Congestive heart failure (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Jinhui Wu, MD

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How do I know if I have heart failure and what are the symptoms of heart failure?

Early heart failure does not have any symptoms. As the disease developes, people may notice one or more of the following symptoms:

• Shortness of breath
• Hemoptysis or pink frothy sputum
• Blood and fluid to back up into the lungs
• Edema in the feet, ankles and legs
• Tiredness

Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

Who is at risk for heart failure?

Certain factors increase your risk of getting heart disease, then increase your risk of getting heart failure. You are at a higher risk if you are:

• A woman age 55 or older
• A man age 45 or older
• Obesity or overweight
• Smoking
• High cholesterol
• High blood pressure
• Heavy drinking
• Diabetes
• Lack of exercise

How to know you have heart failure?

• BNP(Brain natriuretic peptide)/ NT-proBNP (N-terminal pro b-type natriuretic peptide) test: Either BNP or NT-proBNP may be used to help diagnose heart failure and to grade the severity of that heart failure. Foremore, the levels can help doctors differentiate between heart failure and lung diseases.
• Echocardiogram: This is a painless and no risk test for patients. Cardiac echo can demonstrate both structure and function of the heart. It can tell the doctor the left ventricular ejection fraction and help doctor detect the heart function.
• Chest X-ray: The test can creat the picture of the heart and lungs. When heart failure appears, the picture may show largened heart and pulmonary venous pleonaemia.
• Cardiac MRI (magnetic resonance imaging): Cardiac MRI can create both still and moving pictures of the heart and major blood vesselsheart. It can help doctors analyse the structure and function of the heart and decide the treatment protocols for the patient.
• Cardiac biomarkers: This is a blood test. It needs to be done to identify your basic cardiac diseases such as acute coronary syndrome.
• Electrocardiogram: This is a simple and painless test that records the heart's electrical activity. It also needs to be done to detect your basic cardiac diseases.
• Thoracentesis: In heart failure, the pleural space is filled with more fluid than normal and it can cause patient feels shortness of breath. During the procedure, the doctor inserts a thin needle or plastic tube into the pleural space and draws out the excess fluid to detect the cause of the pleural effusion.

When to seek urgent medical care?

Patients with early heart failure can compensate. With the disease developing, the heart function decompensate and patients demonstrate a series of signs and symptoms. Call your health care provider if symptoms of heart failure develops. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:

• Serious shortness of breath
• Patients can not lie in flat at night, even orthopnea.
• Hemoptysis or pink frothy sputum

Treatment options

Patients with heart failurw have many treatment options. The selection depends on the condition of the disease. The options are general therapy, medications, bioventricular pacemaker and heart transplantation.

General therapy: Because heart failure is a clinical syndrome of multiple heart diseases, the following measurements are important.

• Treating basic cardiac disease such as controlling blood pressure, improving myocardial perfusion and surgery for impaired heart valves。
• Removing incentives such as treating pneumonia, arrhythmia, hypokalemia.
• Having a good rest and keeping a quiet emotion.

Medications:

• Diuretics: Diuretics can release the symptom of shortness of breath and the sign of edema quickly. There are three kinds of diuretics, loop diuretics, thiazides and potassium-sparing diuretics. The patients should take the medicines under the doctor's direction and check the blood level of electrolyes regularly.
• Angiotensin converting enzyme inhibitor (ACEI)
• Beta blockers
• Digitalis

Bioventricular pacemaker

Heart transplantation

Where to find medical care for heart failure?

Directions to Hospitals Treating heart failure

Copyleft Sources

http://www.nlm.nih.gov/medlineplus/heartfailure.html