If you have recently been diagnosed with heart failure, (sometimes referred to as “congestive heart failure”) you probably have many questions. The name “heart failure” can elicit fear and confusion initially. “Failure” may cause you to think your heart is no longer working, but really a better term for heart failure is “heart weakness”, meaning your heart is weak but still trying its best! Heart failure is a chronic condition which means it won’t likely go away completely, but don’t worry, with proper care, most people can successfully manage their symptoms and even improve their heart failure! The best thing you can do now for you and your heart is to learn all you can about your condition and what you can do to keep your heart functioning optimally and avoid complications.
What is heart failure?
Heart failure is when your heart is weak and therefore unable to pump and circulate the blood throughout the body as it normally would. A normal heart pumps to carry oxygen, fluid and nutrients through the bloodstream to the tissues that need them throughout the entire body. The heart is normally about the size of a fist. However, with heart failure, the heart can become enlarged and therefore less effective at circulating the blood. This means that some parts of the body may not be receiving adequate oxygen and nutrients. Fluid can often start to build up causing swelling and other complications.
Heart failure is often described as having either “reduced ejection fraction” or “preserved ejection fraction”. Ejection fraction is a measurement of how much blood leaves the heart with each beat.
- Normal Ejection Fraction = 50-70%
- Borderline Ejection Fraction = 41-49%
- Reduced Ejection Fraction = ≤40%
However, in some cases, an individual may have insufficient heart function (heart failure), but their ejection fraction (EF) remains normal. Borderline ejection fraction will usually cause symptoms only occasionally, especially during times of physical activity. Whereas with reduced ejection fraction, symptoms may be felt more consistently and even while resting.
What causes heart failure?
Heart failure is caused by stress to the heart that either damages the heart tissue or causes the heart to have to work too hard. Common risk factors include:
- Obesity
- Coronary artery disease –buildup of fat/plaque in the arteries (atherosclerosis)
- High blood pressure
- Diabetes
- Aging
- Overactive thyroid
- Smoking
- Alcohol or drug use
- Certain types of radiation or chemotherapy
Certain health conditions that can lead to heart failure are:
- Previous heart attack
- Heart valve abnormalities
- Severe anemia
- Arrythmias
What are the signs and symptoms?
The most common symptoms of heart failure are:
- Shortness of breath
- Cough
- Fluid buildup/swelling
- Rapid weight gain
- Tiredness/fatigue
- Increased heartrate
- Confusion or memory changes
- Loss of appetite
It is important to track your symptoms daily to rapidly identify and treat any worsening symptoms before they lead to further complications. Click here for a helpful daily symptom tracker to keep handy.
How is it treated?
Depending on the level of heart damage and your stage of heart failure, treatment goals will vary from preventing symptoms, symptom management, to improving ejection fraction. Treatment measures usually include lifestyle changes, medications and surgeries/procedures if necessary.
Lifestyle Changes
- Eat Healthy – If you have heart failure following a heart healthy, low-sodium diet is key. Sodium is a mineral found in salt. Sodium attracts water and can cause fluid buildup; therefore, it is especially important to limit salt intake for individuals with heart failure. Talk to your doctor about what daily sodium limit they recommend for you; 1500 mg per day is a common recommendation, though your healthcare provider may have a slightly higher or lower recommendation based on your individual health needs. About 70% of the sodium in our American diet comes from processed foods. To cut back on your sodium intake, start by avoiding processed and fast foods. Try increasing your intake of fruits and vegetables which are naturally lower in sodium. Familiarize yourself with the nutrition labels found on food items; you can use this sodium tracker to record your sodium intake with each meal.
- Physical Activity – Staying active is beneficial for heart health. Make sure to talk with your healthcare provider before starting any exercise routine. In general, it is recommended to get around 150 minutes of mild to moderate activity per week (or 30 minutes 5x/week). It is important to listen to your body and avoid overexerting yourself; if you become tired or short of breath, take a break to rest. The activity doesn’t have to be strenuous; activities such as walking, housework and gardening can all be counted as physical activity. Try to make it fun; maybe put on some upbeat music while cleaning the house or even just to dance around!
- Your doctor may recommend cardiac rehab which is a medically supervised physical therapy program for your heart and lungs. Cardiac rehab has been greatly beneficial for many people as they try to manage their heart failure. Consider asking your healthcare provider if cardiac rehab is right for you.
- Symptom Tracking – Keeping track of your symptoms is another key lifestyle modification that can be very beneficial for people with heart failure. Heart failure symptoms can deteriorate slowly over time and, if left unaddressed, can lead to complications such as fluid overload, pneumonia, and hospitalization.
- Make sure to weigh yourself daily. Weight yourself first thing each day, before you eat or drink. Notify your healthcare provider if you experience a weight gain of 2-3 lbs in a day or 5 lbs in a week. Your doctor may also recommend you track your blood pressure regularly. For more information, check out the American Heart Association’s “blood pressure toolkit.”
- Quit Smoking – Did you know that smoking can increase blood pressure and heart rate along with robbing your tissues (including your heart) of necessary oxygen? Get tips for quitting here.
- Managing Stress – Getting enough rest and managing stress levels is another way to take care of your heart. It is important to avoid overtaxing your heart when it is weak. If you are struggling with stress, anxiety, or sleep changes, consider scheduling an appointment with your healthcare provider to discuss it.
- Immunizations – Make sure to stay current with vaccines including flu, COVID and pneumonia. Having a chronic heart condition like heart failure puts you at greater risk of illness and complications.
Medications
Medication treatment for heart failure will usually include a combination of several different medication types. The goal of these medications is to:
- Widen blood vessels and reduce tension of blood vessels to improve circulation and reduce the workload on the heart.
- Reduce fluid volume. Diuretics, also known as water pills, can help your body get rid of water weight to improve swelling and reduce the heart’s work circulating the excess fluid.
- Help the heart efficiently pump blood with less effort.
- Reduce inflammation, cholesterol and narrowing of blood vessels from plaque buildup.
Surgeries/procedures
Certain devices and procedures may also be recommended for people with heart failure. If you have an irregular heartbeat, your doctor may perform a procedure to return your heart to a normal rhythm. If a valve abnormality is present, then you may require a valve replacement. LVAD (left ventricular assist device) is an implantable pump that can help your heart circulate the blood. In some cases, a heart transplant may be necessary and the LVAD can be used temporarily while waiting for transplant surgery. Your healthcare provider may recommend other treatments based on your individual needs.
Where can I find more information and support?
Whenever you receive a new diagnosis, it is normal to experience some uncertainty while adjusting to the learning curve. Talking with your healthcare professional is a great place to start; check out this “discussion guide” for tips to make the most out of your appointments. For more information and support, here is a list of additional resources
American Heart Association – education and tools
Mendedheart.org – a community of peer-peer support for patients of heart disease
American Heart Association Recipes – a free library of delicious, heart healthy recipes
Medication Assistance Programs – a list of financial resources for prescription costs
Caregiver Action Network – free education and support for family caregivers across the nation