HydroDIURIL, other brands) continue to be a very effective way to lower blood pressure for people with hypertension. They're inexpensive, and results from large studies have shown them to be at least as effective as other types of blood pressure drugs for most patients.
But if you're taking a diuretic, your potassium levels need to be watched. These drugs direct the kidneys to pump water and sodium into the urine. Unfortunately, potassium also slips through the open floodgates. A low potassium level can cause muscle weakness, cramping, or an abnormal heartbeat, which is especially dangerous for people with heart problems.
Potassium pills are one solution, but some tend to taste bad, so people may neglect to take them. Eating foods rich in potassium, like bananas, may help, but often that's not enough. Spironolactone (Aldactone) and triamterene (Dyrenium) are diuretics that "spare" potassium, leaving levels high, but they're pretty weak as diuretics. Dyazide (available as a generic) is an attempt to strike a balance: It's part thiazide, part potassium-sparing diuretic.