Tag: heart failure

What is Congestive Heart Failure?

It’s a terrifying moment for many patients: the moment when the doctor enters their hospital room and informs them they are suffering from congestive heart failure. Many people do not know what congestive heart failure is or what it means for their life, and they ask themselves, “Is congestive heart failure the end of my world as I know it?”

Congestive heart failure occurs when for whatever reason the heart is unable to effectively pump the blood through the body. This usually occurs when the heart muscle is weak due to disease or stressed beyond its ability to function. Congestive heart failure is usually a secondary disease following another cardiac condition, primarily either coronary artery disease, cardiomyopathies, myocarditis, valvular disease, or cardiac arrhythmias, with coronary artery disease carrying the poorest prognosis. It may also follow a myocardial infarction, renal failure, sepsis or severe anemia.

Each side of the heart has a different function, and therefore will have a slightly different effect on the body when it is unable to fulfill that function. If it is the left side of the heart that has failed accumulation of fluid in and around the lungs will cause the patient to experience difficulty breathing, and the kidneys will respond to the reduced blood in the circulation by retaining fluid as well. If it is the right side that fails the excess fluid accumulates in the venous system, giving the patient a generalized edema that becomes more severe as their condition deteriorates.

Dyspnea is the prevalent presenting symptom in congestive heart failure, although the severity will vary from patient to patient. Some will possess perfectly normal pulmonary function until under exertion, such as while exercising, walking up stairs or mowing their lawn; others will have so much fluid accumulated that simply rising from bed in the morning will prove difficult. These patients will also usually become easily fatigued due to a lack of oxygen to the tissues. Heart failure will also cause a condition known as pitting edema, in which the body retains fluid to the point that when pressure is applied to specific spot on the body the indentation remains (non-pitting edema is not caused by heart failure).

Treatment of congestive heart failure consists primarily of treating the symptoms. Vital signs should be taken regularly, and often diuretics will be prescribed to facilitate expulsion of accumulated fluid from the body. While in the hospital fluid intake and output will be measured very carefully. Patients will probably be placed in an upright position to assist in moving fluid from around the heart and lungs, given potassium supplements and prescribed bed rest for a period of time. BUN levels and serum creatinine, potassium, sodium, chloride and bicarbonate levels are monitered frequently by a physician.

There are several factors that contribute to congestive heart failure and, if diagnosed, should be treated and maintained. These include hypertension, anemia or poycythemia, endocrine disorders, malnutrition, drug or alcohol use and obesity. Therefore, it is very important that patients suffering from congestive heart failure pay particular attention to maintaining a healthy lifestyle. A doctor can aid in establishing the best diet and exercise plan with each individual to prevent placing undue stress on the heart and lungs.

While no said cure exists for congestive heart failure and the prognosis varies from case to case, by following a strict diet and exercise program, taking all prescribed medications regularly and maintaining a close relationship with their physicians many patients who suffer from heart failure can continue to lead a fairly normal life.

What Evidence of Congestive Heart Failure is a Diagnosis Based

What Evidence of Congestive Heart Failure is a Diagnosis Based on?

While all cardiac conditions carry similar symptoms of chest pain and difficulty breathing, congestive heart failure generally presents with a very specific set of symptoms and lab results, giving doctors a very firm set of clues upon which to base a definite diagnosis.

Dyspnea, or difficulty breathing, coupled with severe pitting edema (when the body retains fluid to the point of holding the imprint of an object that is pressed into the skin for several minutes) are generally the first pieces of evidence pointing to congestive heart failure. Heart failure results in the heart not being able to efficiently pump blood throughout the body; as a result, fluid accumulates rather than being excreted and causes the body to swell as if it were a water balloon. Non-pitting edema, or fluid retention that does not hold an imprint, is not caused by heart failure and indicates that another diagnosis needs to be made. The patient may produce a frothy pink sputum when they cough.

In addition to the symptoms related to the fluid accumulation general weakness and malaise, particularly during times of physical exertion are frequent complaints of patients suffering from congestive heart failure, and should not be ignored. This is caused by a lack of nutrients and oxygen from the blood to the body tissues, and may result in permanent damage to the organs if they are left without these vital elements for a prolonged period of time. Anuria, or a lack of urination, is also evidential of heart failure as fluid accumulates in the tissues rather than being properly excreted. Patients may suffer from a changed mental status due to toxins accumulating in the body.

Once the physician suspects heart failure based on the physical evidence, blood samples will be sent to the laboratory. Beta-natriuretic peptide, or BNP, is an excellent screening tool in suspected cases of heart failure. This hormone is produced in greater quantities by the failing heart muscle as fluid levels rise, with a level between one hundred and five hundred pg/mg suggesting congestive heart failure and greater than five hundred being fairly diagnostic; however, an elevated BNP should not be considered to be sufficient evidence upon which to base a positive diagnosis, as conditions such as renal failure, ventricular strain, tumors or hypoxia can also cause BNP levels to rise. Arterial blood gases may be tested to determine the degree of hypoxemia. A decreased erythrocyte sedimentation rate, proteinuria (protein in the urine), and a mild azotemia (elevated blood urea level) can be seen in early to moderate disease. An increased serum creatinine, hyperbilirubinemia (increased bilirubin in the blood) and dilutional hyponatremia (decreased serum sodium levels) are evidence the patient is suffering from a more advanced case of heart failure.

Radiology will also wish to perform imaging studies to evaluate the condition of the heart. A chest x-ray will generally reveal cardiomegaly (enlargement of the heart) and pleural effusion (fluid around the heart). An echocardiogram may be performed to evaluate the internal structures of the heart to evaluate for any structural abnormalities, as in the case of mitral stenosis. This provides evidence to determine the underlying cause of congestive heart failure, particularly in suspected cases of valvular heart disease.

Physicians are like detectives, if you will. Once these tests have all been run they will gather these pieces of evidence together and put them together to form a fairly accurate picture of the patient’s condition, allowing for an accurate diagnosis leading to proper treatment.

Public Health

Experts are outraged over the fact that the U.S. Government does not track Heart Diseases. American Heart Association feels that since heart failure is the number one killer amongst men and women that it should concern the government since it does concern the public health. Our government should track national rates of heart disease and stroke to help cut the incidences of these prime causes of death.

Currently data is collected by different sources and then published once a year in the AHA annual Heart Disease and Stroke journal. The Public Health does not keep a record of heart diseases as they do for other illnesses. The doctors of today have to rely on information provided by different sources as journals and magazines. The Public Health is for everybody’s concern and since the government controls this division, it is highly advisable that they start tracking patients with heart problems.

It is true that the American Heart Association has been doing a great job compiling this information from many and various sources. The fact is that there are many missing pieces, and it is not a good idea to have a nongovernmental agency, with no authority to modify data collected. The fact that the Public Health Department has no control over the facts or evaluation means that changes are slowly improved.

The Public Health Department has the capability of being a surveillance unit that can evaluate how data gets collected then make changes as needed. The Public Health Department can make sure that everyone in the medical field has access to all the information concerning the heart.

It is up to the Public Health Department to gather the needed information from the primary physicians, simply have the physicians report heart disease and stroke whenever possible. The information shared with doctors and patients would be much more obtainable. The public is under the false impression that the medical field is well informed about heart diseases. The truth about the situation is that there is no formal method of collecting data. That in reality without the efforts of the AHA doctors would not be as advanced as they are today concerning heart related problems. The current data collected by surveys needs some modification to help with increasing the physician’s capability to treat heart patients.

– National surveys should expand existing questions on risk factors for heart disease, stroke, and other vascular diseases. Include in the survey risk factors such as physical inactivity, unhealthy diet, smoking and obesity.

– The Public Health System should standardize data collection across existing surveys to eliminate duplication and make information easier to compare.

– Laboratory results on cholesterol levels and blood sugar control to information collected from physician visits needs to be compiled for the possibility of discovering any connections to heart problems. The Public Health Department duty should be to maintain these records for our own safety and well-being.

Let us note that heart health is of interest to the U.S. Food and Drug Administration offers advice on how to keep your heart healthy.

Medications

Medications are all important when it comes to healthy heart care. The patient needs to understand how the proper medication effects the heart. The fact that the heart has different problems means that accordingly the medication may vary as well. It is possible to have multiple problems such as high blood pressure and cholesterol then you would need two different types of medications.

The medicine that is Beta-Blockers, which reduce the heart rate and the output of blood by counteracting a hormone called noradrenalin, is not recommended for people with severe heart failure. Diuretics are a medication that helps people with fluid retention. The digitalis medicines increase the force of the heart’s contractions, helping to improve circulation. The medicines known as Angiotensin converting enzyme (ACE) inhibitors and Angiotensin II receptor blockers (ARBS) may improve survival among heart failure patients and may slow or prevent the loss of heart pumping activity. The ACE inhibitors were originally developed as a treatment for high blood pressure the inhibitors help heart failure patients by decreasing the pressure inside the blood vessels. This results in the heart not needing to work as hard to pump blood through the vessels. Nitrate or hydralazine is prescribed to patients who cannot take ACE inhibitors or ARBS. These medications help relax tension in blood vessels and improve blood flow.

These are the basic groups of medications but they are manufactured by drug companies that attach their own name, however, just read the explanation you will get from your pharmacist and that will let you know the type of medication you are taking. Patients with high cholesterol levels take a drug called Lipitor while another patient might be in need of a Beta-Blocker so the medicine named Plavix. A patient might be inclined to strokes therefore; Nadolol helps with this problem. One medication that you can take that is highly recommended is Bayer Aspirin 81mg. The Aspirin known to stop heart attacks or prevent heart attacks and this medicine bought over the counter without a prescription.

The above medications are just a few that your doctor can prescribe for you according to your heart condition. The heart is one of the most vital organs in our body. It is essential that we take care of our heart in order to survive. That is why taking medications are a very serious matter. This could prevent your heart from functioning. I knew a man who was not of the wisest nature and whenever he traveled on his short weekend trips would take all of us heart medications on Friday afternoon so he would not have to take them with him. The first time he proclaimed that the room went round and he was dizzy for a while. This did not stop him the next time he did this when he stood up his heart stopped. Yes, the man died at the age of 55 years simply because he mismanaged his medications. Please only take what your doctor recommends and only as it is prescribed.