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Congestive Heart Failure

What is “heart failure?”

Despite what some may think, heart failure is not the same as a heart attack. It is not something that happens suddenly like a heart attack, but rather gradually over time as the heart ages and/or as a result of prior heart damage.

Congestive heart failure occurs when the heart pumps less blood to the body than needed to fully function. Some blood backs up causing lung “congestion” and ankle “edema.”

There are two main types of heart failure:
  1. Weak heart failure - due to prior heart attack or viral damage, severe heart valve leakage or untreated rapid heart beats. In the beginning, the heart can hide being slightly weak by enlarging and contracting harder and faster. As heart failure worsens, further enlargement and resultant fluid retention causes even more heart weakening and further reduces blood pumping. Untreated, this cycle continues until the heart/body can’t function with progressively reduced blood flow and hospitalization, even death at advanced stages result.

  2. Strong heart failure - (More common) heart failure is that due to very stiff, thickened and/or overly strong heart mostly due to years of under-treated high blood pressure, diabetes, or naturally stiffened hearts of the elderly. Just like a weak heart can’t pump enough blood, an overly strong/stiff heart can’t work effectively, similar to a muscle-bound wrestler trying to do a graceful dance. The stiff heart also leads to less pumped blood and similar backing up of retained fluids in the lungs and legs: the stiffer the heart, the more swelling and lung congestion.
Dr. Laham is a board certified interventional cardiologist and director of the heart failure clinic at HFM’s Heart & Vascular Center.

Or call 920-320-3000

No matter which type of heart failure (too strong or too weak), increasing fatigue, breathing problems, swelling and poor quality of life lead many to seek doctor’s help. Unfortunately, without regular heart checks, it may be take years to recognize this, and may be too advanced to reverse.

Symptoms that those with heart failure may have include:
  • Breathlessness or chest pain while active, at rest, or even sleeping: especially while lying flat usually needing to sleep on several pillows or in a chair.
  • Persistent coughing or wheezing.
  • Swelling in the feet, ankles, legs or abdomen often with weight gain.
  • Constant tiredness/generalized fatigue and loss of endurance.
  • Feeling full in the stomach or decreased appetite
  • Confusion or memory loss
It is essential for heart failure patients to work with their primary physician and/or a heart specialist not only to treat symptoms, but also to arrange heart tests to help figure out what caused the problem. Sometimes tests find a durable remedy such as stents, bypass or valve surgery to correct the main cause.

Regardless of heart failure type each method requires water pills, and careful dietary fluid and salt restriction to reverse swelling and shortness of breath. Often, many other combinations of medications are needed for effective heart failure therapy.

To best control congestive heart failure and help change lifestyle, ideally heart failure patients should have regular contact with a team of registered nurses, pharmacists, dietitians and physical/occupational therapists to develop a tailored dietary, medication and exercise program and to monitor any warning signs of problems before they lead to trouble or hospitalization. Changing to a healthy low salt, low alcohol, and low caffeine diet; avoiding smoking and stress together with exercising and avoiding restaurants due to their high salt content if possible, all may help.

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