Topic Overview
What is heart failure?
Heart failure means that your heart muscle does not
pump as much blood as your body needs. Failure does not mean that your heart
has stopped. It means that your heart is not pumping as well as it
should.
Because your heart cannot pump well, your body tries to
make up for it. To do this:
- Your body holds on to salt and water. This increases the
amount of blood in your bloodstream.
- Your heart beats faster.
- Your heart gets bigger. See a picture of an
enlarged heart.
Your body has an amazing ability to make up for heart
failure. It may do such a good job that you don't know you have a disease. But
at some point, your heart and body will no longer be able
to keep up. Then fluid starts to build up in your body, and you have symptoms
like feeling weak and out of breath.
This fluid buildup is called
congestion. It's why some doctors call the disease congestive heart failure.
Heart failure usually gets worse over time. But treatment can
slow the disease and help you feel better and live longer.
What causes heart failure?
Anything that damages
your heart or affects how well it pumps can lead to heart failure. Common causes of heart failure are:
Other conditions that can lead to heart failure
include:
What are the symptoms?
Symptoms of heart failure
start to happen when your heart cannot pump enough blood to the rest of your
body. In the early stages, you may:
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Feel tired easily.
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Be short of breath when you exert
yourself.
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Feel like your heart is pounding or
racing (palpitations).
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Feel weak or dizzy.
As heart failure gets worse, fluid starts to build up in
your lungs and other parts of your body. This may cause you to:
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Feel short of breath even at
rest.
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Have swelling (edema), especially in
your legs, ankles, and feet.
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Gain weight. This may happen over just
a day or two, or more slowly.
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Cough or wheeze, especially when you
lie down.
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Need to urinate more at night.
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Feel bloated or sick to your stomach.
If your symptoms suddenly get worse, you will need
emergency care.
How is heart failure diagnosed?
Your doctor may
diagnose heart failure based on your symptoms and a physical exam. But you will
need tests to find the cause and type of heart failure so that you can get the
right treatment. These tests may include:
An echocardiogram is the best and
simplest way to find out if you have heart failure, what type it is, and what
is causing it. Your doctor can also use it to see if your heart failure is
getting worse. It can measure how much blood your heart pumps to your body.
This measurement is called the
ejection fraction. If your ejection fraction gets
lower and you are having more symptoms, it means that your
heart failure is getting worse.
How is it treated?
Most people with heart failure need to take several
medicines. Your doctor may prescribe medicines to:
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Help keep heart failure from getting worse. These drugs include ACE inhibitors, angiotensin II receptor
blockers (ARBs), beta-blockers, and vasodilators like hydralazine and
nitroglycerin.
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Reduce symptoms so you feel better.
These drugs include diuretics (water pills), digoxin, and potassium.
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Treat the cause of your heart
failure.
It is very important to take your medicines exactly as
your doctor tells you to. If you don't, your heart failure could get worse.
Depending on the cause of your heart failure, you might need
surgery to help your heart work better. For example:
-
You might have
bypass surgery
or
angioplasty
to
open clogged arteries, or you may need surgery to repair or replace a heart
valve.
-
You might need to have a
pacemaker
or a
defibrillator
if you have a
problem with your heart rhythm. These help your heart keep a steady
rhythm.
Lifestyle changes are an important part of treatment.
They can help slow down heart failure. They may also help control other
diseases that make heart failure worse, such as high blood pressure, diabetes,
and coronary artery disease. The best steps you can take are to:
-
Eat less salt (sodium). Sodium causes your body to retain water and makes it
harder for your heart to pump. Your doctor may also ask you to
limit how much fluid you drink.
-
Get regular exercise. Your doctor can
tell you what level of exercise is safe for you, how to check your
pulse, and how to know if you are doing too much.
-
Take rest breaks during the day.
-
Lose weight if you are overweight. Even
a few pounds can make a difference.
-
Stop smoking. Smoking damages your
heart and makes exercise harder to do.
-
Limit alcohol. Ask your doctor how
much, if any, is safe.
To stay as healthy as possible, work closely with your
doctor. Have all your tests, and go to all your appointments. It is also
important to:
- Talk to your doctor before you take any
new medicine, including nonprescription and prescription drugs, vitamins, and
herbs. Some of them may make your heart failure worse.
- Keep track of your symptoms. Weigh yourself at the
same time every day, and write down your weight. Call your doctor if
you have a sudden weight gain, a change in your ability to exercise, or any
sudden change in your symptoms.
What can you expect if you have heart failure?
Medicines and lifestyle changes can slow or even reverse heart failure
for some people. But heart failure often gets worse over time.
Early on, your symptoms may not be too bad. As heart failure
gets worse, you may need to limit your activities.
Treatment can often help reduce symptoms, but it usually does not get rid of
them.
Heart failure can also lead to other health problems. These
may include:
Your doctor may be able to give you medicine or other
treatment to prevent or treat these problems.
Heart failure can
get worse suddenly. If this happens, you will need emergency care. To prevent
sudden heart failure, you need to avoid things that
can trigger it. These include eating too much salt, missing a dose of your
medicine, and exercising too hard.
You may want to think about
planning for the future. A
living will lets doctors know what type of
life-support measures you want if your health gets much worse. You can also
choose a
health care agent to make decisions in case you are
not able to. It can be comforting to know that you will get the type of care
you want.
Knowing that your health may get worse can be hard. It
is normal to sometimes feel sad or hopeless. But if these feelings last, talk
to your doctor. Antidepressant medicines, counseling, or
both may help you cope.
Frequently Asked Questions
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Learning about heart failure:
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Being diagnosed:
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Getting treatment:
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Ongoing concerns:
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Living with heart failure:
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End-of-life issues:
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Cause
Many problems can cause
heart failure, including damage to the heart's muscle,
valves, or electrical system. These can all affect how well the heart
pumps.
Problems that damage the heart
muscle
Other things that damage the heart's
valves
Problems with the heart's electrical
system
- Fast, slow, or irregular heart rhythms,
including
atrial fibrillation
- Electrical
signals that don't flow as they should from the upper to the lower part of the
heart (heart block)
Other problems
- Disease of the sac
around the heart (pericarditis)
- Postpartum heart failure.
This rare problem can happen late in a
woman's pregnancy or within the first 5 months after
delivery.
- Severe
anemia
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Hyperthyroidism
Certain triggers,
such as too much sodium or not taking medicines the right way, may
suddenly make heart failure worse. This can sometimes cause deadly
problems such as
pulmonary edema or
cardiogenic shock.
Symptoms
At first you may not have any
symptoms from heart failure. But as your heart has more
trouble pumping enough blood to your body, you may get short of breath when you
walk or do other activities. You also may feel very tired.
Your heart will try to
make up for heart failure by pumping faster and by
pumping more blood with each beat. But over time, these efforts can make your
heart weaker and can make symptoms worse.
Main symptoms of heart
failure
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Symptom
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What
happens?
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Shortness of breath
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- You can't catch your breath.
- You feel tightness in
your chest.
- You feel tired when you
walk.
- You need to stop a
lot when you walk.
- It may get worse when you lie flat, and it may
wake you up at night.
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Swelling in the feet and ankles
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- It gets worse at the end of the day
or after you stand for long periods.
- It may hurt.
- Pressure can leave impressions in
your skin.
- Shoes may no longer fit.
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Being very tired (fatigue)
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- You have less energy
and feel more tired than usual.
- You can't exert yourself like you could
before.
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Abnormal heartbeat
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- Your heart races or pounds.
- Your heart skips beats (palpitations).
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Change in urination
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- You urinate
more at night.
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Weight gain
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- Fluid builds up, and weight goes up
quickly.
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How doctors talk about heart
failure
- Heart failure is grouped—or
classified—according to symptoms.
Your treatment is based partly on what class of symptoms you
have.
- There's also another way to define heart failure.
It's based on the
stages you might go through as your heart failure gets
worse. Your doctor also may make treatment choices based on your stage of heart
failure.
Symptoms of sudden heart failure
Sometimes your symptoms may get worse very quickly. This is
called sudden heart failure. It causes fluid to build up in your lungs, causing
congestion. (This is why the problem is often called congestive heart
failure.) Symptoms may include:
- Severe shortness of breath.
- An irregular or fast heartbeat.
- Coughing up foamy, pink mucus.
Sudden heart failure is an emergency.
You need care right away.
When to Call a Doctor
Call
911
or other emergency services immediately if you have:
- Chest pain that has not gone away within 5 minutes after
you have taken one nitroglycerin dose and/or
rested, especially if the pain is pressing or crushing and
occurs with shortness of breath, sweating, and nausea.
- Symptoms of a
stroke. These include:
- Sudden
numbness, tingling, weakness, or paralysis in your face, arm, or leg,
especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble
understanding simple statements.
- Sudden problems with walking or
balance.
- A sudden, severe headache that is different from past
headaches.
- Symptoms of
sudden heart failure, such as:
- Severe shortness of breath (trouble getting a breath even
when resting).
- Suddenly getting an irregular
heartbeat that lasts for a while, or getting a very
fast heartbeat along with dizziness,
nausea, or fainting.
- Foamy, pink mucus with a cough and shortness of
breath.
Call your doctor soon if you have symptoms of
heart failure, which include:
- Being very tired or having weakness that
prevents you from doing your usual activities.
- Trouble breathing during routine activities
or exercise that did not cause problems before.
- Shortness of breath when you lie down.
- Waking up at night with shortness of breath or feeling as though
you are suffocating.
- A dry, hacking cough, especially when you lie down.
- Sudden weight gain, such as
3 lb (1.4 kg) or more in 2 to 3
days.
- Increased fluid buildup in your body (most often in the
legs).
Also call your doctor soon if you have been
diagnosed with heart failure and your symptoms get worse. In
general, it is a good idea to call your doctor anytime you have a sudden change
in symptoms.
Call your doctor right away if you have a pacemaker or ICD and think you have an infection near the device. Signs of an infection include:
- Changes in the skin around your pacemaker or ICD, such as:
- Swelling.
- Warmth.
- Redness.
- Pain.
- Unexplained fever.
Watchful waiting
You can
try home treatment for symptoms such as
mild fluid buildup (edema) and feeling very tired. But sudden shortness of breath, even if it is
mild, should always be checked by your doctor.
- If symptoms go away and don't return, you
may not need more treatment.
- See your doctor if you
often need home treatment to keep even minor symptoms
under control.
Who to see
The following health professionals can
treat you for heart failure:
Exams and Tests
Heart failure
is a complex
problem. So you will likely have
several different tests over time. These tests can:
- Find out if you have heart failure.
- Find
the cause of your heart failure.
- Find the
type of heart failure you have.
- Show how
bad your heart failure is (class and
stage).
- See how well
your treatment is working.
If you have symptoms that suggest heart failure,
you may have:
An
echocardiogram is the best and simplest way to
diagnose heart failure. It also can help guide
treatment.
Sometimes, because of a person's weight,
breast size, or severe lung disease, an echocardiogram might not be accurate.
If that happens, a
cardiac blood pool scan may be done
instead. It checks how well the left ventricle is
pumping. But it's not as good at finding
heart valve disease and a thick
heart muscle.
Tests also may be done to find areas of the heart that are not getting enough blood. These tests include:
Treatment Overview
Your treatment for
heart failure depends on:
Sometimes
heart failure can be fixed if another problem can be corrected, such as
by replacing a heart valve or treating hyperthyroidism.
Heart failure
caused by a heart attack may be treated with coronary artery bypass surgery or
angioplasty, medicine, and
cardiac rehabilitation.
Initial treatment
In the early stages of
heart failure, you'll take medicines and make
lifestyles changes that can improve your symptoms. Treatment also may prevent
more damage to your heart.
You will have
regular doctor visits to see how treatment is working and to make changes to
your care as needed.
Medicines
You will likely
take:
You also will likely take medicines to treat
the cause of your heart failure. For more information, see the
Medications section.
It's very important to take your medicines exactly as your
doctor prescribes.
Lifestyle changes
You will need to make some changes in your daily life to treat
heart failure. Your doctor may ask you to:
- Eat less salt.
- Be more active.
- Stay at a healthy weight, or lose weight if you
need to. Even
a few pounds can make a difference.
- Stop smoking.
- Limit alcohol.
- Control your blood pressure.
- Control your diabetes.
- Limit how much
fluid you drink.
Making lifestyle changes can be hard. For
more information, see the
Living With Heart Failure section.
Ongoing treatment
You will keep
following your lifestyle changes, such as limiting sodium, not smoking, and
being active.
Your doctor will add other medicines and
other treatments as you need them. Your doctor also will try to
prevent or treat problems—such as fever,
arrhythmia, and
anemia—that can lead to
sudden heart failure.
Your
treatment may include:
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Getting vaccines. Your doctor may want you to get vaccines against
pneumonia and the flu
(influenza). These vaccines can keep you from getting
infections that could put you in the hospital.
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Checking your weight. Your doctor will probably give you
guidelines for watching fluid buildup and tell you how much weight gain is too
much.
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Getting devices to fix heart rhythm problems. In some cases, your doctor may recommend a
biventricular pacemaker that is
placed in your chest to keep your heart beating at a normal rhythm. This is also called cardiac resynchronization therapy (CRT). Or you may
have an
implantable cardioverter-defibrillator (ICD) to stop a deadly rhythm. Some people get a pacemaker that is combined with an
ICD.
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Oxygen treatment. Your doctor may recommend
oxygen therapy to reduce your
shortness of breath and increase your ability to exercise.
Treatment if your condition gets
much worse
In some cases when standard
treatment doesn't help, you may have other
treatments. These include:
But these are options for only a very small number of
people.
Palliative care
As your heart
failure gets worse, you may want to think about
palliative care. It's a kind of
care for people who have illnesses that don't go away and often get worse over
time. It's different than care to cure your illness. But
some people combine both types of care.
Palliative care:
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May improve your quality of life—not just in your body, but also in your mind and
spirit.
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May help you manage symptoms or side
effects from treatment.
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Can help you cope
with your feelings about living with a long-term illness.
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Can help you make plans around your medical
care.
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Can help your family better understand
your illness and how to support you.
If you are interested in palliative care, talk to
your doctor. He or she may be able to manage your care or refer you to a doctor
who specializes in this type of care.
For more information, see
the topic
Palliative Care.
End-of-life care
Because heart failure tends to get worse over
time, it's important to think about what kind of care you would like at the end
of your life. It's also important that your doctor and family know what you
want.
An advance directive is a
legal document that tells doctors how to care for you at
the end of your life. For more information, see
End-of-Life Decisions.
Prevention
The
best way to prevent
heart failure is to:
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Lower your risk of getting heart disease by making lifestyle changes.
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Control certain health problems, such as
high blood pressure and
diabetes.
To reduce your risk:
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Don't smoke. If you
smoke, quit. Smoking greatly increases your risk for heart disease. Avoid
secondhand smoke too.
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Lower your cholesterol. If you have
high cholesterol, follow your doctor's advice for
lowering it. Eating a heart-healthy diet—such as the
TLC diet —exercising, and quitting
smoking will help keep your cholesterol low.
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Control your blood pressure. High blood pressure raises your risk of getting heart
disease and heart failure. Exercising,
limiting alcohol, and controlling stress will help keep your blood pressure in
a healthy range.
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Get regular exercise. Exercise will help
control your weight, blood pressure, and stress. Controlling these things will help keep
your heart healthy. Try to do activities that raise your heart rate. Aim
for at least 2½ hours of
moderate exercise a week.
One way to do this is to be active at least 10 minutes 3 times a day, 5 days a
week. Talk to your doctor before starting an exercise
program.
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Control diabetes. Take your medicines as directed, and
work with your doctor to make a diet and
exercise plan to control diabetes.
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Limit alcohol. If you drink alcohol, drink
moderately. This means no more than 2 drinks a day for men
and 1 drink a day for women.
Heavy consumption of alcohol can lead to heart
failure.
Living With Heart Failure
You can feel better when you have heart failure by taking your medicines as directed, having a healthy lifestyle, and avoiding things that make heart failure worse. To find out the things you can do every day, what to watch for, and when to call a doctor, see:
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Quick Tips: Self-Care for Heart Failure
Taking medicines
Having a healthy lifestyle
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Limit sodium.
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Heart Failure: Eating Less Salt
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Low-Salt Diets: Eating Out
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Exercise regularly. If
you aren't already active, your doctor may want you to start
exercising. You could do it in a program or on your own. Try to do
activities that raise your heart rate. Aim
for at least 2½ hours of
moderate exercise a week.
One way to do this is to be active at least 10 minutes 3 times a day, 5 days a
week. You can start slowly if you haven't exercised much before. For
more information, see the topic
Cardiac Rehabilitation. For information on starting
and staying with an exercise program, see:
- Heart Failure: Activity and Exercise.
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Check your
weight at the same time every day. For information,
see:
- Heart Failure: Checking Your Weight.
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Try to lose weight if
you are overweight. Eating a heart-healthy diet and exercising regularly
will help you lose weight. Even
a few pounds can make a difference.
-
Stop smoking. Smoking increases your
risk for heart disease and makes it harder to exercise.
Avoid
secondhand smoke too. For more information,
see Quitting Smoking.
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Avoid
too much
alcohol
. This means drinking no more than 2 drinks a day for
men and 1 drink a day for women.
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Limit your fluids if needed. For information, see:
- Heart Failure: Watching Your Fluids.
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Oxygen treatment. Your doctor may recommend
oxygen therapy to reduce your
shortness of breath and increase your ability to exercise.
Avoiding things that make heart failure
worse
Avoid triggers,
such as too much salt (sodium) and certain medicines, that can cause sudden
heart failure. For more information, see:
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Heart Failure: Avoiding Triggers for Sudden Heart Failure.
Treating your sleep problems
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One Man's Story:
Pete, 70
"I was having a lot of trouble getting enough sleep. I
was snoring so bad that my wife was sleeping in another room. I'd wake up 7
times a night. Sometimes I'd wake up gasping for breath. The next day I'd be so
tired that I'd fall asleep while doing my woodworking in the garage. And I was
really fuzzy-headed. I couldn't remember anything.
"I thought it
might be my heart failure. So I decided to talk to my doctor about it, and he
suggested a sleep study. I found out that I have sleep apnea. I haven't been
getting enough oxygen because of it. He put me on a CPAP machine at night. I've
used it for the past 4 months.
"It took a little time to get used
to sleeping with a mask. But I'm sleeping much better. Now if I wake up, it's
only once, and I go right back to sleep. I feel so much better during the
day."—Pete
This story is based on information gathered from many people living with heart failure.
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Many people with heart failure have trouble
sleeping. Your doctor may be able to find out what is causing your
sleep problems and help you get a good night's
sleep.
For more information,
see:
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Sleep Apnea: Should I Have a Sleep Study?
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Insomnia: Improving Your Sleep.
Getting help for problems with
sex
Most people with heart failure
can still have an active sex life. But sexual problems are common. Your
interest may drop, or you may have shortness of breath or other symptoms that
limit your ability to have sex. Men may have erection
problems.
Talk to your doctor. You can get
help for erection problems or other sexual troubles. You also can follow
some tips to make sex easier on your heart. For more information, see the
topics:
Other things you can do to take care of
yourself
Help for caregivers
It can be rewarding to help a loved one with heart failure. But
it's also a lot of work. And it can be hard emotionally.
If you are taking care of a loved one, make sure that you also take
care of yourself. This can mean taking breaks by getting help from family or
friends. You also may be able to use respite care. These services provide
someone who will stay with your loved one while you get out of the house for a
few hours. For more information, see:
Coping With Your Feelings
Heart failure
brings big changes to your life. You may struggle with sadness and worry. You
may wonder if you'll still be able to enjoy your life. Coping with your
feelings and seeking help when you need it can help you live better with heart
failure.
Depression and anxiety
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One Woman's Story:
Joan, 54
"I would sit at my kitchen table and feel I was in this
cloud of dread. I didn't feel like me. I felt like, 'I'm never going to be me
again.'"—Joan
Read about
how Joan got help for depression and anxiety.
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Heart failure can be hard on your
emotions. You may feel
depressed that you can't do some of the things you
used to do. You may worry about your future. And symptoms of heart failure,
such as shortness of breath, can make this
anxiety worse.
These feelings are common.
Talk to your doctor if you have
symptoms of depression or are worried a lot.
Depression and anxiety can be treated with counseling and medicine.
You also can help yourself feel better by
changing your "self-talk." Those are the things you tell yourself about how
you're coping. Negative thoughts can make you feel bad. Changing the way you
think can change the way you feel. To learn how to think in a positive way,
see:
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Anxiety: Using Positive Thinking.
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Depression: Using Positive Thinking.
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Positive Thinking: Stopping Unwanted Thoughts.
For more information, see the topics:
Stress
The challenges of living with heart
failure can increase your stress. And stress can make living with heart failure
even harder. Stress also can disturb your sleep and make depression and anxiety
worse. Here are some things that can help your body, mind, and
spirit:
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Doing progressive muscle relaxation
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Managing your time
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Reducing stress by being assertive
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Doing breathing exercises to relax
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Doing guided imagery to relax
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Doing meditation
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Practicing yoga to relax
Getting support
Emotional support from friends and family can help you cope with the struggles
of heart failure. You might want to think about joining a heart failure support
group. Ask your doctor about the types of support that are available where you
live.
Meeting other people with the same
problems can help you know you're not alone. If you're shy or aren't a joiner,
you can look at an online support group. Even though people online aren't
talking face-to-face, they're sharing their feelings and creating a
community.
Medications
You probably will need to take
several medicines to treat
heart failure, even if you don't
have symptoms yet. Medicines don't cure heart failure. But
they can help your heart work better and improve any symptoms that
you do have.
Medicines can:
- Relieve or control
symptoms.
- Treat other health problems you have, such as
coronary artery disease.
- Improve your
daily quality of life.
- Slow the rate at which your heart failure
gets worse.
- Reduce the chance of other problems from heart failure,
such as
stroke.
- Reduce hospital
stays.
- Help you live as long as possible.
It's very important to take your medicines
exactly as your doctor says. If you don't, your heart
failure may get worse or you may get sudden heart failure. For more information,
see:
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Heart Failure: Taking Medicines Properly.
Medicine Choices
The medicines you take
will depend on the type of heart failure you have. Some of the medicines treat
the heart's pumping problems (systolic heart
failure), while others treat problems with filling (diastolic heart failure). The most commonly used
medicines are listed below.
Medicines for pumping problems (systolic heart failure)
These include:
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ACE inhibitors
(angiotensin-converting enzyme inhibitors)
to relax and widen blood vessels. This
makes it easier for blood to flow.
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ARBs
(angiotensin II receptor
blockers) to make it easier for blood to flow through the
vessels.
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Diuretics
to
help relieve symptoms like swelling in the legs.
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Aldosterone receptor antagonists
to make the kidneys get rid of extra
fluid.
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Digoxin
to help the heart pump more blood with each beat.
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Beta-blockers
slow the heart rate and may help the heart fill with blood more completely.
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Vasodilators
to lower blood pressure and reduce the workload on the
heart.
Medicines for filling problems (diastolic heart failure)
Medicines that might be used include:
Other medicines
You also may take other medicines for health problems that can
cause heart failure or for problems caused by heart failure. These problems
include irregular heart rhythms, blood clots, and
high blood pressure.
The medicines include:
What to Think About
Talk to your doctor
before you take any
over-the-counter medicines. Some of them might make
your symptoms worse. For more information, see:
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Heart Failure: Avoiding Medicines That Make Symptoms Worse.
Surgery
People who have
heart failure may have surgery to:
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Open clogged arteries.
Coronary artery bypass surgery
or
angioplasty may help some people who have heart
failure with chest pain (angina) or who have had a heart
attack.
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Fix problems that cause heart
failure, such as damaged valves.
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Get a new heart. You have to meet certain conditions to get a heart transplant.
But you may be able to have one if you have very bad, life-limiting
symptoms.
Surgery Choices
For more information on bypass surgery and
angioplasty, see the topic
Coronary Artery Disease.
Other Treatment
If you have heart failure, you may get
a device to fix a deadly heart rhythm or to help your heart pump
better.
Pacemakers
Cardiac resynchronization therapy (CRT) uses a biventricular pacemaker which makes the
heart’s lower chambers (ventricles) pump in the right
order.
This type of pacemaker
can help you feel better so you can be more active. It also can help keep you
out of the hospital and help you live longer. For
more information on pacemakers, see:
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Heart Failure: Should I Get a Pacemaker (Cardiac Resynchronization Therapy)?
If you get a pacemaker, you have to be careful
not to get too close to some devices with strong magnetic or electrical fields.
These include
MRI machines, battery-powered cordless power tools,
and CB or ham radios. But most everyday appliances are safe. For more
information, see:
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Heart Problems: Living With a Pacemaker or ICD.
A pacemaker may be used alone or along
with an implantable cardioverter-defibrillator (ICD) for heart
failure.
Implantable defibrillators (ICDs)
Implantable cardioverter-defibrillators (ICDs) can
prevent sudden death from an abnormal heart rhythm and may help you live
longer. An ICD checks the heart for very fast
and deadly heart rhythms. If the heart goes into one of these
rhythms, the ICD shocks it to stop the deadly rhythm and
returns the heart to a normal rhythm. For more information, see:
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Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
If you get an ICD, you have to be careful not
to get too close to some devices with strong magnetic or electrical fields.
These include
MRI machines, battery-powered cordless power tools,
and CB or ham radios. But most everyday appliances are safe. For more
information, see:
-
Heart Problems: Living With a Pacemaker or ICD.
An ICD may be used alone or along
with a pacemaker for heart failure.
Ventricular assist devices (VADs)
Ventricular assist devices (VADs), also known as heart
pumps, may be placed into the chest to help the heart pump
more blood.
VADs can keep people alive until
a donor heart is available for transplant. In some cases, VADs may also be used
as an alternative to heart transplant for long-term treatment. VADs are used in people who have severe heart failure.
Other treatments
In some cases you might
have:
Supplements
Talk
to your doctor before you take any over-the-counter medicine or
supplement. There's no strong evidence that
vitamins or other supplements can help treat heart
failure.
They are used along with medical heart failure treatments, not instead of treatment.
But you may still hear
about supplements that might improve heart failure
symptoms. But no supplement has been shown definitely to relieve heart
failure or help you live longer.
Examples include coenzyme Q10, fish oil, and hawthorn.
- Only some of the studies of coenzyme Q10 showed that it helps heart
failure symptoms.1
-
Fish oil supplements have not been shown to definitely help heart failure patients feel better or live longer. But eating fish that have a lot of omega-3 fatty acids, like tuna and salmon, are part of a heart-healthy diet.
-
Hawthorn is an herb that is sometimes used in Europe and Asia
to try to increase blood flow to the heart.
End-of-Life Decisions
Heart failure
tends to get worse over time. So you
need to decide what kind of care you want at the end of your
life.
It can be hard to have talks with your
doctor and family about the end of your life. But making these decisions now
may bring you and your family peace of mind. Your family won't have to wonder
what you want. And you can spend your time focusing on your
relationships.
You will need to decide if you want
life-support measures if your health gets very bad. An
advance directive is a legal document that
tells doctors how to care for you at the end of your life.
This care includes electronic devices that are used for heart failure, such as pacemakers. You also can say where you want to have care. And you can name
someone who can make sure your wishes are followed.
For more information, see the topics:
Other Places To Get Help
Organizations
|
American Heart Association (AHA)
|
| 7272 Greenville Avenue |
| Dallas, TX 75231 |
| Phone: |
1-800-AHA-USA1 (1-800-242-8721) |
| Web Address: |
www.heart.org |
| |
|
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
|
|
|
Heart Failure Society of America
|
| Court International, Suite 240 S |
| 2550 University Avenue West |
| Saint Paul, Minnesota 55114 |
| Phone: |
(651) 642-1633 |
| Fax: |
(651) 642-1502 |
| Email: |
info@hfsa.org |
| Web Address: |
www.abouthf.org |
| |
|
The Heart Failure Society of America provides
information and education for people with heart failure and their families. The
Web site has education modules designed to help people with heart failure,
their loved ones, and individuals at risk to work better with their doctors or
nurses.
|
|
|
Heart Rhythm Society
|
| 1400 K Street NW |
| Suite 500 |
| Washington, DC 20005 |
| Phone: |
(202) 464-3400 |
| Fax: |
(202) 464-3401 |
| Web Address: |
www.hrsonline.org |
| |
|
The Heart Rhythm Society provides information for
patients and the public about heart rhythm problems. The website includes a
section that focuses on patient information. This information includes causes,
prevention, tests, treatment, and patient stories about heart rhythm problems.
You can use the Find a Specialist section of the website to search for a heart
rhythm specialist practicing in your area.
|
|
|
HeartHub for Patients
|
| Web Address: |
www.hearthub.org |
| |
|
HeartHub for Patients is a website from the American Heart
Association. It provides patient-focused information, tools, and resources
about heart diseases and stroke. The site helps you understand and manage your
health. It includes online tools that explain your risks and treatment options.
The site includes articles, the latest news in health and research, videos,
interactive tools, forums and community groups, and e-newsletters.
The website includes health centers that cover heart rhythm problems,
cardiac rehabilitation, caregivers, cholesterol, diabetes, heart attack, heart
failure, high blood pressure, peripheral artery disease, and stroke.
HeartHub for Patients also links to Heart360.org, another American Heart Association
website. Heart360 is a tool that helps you send and receive medical
information with your doctor. It also helps you monitor your health at home. It
gives you access to tools to manage and monitor high blood pressure, diabetes,
high cholesterol, physical activity, and nutrition.
|
|
|
National Heart, Lung, and Blood Institute
(NHLBI)
|
| P.O. Box 30105 |
| Bethesda, MD 20824-0105 |
| Phone: |
(301) 592-8573 |
| Fax: |
(240) 629-3246 |
| TDD: |
(240) 629-3255 |
| Email: |
nhlbiinfo@nhlbi.nih.gov |
| Web Address: |
www.nhlbi.nih.gov |
| |
|
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating:
- Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
- Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
pneumonia.
- Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
|
|
|
National Institutes of Health Senior
Health
|
| 9000 Rockville Pike |
| Bethesda, MD 20892 |
| Phone: |
(301) 496-4000 |
| Email: |
custserv@nlm.nih.gov |
| Web Address: |
www.NIHSeniorHealth.gov |
| |
|
This Web site for older adults offers aging-related
health information. The Web site's senior-friendly features include large
print, simple navigation, and short, easy-to-read segments of information. A
visitor to this Web site can click special buttons to hear the text aloud, make
the text larger, or turn on higher contrast for easier viewing.
The
site was developed by the National Institute on Aging (NIA) and the National
Library of Medicine (NLM), both part of the National Institutes of Health
(NIH). NIHSeniorHealth features up-to-date health information from NIH. Also,
the American Geriatrics Society provides independent review of some of the
material found on this Web site.
|
|
References
Citations
-
Coenzyme Q10 (2006). Medical Letter on Drugs and Therapeutics, 48(1229): 19–20.
Other Works Consulted
- Baddour LM, et al. (2010). Update on cardiovascular implantable electronic device infections and their management. A scientific statement from the American Heart Association. Circulation, 121(3): 458–477.
- Drugs for treatment of chronic heart failure (2009). Treatment Guidelines From The Medical Letter, 7(83): 53–56.
- Epstein AE, et al. (2008). ACC/AHA/HRS 2008 Guidelines
for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the
American College of Cardiology/American Heart Association Task Force on
Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002
Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia
Devices): Developed in Collaboration With the American Association for Thoracic
Surgery and Society of Thoracic Surgeons. Circulation,
117(21): e350–e408.
- Hunt SA, et al. (2009). 2009 focused update
incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management
of heart failure in adults. A report of the American College of Cardiology
Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation, 119(14): e391–e479.
- Kaul S, et al. (2010) Thiazolidinedione drugs and cardiovascular risks: A science advisory from the American Heart Association and American College of Cardiology Foundation. Circulation, 121(16): 1868–1877.
- Lampert R, et al. (2010). HRS Expert consensus statement on the management of cardiovascular implantable electronic devices (CIEDs) in patients nearing end of life or requesting withdrawal of therapy. Heart Rhythm, 7(7): 1088–1026. Available online: http://www.hrsonline.org/Policy/ClinicalGuidelines/upload/ceids_mgmt_eol.pdf.
- McKelvie R (2010). Heart failure, search date May 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- Pina IL, et al. (2003). Exercise and heart failure: A
statement from the American Heart Association Committee on Exercise,
Rehabilitation, and Prevention. Circulation, 107(8):
1210–1225.
- Riegel B, et al. (2009). State of the science. Promoting self-care in patients with heart failure. A scientific statement from the American Heart Association. Circulation, 120(12): 1141–1163.
- Roy D, et al. (2008). Rhythm control versus rate
control for atrial fibrillation and heart failure. New England Journal of Medicine, 358(25): 2667–2677.
- Schocken DD, et al. (2008). Prevention of heart
failure: A scientific statement from the American Heart Association Councils on
Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and
High Blood Pressure Research; Quality of Care and Outcomes Research
Interdisciplinary Working Group; and Functional Genomics and Translational
Biology Interdisciplinary Working Group. Circulation,
117(19): 2544–2565.
- Sears SF, et al. (2005). How to respond to an implantable cardioverter-defibrillator shock. Circulation, 111(23): e380–e382.
- Slaughter MS, et al. (2009). Advanced heart failure treated with continuous-flow left ventricular assist device. New England Journal of Medicine, 361(23): 2241–2251.
- Smith SC, et al. (2006). AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: Endorsed by the National Heart, Lung, and Blood Institute.
Circulation, 113(19): 2363–2372. [Erratum in
Circulation, 113(22): 847.]
- Somers VK, et al. (2008). Sleep apnea and
cardiovascular disease: An American Heart Association/American College of
Cardiology Foundation Scientific Statement from the American Heart Association
Council for High Blood Pressure Research Professional Education Committee,
Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular
Nursing in collaboration with the National Heart, Lung, and Blood Institute
National Center on Sleep Disorders Research (National Institutes of Health).
Circulation, 118(10): 1080–1111.
- U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
- Weintraub NL, et al. (2010). Acute heart failure syndromes: Emergency department presentation, treatment, and disposition: Current approaches and future aims. A scientific statement from the American Heart Association. Circulation, 122(19): 1975–1996.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
Robert A. Kloner, MD, PhD - Cardiology |
|
Last Revised
|
December 15, 2010 |