Heart FailureÑLiving within your limits

By M. Diaa Alaoua, MD, FACC & Fadi Alsous, MD
Cardiology, Eau Claire Heart Institute

It is estimated that 2 to 3 million Americans have heart failure, and each year more than 400,000 new cases are diagnosed. The annual number of deaths approaches 200,000 and heart failure is considered the leading diagnosis at hospitals for discharged patients older than 65 years.

The term "heart failure" does not mean that the heart does not work at all, but it does indicate a serious condition, which commonly affects the heart. It is a group of symptoms, caused by more than one disease, in which the heart muscle is weakened or overloaded with blood and becomes unable to pump enough blood to meet the body's needs of oxygen and food.

The list of heart failure causes is long, with the major causes being high blood pressure and heart attack. Other less common causes are valvular heart disease and excessive alcohol intake.

When the heart muscle can not pump enough blood, the heart becomes "congested" with blood. This extra blood builds up in the lungs causing them to become heavy, resulting in shortness of breath. It can also build up in the legs causing swelling of the feet. In addition, it builds up in the liver and abdomen causing nausea and a decrease in appetite and an increase in the abdomen diameter. In general, there is an increase in body weight. On the other hand, the decrease in blood supply to the muscles will cause fatigue during exertion, and the decrease in the blood supply to the kidneys will cause a decrease in the amount of the urine, since the kidneys normally receive a significant amount of the circulating blood and remove the extra water from it.

It is important to know that not every patient with weak heart muscle will have the symptoms of heart failure that are mentioned above. In fact, a recent study conducted in Scotland reported that 50% of patients with heart failure had no symptoms. It is very important to recognize and treat those patients with clinically "silent" heart failure to prevent or delay the progression to a more clinically obvious and more deadly and financially costly condition.

How is it diagnosed?

Your doctor will ask you about your symptoms. Your provider can usually diagnose congestive heart failure from a complete physical exam.

The following tests may be done:

Electrocardiogram (a recording of the heart electrical activity)

Echocardiogram (a sound wave test)

How is it treated?

Heart failure is a serious disease. However, the proper combination of medications and a reduced salt diet will greatly improve your symptoms and can allow you to return to relatively normal living.

There are four goals in treating heart failure:

To decrease the workload on your heart

To get rid of excess water in your body

To increase the ability of your heart to pump

To treat any underlying causes or factors that may make it worse

Your provider will also put you on a low-salt diet. Too much sodium causes
your body to retain water, which increases the workload on your heart. Some nonprescription drugs are high in sodium. Ask your provider which
over-the-counter medications are safe to use.

How can I take care of myself?

Patients frequently ask questions about what they can do to help themselves.
The answer is to learn to live within the limits of your condition.

The following guidelines may help:

Get enough rest, and reduce as much as possible the emotional stress in your life. Anxiety and anger can increase your heart rate and blood pressure.

Check your pulse rate daily.

Learn how to take your blood pressure or have a family member learn how to take it.

Accept the fact that taking heart medications and limiting salt in your diet
are a permanent part of your life.

Weigh yourself at least every other day, at the same time of the day, if possible. Contact your provider if you gain more than 3 pounds in 1 week. Weight gain may mean your body is having trouble getting rid of excess fluid.

Know the symptoms of potassium loss, which include muscle cramps, muscle weakness, irritability and sometimes irregular heartbeat.

Consult a written diet and list of foods when you are planning your meals.

Increase your activities gradually.

Avoid extremes of hot and cold (including hot tubs), which may cause your heart to work harder.

Report new symptoms to your physician.

For more information, or to schedule an appointment with Dr. Alaoua or Dr. Alsous, contact Eau Claire Heart Institute » 715-839-4078.