Heart Failure – Diagnosis, Treatment, and Prevention

Daniel Marcus';

By Daniel Marcus

Posted on September 21st, 2022 in News, Myths & Tips

Over 960,000 people are diagnosed with heart failure every year in the United States. The condition occurs when the heart muscle is too weak to pump blood properly throughout the body.

Approximately 6 million people in the country live with heart failure. Up to 14% of those with the condition eventually pass away.

Some of the risk factors for heart failure are tobacco smoking, having a diet rich in fat, cholesterol, and salt, excessive alcohol consumption, and being sedentary.

Regardless of the underlying health condition causing it, heart failure develops when the heart muscle becomes too weak to stiff, preventing it from pumping blood through the body at maximum capacity. The following are the underlying conditions that may cause heart failure:

  • coronary artery disease
  • high blood pressure
  • diabetes
  • atrial fibrillation
  • cardiomyopathy
  • valvular heart disease
  • obesity
  • a previous heart attack
  • infection

It is worthy of note that heart failure does not mean the heart has stopped working. There are two types of heart failure. In heart failure with reduced ejection fraction, the heart is weak and unable to pump enough blood, whereas in heart failure with preserved ejection fraction, the left ventricle cannot relax normally because the heart muscle is stiff. It is essential to acknowledge that women have the same risk of coming to struggle with this condition as men. "Women are more likely to have heart failure in older age, and more likely to develop it from a stiff heart caused by high blood pressure or a heart valve problem than a heart weakened by heart attacks," says Dr. Michele Hamilton, director of the Advanced Heart Failure Program at Cedars-Sinai.

How Is Heart Failure Diagnosed?

If you experience symptoms of heart failure, which include a persistent cough that worsens at night, fatigue, shortness of breath during everyday activities, weight gain with swelling in the feet, legs, or abdomen, trouble breathing when lying down, and irregular heartbeat, you physician will order some of the following diagnostic tests and exams for you:

  • electrocardiogram: it is a fast, reliable, and simple test that records the electrical activity of the heart and can detect abnormalities
  • blood tests: their purpose is to find out whether there is something in your blood that could indicate heart failure
  • echocardiogram: as a type of ultrasound, it uses soundwaves to examine your heart and determine whether it is working properly
  • breathing tests: they include spirometry and a peak flow test, and you may be asked to blow into a tube to see whether you have a lung problem contributing to heart failure
  • chest X-rays: by having a chest X-ray, your doctor can observe whether your heart is bigger than it should be, you have a lung condition, or there is fluid in your lungs

Patients with heart failure will be assigned a class from one to four, depending on how severe their condition is. Those with class one do not experience any symptoms during their usual activities, while people with class two heart failure are comfortable when they rest, but physical activity triggers symptoms. In people with class three heart failure, minor physical activity triggers symptoms, and those with class four are unable to perform any daily activity without discomfort.

The Most Effective Treatment for Heart Failure

Early diagnosis is key in treating heart failure. The medications usually prescribed to patients with this condition include ACE inhibitors, ivabradine, beta-blockers, sacubitril, and mineralocorticoid receptor antagonists. "For heart failure patients, it takes a while working with your doctors and healthcare team to gradually get up to the best doses of the specific medicines that are best for you," Dr. Hamilton says. Still, to reap the benefits of treatment, the person will also have to make some lifestyle changes, such as:

  • reducing salt in their diet
  • engaging in physical activity
  • drinking fewer liquids
  • avoiding or limiting alcohol intake
  • monitoring their blood pressure
  • quitting smoking
  • maintaining a healthy weight
  • avoiding or limiting caffeine
  • managing daily stress

People who struggle with heart failure can also benefit from special devices that remove excess salt and water from their blood and, in severe cases, a heart transplant or surgery. The procedures available for patients with this condition are heart valve surgery and coronary angioplasty. However, "most patients with heart failure can live a very active lifestyle and not require the more advanced interventions," according to Dr. Hamilton. It is important to keep in mind that treating heart failure is not "a one-time problem with a one-time fix".

Preventing Heart Failure

Fortunately, there are many ways a person can significantly lower their risk of heart failure, as the condition is often the consequence of unhealthy lifestyle factors. Therefore, to prevent heart failure, people should keep their blood pressure under control, seek treatment if they already have a form of heart disease, quit smoking, control their diabetes if they have it, limit their intake of saturated fats, added sugars, and salt, eat plenty of fresh fruit, whole grains, and vegetables, limit their alcohol consumption, and lose weight if they are overweight or obese.

"The care of heart failure has changed dramatically over the past 10 years. We have new medications that have been shown to substantially increase a patient's survival, as well as reduce their chance of being in the hospital," says Dr. Hamilton. By eliminating the risk factors, your chances of developing heart failure will become considerably lower. Over 50% of patients who have class four heart failure die within 12 months from their diagnosis, so it is of utmost importance to do all in your power to prevent this condition and, if you already have it, to take your medication.