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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 Heart Failure?
 

What Is Heart Failure?

Heart failure is a condition in which the heart can"t pump enough blood to meet the body"s needs. In some cases, the heart can"t fill with enough blood. In other cases, the heart can"t pump blood to the rest of the body with enough force. Some people have both problems.

The term "heart failure" doesn"t mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care.

Heart failure develops over time as the heart"s pumping action grows weaker. The condition can affect the right side of the heart only, or it can affect both sides of the heart. Most cases involve both sides of the heart.

Right-side heart failure occurs if the heart can"t pump enough blood to the lungs to pick up oxygen. Left-side heart failure occurs if the heart can"t pump enough oxygen-rich blood to the rest of the body.

Right-side heart failure may cause fluid to build up in the feet, ankles, legs, liver, abdomen, and the veins in the neck. Right-side and left-side heart failure also may cause shortness of breath and fatigue (tiredness).

What Causes Heart Failure?

Conditions that damage or overwork the heart muscle can cause heart failure. Over time, the heart weakens. It isn"t able to fill with and/or pump blood as well as it should.

As the heart weakens, certain proteins and substances might be released into the blood. These substances have a toxic effect on the heart and blood flow, and they worsen heart failure.

Common Causes of Heart Failure

The most common causes of heart failure are coronary heart disease (CHD), high blood pressure, and diabetes. Treating these problems can prevent or improve heart failure.

Other diseases and conditions also can lead to heart failure, such as:

  • Cardiomyopathy or heart muscle disease. Cardiomyopathy may be present at birth or caused by injury or infection.
  • Heart valve disease. Problems with the heart valves may be present at birth or caused by infection, heart attack, or damage from heart disease.
  • Arrhythmias or irregular heartbeats. These heart problems may be present at birth or caused by heart disease or heart defects.
  • Congenital heart defects. These problems with the heart"s structure are present at birth.

Who Is at Risk for Heart Failure?

About 5.8 million people in the United States have heart failure. The number of people who have this condition is growing.

Heart failure is more common in:

  • People who are 65 years old or older.
  • African Americans. African Americans are more likely to have heart failure than people of other races.
  • People who are overweight.
  • People who have had a heart attack.
  • Men. Men have a higher rate of heart failure than women.

What Are the Signs and Symptoms of Heart Failure?

The most common signs and symptoms of heart failure are:

  • Shortness of breath or trouble breathing
  • Fatigue (tiredness)
  • Swelling in the ankles, feet, legs, abdomen, and veins in the neck

How Is Heart Failure Diagnosed?

Dr. Augusto Villa will diagnose heart failure based on your medical and family histories, a physical exam, and test results. The signs and symptoms of heart failure also are common in other conditions. Thus, Dr. Villa will:

  • Find out whether you have a disease or condition that can cause heart failure, such as coronary heart disease (CHD), high blood pressure, or diabetes.
  • Rule out other causes of your symptoms.
  • Find any damage to your heart and check how well your heart pumps blood.

Early diagnosis and treatment can help people who have heart failure live longer, more active lives.

Medical and Family Histories

Dr. Villa will ask whether you or others in your family have or have had a disease or condition that can cause heart failure.

Dr. Villa also will ask about your symptoms. He will want to know which symptoms you have, when they occur, how long you"ve had them, and how severe they are. Your answers will help show whether and how much your symptoms limit your daily routine.

Physical Exam

During the physical exam, Dr. Villa will:

  • Listen to your heart for sounds that aren"t normal.
  • Listen to your lungs for the sounds of extra fluid buildup.
  • Look for swelling in your ankles, feet, legs, abdomen, and the veins in your neck.

Diagnostic Tests

No single test can diagnose heart failure. If you have signs and symptoms of heart failure, Dr. Villa may recommend one or more of the following tests.

  • EKG (Electrocardiogram)
  • Chest X Ray
  • BNP Blood Test (checks the level of a hormone in your blood)
  • Echocardiography
  • Doppler Ultrasound
  • Holter Monitor
  • Nuclear Heart Scan
  • Cardiac Catheterization
  • Coronary Angiography
  • Stress Test
  • Cardiac MRI (magnetic resonance imaging)

How Is Heart Failure Treated?

Early diagnosis and treatment can help people who have heart failure live longer, more active lives. Treatment for heart failure will depend on the type and stage of heart failure (the severity of the condition).

The goals of treatment for all stages of heart failure include:

  • Treating the condition"s underlying cause, such as coronary heart disease (CHD), high blood pressure, or diabetes.
  • Reducing symptoms.
  • Stopping the heart failure from getting worse.
  • Increasing your lifespan and improving your quality of life.

Treatments usually include lifestyle changes, medicines, and ongoing care. If you have severe heart failure, you also may need medical procedures or surgery.

Lifestyle Changes

Simple changes can help you feel better and control heart failure. The sooner you make these changes, the better off you"ll likely be.

A Heart Healthy Diet

Following a heart healthy diet is an important part of managing heart failure. In fact, not having a proper diet can make heart failure worse. Ask Dr. Villa to create an eating plan that works for you.

A healthy diet includes a variety of vegetables and fruits. It also includes whole grains, fat-free or low-fat dairy products, and protein foods, such as lean meats, eggs, poultry without skin, seafood, nuts, seeds, beans, and peas.

A healthy diet is low in sodium (salt), solid fats (saturated fat), added sugars and refined grains. A balanced, nutrient-rich diet can help your heart work better. Getting enough potassium is important for people who have heart failure. Some heart failure medicines deplete the potassium in your body. Lack of potassium can cause very rapid heart rhythms that can lead to sudden death.

Fluid Intake

It"s important for people who have heart failure to drink the correct amounts and types of fluid. Drinking too much fluid can worsen heart failure. Also, if you have heart failure, you shouldn"t drink alcohol.

Talk with your doctor about what amounts and types of fluid you should have each day.

Other Lifestyle Changes

Taking steps to control risk factors for CHD, high blood pressure, and diabetes will help control heart failure. For example:

  • Lose weight if you"re overweight or obese. Work with your health care team to lose weight safely.
  • Be physically active (as your doctor advises) to become more fit and stay as active as possible.
  • Quit smoking and avoid using illegal drugs. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke. Smoking and drugs can worsen heart failure and harm your health.
  • Get enough rest.

Medicines

Dr. Villa will prescribe medicines based on the type of heart failure you have, how severe it is, and your response to certain medicines. The following medicines are commonly used to treat heart failure:

  • Diuretics (water or fluid pills) help reduce fluid buildup in your lungs and swelling in your feet and ankles.
  • ACE inhibitors lower blood pressure and reduce strain on your heart. They also may reduce the risk of a future heart attack.
  • Aldosterone antagonists trigger the body to get rid of salt and water through urine. This lowers the volume of blood that the heart must pump.
  • Angiotensin receptor blockers relax your blood vessels and lower blood pressure to decrease your heart"s workload.
  • Beta blockers slow your heart rate and lower your blood pressure to decrease your heart"s workload.
  • Isosorbide dinitrate/hydralazine hydrochloride helps relax your blood vessels so your heart doesn"t work as hard to pump blood. Studies have shown that this medicine can reduce the risk of death in African Americans. More studies are needed to find out whether this medicine will benefit other racial groups.
  • Digoxin makes the heart beat stronger and pump more blood.

Medical Procedures and Surgery

As heart failure worsens, lifestyle changes and medicines may no longer control your symptoms. You may need a medical procedure or surgery.

If you have heart damage and severe heart failure symptoms, Dr. Villa might recommend a cardiac resynchronization therapy (CRT) device or an implantable cardioverter defibrillator (ICD).

In heart failure, the right and left sides of the heart may no longer contract at the same time. This disrupts the heart"s pumping. To correct this problem, Dr. Villa might recommend to implant a CRT device (a type of pacemaker) near your heart. This device helps both sides of your heart contract at the same time, which can decrease heart failure symptoms.

Some people who have heart failure have very rapid, irregular heartbeats. Without treatment, these heartbeats can cause sudden cardiac arrest. Dr. Villa might recommend to implant an ICD near your heart to solve this problem. An ICD checks your heart rate and uses electrical pulses to correct irregular heart rhythms.

People who have severe heart failure symptoms at rest, despite other treatments, may need:

  • A mechanical heart pump, such as a left ventricular assist device. This device helps pump blood from the heart to the rest of the body. You may use a heart pump until you have surgery or as a long-term treatment.
  • Heart transplant. A heart transplant is an operation in which a person"s diseased heart is replaced with a healthy heart from a deceased donor. Heart transplants are done as a life-saving measure for end-stage heart failure when medical treatment and less drastic surgery have failed.
  • Experimental treatments. Studies are under way to find new and better ways to treat heart failure.

How Can Heart Failure Be Prevented?

You can take steps to prevent heart failure. The sooner you start, the better your chances of preventing or delaying the condition.

For People Who Have Healthy Hearts

If you have a healthy heart, you can take action to prevent heart disease and heart failure. To reduce your risk of heart disease:

  • Follow a healthy diet.
  • If you smoke, make an effort to quit.
  • If you"re overweight or obese, try to lose weight.
  • Be physically active. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week.
  • Avoid using illegal drugs.

For People Who Are at High Risk for Heart Failure

Even if you"re at high risk for heart failure, you can take steps to reduce your risk. People at high risk include those who have coronary heart disease, high blood pressure, or diabetes.

  • Follow all of the steps listed above. Talk with Dr. Villa about what types and amounts of physical activity are safe for you.
  • Treat and control any conditions that can cause heart failure. Take medicines as your doctor prescribes.
  • Avoid drinking alcohol.

 

 
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