Heart Failure

Heart failure is a common condition affecting over 5 million Americans with over a half million new patients diagnosed each year.  Heart failure is a condition in which the heart is unable to meet the needs of the body, most often manifesting with symptoms of increased shortness of breath during activity or even at rest.  Other common symptoms include fatigue, swelling particularly of the legs associated with weight gain, abdominal bloating, chest pain, and passing out episodes.

The most common cause of heart failure in the United States is heart attacks due to coronary artery disease which leaves the heart muscle weakened and unable to pump a proper amount of blood.  Other common causes of heart failure include high blood pressure and heart valves that may be narrowed or leaking.   Frequently, heart failure may occur even when the pump function is normal.  This occurs when the heart muscle has become stiff, often due to hypertension.

Heart failure usually can be diagnosed based on a patient’s symptoms and physical exam.  Routine tests including bloodwork, an ECG, and a chest x-ray are done to confirm the diagnosis and determine the reason why a patient has developed heart failure.  Commonly, an echocardiogram, an ultrasound of the heart, is ordered to evaluate the pumping and relaxing ability of the heart as well as to evaluate the heart valves for leakage or narrowing.  Further heart testing may be needed in some patients.

Limiting the amount of sodium intake is very important in treating heart failure, as well as avoiding certain medications such as ibuprofen which can lead to sodium and water retention.  There are a number of medical therapies for patients with heart failure.  The most effective medicines include diuretics, ace-inhibitors, beta-blockers, and digoxin. 

Your doctor will determine the best regimen of medications which may include some or all of the above.  Other therapies including special pacemakers are available for certain patients with heart failure that do not respond to routine dietary and medical therapy.

Shaun D. Harper, M.D.

(The author has no financial incentive to promote any particular brand or type of therapy.)