About Heart Failure


Heart failure was the topic at a recent free community seminar at Swedish Medical Center. Below we share with you some of the questions and answers discussed at the seminar.

What is heart failure?

Your heart is a muscle and its main function is to pump blood throughout the body. Heart failure means that your heart is not pumping blood adequately. The "pump"is failing. Either your heart muscle is weak and cannot pump out adequate amounts of blood, or your heart is stiff and is not able to fill with enough blood.

What symptoms will I notice if I have heart failure?

Most people notice fatigue, shortness of breath, swelling, rapid weight gain and sometimes cough.

What tests diagnose heart failure?

The standard test to determine if heart failure is present is the echocardiogram. It is an ultrasound of the heart that can measure the strength of the heart beats and determine if the heart is relaxed enough in between heart beats. The term for the amount of blood pumped out of the heart is "Ejection Fraction" (EF). Normal is over 55%. If you have been diagnosed with heart failure and your EF is less than 55%, you have a weakened heart muscle; if it is 55 or greater, your heart is stiff. Another test is the BNP. This is a blood test that can be done to help determine if you have heart failure. If it is high, you may have some degree of heart failure flare up, though other illnesses can cause it to go up. A standard chest X-ray is also helpful in determining if the heart is enlarged and to see if there is fluid in the lungs.

What puts me at risk for developing heart failure?

Risk factors for developing heart failure are high blood pressure, history of heart attack or blocked heart arteries, disease of heart valves, viral infections of the heart, excess alcohol intake, family history, certain chemotherapy agents, birth defects and heart rhythm disturbances. There are some cases of heart failure in which we are unable to determine the cause.

How is heart failure treated?

There are several medications that have proven to improve quality of life, slow the progression of the disease and help you to live longer. These medicines block certain chemicals that the body produces as a result of lower blood flow. Blocking these chemicals helps to protect the heart and the kidneys while allowing the heart to work more efficiently. Beta Blockers and ACE Inhibitors are two types of medications that are most prescribed. They help the heart relax and beat stronger, and they lower the blood pressure so the heart does not have to beat against high pressures. Many people require water pills to get rid of extra fluid that results in swelling. If you are on a water pill then you will probably also be given a potassium supplement. Occasionally digitalis is used to help strengthen and slow the heart. Whatever medication your doctor puts you on, it is important to take them as prescribed. Do not stop any medication unless instructed to do so. Sometimes people feel a lot better on their medications and stop taking thembecause they think they no longer need it. Remember, the medication does not cure the disease, but only manages it. If medication is stopped without a doctor’s recommendation, the heart failure can worsen.

There are special pacemakers available for people who have a block in the electrical pathway of the heart. This type of block causes the right and left side of the heart to beat at slightly different times, which weakens the heart. This can be corrected with a pacemaker that stimulates the right and left side to beat together so that more blood is ejected out with each heart beat.

If heart failure is caused by malfunctioning heart valves, surgery may be recommended to repair or replace the valve. If there are blockages in heart arteries, you may experience improvement by restoring circulation to the heart muscle. This can be accomplished with either stents in the heart arteries or by undergoing bypass surgery.

What can I do to help treat my heart failure?

Staying on your medication and keeping all your doctor’s appointments are crucial to maintaining good heart health. Notify your doctor if you experience rapid weight gain, swelling or increased shortness of breath.

Cutting down on the amount of sodium in your diet is just as important as taking your medication. In most cases it is recommended you not have more than 2000 mg of sodium in a day. You will need to read labels to determine the sodium content of different foods. Most of the sodium we consume comes from processed foods such as deli meats, canned foods, frozen meals, bacon, ham and sausage. Dieticians are available to help you learn how to reduce your salt intake.

Omega 3 fatty acids also have a small benefit for some people with heart failure. Ask your doctor if this is right for you.

If you smoke, ask your doctor how you can quit. If you drink more than one alcoholic beverage in a day cut back to one a day or stop altogether.

Be sure you are up to date with the pneumonia vaccine and get an annual flu shot.

Remember, heart failure does not mean your heart has stopped beating, but that your heart is not pumping as well as it should. It is important that you and your doctor work together to help manage your symptoms so you feel better and prevent the heart from weakening any further.

Learn about the American Heart Association's Practice Guidelines for the Diagnoses and Management of Heart Failure in Adults