Heart failure is a chronic condition where the heart is unable to pump enough blood to meet the demands of the body. Exercise and medication are the first steps in treatment; if heart failure gets worse, surgery may also be required. How well you care for yourself is one of many variables that affect your outlook.
You can read more in this article about the causes, signs, and treatments of heart failure. Read on with us!
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What is Congestive Heart Failure?
Heart failure, also known as congestive heart failure, is a chronic condition that gets worse with time. Heart failure, despite the name suggesting otherwise, is the inability of the heart to pump blood as effectively as it should. When your heart has less pumping power, that can damage your organs and fluid can collect in your lungs.
When your heart is unable to pump enough blood, you experience congestive heart failure. Other parts of your body begin to accumulate as a result, most frequently your lungs and lower extremities (feet/legs).
More than 870,000 people are given the diagnosis with heart failure each year, and nearly six million Americans already have the condition. The most common reason for hospitalization for people over 65 is heart failure (congestive heart failure).
There are three types of Heart Failure:
- Left-sided heart failure: Heart failure with reduced left ventricular function (HF-rEF); Heart failure with preserved left ventricular function (HF-pEF)
- Right-sided heart failure
What Causes Congestive Heart Failure？
Heart failure can have many causes. The most common causes are:
- Cardiomyopathy, which affects the heart muscle and may be inherited or acquired, results in changes to the heart muscle tissue and functional failure.
- Arrhythmias – heart rhythm problems such as atrial fibrillation which impairs the contraction strength of the heart by the persistent fast heart rate is one of the many rhythm disturbances causing the heart to pump less efficiently.
- Coronary heart disease is characterized by atherosclerosis, or fatty buildup in the arteries that supply blood to the heart, which can result in angina symptoms or heart damage from a heart attack.
- High blood pressure, or hypertension, can place additional stress on the heart and eventually cause heart failure.
- Birth defects that interfere with the heart’s normal function are known as congenital heart disease.
- When a person has heart valve disease, the volume and strain on the heart increase, weakening it. This is caused by defects and damage to the valves.
4 Stages of Congestive Heart Failure
There are four stages of heart failure, ranging from advanced heart failure to a high risk of developing it: stage 1, stage 2, stage 3, and stage 4.
The four stages of heart failure are distinct from the four classes of heart failure symptoms listed by the New York Heart Association (NYHA), which show the severity of symptoms from class one (no symptoms) to class four (symptoms at rest), which is the most severe.
Stage 1
While engaging in physical activity is not problematic, Stage 1 patients are thought to be at a high risk of developing congestive heart failure. This diagnosis can result from factors including:
- Family history
- Coronary Artery Disease
- Diabetes
- High blood pressure
- Hypertension
- Heart attack
- Obesity
Stage 2
A structural heart condition, such as systolic left ventricular dysfunction, which is closely associated with the development of heart failure, has been identified in patients with Stage 2 heart failure via echocardiogram. Patients experience no symptoms of heart failure in this stage.
Stage 3
Patients with structural heart disease move into Stage 3 when they start experiencing symptoms of heart failure, such as:
- Coughing and wheezing
- Fatigue
- Shortness of breath
- Inability to exercise
- Increased nighttime urination
- Trouble concentrating
- Nausea
- Rapid or irregular heartbeat
- Swollen legs, ankles, or feet
- Weight gain
Stage 4
Patients in Stage 4 have severe symptoms that do not improve with therapy. Heart failure has reached its climax at this point. They are likely to have NYHA class three to four symptoms, which means they show symptoms on mild or minimal exertion or at rest.
Treatment for Each Stage
Treatment for Stage 1
The usual treatment plan for patients with Stage 1 heart failure is primary prevention which includes:
- Regular exercise, being active, walking every day
- Quitting smoking
- Treatment for high blood pressure (medication, low-sodium diet, active lifestyle)
- Treatment for high cholesterol
- Not drinking alcohol or using recreational drugs
- Medications for an underlying cause such as diabetes
Treatment for Stage 2
The usual treatment plan for patients with Stage B heart failure includes:
- Treatments listed in Stage A
- Angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB)
- Beta-blocker if you have had a heart attack and your EF is 40% or lower
- Aldosterone antagonist if you have had a heart attack or if you have diabetes and an EF of 35% or less (to reduce the risk of your heart muscle getting bigger and pumping poorly).
- SGLT2 inhibitor medication
- Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, or valve disease
Treatment for Stage 3
The usual treatment plan for patients with Stage 3 HF-rEF includes:
- Treatments listed in Stages A and B
- (ACE-I, ARB or angiotensin receptor/neprilysin inhibitor combination)
- If other treatments are unsuccessful at alleviating your symptoms, take hydralazine and nitrate together. Patients who are African-American should take this medication (even if they are taking other vasodilator medications) if they have moderate-to-severe symptoms
- Medications that slow the heart rate if your heart rate is faster than 70 beats per minute and you still have symptoms despite beta-blocker
- Restrict sodium (salt) in your diet
- Keep track of your weight every day to assess for fluid retention
- Possible fluid restriction; Possible cardiac resynchronization therapy (biventricular pacemaker); Possible implantable cardiac defibrillator (lCD) therapy
Treatment for Stage 4
The usual treatment plan for patients with Stage 4 heart failure includes:
- Treatments listed in Stages 1, 2 and 3
- Evaluation for more advanced treatment options, including heart transplant, ventricular assist devices, heart surgery, continuous infusion of intravenous inotropic drugs, palliative or hospice care or research therapies
Conclusion
Discuss your preferences for medical care with your doctor and family because congestive heart failure is a chronic, lifelong condition. You can complete an advance directive or living will so that everyone involved in your care knows what you want. Your wishes regarding life-extending procedures will be spelled out in a living will. In case you become incapable of making these decisions later in life, it is best to draft a living will while you are still healthy.
