Recognizing the FACES of heart failure

Heart failure is a condition with many faces. It can affect all ethnic groups, all ages and it’s important to know that it is not just people near the end of their lifespan who develop it.  Unfortunately, heart failure can even affect people in the prime of their life. 

Heart failure – just the name itself sounds menacing and somewhat confusing.  The nomenclature gives the impression that the heart has stopped beating to be called “heart failure” but that’s not the case at all.  The heart has not failed completely but is does mean your heart is not pumping blood as efficiently as it should.  The heart is still beating but it is not able to keep up with the body’s constant need for blood and oxygen each and every day.

What is heart failure?

Heart failure is one of the most common reasons why people over the age of 65 are admitted into the hospital.  In fact, around 5.7 million Americans live with heart failure with those past the age of 40 having a one-in-five chance of developing the condition in their lifetime.   Heart failure can take a long time to develop leading to the heart becoming weaker and less capable of pumping blood throughout the body.

Over time as heart failure develops, the body will try to compensate for an inadequate blood supply.  To keep the heart beating, stress hormones rise as blood vessels narrow to keep blood pressure stable.  It’s important for blood to continually reach the heart and brain so to keep that happening, the body will divert blood away from less critical tissue.  During this overcompensation, sodium and fluid will be retained in an attempt to supplement the volume of circulating blood.

 Causes of heart failure

There can be a multitude of causes leading to heart failure.  The most common cause is coronary artery disease (CAD).  CAD can occur when arteries supplying blood to the heart muscle narrow due to buildup of fatty deposits called plaque. 

Other causes of heart failure include:

·      Heart defects since birth

·      Past heart attack that damaged the heart muscle

·      High blood pressure

·      Heart valve disease

·      Being overweight

·      Diabetes

·      Thyroid issues

·      Alcohol or drug abuse

·      Infection of the heart or the heart valves

·      Certain types of chemotherapy

 FACES of heart failure

To help both doctors and patients quickly spot a possible combination of heart failure symptoms, the Heart Failure Society of America developed a handy tool that goes by the acronym FACES:

F=Fatigue – When the heart can’t pump enough oxygen-rich blood to meet the body’s energy needs, a general feeling of tiredness or fatigue sets in.

A=Activity limitation – People with heart failure are often unable to do their normal activities because they become easily tired and short of breath.

C=Congestion – Fluid buildup in the lungs can result in coughing, wheezing, and breathing difficulty.

E=Edema or ankle swelling – When the heart doesn’t have enough pumping power to force used blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs, and abdomen.   Excess fluid can also cause rapid weight gain.

S=Shortness of breath – Fluid in the lungs makes it more difficult for carbon dioxide in used blood to be exchanged for fresh oxygen.  It may also be harder to breathe when lying down because gravity allows fluid from below the lungs to travel up the torso. 

By themselves, these five warning signs do not confirm a diagnosis of heart failure, but they do convey a sense of urgency to seek advice from your healthcare provider. 

Diagnosing heart failure

When being seen for possibly having heart failure, your doctor will conduct a physical exam in addition to using two tools to spot the presence of this condition.  One is an echocardiogram which is a simple, noninvasive test that uses ultrasound to create images of your heart while it beats.  If it shows a lower-than-normal percentage of blood leaving the heart when the left ventricle contracts, there is a strong possibility of heart muscle damage.  Other findings pointing to heart failure include abnormal thickening and ballooning of the heart wall and malfunctioning heart valves. 

The second tool is to look for biomarkers in the blood to help identify early-onset heart failure.  One such type of biomarker is B-type natriuretic peptide, which is released when the heart is under stress.  Once the diagnosis is confirmed that you have heart failure, further testing may be necessary to figure out what’s causing the heart’s dysfunction and to determine the best treatment approach.

How is heart failure treated and managed?

Fortunately, there are a number of treatment methods that can be successful at managing heart failure.  In the past, people with heart failure had an average life span after diagnosis of about 5 years.  Now, thanks to earlier diagnosis and advances in how it is treated, many people with heart failure can enjoy many more years of life ahead.

Here are some ways heart failure can be treated:

·      Medications can be given to strengthen the heart along with water pills to rid the body of excess fluid.

·      Follow a low-sodium diet

·      Possibly treated with oxygen for use at home

·      In some cases, surgery or cardiac devices may be needed

Once a person is told they have heart failure, there are many lifestyle changes they should make that will be important in managing the condition.  Incorporating these changes will be necessary in order to prevent further damage to the heart leading to even more serious consequences. 

Here are some lifestyle habits a person can do to manage heart failure:

·      Quit smoking if you smoke

·      Take all medications prescribed

·      Weigh yourself daily checking for weight gain causes by fluid retention

·      Keep track of your daily fluid intake

·      Monitor blood pressure daily

·      If overweight, lose weight and strive to reach and maintain a healthy body weight

·      Avoid or limit alcohol and caffeine

·      Consume a heart-healthy diet low in sodium, saturated fat and trans fat

·      Reduce sodium intake by consuming less salt and salty foods

·      Be physically active on a regular basis

·      Get adequate sleep