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  Augusto E. Villa, MD, FACC, FSCAI
Diplomate American Board of Cardiovascular Diseases,
Interventional Cardiology, Endovascular Medicine,
and Internal Medicine.

600 University Boulevard, Suite 200, Jupiter, FL. 33458
Ph. (561) 627-2912 • Fax (561) 627-2207
 
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What is Congestive Heart Failure?
 

What is Congestive Heart Failure?

Congestive heart failure is a condition in which your heart can"t pump enough oxygen-rich blood to meet your body"s needs. When your heart doesn"t pump efficiently, blood may back up into your lungs and other tissues.

The severity of congestive heart failure depends on how much pumping capacity your heart has lost. As they age, most people lose some pumping capacity. However, in congestive heart failure, your heart has very little pumping capacity. Congestive heart failure often results from damage caused by a heart attack, high blood pressure, diabetes or other conditions.

Diagnosis

To diagnose heart failure, Dr. Augusto Villa will discuss with you your medical history and risk factors, he will perform a thorough physical examination and he may also recommend other tests, including:

Blood Tests: Blood tests may indicate other diseases that affect your heart. A blood test for congestive heart failure checks for levels of a hormone called B-type natriuretic peptide (BNP). Your heart secretes BNP in high levels when overworked. A large amount of BNP in the blood may suggest congestive heart failure.

Chest X-ray: An X-ray image shows the size and shape of your lungs and heart. In congestive heart failure, your heart may appear enlarged and fluid buildup may be visible in your lungs. An X-ray can also be used to diagnose other conditions.

Coronary Catheterization: In this test Dr. Augusto Villa inserts a thin, flexible tube (catheter) into a blood vessel in your groin or wrist and guides the catheter to your heart. He injects a dye into the arteries in your heart, making the arteries visible under X-ray. This test identifies narrowed arteries to your heart (coronary artery disease), which can cause congestive heart failure. The test also helps to show the strength of your heart"s main pumping chamber (left ventricle) and the health of your heart valves.

Echocardiogram: An echocardiogram uses sound waves to produce a detailed video image of your heart"s size, structure and function. These images can help Dr. Villa to determine your heart"s pumping capacity and distinguish between forms of heart failure. This test also measures the percentage of blood pumping out of the heart"s main pumping chamber.

Electrocardiogram (ECG): In this test, Dr. Villa places sensor patches with wires attached (electrodes) on your skin to measure the electrical impulses given off by your heart. This test can reveal heart rhythm disorders and damage to your heart from a heart attack.

Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields and radio waves to create detailed images of your heart.

Myocardial Biopsy: In this test, Dr. Villa inserts a small flexible biopsy cord into a vein in your neck or groin, and small pieces of the heart muscle are taken. This test is performed to diagnose certain types of heart muscle diseases that cause heart failure.

Right Heart Catheterization: In this test, Dr. Villa inserts a thin, flexible tube (catheter) into a blood vessel (vein) in your neck or groin and guides the catheter to the heart to measure pressures within the heart chambers. This helps guide treatment in heart failure.

Stress Tests: In a stress test or exercise test, you exercise on a treadmill or stationary bicycle, or take a drug to simulate heart activity during exercise, while an electrocardiogram (ECG) monitors your heart. The exercise test helps Dr. Villa judge your therapy"s effectiveness and plan the timing of more advanced treatments. Different types of stress tests measure the heart"s response to exercise in different ways and are used in different situations.

Radionuclide Ventriculography or Multiple-Gated Acquisition Scanning (MUGA): In this nuclear medicine test, Dr. Villa injects a small amount of radioactive dye into your vein and special cameras show how much blood your heart can pump with each beat.

Results of these tests helps Dr. Villa determine the cause of your symptoms and develop a treatment plan. Dr. Villa classifies heart failure based on a scale of I to IV. In Class I heart failure, the mildest form, you can perform everyday activities and not feel winded or fatigued. In Class IV, the most severe, you have shortness of breath even when you are at rest.

Treatment

Congestive heart failure treatment can significantly improve your symptoms and help your weakened heart work as efficiently as possible. Dr. Villa treats some patients by correcting the underlying cause of the condition, such as controlling a fast heart rhythm, opening blocked arteries or repairing or replacing diseased valves. Heart failure specialists also treat conditions that may aggravate your underlying heart problems, such as sleep apnea, thyroid problems, anemia and other blood abnormalities.

Congestive heart failure treatment includes surgery, medical devices, medications and lifestyle changes.

Surgery

Heart valve repair or replacement: Dr. Villa may recommend heart valve repair or replacement surgery to treat an underlying condition that led to congestive heart failure. Heart valve surgery may relieve your symptoms and improve your quality of life.

Coronary bypass surgery: Dr. Villa may recommend coronary bypass surgery to treat your congestive heart failure if your disease results from severely narrowed coronary arteries.

Heart transplant: Patients who have severe congestive heart failure may need a heart transplant.

Myectomy: In a myectomy, the surgeon removes part of the overgrown septal muscle in your heart to decrease the blockage that occurs in hypertrophic cardiomyopathy. Surgeons may perform myectomy when medication no longer relieves your symptoms.

Medical devices

Ventricular assist device (VAD): When your weakened heart needs help pumping blood, surgeons may implant a VAD into your abdomen and attach it to your heart. These mechanical heart pumps can be used either as a "bridge" to heart transplant or as permanent therapy for people who aren"t candidates for a transplant.

Cardiac Resynchronization Therapy (CRT) device (biventricular cardiac pacemaker): A cardiac resynchronization therapy device (biventricular cardiac heart pacemaker) sends specifically timed electrical impulses to your heart"s lower chambers. CRTs are suitable for people who have moderate to severe congestive heart failure and abnormal electrical conduction in the heart.

Internal cardiac defibrillator (ICD): Dr. Villa may implant ICDs under the skin to monitor and treat fast or abnormal heart rhythms (arrhythmias), which occur in some patients who have heart failure. The ICD sends electrical signals to your heart if it detects a high or abnormal rhythm to shock your heart into beating more slowly and pumping more effectively.

Medications

Dr. Augusto Villa usually treats patients who have congestive heart failure with medications proven to relieve symptoms and increase survival in people who have heart failure. He may also prescribe medications to lower blood pressure, improve circulation and prevent blocked arteries or blood thinners to prevent blood clots.

Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors lower blood pressure, improve blood flow and decrease your heart"s workload.

Angiotensin II (A-II) receptor blockers: These drugs provide several benefits of ACE inhibitors without the potential side effect of a persistent cough.

Beta blockers: Beta blockers slow the heart rate, lower blood pressure and lessen the risk of some abnormal heart rhythms.

Digoxin: Also known as digitalis, digoxin increases the strength of heart contractions and tends to slow your heartbeat.

Diuretics: Diuretics prevent fluid from collecting in your body and decrease fluid in your lungs, making breathing easier.

Nesiritide: Nesiritide, which is given through a vein (intravenously), is a synthetic version of B-type natriuretic peptide (BNP), a hormone that occurs naturally in your body.

Aldosterone antagonists: These medications may help your heart work better, reverse scarring of the heart and help prolong your life if you have severe congestive heart failure.

Inotropes: These are intravenous medications used in severe heart failure patients to improve heart pumping function and maintain blood pressure.

Lifestyle Changes

Lifestyle changes often can relieve symptoms of congestive heart failure and prevent your disease from worsening. Some changes you can make include:

  • Avoiding or limiting alcohol to one drink two or three times a week.
  • Avoiding or limiting caffeine.
  • Eating a low-fat, low-sodium diet.
  • Exercising by yourself or in a structured cardiac rehabilitation program.
  • Maintaining a healthy weight or losing weight if you"re overweight.
  • Quitting smoking.
  • Reducing stress.

 

 

 

 

 
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