- Heart failure is a pathophysiological state in which cardiac output is insufficient to meet the needs of the body and lungs. The term "congestive heart failure" is often used, as one of the common symptoms is congestion, or build-up of fluid in a person's tissues and veins in the lungs or other parts of the body.
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The main pathophysiology of heart failure is a reduction in the efficiency of the heart muscle, through damage or overloading. As such, it can be caused by a wide number of conditions, including myocardial infarction (in which the heart muscle is starved of oxygen and dies), hypertension (which increases the force of contraction needed to pump blood) and amyloidosis (in which misfolded ...
- Cardiovascular system
- Lifestyle changes
Management of heart failure requires a multimodal approach. It involves a combination of lifestyle modifications, medications, and possibly the use of devices or surgery.
People with congestive heart failure are educated to undertake various non-pharmacological measures to improve symptoms and prognosis. Such measures include: 1. Moderate physical activity, when symptoms are mild or moderate; or bed rest when symptoms are severe. 2. If sleep apnea is identified, treat with CPAP, BiPAP, dental appliances or surgery. Sleep apnea is an under-recognized risk factor for heart failure. 3. Weight reduction – through physical activity and dietary modification, as ...
There is a significant evidence–practice gap in the treatment of CHF; particularly the underuse of ACE inhibitors and β-blockers and aldosterone antagonists which have been shown to provide mortality benefit. Treatment of CHF aims to relieve symptoms, to maintain a euvolemic state, and to improve prognosis by delaying progression of heart failure and reducing cardiovascular risk. Medications used include: diuretic agents, vasodilator agents, positive inotropes, ACE inhibitors, beta ...
CRT: People with NYHA class III or IV, left ventricular ejection fraction of 35% or less and a QRS interval of 120 ms or more may benefit from cardiac resynchronization therapy, through implantation of a bi-ventricular pacemaker. This treatment modality may alleviate symptoms, improving quality of life, and in some trials has been proven to reduce mortality. The COMPANION trial demonstrated that CRT improved survival in individuals with NYHA class III or IV heart failure with a widened QRS compl
The final option, if other measures have failed, is heart transplantation or implantation of an artificial heart. These remain the recommended surgical treatment options. However, the limited number of hearts available for transplantation in a growing group of candidates, has led to the development of alternative surgical approaches to heart failure. These commonly involve surgical left ventricular remodeling. The aim of the procedures is to reduce the ventricle diameter, improve its shape and/o
- Signs and symptoms
Acute decompensated heart failure is a sudden worsening of the signs and symptoms of heart failure, which typically includes difficulty breathing, leg or feet swelling, and fatigue. ADHF is a common and potentially serious cause of acute respiratory distress. The condition is caused by severe congestion of multiple organs by fluid that is inadequately circulated by the failing heart. An attack of decompensation can be caused by underlying medical illness, such as myocardial infarction, an abnorm
Difficulty breathing, a cardinal symptom of left ventricular failure, may manifest with progressively increasing severity as the following: 1. Difficulty breathing with physical activity 2. Difficulty breathing while lying flat 3. Episodes of waking up from sleep gasping for air 4. Acute pulmonary edema Other cardiac symptoms of heart failure include chest pain/pressure and palpitations. Common noncardiac signs and symptoms of heart failure include loss of appetite, nausea, weight loss, bloating
Chronic stable heart failure may easily decompensate. This most commonly results from an intercurrent illness, myocardial infarction, abnormal heart rhythms, uncontrolled high blood pressure, or the person's failure to maintain a fluid restriction, diet, or medication. Other well recognized precipitating factors include anemia and hyperthyroidism which place additional strain on the heart muscle. Excessive fluid or salt intake, and medication that causes fluid retention such as NSAIDs and thiazo
A jugular venous distension is the most sensitive clinical sign for acute decompensation.
In acute decompensated heart failure, the immediate goal is to re-establish adequate perfusion and oxygen delivery to end organs. This entails ensuring that airway, breathing, and circulation are adequate. Management consists of propping up the head of the patient, giving oxygen to correct hypoxemia, administering morphine, diuretics like furosemide, addition of an ACE inhibitor, use of nitrates and use of digoxin if indicated for the heart failure and if arrhythmic.
Heart failure is different from cardiac arrest, because the heart is still working. Heart failure can be sudden (" acute "), like after a heart attack , or can come on slowly . Someone with heart failure can have shortness of breath (which may be worse when they lie flat ), waking up breathless at night, swelling of the legs, and needing to ...
Cardiovascular disease; Micrograph of a heart with fibrosis (yellow) and amyloidosis (brown). Movat's stain.: Specialty: Cardiology: Usual onset: Older adults: Types: Coronary artery diseases, stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy
Coronary artery disease (CAD), also known as coronary heart disease (CHD), ischemic heart disease (IHD), or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of plaque (atherosclerosis) in the arteries of the heart. It is the most common of the cardiovascular diseases.
It is an independent predisposing factor for heart failure, coronary artery disease, stroke, renal disease, and peripheral arterial disease.   It is the most important risk factor for cardiovascular morbidity and mortality , in industrialized countries .
The American Heart Association explains heart failure (HF), sometimes called congestive heart failure (CHF), as a chronic, progressive condition in which the heart muscle is unable to pump enough blood through the heart to meet the body's needs for blood and oxygen. Learn more.
- Risk Factors
Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.Not all conditions that lead to heart failure can be reversed, but treatments can improve the signs and symptoms of heart failure and help you live longer. Lifestyle changes — such a...
Heart failure can be ongoing (chronic), or your condition may start suddenly (acute).Heart failure signs and symptoms may include: 1. Shortness of breath (dyspnea) when you exert yourself or when you lie down 2. Fatigue and weakness 3. Swelling (edema) in your legs, ankles and feet 4. Rapid or irregular heartbeat 5. Reduced ability to exercise 6. Persistent cough or wheezing with white or pink blood-tinged phlegm 7. Increased need to urinate at night 8. Swelling of your abdomen (ascites) 9. V...
Heart failure often develops after other conditions have damaged or weakened your heart. However, the heart doesn't need to be weakened to cause heart failure. It can also occur if the heart becomes too stiff.In heart failure, the main pumping chambers of your heart (the ventricles) may become stiff and not fill properly between beats. In some cases of heart failure, your heart muscle may become damaged and weakened, and the ventricles stretch (dilate) to the point that the heart can't pump b...
A single risk factor may be enough to cause heart failure, but a combination of factors also increases your risk.Risk factors include: 1. High blood pressure. Your heart works harder than it has to if your blood pressure is high. 2. Coronary artery disease. Narrowed arteries may limit your heart's supply of oxygen-rich blood, resulting in weakened heart muscle. 3. Heart attack. A heart attack is a form of coronary disease that occurs suddenly. Damage to your heart muscle from a heart attack m...
If you have heart failure, your outlook depends on the cause and the severity, your overall health, and other factors such as your age. Complications can include: 1. Kidney damage or failure. Heart failure can reduce the blood flow to your kidneys, which can eventually cause kidney failure if left untreated. Kidney damage from heart failure can require dialysis for treatment. 2. Heart valve problems. The valves of your heart, which keep blood flowing in the proper direction through your heart...
The key to preventing heart failure is to reduce your risk factors. You can control or eliminate many of the risk factors for heart disease — high blood pressure and coronary artery disease, for example — by making lifestyle changes along with the help of any needed medications.Lifestyle changes you can make to help prevent heart failure include: 1. Not smoking 2. Controlling certain conditions, such as high blood pressure and diabetes 3. Staying physically active 4. Eating healthy foods 5. M...