Symptoms of Heart Failure
A number of symptoms are associated with Heart Failure, but none is specific for the condition. Perhaps the best known symptom is shortness of breath (“Dyspnea”). In Heart Failure, this may result from excess fluid in the lungs. The breathing difficulties may occur at rest or during exercise. In some cases, congestion may be severe enough to prevent or interrupt sleep.
Fatigue or easy tiring is another common symptom. As the heart’s pumping capacity decreases, muscles and other tissues receive less oxygen and nutrition, which are carried in the blood. Without proper “Fuel” the body cannot perform as much work, which translates into fatigue. Fluid accumulation, or edema, may cause swelling of the feet, ankles, legs, and occasionally, the abdomen. Excess fluid retained by the body may result in weight gain, which sometimes occurs fairly quickly.
Persistent coughing is another common sign, especially coughing that regularly produces mucus or pink, blood–tinged sputum. Some people develop raspy breathing or wheezing. Because heart failure usually develops slowly, the symptoms may not appear until the condition has progressed over years. The heart hides the underlying problem by making adjustments that delay–but do not prevent–the eventual loss in pumping capacity.
The heart adjusts, or compensates, in three ways to cope with and hide the effects of heart failure
- Enlargement (“Dilatation”), which allows more blood into the heart.
- Thickening of muscle fibers (“Hypertrophy”) to strengthen the heart muscle, which allows the heart to contract more forcefully and pump more blood.
- More frequent contraction, which increases circulation.
Treatments are available
Heart failure caused by an excessive workload are curable by treating the primary disease, such as Anemia or Thyrotoxicosis. Also curable are forms caused by anatomical problems, such as a Heart Valve Defect. These defects can be surgically corrected. However, for the common forms of heart failure–those due to damaged heart muscle–no known cure exists. But treatment for these forms may be quite successful. The treatment seeks to improve patients’ quality of life and length of survival through lifestyle change and Drug therapy.
Patients can minimize the effects of heart failure by controlling the risk factors for heart disease. Obvious steps include quitting smoking, losing weight if necessary, abstaining from alcohol, and making dietary changes to reduce the amount of salt and fat consumed. Regular, moderate exercise is also helpful for many patients, though the amount and intensity should be carefully monitored by a physician. But, even with lifestyle changes, most heart failure patients must take medication. Many patients receive two or more drugs.
Several types of drugs have proven useful in the treatment of heart failure
- Diuretics help reduce the amount of fluid in the body and are useful for patients with fluid retention and hypertension.
- Digitalis increases the force of the heart’s contractions, helping to improve circulation.
- Results of recent studies have placed more emphasis on the use of drugs known as Angiotensin Converting Enzyme (ACE) inhibitors. Several large studies have indicated that ACE inhibitors improve survival among heart failure patients and may slow, or perhaps even prevent, the loss of heart pumping activity.
Patients who cannot take ACE inhibitors may get a Nitrate and/or a drug called Hydralazine, each of which helps relax tension in blood vessels to improve blood flow. Listed below are some of the medications prescribed for heart failure. Not all medications are suitable for all patients, and more than one drug may be needed.
ACE Inhibitors
These prevent the production of a chemical that causes blood vessels to narrow. As a result, blood pressure drops and the heart does not have to work as hard to pump blood. Side effects may include coughing, skin rashes, fluid retention, excess potassium in the bloodstream, kidney problems, and an altered or lost sense of taste.
Digitalis
Increases the force of the heart’s contractions. It also slows certain fast heart rhythms. As a result, the heart beats less frequently but more effectively, and more blood is pumped into the arteries. Side effects may include nausea, vomiting, loss of appetite, diarrhea, confusion, and new heartbeat irregularities.
Diuretics
These decrease the body’s retention of salt and so of water. Diuretics are commonly prescribed to reduce high blood pressure. Diuretics come in many types, with different periods of effectiveness. Side effects may include loss of too much potassium, weakness, muscle cramps, joint pains, and impotence.
Hydralazine
This drug widens blood vessels, easing blood flow. Side effects may include headaches, rapid heartbeat, and joint pain.
Nitrates
This drug is used mostly for chest pain, but may also help diminish heart failure symptoms. It is a smooth–muscle relaxer and widens blood vessels. It acts to lower primarily Systolic blood pressure.
