Approximately five million Americans have heart failure and nearly 700,000 new cases are diagnosed each year. Heart failure occurs when your heart muscle is weakened and not able to pump blood to your body organs. Heart failure also can occur if the heart gets too stiff and is unable to relax to fill up with blood. Though the heart continues to work it is unable to provide enough oxygen and nutrients to the tissues and organs to perform regular activities. The heart has to work harder to provide blood to the body and as a result increases in size and becomes weaker and/or stiffer. When the heart muscle cannot pump the needed blood to the body, blood may back up and collect in the lungs causing shortness of breath, and may cause swelling of the abdomen and arms and legs.
Heart failure can be caused by:
Heart attack, where a large part of the heart muscle is destroyed due to a blockage in the blood vessel feeding the heart. This causes the rest of the heart muscle to work harder and often cannot keep up with the demand.
Diseases that directly affect the heart muscle, referred to as cardiomyopathy which means a weakness of the heart muscle. Cardiomyopathy may be caused by a lack of blood flow to the muscle as with a heart attack or with blockages, or may be caused by an infection, certain drugs or toxins and alcohol or substance abuse.
Certain conditions that overwork the heart may lead to heart failure, such as hypertension, irregular or rapid heart rhythms, thyroid disease, sleep apnea, heart valve disease or kidney disease.
Accumulation of fluid is the underlying cause of many of the symptoms of heart failure. Treatment commonly centers around ways to decrease the fluid in the body in order to decrease the work load on the heart.
Common symptoms of heart failure include:
- Shortness of breath
- Difficulty breathing when laying down at night
- Loss of stamina
Unexplained weight gain with swelling of the abdomen (bloating), fingers, legs, ankles or feet and frequent cough.
The first step is an evaluation to determine the underlying cause of heart failure and identifying how to correct/improve the situation, to "correct the correctable". Tests may include an echocardiogram, a nuclear perfusion study and possibly a heart catheterization. Screening for sleep apnea also will be performed. An evaluation of exercise tolerance may be done with a cardiopulmonary stress test. A blood test called brain natriuretic peptide, or BNP, will be done periodically to determine the level of fluid retention.
Treatment will include dietary counseling to address fluid and sodium (salt) restrictions, and education to improve compliance with medication, exercise program and when to seek medical care.
Medications will be prescribed to decrease the work load on your heart so it can pump easier, to help strengthen the heart muscle, to regulate your heart rhythm and to remove excess fluid from your body.
The Bryan Heart Heart Improvement Program is a comprehensive heart failure program featuring advanced medical and surgical therapy, as well as experimental treatments. The goals of the Heart Improvement Program are to help patients lead as normal a life as possible and to improve the length and quality of life. Experienced cardiologists and nursing staff use the newest technology and equipment available to provide the best of care. Participation in the newest drug and device clinical trials is available for those eligible.