What is heart failure?
Dr. Majure: Heart failure means your heart is not pumping blood effectively enough to meet your body’s needs. The heart delivers blood and oxygen throughout our bodies so that our organs, muscles, and cells can perform their essential functions. We need a functioning heart that can move blood through our bodies efficiently in order to live.
The heart can fail either by not relaxing well enough — what is known as diastolic heart failure, which prevents blood from entering the heart properly due to stiffness in the heart wall; or by not squeezing enough to pump the blood out and into the rest of the body, which is called systolic heart failure.
What are the symptoms of heart failure?
The most common symptoms of heart failure are shortness of breath with exertion or when lying down, fatigue, abdominal swelling, and swelling of the lower legs. Some people might find themselves having to sleep on extra pillows to help them breathe better, because fluid may be backed up in their lungs. As heart failure gets more advanced, these symptoms tend to worsen.
How do you know if you are in heart failure, and when should you reach out to your doctor?
Heart failure is a spectrum, and symptoms can range from mild to severe. Sometimes people might ignore symptoms that are crucial warning signs, like shortness of breath. The important thing is that we identify symptoms of heart failure early on, take it seriously, and treat it aggressively to prevent the illness from progressing.
You should always let your doctor know if you have new symptoms, or if symptoms grow worse. A diagnosis of heart failure will typically include a physical exam, bloodwork, and sometimes a chest X-ray and echocardiogram. Once heart failure is diagnosed, the treatment needs to be aggressive, thorough, and consistent.
What causes heart failure?
Common causes of heart failure are high blood pressure (hypertension) and coronary artery disease. These often coexist.
Coronary artery disease develops when arteries that supply blood to the heart become diseased, leading to blockages that can cause a heart attack, which scars the heart muscle. If the heart muscle is scarred, it can’t squeeze appropriately, and that can lead to heart failure.
Blood pressure is the force of blood pushing against the walls of your arteries, and high blood pressure can damage the arteries and increase the workload of the heart and blood vessels. As time goes on, the heart may start to fail and not pump as effectively as it did in the past.
Who is most at risk of heart failure?
Some people are more susceptible to high blood pressure at a very young age. For instance, we see a large proportion of young men of African descent who have very high blood pressure, and that can lead to heart failure at a very young age. Obesity and diabetes are also risk factors because of their association with high blood pressure.
Genetic factors play a role as well. If there is a family history of hypertension, heart attack, or diabetes, a person can be at risk for developing heart failure.
What are treatment options for heart failure?
Treatment depends on the type of heart failure a person has. Whether a person has systolic or diastolic heart failure, there are medications and therapies that can be used to treat each person’s individual case. However, most of the therapies we have that can make people live longer are for the treatment of systolic heart failure. These medicines work by decreasing the impact of hormonal stimuli that can hurt or damage the heart.
We take heart failure very seriously and treat it aggressively. We not only want to improve a patient’s symptoms, we want to improve their heart function and reduce their risk of dying. But despite our best efforts, there are times when people need additional therapies like a heart transplant or left ventricular assist device (LVAD), which is a mechanical pump that assists the heart in pumping blood to the body.
What can people do to prevent heart failure?
Controlling risk factors that are associated with the development of heart failure is very important and proven to prevent the onset of heart failure.
Dr. Majure recommends taking the following steps to help reduce your risk.