Tag: cardiac arrhythmia

Living With Heart Failure-How Congestive Heart Failure Impacts Your Life

Living With Heart Failure-How Congestive Heart Failure Impacts Your Life

Heart failure, as well as all the risks that accompany it, can be a terrifying prospect for any man, woman or child. The impact of a heart, the body’s central tool for survival, no longer functioning may seem like the beginning of the end. The good news is, by establishing an effective treatment plan with your cardiologist the prognosis, and the chances for you to lead a normal life, increase exponentially.

Heart failure occurs when the heart can no longer efficiently pump blood throughout the body. The blood pools, and while organs are deprived of vital, life giving oxygen and nutrients the excess sodium that would normally be excreted in the urine builds up in the tissues, resulting in fluid retention that leads to organ stress and the dyspnea that is so common in cases of congestive heart failure. Left untreated, the oxygen deprived organs will eventually cease to function and the patient will die.

Fortunately, there are now many ways to combat the mortality factor associated with heart failure. Doctors can prescribe medications to facilitate the flow of blood through the body and take some of the pressure off the heart; blood thinners can decrease the chances of clots forming in the veins. Aside from medicinal means, there are many factors that may be altered in your lifestyle to impact the prognosis of your disease.

It is essential that the body be given sufficient time to rest in a day. While at rest the heart can more easily pump blood throughout the body; just as you would rest an injured leg when it began to pain you, you should rest your heart as well. On the flip side, it is important to establish a daily exercise routine. It doesn’t have to be three hours of aerobics; a half hour walk every day would have a greater impact on your physical being than nothing. Consult with your physician to find the plan that works best for your individual circumstances.

Along with an exercise plan you should work with your doctor to find the best diet plan for you. In most cases a low sodium diet is recommended to help reduce fluid retention. Diuretics can greatly affect the levels of potassium in the body causing hypokalemia, which can lead to muscle weakness, paralysis and a fatal cardiac arrhythmia; therefore, very often if you have been given a diuretic to take daily a potassium supplement will also be prescribed.

Nicotine can create a serious problem for patients with heart failure. It increases the heart rate and blood pressure while having a negative impact on the oxygen level in the blood. All of these things cause the heart to work harder. It is strongly recommended that if you have been diagnosed with heart failure you quit smoking completely.

Hand in hand with smoking are the inherent dangers associated with contracting a case of pneumonia or flu. If you are able you should receive an annual flu shot, as well as the one time dose of pneumococcal vaccine. This will provide some level of protection against pneumococci bacteria, the major cause of bacterial pneumonia. Pneumonia is a problem for the same reasons as smoking; the decreased oxygen levels in the blood cause the heart to work harder in an attempt to compensate and get oxygen to the organs and tissues. If possible, avoid crowded areas during cold and flu season, and stay away from people you know are sick.

Amazingly, something as simple as the clothes you wear can impact your condition if you have suffered heart failure. Tight clothing can cause blood clots and restrict blood flow to the extremities. In addition, in cases of extreme temperature your clothes should be weather appropriate; if the body has to work to maintain its temperature the heart will have to work that much harder.

Sexual relations can usually be continued as before; however, they should occur in as peaceful an environment as possible to prevent undue stress. If your condition is severe it is important that you discuss this with your physician; it may be necessary to forego sexual relations for a time in favor of other, less stressful shows of affection.

Each of these steps will help you continue to live much as you did before being diagnosed. Heart failure will inevitably impact your life; it is entirely up to you how much.

How do Physicians Treat Congestive Heart Failure?

Congestive heart failure is precisely what it sounds like; it is a failure of the heart to properly function, and its effects on the body can be devastating. Physicians do their best to treat the symptoms and give the patient the best prognosis possible; however, no true cure for congestive heart failure currently exists.

Heart failure occurs when the heart is unable to properly pump blood throughout the body; as a result, rather than distributing nutrients and oxygen to the tissues and then excreting the excess fluid into the urine the blood pools. This results in either a systemic or localized edema as fluid builds up in the veins and organs, causing swelling of the extremities as well as the organs themselves (this fluid accumulation is responsible for an excessive amount of stress on the heart as fluid accumulates in the pleural cavity as well as the dyspnea, or difficulty breathing, often symptomatic of heart failure). The swelling and lack of oxygen and nutrients will result in permanent damage to the organs if left untreated, providing a very poor prognosis for the patient.

The first stage of treatment generally consists of the administration of extra oxygen to attempt to return the oxygen levels in the tissues to normal. Once oxygen has been administered and a pulse oximeter reveals blood oxygen levels to be acceptable the focus will shift to attempting to treat the fluid build-up in the body. Diuretics will be administered to assist the excess fluid on its path out of the body via the urinary tract, and nitrates are administered to cause the vessels to dilate, allowing blood to flow more freely without the heart having to work quite as hard. Treatment with diuretics is often accompanied by supplemental potassium, as the body will excrete potassium in the urine and long term hypokalemia may result in muscle weakness or paralysis, as well as an increased risk of fatal cardiac arrhythmia.

Patients will often be sent home from the hospital with diuretics, as well as a medication known as an ACE inhibitor (an angiotensin-converting enzyme inhibitor) which prevents the body from creating angiotensin, a substance which raises blood pressure and causes the blood vessels to constrict. An angiotensin II receptor blocker may also be administered if the patient continues to produce angiotensin. Patients may also be treated with vasodilators other than ACE inhibitors, particularly if they have responded poorly to treatments with ACE inhibitors in the past. Nitroglycerin is a common example of this type of medication.

Digitalis, or Digoxin, may be prescribed to strengthen the force of the heart’s contractions, aiding it to push blood throughout the body. Treatment with a beta blocker is also beneficial in cases of heart failure, preventing the heart from beating more rapidly in an attempt to compensate for the poor movement of the blood in the body and placing more stress on the weakened muscle.

Blood thinners are used to prevent the formation of clots in the body that may be caused by the decreased movement of the blood in the vessels. Coumadin and heparin are the most commonly prescribed blood thinners in use today; however, due to an increased risk of bleeding patients taking these medications should undergo coagulation testing regularly.

Lifestyle changes are just as important as medications in the long term treatment of heart failure. Patients should consult with their doctor to establish an appropriate (low sodium) diet and exercise program, and should do at least some moderate exercise daily. Equally important is taking sufficient time to rest every day. The heart pumps more easily when the body is at rest, which is vital to an already overstressed muscle. The nicotine from cigarettes causes an increase in heart rate, blood pressure, and the tendency for clumping in the blood vessels; patients with heart failure should abstain from smoking. Flu or pneumonia can be very difficult for hearts that are failing as they attempt to compensate for the lack of oxygen in the bloodstream being carried to the organs. It is very important that patients receive an annual influenza vaccine, as well as a dose of the pneumococcal vaccine, which will protect them from the pneumococcal bacteria that cause over eighty percent of cases of bacterial pneumonia. Wearing non-constrictive clothing will assist in preventing blood clots and facilitating blood flow to the extremeties, and in cases of extremely warm or extremely cold temperatures it is important that the patient take all precautions necessary to keep the body at an appropriate temperature..

Researchers are still seeking to find a cure for congestive heart failure; however, until that day comes it is extremely important that patients suffering from heart failure follow the treatment plan outlined by their physician. With careful attention to maintaining their condition, the prognosis associated with heart failure increases dramatically.

How CHF Patients can Take Advantage of Translational Research?

In nature every action spawns a separate and equal reaction. In the field of medicine, the reaction may not always be equal to the action. The performance of a particular treatment in the lab on test animals may not be the same as would be seen in a human subject; this is where the field of translational research comes in.

Translational research takes research from the laboratory to the patient’s bedside. This can be done in several forms. In its earliest stages a treatment will undergo controlled clinical trials with a voluntary group of test subjects. If these small, controlled tests meet the acceptable range of success the treatment is then taken to research hospitals such as St. Jude’s or Children’s Hospital of Boston. Here patients are given the opportunity to experience new methods of control and treatment of a disease with the understanding that it is still considered highly experimental; however, for many these treatments represent a chance for a cure that previously as out of reach for them as the moon.

Congestive heart failure is, at the moment, an incurable event, occurring when for whatever reason the cells of the heart muscle are destroyed and the heart can no longer adequately pump blood throughout the body. Once the cells in the heart tissue are non-functional the body is unable to replace them, making it impossible for the heart to regain full heart function on its own. The current mortality rate is high, and over fifty percent of patients with congestive heart failure will die within five years of being diagnosed. There are many treatment options currently being considered for congestive heart failure, however, and a number of new technologies being tested daily. For example, Montefiore Medical Center in New York City is currently doing clinical trials on a drug known as Lovosimendan, a calcium sensitizer that does not trigger cardiac arrhythmia, and research into the possibility of using stem cells to regrow cardiac tissue is ongoing.

For a patient to take advantage of these options they should discuss the possibility of being a subject for clinical testing with their physician to see if they would be a good candidate, then allow the physician to make a recommendation on a course of action from there. It may be suggested that the patient contact a research facility, or the physician may suggest their name for a clinical trial they know is occurring soon. If the patient lives in an area with a research hospital nearby, chances are there will be an opportunity for them to benefit from the hospital’s policy on translational research.

It should be understood that translational research is precisely what it sounds like; research. Scientists and doctors are often still learning about the treatment and its effect on the human body, and there is always a possibility that it will be unsuccessful or carry with it many hazardous side effects. These courses of treatments are unknowns to physician and researcher alike. For patients who have run out of options, however, even the possibility of a negative effect cannot stifle what the opportunity to be part of a translational research project provides: hope.

What New Therapies for Treatment of Congestive Heart Failure?

Heart disease is one of the deadliest killers in the world to date. Congestive heart failure, a condition found secondary to many major cardiac diseases, possesses its own high mortality rate. Fifty percent of those diagnosed with congestive heart failure will die within the five following years. Scientists and researchers are struggling to understand the exact mechanisms of the disease, and to find a cure.

Congestive heart failure results as the cells in the heart die or become non-functioning due to an event such as a myocardial infarction (a heart attack) or ischemic heart disease. Whatever the cause, the heart is subsequently unable to pump blood adequately throughout the body, resulting in the blood pooling in the organs and fluid building up in and around the lungs as sodium is unable to be properly excreted, causing the dyspnea that is the classic symptom of congestive heart failure.

Clinical research is targeted at both the treatment of the disease and the possibility of repairing the damaged cells in the heart. Current research is underway to test new medications that would assist in vasodilation, as well as a calcium inhibitor that would not result in the higher incidence of cardiac arrhythmia seen with the medications currently on the market.

In the age of natural medicine, the power of the mind has been invoked in clinical trials to use meditation and relaxation techniques to combat the stress on the heart that can be the breaking point for patients with heart failure. Stress has been shown to negatively affect the body’s blood pressure, forcing the heart to work harder and placing an undue amount of pressure on an already weakened muscle. The theory lies in the belief that by learning to maintain a low level of mental stress the heart will be less stressed and therefore less likely to fail completely, and the patient can be given a better prognosis.

Alongside the return to natural, holistic methods of treatment is an incredible advancement in clinical technology that was not available twenty or thirty years ago. Scientists claim to have identified a set of altered genes that can make an individual more disposed to suffer from congestive heart failure and are using their current knowledge of genes and the benefits of gene therapy to attempt to reverse the effect. In addition, medications to tamp down on the genes’ activities, such as beta blockers and alpha-2 agonists are already available and being used in treatment programs.

Also being explored is the possibility of using stem cells, the body’s pluripotent progenitors, to assist in reparation of the damaged heart tissue. Clinical trials showed that patients suffering from congestive heart failure responded very favorably to an injection of their own stem cells into the heart, although the exact means by which this causes improvement is as yet unknown. It is suspected that these cells either facilitate the growth of new vessels in the heart or act as beacon, attracting the body’s own healing cells to the site of the damage and stimulating repair.

The possibility of actually growing healthy tissue from embryonic stem cells to be transplanted is also being explored, although the controversial nature of the use of embryonic stem cells due to the necessary destruction of the embryo makes this questionable in the foreseeable future. Scientists have determined that adult stem cells simply cannot provide an adequate number of new cells to meet the needs of patients who have suffered heart failure.

Heart failure is incredibly dangerous because the body cannot reproduce the dead tissue cells in the heart; however, with modern advancements it is the great hope of researchers everywhere to one day find a cure.